blood results

rygran

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Trusted Member
Just got my results pre cycle from letsgetchecked

Testosterone 12.4 nmol/L - normal (7.6 - 31.4)
SHBG 34.0 nmol/L - normal (16 - 55)
Free androgen index 36.5 - normal (24-104)
Prolactin 423.0 mIU/L - normal (86 - 324)
Oestradiol 69.0 pmol/L - normal (< 192)

should I be worried about the high prolactin? The nurse emailed me to say that low sleep, strenuous exercise or a high protein diet could cause this... or a thyroid issue. I just started on a low dose tren cycle, maybe I need to bump my prami to .25/day given I was already high to start?

test still seems high enough to avoid trt?
 
Was that prolactin reading before tren? If so, that's fairly high. You're going to want to keep an eye on that whilst running tren.

FWIW my prolactin went over 800 off test alone when E was high. I started P-5-P and brought E down, prolactin came back into range.
 
Any medical history?
Have you done gear previously? How long ago was your last cycle?
Are you taking any regular medications?
What supplements are you taking?
 
Any medical history?
Have you done gear previously? How long ago was your last cycle?
Are you taking any regular medications?
What supplements are you taking?

No gear since last October. I take topirimate and no supplements. No real medical history that I can think of.


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Off topic..

Do you find it helps with migraines? How many migraines a year did you get and what was the severity?

I usually have approx 3-4 year.
 
Okay so your medical history is migraine headaches, which you take topamax as prophylaxsis.

Unlikely, but this important to know because if im considering intracranial pathology, headaches (or even seizures) may be a sign of that, which may have been misdiagnosed as headaches/migraines... but anyways

High prolactin.... not many causes which makes things easier to diagnose. I'll just go through them for you and you can ponder if these apply to you:

1. most commonly would be medications. If your taking any SSRIs or anti-psychotic medication this will raise your prolactin from inhibiting dopamine.

2. next would be pregnancy or chest-wall/nipple stimulation (any gyno? recent trauma to the chest? shingles?)

3. next, and getting more rare, would be issues in the brain. Usually prolactinoma or an pituitary adenoma that is compressing the hypothalamic stalk, preventing dopamine release and subsequent supression of prolactin... I think this is unlikely in you, but you do apparently have headaches and take an unusual medication for that. Do you have any vision changes? Double vision or particularly loss of peripheral vision? When did these 'migraines' start? Are they getting any worse or more frequent?

4. Lastly, on a similar category to #3 (intracranial) is hypothyroidism, but also very uncommon. Still a cheap test is to get TSH to rule this out. A family doc can do this.


In summary, if this is concerning you, I would visit your family doctor and FIRST confirm prolactinemia by getting it ordered through the regular channels (not a lab in the UK, as im not sure if prolactin levels are reliable from blood at room temp for 1-2 days during shipping). Next, and along with that, a simple TSH would be reasonable. If there is truely high prolactin, TSH is normal, and your physical exam is normal, you'll likely be referred to an endocrinologist and may have a pituitary/sella MRI done to look for any adenomas. As a reassurance however, your prolactin isnt sky-high, so i think prolactinoma (prolactin producing tumor) and other weird/wonderful diagnoses are less likely....
 
Last edited:
Off topic..

Do you find it helps with migraines? How many migraines a year did you get and what was the severity?

I usually have approx 3-4 year.

I wouldn’t take anything for 3-4 a year. I would get 3-4 a week before staring the pills. To be fair they weren’t all “migraines” but moderate to severe headaches with I’d guess 12+ actual migraines a year. I know several ppl on this medication for this exact reason so maybe it’s just common where I’m at. Propranolol was an option as well, which I did try at one time but I had side effects at the lowest dose and had to stop.




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Okay so your medical history is migraine headaches, which you take topamax as prophylaxsis.

Unlikely, but this important to know because if im considering intracranial pathology, headaches (or even seizures) may be a sign of that, which may have been misdiagnosed as headaches/migraines... but anyways

High prolactin.... not many causes which makes things easier to diagnose. I'll just go through them for you and you can ponder if these apply to you:

1. most commonly would be medications. If your taking any SSRIs or anti-psychotic medication this will raise your prolactin from inhibiting dopamine.

2. next would be pregnancy or chest-wall/nipple stimulation (any gyno? recent trauma to the chest? shingles?)

3. next, and getting more rare, would be issues in the brain. Usually prolactinoma or an pituitary adenoma that is compressing the hypothalamic stalk, preventing dopamine release and subsequent supression of prolactin... I think this is unlikely in you, but you do apparently have headaches and take an unusual medication for that. Do you have any vision changes? Double vision or particularly loss of peripheral vision? When did these 'migraines' start? Are they getting any worse or more frequent?

4. Lastly, on a similar category to #3 (intracranial) is hypothyroidism, but also very uncommon. Still a cheap test is to get TSH to rule this out. A family doc can do this.


In summary, if this is concerning you, I would visit your family doctor and FIRST confirm prolactinemia by getting it ordered through the regular channels (not a lab in the UK, as im not sure if prolactin levels are reliable from blood at room temp for 1-2 days during shipping). Next, and along with that, a simple TSH would be reasonable. If there is truely high prolactin, TSH is normal, and your physical exam is normal, you'll likely be referred to an endocrinologist and may have a pituitary/sella MRI done to look for any adenomas. As a reassurance however, your prolactin isnt sky-high, so i think prolactinoma (prolactin producing tumor) and other weird/wonderful diagnoses are less likely....

Thank you for taking the time to write these posts. My tsh has come back normal in the past but I can try to have it checked again. Obviously you are some kind of health professional so I’ll apologize for saying that I can’t stand the way our system is down here in southern Ontario and find myself staying clear of a dr office for anything more than a common cold anymore. My dr flips on me if he finds out I went to a clinic, but if I approach him for help on some subjects ie anything hormonal he ignores it or passes me off to a specialist who then ignores it. Yes. I need a new dr. At that point I risk a new age dr who follows the 1 question per visit or the $$x.xx yearly charges for refills over the phone. No thank you.

I saw an endo last year to have test levels checked. I believe thyroid was on there. Everything was good.

I dream of a day when I have a dr I can have a real conversation with and ask real questions to. One I can discuss all conditions including the use of gear and they just help me feel my best.


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Sorry to hear about your experiences over in ON... these issues are across canada unfortunately and a big part of it is because the health care system rewards high-throughput of patients due to a FFS (fee-for-service) billing model, opposed to taking more time with each person..... but i digress

Remember your not tied-to/obligated to see any one doc, and best of luck finding a family doc you jive with. You wont find a doc to promote the use off AAS's or help prescribe (unless truly hypo T), however you should be able to find somebody who will reliably monitor you without judgement and open for honest discussions....

Lastly, if you saw an endo last year, you SHOULD (depending on the exact time last year) be able to contact their office and get back in without a re-referral . Was prolactin checked back then? Why did you see an endo? Feel free to PM me as well

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And as an aside, I see typtans used much more commonly for migraines. When we get into antiepileptics (topamax, carbamazipine, etc) or beta-blockers... thats usually done by a neurologist with a headache clinic for severe cases like you describe
 
Thanks Peter. I was referred to a neurologist who prescribed the meds for headaches. The endo was referred because i asked to have my test and estro levels checked off cycle to see if I was a candidate for trt. At this point I feel that the health system is starting to shift. Letsgetchecked is an example of this. I’m waiting to see if something more progressive happens before I bother searching for another dr.

Off topic. Can you purchase meds from a pharmacy without a prescription?


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