Minor Hyperprolactima, HCG Monotherapy, 27 Y/O

Pharma TRT
1

First time poster here and I feel like I have read the whole site including stickies.

Brief Description: I’m a 27 years old, 6’2’’ and weigh around 200 pounds. I work out frequently, eat healthy, and outwardly appear to be in good health. A few years ago I was diagnosed with secondary hypogonadism and began HCG monotherapy. I have had multiple pituitary MRIs and nothing was ever found. I also have been on sythroid for hypothyroidism for the last six months after repeated TSH results of around 5 (more details below).

On the below treatment, I feel ‘ok.’ My major concern is my complete lack of libido that has persisted for 3 years. My lack of libido really depresses me as I feel it ruins my ability to date like a normal 20 something guy. My Dr. wonders if I have adult on-set Kallman’s syndrome.

Current Treatment:
325 units of HCG injected SUB-Q EOD.
.5mg Anasterole daily.
Flonase 1 spray daily for dustmite allergy.
50mg synthroid 5x a week. (so around 37mg per day)

LABS:
Glucose, Serum 79 mg/dL (65-99)
BUN 13 mg/dL (6-20)
Creatinine, Serum 1.05 mg/dL (0.76-1/27)
eGFR if NonAfrican Am 98 mL/min/1.73 (>59)
BUN/Creatinine Ratio 12 (8-19)
Sodium, Serum 140 nmol/L (134-144)

WBC 4.9 (3.4-10.9)
RBC 6.11 HIGH (4.14-5.80)
HEMOGLOBIN 17.7 (12.6-17.7)
HEMATOCRIT 53.4 HIGH (37.5-51)
MCV 87 (79-97)
MCH 29 (26.6-33.0)
MCHC 33.1 (31.5-35.7)
RDW 13.3 (12.3-15.4)
PLATELETS 247 (155-379)
NEUTROPHILS 52 (40-74)
LYMPHS 33 (14-46)
MONOCYTES 12 (4-12)
EOS 3 (0-5)
BASOS 0 (0-3)
NEUTROPHILE (ABSOLUTE) 2.5 (1.4-7.0)
LYMPHS (ABSOLUTE) 1.6 (0.7-3.1)
MONOCYTES (ABSOLUTE) .6 (0.1-0.9)
EOS (ABSOLUTE) .1 (0-0.4)
BASO (ABSOLUTE) 0 (0-0.2)
IMMATURE GRANULOCYTES 0 (0-2)
IMMATURE GRANS (ABS) 0 (0-0.1)

Potassium, Serum 4.6 mmol/L (3.5-5.2)
Chloride, Serum 100 mmol/L (97-108)
CO2, Total 25 mmol/L (19-28)
Calcium, Serum 9.6 mg/dL (8.7-10.2)
Protein, Total, Serum 7.4 g/dL (6-8.5)
Albumin, Serum 4.7 g/dL (3.5-5.5)
Globulin 2.7 g/dL (1.5-4.5)
Bilirubin, Total 0.9 mg/dL (0-1.2)
AST 38 IU/L (0-40)
ALT 44 IU/L (0-44)

Vitamin D–Will follow

B12 1131 High pg/ml (211-946)

FSH and LH both low (due to HCG)

Testosterone, Serum 818 ng/dL (348-1197)
Free testosterone (Direct) 18.5 pg/ml (9.3-26.5)

Thyroxine (T4) Free Direct 1.56 ng/dl (0.82-1.77)

TSH 1.240 uIU/ml (0.450-4.500)

Prolactin 16.5 HIGH ng/ml (4.0-15.2)

Estradiol 31.3 pg/ml (7.6-42.6)

My adrenals have been tested in the past and I doubt they are the issue.

My doctor claimed that my high RBC and Hematocrit was a result of the increase testosterone and is not a big worry. (No idea if this is true)

To me it is apparent that my prolactin levels are the reason my libido is in the dumps. I have seen several Endos and they all have refused to prescribe medication to lower my prolactin. I have several theories on what is causing my hyperprolactima
Including:
-I may have a small tumor that has not been detected by my MRIs.
-I have gut issues and may suffer from celiac disease. I am considering going on a gluten free diet.
-----My liver markers are terrible even though I don’t drink,
-----My prolactin is high (a know side effect of gluten intolerance), and
-----On almost a day basis I have abdominal cramping/minor pain. Especially while sitting at work all day.
-The signaling from my previously high TSH may have been stimulating prolactin production. My recent TSH score is the best it has ever been, I hope that my prolactin levels will fall in the long term as well.

Drs. are refusing further treatment, so I am planning on doing some self treatment. I’m considering going gluten free for a couple weeks to see if there is an improvement in gut issues and prolactin levels (and therefore libido. I also am curious about using vitex and/or b6 dosing. I would be afraid to dose b6 much about 100mg daily. I’m not willing to buy caber etc. over the internet (yet at least).

I have seen tons of people saying they will try vitex, but nearly no one replying later whether it worked!
I would highly appreciate any advice and comments.

2

Gluten free diet certainly wouldn’t hurt; just doubt it will help in the way that you think.

Your liver values are NOT terrible. An intense workout a day or two before testing can knock AST and ALT well into the 60’s.

Some have to refrain from training for a full week to get true, uninflated liver values.

Low libido can be due to low E2. You are taking a lot of Anastrazole – .5mg a day is a heavy dose, especially since you are only on HCG. I know your labs show perfectly normal estrogen values but still…

3

His E2 is low at 31??? Isn’t that high if anything?

4

Hey cool tip for dust mite allergies: put your pillows and comforter in the drier for 20 minutes once or twice a week. It kills the live ones and helps remove the dust that you’ll be breathing in every time you move. Got this from one of my biology profs.

5

Would rather see you on something like CLOMID, not HCG. Clomid works more ‘naturally’ via making your body fix itself as opposed to a mimic of LH/ Your E2 is not low. I prefer Aromasin. But I doubt E is playing a role.

Your prolactin is high. If you have had multiple MRIs then it isn’t from a tumor most likely that is significant. You may have a dopamine issue which something like Selegiline 5mg eod may help (which you can easily find online)/ L-Dopa (in Mucuna) would lower it as well but again I prefer something that doesn’t ‘supplement’ but instead boosts your body’s process or fixes an issue. Tyrosine is a little less harsh than L-Dopa. Sam-E may also help boost neurotransmitters. Libido is complicated and is far more involved than just testosterone/estrogen/prolactin. But if you have higher prolactin, dopamine may not be very dominant. An agonist may be a little harsh, but I have found that low doses are fine (again you can find it online).

Begin taking alpha lipoic acid 150mg twice/day, milk thistle and consume turmeric with black pepper in food daily to support your liver. Eat more bitter foods such as parsley and kale.

6

Anastrozole can cause elevated liver enzymes GGT ALT and AST. I’d be inclined to reduced it. 0.5mg EOD or even E3D might be just fine. The half-life is 50hrs.

7

[quote]C27 H40 O3 wrote:
Anastrozole can cause elevated liver enzymes GGT ALT and AST. I’d be inclined to reduced it. 0.5mg EOD or even E3D might be just fine. The half-life is 50hrs.[/quote]

Yes this is very true. I have read cases where people say Arimidex was the only thing that changed and liver enzymes increased.

8

Do you know your free T3 levels? Maybe you’re not converting t4->t3 efficiently. That could be part of the problem.

9

[quote]MightyMouse17 wrote:
Do you know your free T3 levels? Maybe you’re not converting t4->t3 efficiently. That could be part of the problem. [/quote]

I agree with that. Free T3 is very important!!!

10

[quote]WNYdave wrote:
His E2 is low at 31??? Isn’t that high if anything? [/quote]

No.

11

Thanks for the replies! I hope KSman chimes in.

Multiple people----I strongly don’t feel like my E2 is a problem in comparison to my T-levels. People that are gunning for that 50 to 1 ratio are unrealistic IMO. My ALT and AST labs were the same for years before I started Anastrozole.

I’m not ready to try L-Dopa or Selegiline yet to lower my prolactin. First I am considering B6, Vit E, Vitex, Tyrosine, etc. Thoughts?? I know Tyrosine is a little farther away in the chain from Doapmine than L-Dopa, but I would rather start with the weaker things first. Plus, if my job found out I was taking Selegiline without a prescription–my career would be over.
I’m not familiar with Sam-E and would appreciate hearing more about it and it’s safety.

Dr’s keep refusing to check my T3 levels. So I don’t have a lab. At least my TSH has dropped down to the lowest it has ever been.

Bryan Khrahn–thanks for the advice about the gluten free diet. I didn’t know that AST and ALT could be increased by a workout.

C27 H40 O3- Thanks for the dustmite tip, my mattress and pillow are encased in a dustmite-proof case and I wash my sheets weekly in hot water (which kills dustmites too).

Retinoid- I have try clomid in the past and I did not respond to it. I tried 50mg 3x week for over two months. My LH barely went up though my FSH went up to nearly 5. Thanks for the advice regarding my liver, I will look further into that stuff. I strongly agree Dopamine is the issue. The real question is what to do next.

12

Why would your job fire you if you took Selegiline? The metabolites? Vitex is NOT what you want. It may help women, but in my studies and experience it helps increase progesterone which, for women with estrogen dominance, may help libido. For men they want to increase testosterone usually for libido however, as I said, libido is so complicated. Rasagiline is another MAOI-B, but is more expensive and harder to find. Tyrosine may help, but restoring neurochemistry will take time and unfortunately trial and error to see what works best FOR YOU.

13

Thanks Retinoid. I have a security clearance so taking any drugs without a prescription–would mean career over if caught. Do you have any suggestions on Tyrosine dosage or thoughts on zinc/b6?/ or Phenyalanine the other dopamine precursor?

14

An update for anyone interested–

I saw a new Doctor and he willing to give me a trial course of Caber. I will take 1/4mg weekly for four weeks to see if my libido improves. I took my first pill on Saturday and so far have not noticed anything. Is that enough Caber for an effect? How long do you think until I feel something?

15

An update that so far, my libido has not increased from the Caber.

16

Can anyone chime in why its been 10 days on Cabergoline and my libido has not increased? On such a low dosage does it take a while?

17

Some vitamin D labs from labcorp finally arrived:
Vit D3 = 33ng/ml (obviously could be better)
Vit D2 = <1.0 ( worried about this one and researching it)

18

I saw my Dr. today. My prolactin came back as a 7 in a 1-15 range. He wants to up my cabergoline to .25mg twice a week. He also wants to see if the lower prolactin will allow me to produce testosterone on my own. He wants me to go off HCG for a month and see where my testosterone comes back. I’m scared to stop HCG cold turkey. I wish I had clomid or something to take as well. Any thoughts on stopping HCG cold turkey? I’m afraid of how terrible and weak I am going to feel.

19

Here’s my 2 cents. Ask your doc about this. Drop the sythroid and go with straight T3. Dial that in. Drop HCG mono and switch to a standard TRT protocol with T cyp. You’re on a lot of Adex and your E2 is still over 30. That’s caused by HCG mono therapy. HCG drives E2 wild. If you want a simple supplement to deal with your prolactin try dopatone. It’s an awesome dopamine supplement.

If you’re going to come off HCG mono cold turkey run a PCT. HCG is just as suppressive as standard TRT. If that doesn’t make a change consider other causes.

20

Brentf13,

I’ll ask my doctor about the T3 and dopatone. I am trying to avoid testosterone injections as I want to have children someday. I sent a message to my doctor begging for clomid. I hope he will prescribe me some.