I had been referred by my GP to see and Endo as I am on TRT and have high prolactin levels (1275 mU/L). Also my TSH is 3.2 and free T4 14 (range 12 -22).
I was sent for a TRH stimulation test, which I found quite unpleasant initially:
Has anyone else ever had this test and if so did it lead to any diagnosis?
Poor thyroid function is linked to high prolactin, an increase in TSH causes prolactin to increase. In your case TRT probably placed greater demand on a thyroid already on the brink.
You will be told your TSH is normal, only these TSH reference ranges are not normal at all, most doctors are unaware. Endos are usually very bad at treating thyroid problems especially in the UK, poor basterds believe the crap they were taught in medical school which is in range is normal, only the ranges are not normal.
That is interesting, had not heard that before.
My TSH has gradually increased from 2 to 3 so I have a feeling Dr Saya is going to look closer at thyroid during my next visit. My prolactin is above normal as well. I wonder if thyroid hormones would fix both.
edit: after doing some quick reading, it sounds like TRH is what stimulates the release of TSH, but in parallel it also does the same for prolactin… so there is a definite relationship between above normal TSH and above normal (but below a prolactin producing tumor), which is right where I’m at.
Very interesting.
My TSH and Free T4 numbers have held steady so far.
I hope I’m not told its normal, I really didn’t like that test and hope I didn’t have to do it for nothing!
I’ve been trying to read up about the purpose of the test, but from what I can decipher it is used more for people with low TSH so I’m not 100% sure what he Endo was suspecting as a possible issue.
Edit - OK so came across this which was good
Neither TSH or fT4 are the active hormones, your doctor needs to get onboard with proper thyroid testing and get out of the stone age and start testing fT3 which is where the rubber meets the road.
Doctors that do things as they were taught in medical school become irrelevant quickly, unable to truly help their patients, we learn new things all the time and update our knowledge otherwise we become obsolete.
You can’t serious use TSH and fT4 to track thyroid status, I can’t even provide value info at all if I don’t know the fT3/rT3 ratios, nothing is certain without these two tests.
I think he was planning on measuring base t3 also although didn’t say it would be free t3, or not.
Also he didn’t really agree I should be on TRT but didn’t offer up any alternatives for curing the issues I have had.
T3 is obsolete and is not yet an active hormone, fT3 is the newer better test. If you test T3 there will still be more questions like how much hormone is making it into the cells, T3 isn’t useful enough.
A lot of doctors are behind the ball when it comes to normal testosterone, I would stop listening to doctors that don’t even know how to test thyroid levels properly.
The recurring theme on these forums is members stating doctors are saying levels are normal, for an 80 year old when 21 years old, then comes the studies showing disease at levels higher than the sick care definition of normal and you realize someone screwed up somewhere and got it all wrong.
Can you further explain? The first time I hear that, but I have both of them slighltly fucked up.
TSH production is stimulated by an increase in TRH. So, higher TSH usually means higher TRH. TRH also increases production of prolactin at the same time… so there a relationship between TSH and Prolactin. Higher TSH means higher prolactin, usually.
Google TRH TSH Prolactin and you’ll see a lot of info on it
I get it. This is the first thing that can explain slightly elevated prolactin when there is no tumor.
Yep. Everything I’m finding says it commonly puts prolactin above “normal” but not as high as is normally seen in people with prolactin producing tumors. It seems to fit me (and perhaps you?) perfectly.
Perhaps that explains my longer refractory period, finally…
@ncsugrad2002 I’m on caber now, my TSH is not that elevated - 1.75, but I have elevated reverse T3 as well.
@lenono
You may already know about this site but since it’s help me understand thyroid I’ll post it here.
Stopthethyroidmadness