Elevated prolactin/chest growth (bloodwork inside)

[diablosho]

I recently had some bloodwork done for elevated prolactin/estrogen/breast growth, and it showed a few values that are ALMOST outside the range of normal.

TSH: 1.24 [.35-4.00 uIU/mL]
fT4: 1.02 [.81-1.54 ng/dL]
IGF-1, ECL: 342 [88-374 ng/mL]
PT INR: 1.09 [0.8-1.2]
DHEA-S: 276.6 ug/dL
Total Testosterone: 625 [280-800 ng/dL]
Estradiol: 40.7 pg/mL--Has been high (off the charts even) for a long time
Prolactin: 20.7 [0-17]
I'm not sure how to interpret the throid panel, but shouldn't my free T4 level be higher to correlate with my TSH level? What should the proper proportion of T4 to TSH be? I have many of the symptoms of hypothyroidism (I have for a while now), such as always feeling really cold at room temperature, can't seem to lose fat, incredible fatigue (which is definitely unusual), losing hair, mental fog, etc.

IGF-1 looks to be almost out of range, and prolactin is high. According to my endo, these could indicate a pituitary adenoma. And, if the TSH value should be higher, that also could indicate a pituitary adenoma (from what I've read).

I'm concerned that since the values are "within range", the endocrinologist won't even consider that there is a problem. He told me that I could still be going through puberty (at 25-seems unlikely!), and that could be causing my chest growth, and he ordered a breast ultrasound (which I hear is useless for gyno), and right hip x-ray for this problem (which seems unnecessary)! He also said that the elevated prolactin wouldn't have caused my nipple discharge (which last happened in September), but after his previous statements, I don't know if I can trust him! I have other lab tests if necessary! All help wanted, as I have plenty of time (endo told me to come back in 3 months!!!)! Thanks guys, y'all are great!
--Brian
P.S.
Sorry for the long post! Basically, my questions are as follows:
1. Is my TSH/fT4 ratio correct?
2. If not, what should it be?
3. Could I have hypothyroidism (antibodies test is good)?
4. Is IGF-1 a bad sign in this scenario?
5. Any ideas as to the cause of my elevated prolactin/estradiol? I have a brain MRI on Monday (looking for pituitary adenoma I guess).
6. Can men still be going through puberty at 25 years old?
7. Should I find a new doctor?
8. Am I worrying too much?
Thanks again!

 

[The Matrix]

I recently had some bloodwork done for elevated prolactin/estrogen/breast growth, and it showed a few values that are ALMOST outside the range of normal.

TSH: 1.24 [.35-4.00 uIU/mL]
fT4: 1.02 [.81-1.54 ng/dL]
IGF-1, ECL: 342 [88-374 ng/mL]
PT INR: 1.09 [0.8-1.2]
DHEA-S: 276.6 ug/dL
Total Testosterone: 625 [280-800 ng/dL]
Estradiol: 40.7 pg/mL--Has been high (off the charts even) for a long time
Prolactin: 20.7 [0-17]
I'm not sure how to interpret the throid panel, but shouldn't my free T4 level be higher to correlate with my TSH level? What should the proper proportion of T4 to TSH be? I have many of the symptoms of hypothyroidism (I have for a while now), such as always feeling really cold at room temperature, can't seem to lose fat, incredible fatigue (which is definitely unusual), losing hair, mental fog, etc.

IGF-1 looks to be almost out of range, and prolactin is high. According to my endo, these could indicate a pituitary adenoma. And, if the TSH value should be higher, that also could indicate a pituitary adenoma (from what I've read).

I'm concerned that since the values are "within range", the endocrinologist won't even consider that there is a problem. He told me that I could still be going through puberty (at 25-seems unlikely!), and that could be causing my chest growth, and he ordered a breast ultrasound (which I hear is useless for gyno), and right hip x-ray for this problem (which seems unnecessary)! He also said that the elevated prolactin wouldn't have caused my nipple discharge (which last happened in September), but after his previous statements, I don't know if I can trust him! I have other lab tests if necessary! All help wanted, as I have plenty of time (endo told me to come back in 3 months!!!)! Thanks guys, y'all are great!
--Brian
P.S.
Sorry for the long post! Basically, my questions are as follows:
1. Is my TSH/fT4 ratio correct?
2. If not, what should it be?
3. Could I have hypothyroidism (antibodies test is good)?
4. Is IGF-1 a bad sign in this scenario?
5. Any ideas as to the cause of my elevated prolactin/estradiol? I have a brain MRI on Monday (looking for pituitary adenoma I guess).
6. Can men still be going through puberty at 25 years old?
7. Should I find a new doctor?
8. Am I worrying too much?
Thanks again!

I would need to see more data there is not enough to make any kind of proper evaluations.

Your Dr need to listen to his patients and do the appropriate investigation. This is the number one complaint that I have my patients/clients and drs need to start looking at symptoms and causes rather then testing results.
When people have difficult thyroid case (resistance, hashimostis, antibodies against hormones and thyroid) then it can be realy fun. Some of the cases which I have dealth with have been to mayo, top university saying there was nothing wrong in reality there was and with proper treatement they are gradually improving slowly and steady.

You need to look at
1.) neurotransmitters
2.) more indept thyroid testing
3) adrenal function through saliva
4) Look for factors binding hormones
5) MRI scan for structural imbalances

FYI
TSH is wasteful test in a stressed condition


Remember it takes years to get to this point and will not be corrected over night or even in a few weeks. You can take the short road for quick gradification, but never have long term satification..

Trying to identify what is wrong can put your body in a stressed state making matters worse because you start looking at symptoms and have mind set "omg I have ....or it could be...." Find a good dr you have good working relationship with. I have been down this route my self and I spend several years of wasted energy worry abou trivial things. In the end I made my self sicker and basically a cyberchondriac.

 

[diablosho]

I was hoping you would respond Matrix, thanks for that! That's kind of what I was thinking! I know I have some symptoms, but over the years I have grown a sort-of distrust for doctors, so I usually try to educate myself. I understand the rarity of adenomas and things like that, and I'm not TOO worried about it, but I am concerned that I may not get my symptoms fixed because some lab value was "within range".

Can you expand on your suggestions (the 1-5 items) so I can ask my endo to run any tests that may help before I see him again in 3 months. Such as, what kind of neurotransmitters, what thyroid tests, etc. What could elevate prolactin levels? I know a lack of dopamine, overactive adrenals, and pituitary adenoma, but what else should I be investigating? Thanks a lot man, I always look forward to your input!
--Brian