Minor Hyperprolactima, HCG Monotherapy, 27 Y/O

[johnrobert88]

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.

 

[Mr.TT]

This is the most complete first post, ever.
DHT level? SHBG? FT3?, TT3?
That is a lot of ADEX, and your E2 is still high... curious.
Maybe switch to Aromasin?
"Dr. wonders if I have adult
on-set Kallman's syndrome" that is the first time
I have heard of it...
where were your hormone levels before HcG?
That is also a lot of T4 needed when you consider that the HcG
also pushes your thyroid output, because it also acts like TSH.

 

[johnrobert88]

Hey Mr.TT--thanks for saying its complete. I put a lot of work into it!

I'm annoyed. My DHT level was supposed to be tested this go around, but it does not look like it was. I do have signs of high DHT though like hair receding since I started HCG 2 years ago.

I agree that it is a lot of ADEX. If I don't take that much--I definitely get fluid retention. Adult on-set Kallman's syndrome is basically a Dr. saying "your pituitary does not work and I don't know why.) Before the HCG my hormones were terrible. Low T, Low LH/FSH, low E2, and decently high prolactin. Which is another reason why I believe prolactin is the root of this problem.

Concerning SHBG, FT3, and TT3. I don't have current results. My SHBG has always been middle of the range and I have never been tested for FT3 and TT3 unfortunately.

I'm seeing another Doctor on Tuesday. In the meantime I want to figure out what a course of supplements would be. I know supplements are not pharmacy strength but I figured if I started somewhere....I minus well start at the weaker stuff. I am consider Vitex, Tyrosine, Vit B6, Vit E, and ZMA. I am very interested in brand suggestions and overall supplement advice. I don't want to try L-dopa. Yet...

 

[zaire2d]

Yes, what you saying completes make sense of just high prolactin hipogonandism, you need Dopamine in order to make testosterone and the body use it, for exemple, without dopamine, even with high T you can`t get an erection.

If I was you, I would take some low dose bromocriptine (full dose is 2.5mg) I would take 1/4. and stop HCG, probably just make you dopamine better will take care of the rest.

Go see another doctor. Stope Vitex and Tyrosine (if you want Tyrosine for raise dopamin you should do phenylalanine for you body control the rate of conversion better) body adapts to it very quickly. And vitamin E should be avoided with high prolactin: Science Round-Up Seconds: Vitamin E Succinate, How It's Extracted from Barley Leaves, Kills Cancer, Ramps up Growth Hormone & Spikes Prolactin. Plus: Testostosterone & Thyroid Hormone Decline Due To Plyometrics & HIIT - SuppVersity: Nutrition and Exe

 

[BJE]

My observations. As has been said, your Arimidex dose is very high. I can't take more than about .5mg per week or I get too low. Your free T is only in the middle of the range. You probably have fairly high SHBG. Higher free test might help. Your HCG dose seems fairly low. I use 250IU HCG every other day along with 200mg per week test cyp. I did 300IU HCG every day on HCG mono. I wasn't satisfied with the results of that. It didn't make me feel well. Your prolactin is high but not extremely high. Certainly high prolactin can cause sex issues, but it seems like I asked my endo once about prolactin because mine was in the high end of the range. If I remember right he said it would have to be a lot higher than the top of the range to be a problem. You might research how high is too high with prolactin.

 

[gellesar]

Dostinex

I have had a similar problem for many years....my advise to you is to get on Dostinex(Cabergoline) try half a unit twice a week, it will lower your prolactine, and your libido will improve significantly. It has minor side effects that I know of, specially when compared to Bromocriptine, and it is as effective. Test your prolactine levels every three months to make sure you are not too low.

 

[johnrobert88]

Guys--I appreciate all the input. 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?

 

[gellesar]

Give it a full month, it should work and you will see a change in your libido

 

[johnrobert88]

Not being impatient...but so far no changes in libido.

 

[johnrobert88]

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

 

[brundel]

Im surprised Caber isnt doing anything.
Libido doesnt increase in everyone though I dont think.

Dose is too low. double it.

.25 x 2 weekly. Still a low dose.

 

[johnrobert88]

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)

 

[brundel]

Vitamin D may help with libido.

Or try PT141

 

[BJE]

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)

Vitamin D should be more like 70. Get more sunlight and take vitimin D.

 

[johnrobert88]

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.

 

[BJE]

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.

I'll ask anyone here what is the optimal range for prolactin? I last had mine checked several years ago and it seems like it was around 10 or perhaps close to 15. I asked my endo about it and he told me it would have to be many times over the top of the range before it became a problem. Now reading this post I'm wondering if I should look into my prolactin level again.

 

[BJE]

Any thoughts on stopping HCG cold turkey? I'm afraid of how terrible and weak I am going to feel.

I quit HCG cold turkey once when it was the only thing I was taking. My test level quickly dropped to below normal so I started using it again then switched to using test cyp and HCG. The thing with HCG as I understand it is that it suppressed the HPTA such that the pituitary stops signaling testosterone production. Without something like Clomid I think you will be a long time with low test before normal signaling resumes.

 

[johnrobert88]

I'll ask anyone here what is the optimal range for prolactin? I last had mine checked several years ago and it seems like it was around 10 or perhaps close to 15. I asked my endo about it and he told me it would have to be many times over the top of the range before it became a problem. Now reading this post I'm wondering if I should look into my prolactin level again.

BJE optimal prolactin is around 5. A prolactin of around 15 sucks and hurts libido. 15 and above is consider hyperprolactiema.

 

[johnrobert88]

I quit HCG cold turkey once when it was the only thing I was taking. My test level quickly dropped to below normal so I started using it again then switched to using test cyp and HCG. The thing with HCG as I understand it is that it suppressed the HPTA such that the pituitary stops signaling testosterone production. Without something like Clomid I think you will be a long time with low test before normal signaling resumes.

I agree with you in that I need clomid. I left a message with my doctor begging for a script. He seems to think cabergoline is enough to motivate my pituitary but I am not convinced. I'm just sick of HCG to be honest and I wish so badly that I could get things restarted. HCG cold storage is such a pain in the ass, especially when traveling.

 

[johnrobert88]

Just an update. I have started just clomid 25 mg/day. It has given me some water retention, so I hope that's a good sign that it is working.

 

[johnrobert88]

Just an update that I am taking only clomid 25mg/daily now for a month. I am getting some water retention (ankles) so I hope that is a sign that it is working.