23M, 6'/183 cm, 92-93kg, 18-20% bodyfat (estimated). Dutch.
It's been a year since first bloodwork that showed T at 11.4 nmol/l.
In that time I've seen an endocrinologist and an urologist for help. Endo put me on cabergoline for elevated prolactin for 3 months. Cessation has made my prolactin rise again.
Bloodwork
Diet
at this point is brown rice, eggs, lean beef, chicken, veggies (carrots, varous peas), fruits (apples, bananas), lots of beans, olive oil. I significantly increased fiber intake and I cut out most of the dairy I used to take in (from 2l milk and 1kg cottage cheese to 0.7l milk) in an attempt to raise SHBG levels. Also attempted to mainly eat low GI foods. Fast food very occasionally.
Symptoms
I have likely been always like this - I do not have a different baseline to compare to. So I do not know if I feel "normal", or "bad". I don't think I feel as I should.
Questions
I have tried to disclose as much information as I can, all that I think is relevant.
It's been a year since first bloodwork that showed T at 11.4 nmol/l.
In that time I've seen an endocrinologist and an urologist for help. Endo put me on cabergoline for elevated prolactin for 3 months. Cessation has made my prolactin rise again.
Bloodwork
- First bloodwork: https://i.imgur.com/EXK99yN.jpg. Test not listed, but it was at 11.4 nmol/l
- Bloodwork at endo's: https://i.imgur.com/HoLwqPO.png. Before caber treatment. Prolactin twice the max range. Poor cholesterol profile (likely genetics). Prescribed cabergoline 1mg/week. **I did go on a fap marathon the night before**, bloods taken in morning.
- Bloodwork while on caber: https://i.imgur.com/cvQsRBp.png. A month in or so. Notice the increased testosterone levels. SHBG in a good spot. **If my test levels had initially been like these, I probably would not have pursued it further.** I think my erections were somewhat better, there was ONE day where I had continuous rockhard erections. Also days where I couldn't get an erection at all. I was anxious about medication working, possibility of shit numbers returning after cessation of cabergoline. Members of my powerlifting association said I looked more buff, but I started a higher volume program (Sheiko) at the same time so it is anyone's guess. One friend, without being probed, said he thought my gyno had increased.
- Bloodwork, month after caber cessation: https://i.imgur.com/raQjUW3.jpg. Notice significant decline in testosterone and SHBG, while prolactin is still significantly below reference range. Elevated TSH is from iodine supplementation.
- Ruling out hypothyroidism and Hashimoto's: https://i.imgur.com/bu9Re0t.png. Medical immunologist said I'm clear.
- Bloodwork, 3 months after caber cessation: https://i.imgur.com/YNAkhYT.png. SHBG/albumin (hopefully) still to come, but I think they ****ed up. Fairly sure I didn't masturbate the day before. I did attempt to have sex late night, but didn't ejaculate. There is one thing I don't understand about this bloodwork. They tested for macroprolactin and monomeric prolactin after it was shown that total prolactin was out of range. 25% of my total prolactin is from macro prolactin, and my monomeric prolactin is in range (447 @ 25-635). But **how come** the range for monomeric prolactin can go higher than that of total prolactin? A total prolactin of 447 would still be out of range.
Diet
at this point is brown rice, eggs, lean beef, chicken, veggies (carrots, varous peas), fruits (apples, bananas), lots of beans, olive oil. I significantly increased fiber intake and I cut out most of the dairy I used to take in (from 2l milk and 1kg cottage cheese to 0.7l milk) in an attempt to raise SHBG levels. Also attempted to mainly eat low GI foods. Fast food very occasionally.
Symptoms
- No morning wood/spontaneous erections/soft erections (full disclosure, I fap a lot, probably like 2/day on average. However even then I do not get a strong erection. Suspect I might be addicted. I get very little gratification from it. It's more like something I do to kill time when I am too fatigued. However it could be the cause of these symptoms I guess. I have attempted to not fap, but usually give in a couple days in).
- (minor?) Gyno (confirmed by endo).
- Brain Fog
- Fatigue. Lots of trouble getting out of bed in the morning. Usually just lie there in the morning.
- Minor depression, occasionally think of no longer living.
- Symptoms of hypothyroidism. Low body temperatures in the morning, sparse outer eyebrows. TSH slightly elevated at ~2.3.
I have likely been always like this - I do not have a different baseline to compare to. So I do not know if I feel "normal", or "bad". I don't think I feel as I should.
Questions
I have tried to disclose as much information as I can, all that I think is relevant.
- What would you do in my situation? At this point I have made an appointment with a Men's Health Clinic in the UK, early July. Studies have shown prolactin levels do spike after masturbation, but they usually return to normal after an hour or 2 or so.
- I am also going to call back my endo and point at my elevated prolactin again. But what's he gonna do? My test/SHBG looked decent at 0 prolactin, but do I want to attain those levels while being on caber (rather strong medication) for an indefinite period of time. Hoping to get an mri.
- Basically, would you go through with the appointment with the TRT doc based on this? I feel like I'm going to keep wondering what life should feel like if I don't.
- One of my worries is that my SHBG is low and that I will not respond well to TRT. The latest test showed it was at 16 nmol/l when test levels were at 14.8 nmol/l. However, it has been shown to be able to change, as it was previously at 23.2 nmol/l when my test levels were at 16.4 nmol/l - so I am not in the exact same situation as ERO or vestpocket.
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