Yeah I basically have all mental symptoms of hypogonadism. Beside that my prolactin is very elevated (without prolactinoma) my LH and FSH is elevated, my estradiol is elevated (I think). I have gynecomastia and sporadically lactation. I have a varicocele which I had throughout puberty, and I’ve suffered from symptoms of low-testosterone during puberty too. Here’s my first thread regarding hyperprolactinemia Help with Interpreting Lab Bloodwork Results
To keep it simple, since no prolactinoma were found on MRI and my LH and FSH is elevated, and with varicocele and testicular problems during puberty in mind, I now believe that I have primary hypogonadism which caused androgen defiency and estrogen excess during puberty, which in turn increased prolactin.
Lack of testosterone also created mental problems which have created many other problems in my life, and contributed to mental illness and stress, and stress is known to elevate prolactin even further (especially in the present of high estrogen, and this also explain why my prolactin levels and lactation get worse during stress). My ACTH and cortisol are also elevated.
With all that said, I just find the ranges of bioactive testosterone to be wrong. They’re not accurate compared with FAI, and they simply doesn’t make sense. For example I have a friend on TRT. Before TRT he’s total testosterone (TT) was 12 nmol/l (346 ng/dl) and SHBG 26, that gives him (according to issam) a bioactive testosterone of 186 ng/dl. That’s at the higher end of normal according to the range.
After TRT he’s TT is 28 nmol/l (808 ng/dl) and SHBG 24, which gives a bioactive value of 513 ng/dl, and he feel much better now. According to the range he’s now way too high. Obviously something is wrong here.