Ugh...need some help

[RavensFan2k3]

I've had low testosterone since I was in my mid teens, and now I'm only in my early 20s but have to suffer from low test. I've been do numerious of doctors, none have been able to help me. Every blood test I have had, my total test was in the 200s or 300s, estradial has usuall been normal(in the 20s), LH and FSH normal as well in the upper range), but the one thing that has always been just alittle above range is prolactin. Is this what could be causing my problems? I've spent thousands of dollars through these past 5 years trying to cure myself. I just got som Cabaser(cabergoline) to see if it will do anything, if prolactin is indeed my issue. My symptoms are low libido, erectile dysfunction, fatigue, no motivation, cant build muscle, small testicles, etc...What do you guys think? I can post blood work if necessary...

 

[RavensFan2k3]

no body can help?

 

[thenxtgrt1]

no body can help?

Post labs...that would be a big help. And it sounds like you need to visit an experienced trt doc. Run of the mill endos/uro's typically won't be able to provide much help.

 

[Philec48]

If your LH and FSH are in upper range, sounds like your hypogonadism is primary, ie, testicles just can't make enough testosterone even when properly signaled to do so. Shouldn't take thousands of dollars to fix - just the appropriate amount of TRT. If you do go on TRT, keep an eye on estradiol, as it can go too high due to aromatization. Hopefully, you can find a doc willing to help keep that in check.

Try to find an endo that specializes in hormone replacement therapy for men. As thenxtgrt1 pointed out, run of the mill endos/uros will likely not help much. You may be surprised to know that there are some gynecologists that have male patients they treat for hypogonadism. This is just another possible avenue to explore if other routes don't pan out.

 

[pmgamer18]

Yep we need to see your labs if your Total T levels are 200 to 300 and your LH and FSH are mid range or higher with high prolactin this dose not add up. Unless you have a pituitary tumor running up your prolactin levels and your testis don't work this is rare to have happen.

 

[RavensFan2k3]

Here are the most recent labs...

Total Test 303 ng/dL(241-827)
Free Test 10.3 pg/mL

Estradiol 23 pg/mL(0-53)
Total Estrogen 138 pg/mL(40-115)

LH 5.0 mIU/mL(0.5-5.3)
FSH 6.7 mIU/mL(1.4-18.1)

17-OH Progesterone 152 ng/dL(5-160)

Cortisol 17.2 ug/dL(3.1-22.4)

ACTH, Plasma 63 pg/mL(6-48)

Prolactin 26 ng/mL(2.1-17.7)


This was the test a couple of months before this one, I had just got off of DHEA before this one.

FSH 9.3 mIU/mL (2.0-9.2)

LH 3.4 mIU/mL

Androstenedione, Serum 95 ng/dL (44-186)

T4, free(Direct) 1.63 ng/dL (0.61-1.76)

Free Testosterone(Direct) 9.8 pg/mL

Insulin-Like Growth Factor I 182 ng/mL (127-424)

TSH 1.601 (0.450-4.500)

Estrogens, Total 145 pg/mL (40-115)

*Estradiol 37 pg/mL (0-53)

DHEA-Sulfate 210 ug/dL (108-441)

T3 118 ng/dL (85-205)

Growth Hormone, Serum <0.1 ng/mL (0.0-6.0)

ACTH, Plasma 59 pg/mL (6.48 )

Cortisol 19.4 ug/dL (3.1-22.4)

Prolactin 24.3 ng/mL (2.1-17.7)

SHBG, Serum 19 nmol/L (13-71)

*While I was on DHEA, I had a blood test and my total testosterone was 277 ng/dL and my estrogen was 40 pg/mL. And a few months later, a few weeks after I stopped the DHEA my estradiol was 37 pg/mL...as you see above, so I believe DHEA caused estradiol to be high and that isnt an issue, but total estrogens may be.

PLEASE HELP ME, I AM DYING LITERALLY

 

[pmgamer18]

You need to find out why your Prolactin levels are so high and yet your LH and FSH are asking your Testis for more Testosterone. I am not sure but it looks like you need an MRI done on your Pituitary to rule out a tumor. And it looks to me like on top of this your Primary for some reason your testis are not making Testosterone. Have you ever done Steroids or a lot of HCG I need to ask this or have you use Propecia for hair loss this can do this to your on your testis not working.

If I were you I would see if you can get your Family Dr. to work with Dr. John over the phone to test and treat you to get to the bottom of this.
www.allthingsmale.com

 

[RavensFan2k3]

You need to find out why your Prolactin levels are so high and yet your LH and FSH are asking your Testis for more Testosterone. I am not sure but it looks like you need an MRI done on your Pituitary to rule out a tumor. And it looks to me like on top of this your Primary for some reason your testis are not making Testosterone. Have you ever done Steroids or a lot of HCG I need to ask this or have you use Propecia for hair loss this can do this to your on your testis not working.

If I were you I would see if you can get your Family Dr. to work with Dr. John over the phone to test and treat you to get to the bottom of this.
www.allthingsmale.com

I have had an MRI of my pituitary gland and an ultra sound of my testicles. No tumor or anything else was found. I have never taken steroids or HCG. One of my endo's had me take something the night before another test which brought my ACTH down to 5 and my prolactin to 14.5, but it was just a test nothing permanent.

About my LH and FSH being normal and my testicles not making more testosterone...I've heard that elevated prolactin levels for an extended period of time(thats not due to a tumor) can desensitize leydig cells/testicles to LH/FSH. My prolactin has been elevated for 4-5 years. Could this be it?

 

[pmgamer18]

Yes that is true I did not know you has them tests there are meds to get your Prolactin levels and with hope doing this your testis will jump back in.

 

[RavensFan2k3]

Yes that is true I did not know you has them tests there are meds to get your Prolactin levels and with hope doing this your testis will jump back in.

So having hyperprolactinemia that is not caused by a tumor for too long can really desensitive the leydig cells to responding to LH and FSH? Would lowering prolactin fix this and bring back sensitivity to LH and FSH?

How should cabergoline be dosed in a situation like this?

 

[MSL2009]

Let me know how the cabergoline works out for you raven. I've been wanting to try this medicine as well. Testosterone supplementation don't always lower prolactin levels when a dopamine agonist will.

 

[pmgamer18]

Yes it can and I can't tell you how much to take you need to do a search on this or find a good Dr. that knows about this I am not a Dr. and never had this problem. I am just a guy the has have low t for over 27 yrs and been through the mill seeing one bad Dr. after the other. Here is a link to my story.
http://forums.realthyroidhelp.com/viewtopic.php?f=5&t=9239
At one time I worked as a mod at 6 forums helping men so I get around and learn a lot.

 

[DavesNotHere]

Did they test for TRH? What were your DA levels? Your GH levels are on the low side as well. Did they look at the hypothalamus at all?

 

[RavensFan2k3]

Let me know how the cabergoline works out for you raven. I've been wanting to try this medicine as well. Testosterone supplementation don't always lower prolactin levels when a dopamine agonist will.

alright man, i got you

Yes it can and I can't tell you how much to take you need to do a search on this or find a good Dr. that knows about this I am not a Dr. and never had this problem. I am just a guy the has have low t for over 27 yrs and been through the mill seeing one bad Dr. after the other. Here is a link to my story.
http://forums.realthyroidhelp.com/viewtopic.php?f=5&t=9239
At one time I worked as a mod at 6 forums helping men so I get around and learn a lot.

yeah, i already know your story. you helped me when i first found out about my problem. told me all about E2 and stuff like that. I have a question. Is E2(estradiol) the only form of estrogen i should be worried about? My total estrogen is high, but estradiol is normal. Is that find, or is total estrogen a problem? What causes the other estrogens(estriol, estrone) increase?

Did they test for TRH? What were your DA levels? Your GH levels are on the low side as well. Did they look at the hypothalamus at all?

Nope. I dont know about DA, Yeah GH are low, and no they didnt look at hypothalamus, but they did look at my pituitary gland.

 

[pmgamer18]

Great I talk to so many men I lose track to answer your question yes all you need to worry about is Estradiol. The tests for Total E's are for women and I just stopped doing them once I got my E2 in the right range by this I mean having night time and morning wood so strong you can hang a coat on it the rest follow. The E's in men are not the same as in women. In men E's are made from Testosterone in women it's made from there ovaries. Even Dr. John does not test E's anymore.

 

[RavensFan2k3]

Great I talk to so many men I lose track to answer your question yes all you need to worry about is Estradiol. The tests for Total E's are for women and I just stopped doing them once I got my E2 in the right range by this I mean having night time and morning wood so strong you can hang a coat on it the rest follow. The E's in men are not the same as in women. In men E's are made from Testosterone in women it's made from there ovaries. Even Dr. John does not test E's anymore.

alright cool...so right now, all i need to worry about is prolactin in your opinion? What about DHEA? ACTH? Cortisol?

 

[pmgamer18]

You could test your adrenals one way is to just do a morning fasting cortisol lab test if your 15 or lower then do a 4x's in a day saliva test to see what your rhythm is or what stage of Adrenal Fatigue your at. If your Cortsiol levels are bad so will your DHEA levels see this link about the stages of this. In the first stage one if very high do to the adrenals over working as one goes on the Adrenals fatigue and can't make enough Cortisol this is a big problem in a lot of men with low Testosterone the stress of walking around low does in there Adrenals.
http://www.chronicfatigue.org/ASI 1 .html
In his link is about how to do an ACTH stim. test this can tell you if your Secondary meaning there is a problem with your pituitary even if your MRI is good. ACTH is the message sent to your adrenals to make more Cortisol.
http://en.wikipedia.org/wiki/ACTH_stimulation_test

In this link you will find labs you can buy a 4x's in a Day Saliva Cortisol test.
http://www.stopthethyroidmadness.com/adrenal-info/
If you find your low I can give you more links about treating this problem. Just ask.

 

[RavensFan2k3]

You could test your adrenals one way is to just do a morning fasting cortisol lab test if your 15 or lower then do a 4x's in a day saliva test to see what your rhythm is or what stage of Adrenal Fatigue your at. If your Cortsiol levels are bad so will your DHEA levels see this link about the stages of this. In the first stage one if very high do to the adrenals over working as one goes on the Adrenals fatigue and can't make enough Cortisol this is a big problem in a lot of men with low Testosterone the stress of walking around low does in there Adrenals.
http://www.chronicfatigue.org/ASI 1 .html
In his link is about how to do an ACTH stim. test this can tell you if your Secondary meaning there is a problem with your pituitary even if your MRI is good. ACTH is the message sent to your adrenals to make more Cortisol.
http://en.wikipedia.org/wiki/ACTH_stimulation_test

In this link you will find labs you can buy a 4x's in a Day Saliva Cortisol test.
http://www.stopthethyroidmadness.com/adrenal-info/
If you find your low I can give you more links about treating this problem. Just ask.

i had urine testing done of my cortisol through out the day. i'll post the results in a minute, i didnt understand them one bit, maybe you can decipher them for me.

 

[pmgamer18]

Urine test don't show how your doing morning to night or bedtime. They only show your total Cortisl for the day and I think they are free levels. You need to know if your high enough in the morning falling low by bedtime. People with Adreanl Fatigue some start low in the morning and are high at bedtime this keeps them up all night making it worse.
This link is good read it.
http://www.tmuscle.com/article/diet_and_nutrition/adrenal_fatigue_101&cr=dietAndNutrition

 

[RavensFan2k3]

Urine test don't show how your doing morning to night or bedtime. They only show your total Cortisl for the day and I think they are free levels. You need to know if your high enough in the morning falling low by bedtime. People with Adreanl Fatigue some start low in the morning and are high at bedtime this keeps them up all night making it worse.
This link is good read it.
http://www.tmuscle.com/article/diet_and_nutrition/adrenal_fatigue_101&cr=dietAndNutrition

ok, but from looking at my blood tests posted above, you think my adenals are in trouble?

 

[pmgamer18]

You need to check this you might have a problem it this test was done in the early morning it on the low side most people normol are at 25 of higher do to the stress of having blood taken. And your brain or Pituitary is asking for more Cortisol by sending a low of the ACTH message to your adrenls to make more Cortisol. Your above the top of the range this means your brain sees your low for what is likes.
Cortisol 17.2 ug/dL(3.1-22.4)

ACTH, Plasma 63 pg/mL(6-48)
Read the links in this one on how to read labs.
http://forums.realthyroidhelp.com/viewtopic.php?f=12&t=256

 

[RavensFan2k3]

You need to check this you might have a problem it this test was done in the early morning it on the low side most people normol are at 25 of higher do to the stress of having blood taken. And your brain or Pituitary is asking for more Cortisol by sending a low of the ACTH message to your adrenls to make more Cortisol. Your above the top of the range this means your brain sees your low for what is likes.
Cortisol 17.2 ug/dL(3.1-22.4)

ACTH, Plasma 63 pg/mL(6-48)
Read the links in this one on how to read labs.
http://forums.realthyroidhelp.com/viewtopic.php?f=12&t=256

ok so my cortisol is low for someone in the morning, and my body see's this since its trying to tell my body to make more(high ACTH). Is my DHEA low aswell?

 

[pmgamer18]

Yes your DHEA is on the low side get some 25mgs and take one a day it might help.

 

[RavensFan2k3]

Yes your DHEA is on the low side get some 25mgs and take one a day it might help.

I've taken 25mg DHEA 2x daily aswell as 4 pellets of isocort 2x daily before, all it seemed to do was increase my estradiol to 40 pg/mL

 

[pmgamer18]

Well yes 50 mgs of DHEA is a high dose I said to take 25 mgs 1x's / day. Isocort will not up your Estradiol levels but high Estradiol or low can mess with Cortisol levels and 8 pills is = 20 mgs of Cortisol but I never did this 4 pills 2x's a day this is the wrong way to take it. You can start your day by taking 4 pills in the morning if your levels are very low on Cortisol a 4x's in a day saliva test. Then do 2 pills at noon and 2 more pills at dinner. Most do 2 pills every 4 hrs.
Here is a link to FAQ's about Adrenals and there problems and how to take meds.
http://forums.realthyroidhelp.com/viewtopic.php?f=12&t=256

 

[RavensFan2k3]

Well yes 50 mgs of DHEA is a high dose I said to take 25 mgs 1x's / day. Isocort will not up your Estradiol levels but high Estradiol or low can mess with Cortisol levels and 8 pills is = 20 mgs of Cortisol but I never did this 4 pills 2x's a day this is the wrong way to take it. You can start your day by taking 4 pills in the morning if your levels are very low on Cortisol a 4x's in a day saliva test. Then do 2 pills at noon and 2 more pills at dinner. Most do 2 pills every 4 hrs.
Here is a link to FAQ's about Adrenals and there problems and how to take meds.
http://forums.realthyroidhelp.com/viewtopic.php?f=12&t=256

i see what you're saying...but do I need that? thats my question

 

[cumkwakka]

i think your t3 total is low as well..

please have your vitamin d checked, i can almost smell it's low, it can up your points 200 or something like that

and get that prolactin handled

 

[pmgamer18]

I don't know how do you feel if you feel good and wake up in the morning feeling like your ready to get on with the day and are looking forward to it no you don't need it. But if you have low adrenals and feel bad in the morning and have trouble sleeping at night yes you need it.

 

[RavensFan2k3]

i think your t3 total is low as well..

please have your vitamin d checked, i can almost smell it's low, it can up your points 200 or something like that

and get that prolactin handled

vitamin D can lower prolactin? how much should i be taking daily?

I don't know how do you feel if you feel good and wake up in the morning feeling like your ready to get on with the day and are looking forward to it no you don't need it. But if you have low adrenals and feel bad in the morning and have trouble sleeping at night yes you need it.

but how do I know those feelings arent caused by low testosterone/high prolactin?

 

[pmgamer18]

You don't until you treat it and if you get better then you know. As for how much Vit. D one needs I take 12,000 IUs of it the kind I use comes in drops each drop is 2000 IU's.
Bio D-Mulsion Forte

 

[RavensFan2k3]

You don't until you treat it and if you get better then you know. As for how much Vit. D one needs I take 12,000 IUs of it the kind I use comes in drops each drop is 2000 IU's.
Bio D-Mulsion Forte

you take the 12,000 IUs all at once? I remember these are vitamin D drops. Do you just drop them onto your toungue?

 

[pmgamer18]

No I put the drops on the back of my hand and lick them off you can start with 4 drops test and go from there.
http://www.mccombsplanstore.com/prodinfo.asp?number=BIOD

 

[RavensFan2k3]

No I put the drops on the back of my hand and lick them off you can start with 4 drops test and go from there.
http://www.mccombsplanstore.com/prodinfo.asp?number=BIOD

ok so you lick them off the back on your hand...but do you take all 6 drops at once?

 

[pmgamer18]

Yes but I go by my labs and I am dam low on 6 drops all at once my labs are 75 now range is 20 to 100 ng/mL Total. Some people split it up and take 2 drops at bed time it helps one sleep.

 

[RavensFan2k3]

Yes your DHEA is on the low side get some 25mgs and take one a day it might help.

if i'm gonna take 25mg of DHEA daily...at what time of day should i take it?

 

[pmgamer18]

I take it in the morning with food.

 

[RavensFan2k3]

I take it in the morning with food.

what other supplements do you take? do you take the vitamin D drops with food or while eating aswell? are you taking some sort of aromotase inhibiter?

 

[pmgamer18]

Yes I take a lot of supplements and I do the Vit. D drops first thing in the morning I put them on the back of my hand and lick it off. Here is a list of my meds and supplements.
=====================================
PHILIP’S MED’S
• Simvastatin(Zocor) 20 mg. bedtime for Cholestrol.
• Arimidex .25 mg. bed time every 24 hours for control of Estradiol.
• Aspirin 81 mg morning 1x/day.
• Alprazolam(Xanax) .25 mg. up to 1x at morning and bedtime.
• Atenolol 50 mg. 1x/day morning for heart beta-blocker cut in half 25 mgs.
• Triamterene/HCTZ 37.5/25 mgs. Every 3 days.
• Armour 4 grains 2 morning and one at noon and one at dinner for Thyroid.
• Potassium Chloride 20 mg. 1x’s a week morning. I will stop taking this when I run out.
• Testosterone .40ml. or 80 mgs shot every 3 days.
• HCG 400 IU’s shot the 2 days each in between the Testosterone shot.
• Celebrex 200 mgs. 2x/day morning and dinner.
• Cortef 5 mgs. 10 mgs morning, 5mgs at 9am, 10 mgs at 1pm and 5 mgs at 6pm.
• Florinef .1 mgs. 1x’s/day.

Supplements
• Vit. A 10,000 IU’s 1x/day.
• Vit. E 400 IU’s 1x/day.
• Folacal Folinic Acid 800 mg. 1x/day
• Feosol Iron 45mgs 3x’s/day morning noon and dinner.
• Glucosamine HCI 1500 MGS. – Chondroitin Sulface 1200 mgs. 2x/day.
• Lovaza 1gm. 1x/day Fish Oil.
• TMG 750mg 1pm and 11pm 2 pills a day.
• Solary Super Bio C 2 x’s/day 1000 mgs. Total.
• l-Arginine and l-Orthinine 100 Capsules, 750 mg, Twinlab 1 at bedtime.
• NOW brand ZMA 800mgs 3 at bedtime.
• Copper 2mgs 1 at noon.
• Dr. Cranton's PrimeNutrients 3/day.
• Maca. 1 tsp in the moning and 1 tsp at noon.
• Biotics Bio-D-Mulsion Forte Vit. D 2000 IU's per drop I am doing 7 drops a day.
• Iodoral Iodine 1 tab / day.
• I went with NOW brand for the following supplements do to a high levels on a Homocysteine Cardiovascular and below normal level of Folate RBC labs.
• NAC N-Acetyl Cysteine, Selenium, Molybdenum - 600 mg.
• B-12 (Brain) Methylcobalamin - 5000 mcg lozenges.
• Coenzyme B Complex.
• P-5-P (Coenzyme B6) 50 mg.
• I am taking 800 mcg. Folacal for low Folate RBC.
• DHEA 25 mgs 1x/day.
• BioCitrate Selenium - 200 mcg 1x’s / day at bedtime.

 

[RavensFan2k3]

Getting more tests done...

my doc wouldnt agree to test DHEA, he said that from the results of cortisol, we'll know enough about the adrenal glands, that DHEA testing wasnt necessary. is this true?