[bloodwork] Bromocriptine Lowered My Prolactin. Alt & Creatinine Still High

franko

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Previous Threads: Franko's Threads | Ray Peat Forum
(See previous threads for previous bloodwork, diet info, and more details about my health issues.)

My latest bloodwork results:


Every Day Protocol (Over last ~3 months)
• 25mg Exemestane
• 2.5mg Bromocriptine
• Estroban
↳ Vitamin A - 5,000 IU
↳ Vitamin D - 1,000 IU
↳ Vitamin E - 65mg (100 IU)
↳ Vitamin K2 (MK-4) - 2mg
• Energin
↳ Thiamine HCL (Vit. B1): 50 mg
↳ Riboflavin 5' Phosphate (Vit. B2): 20 mg
↳ Niacinamide (Vit. B3): 100 mg
↳ Pyrodoxine 5' Phosphate (Vit. B6): 6 mg
• 1g Taurine
• 1g Glycine
• 200mg Caffeine

Main Issues
Depression/Fatigue
• Mild Gynecomastia
• Male Pattern Balding

Commentary
So, bromocriptine worked. That's cool. Wish I would have tried it sooner. Not sure if I should lower my 2.5mg/day dosage because my level is lower than the normal range.

I briefly tried stopping the exemestane, but that brought back my depression / fatigue — which happens when my testosterone is low — so I went back on it.

I still have high Creatinine and ALT. I was trying to address the ALT with the Caffeine, Taurine & Glycine but they don't seem to have had an effect. I am currently doing research to figure out what could be causing them and how to address them.

One factor that stood out in my research is dehydration. I don't feel the "sick" symptoms of dehydration, but I don't drink much water and my urine is never clear. In the past, drinking plain water would cause me to get cold hands and feet and have a stress response. Lately, I just drink milk, juice or soda with meals, and not much water at all in between. I didn't really get that thirsty so it was easy. So I'm starting to try drinking more water. Another factor for creatinine is high blood pressure — which I think I do have a mild case of.

The other factor for creatinine is muscle mass. I'm reading that creatinine levels directly correlate to, and in fact are caused by, muscle mass. I'm not weight lifting right now, but I do have naturally substantial amounts of muscle mass.

Also, I'm seeing some sources that have a range of 0.7 – 1.4 mg/dL for creatinine, which would have put me in the normal range for all but the most recent test.

My testosterone level is okay (526 ng/dL) — which correlates with my general mood — I felt better when my T level was higher, so I'd like to get it to a high-normal level.

The fact that my estradiol is still mid-normal even on 25mg/day exemestane I think shows that how much aromatization was a problem for me. But I'm not sure if I can get my testosterone higher just by inhibiting aromatization further. Testosterone replacement might be the only way to get it higher than this. I am now starting to wonder again whether my varicocele is preventing gonadal testosterone production or whether it's just that too much of it is being aromatized.

Bromocriptine lowered my prolactin, but since that is drug-induced does that mean that it is not a reliable indicator of my tissue estrogen levels? I don't know. But I think I need to do more to lower estrogen / aromatization. Other estrogen symptoms I have are abdominal fat and small cases of varicose vein-like things.

Regarding my gynecomastia: now that I have normal testosterone, normal estrogen and low prolactin, I think these are the conditions that would have prevented mild gynecomastia from starting, but I do not know if they will be able to effectively eliminate the tissue that's already there. I've read that's impossible. Most people say that once you have that tissue, surgery is the only way to remove it. I'm still considering that.

Feedback
Any feedback or advice on my test results / issues is appreciated. In particular, I'd like to hear people's thoughts has any thoughts on lowering Creatinine & ALT, as well as my hypothalamic–pituitary–gonadal axis situation, with the goal of raising testosterone and lower estrogen.
 
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haidut

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Previous Threads: Franko's Threads | Ray Peat Forum
(See previous threads for previous bloodwork, diet info, and more details about my health issues.)

My latest bloodwork results:

View attachment 2218

Every Day Protocol (Over last ~3 months)
• 25mg Exemestane
• 2.5mg Bromocriptine
• Estroban
↳ Vitamin A - 5,000 IU
↳ Vitamin D - 1,000 IU
↳ Vitamin E - 65mg (100 IU)
↳ Vitamin K2 (MK-4) - 2mg
• Energin
↳ Thiamine HCL (Vit. B1): 50 mg
↳ Riboflavin 5' Phosphate (Vit. B2): 20 mg
↳ Niacinamide (Vit. B3): 100 mg
↳ Pyrodoxine 5' Phosphate (Vit. B6): 6 mg
• 1g Taurine
• 1g Glycine
• 200mg Caffeine

Main Issues
Depression/Fatigue
• Mild Gynecomastia
• Male Pattern Balding

Commentary
So, bromocriptine worked. That's cool. Wish I would have tried it sooner. Not sure if I should lower my 2.5mg/day dosage because my level is lower than the normal range.

I briefly tried stopping the exemestane, but that brought back my depression / fatigue — which happens when my testosterone is low — so I went back on it.

I still have high Creatinine and ALT. I was trying to address the ALT with the Caffeine, Taurine & Glycine but they don't seem to have had an effect. I am currently doing research to figure out what could be causing them and how to address them.

One factor that stood out in my research is dehydration. I don't feel the "sick" symptoms of dehydration, but I don't drink much water and my urine is never clear. In the past, drinking plain water would cause me to get cold hands and feet and have a stress response. Lately, I just drink milk, juice or soda with meals, and not much water at all in between. I didn't really get that thirsty so it was easy. So I'm starting to try drinking more water. Another factor for creatinine is high blood pressure — which I think I do have a mild case of.


The other factor for creatinine is muscle mass. I'm reading that creatinine levels directly correlate to, and in fact are caused by, muscle mass. I'm not weight lifting right now, but I do have naturally substantial amounts of muscle mass.

Also, I'm seeing some sources that have a range of 0.7 – 1.4 mg/dL for creatinine, which would have put me in the normal range for all but the most recent test.

My testosterone level is okay (526 ng/dL) — which correlates with my general mood — I felt better when my T level was higher, so I'd like to get it to a high-normal level.

The fact that my estradiol is still mid-normal even on 25mg/day exemestane I think shows that how much aromatization was a problem for me. But I'm not sure if I can get my testosterone higher just by inhibiting aromatization further. Testosterone replacement might be the only way to get it higher than this. I am now starting to wonder again whether my varicocele is preventing gonadal testosterone production or whether it's just that too much of it is being aromatized.

Bromocriptine lowered my prolactin, but since that is drug-induced does that mean that it is not a reliable indicator of my tissue estrogen levels? I don't know. But I think I need to do more to lower estrogen / aromatization. Other estrogen symptoms I have are abdominal fat and small cases of varicose vein-like things.

Regarding my gynecomastia: now that I have normal testosterone, normal estrogen and low prolactin, I think these are the conditions that would have prevented mild gynecomastia from starting, but I do not know if they will be able to effectively eliminate the tissue that's already there. I've read that's impossible. Most people say that once you have that tissue, surgery is the only way to remove it. I'm still considering that.

Feedback
Any feedback or advice on my test results / issues is appreciated. In particular, I'd like to hear people's thoughts has any thoughts on lowering Creatinine & ALT, as well as my hypothalamic–pituitary–gonadal axis situation, with the goal of raising testosterone and lower estrogen.

I think it is worth trying to drop the exemestane and replace with something like 10mg pregnenolone and 5mg DHEA taken twice a day. Exemestane is well-known to be able to cause liver issues in the 25mg/day doses. It is not your blood testosterone that matters but your tissue levels, especially the brain. DHT is the true androgenic antidepressant and low dose DHEA can effectively raise DHT in the brain and other tissues. EstroBan should be able to control estrogen on its own. I would do that regimen for 2-3 weeks and then retest for liver/creatinine.
 

barefooter

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Aug 22, 2013
Messages
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So, bromocriptine worked. That's cool. Wish I would have tried it sooner.

Wow, that'a a big change, congrats. I just got a test back, and my prolactin is pretty similar to what yours was, but a bit higher at 20, so I may see about giving bromocriptine a try. Was your doctor able to prescribe it or did you get it from one of the online pharmacies? Also, did you notice positive benefits as your prolactin went down?
 

Koveras

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Dec 17, 2015
Messages
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Other estrogen symptoms I have are abdominal fat

This is not a symptom of estrogen - in fact inhibiting the aromatization of testosterone can cause this.

Shown here using anastrozole:

Gonadal Steroids and Body Composition, Strength, and Sexual Function in Men

"In cohort 2, the percentage of body fat increased in all groups when the aromatization of testosterone to estradiol was inhibited."

And discussed here:

Recognizing rare disorders: aromatase deficiency. - PubMed - NCBI

"Affected males, on the other hand, do not present with obvious defects at birth, so are diagnosed much later in life, presenting with clinical symptoms, which include tall stature, delayed skeletal maturation, delayed epiphyseal closure, bone pain, eunuchoid body proportions and excess adiposity."

The elevated liver enzymes are possibly caused by the exemestane

Severe prolonged cholestatic hepatitis caused by exemestane
 
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franko

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I think it is worth trying to drop the exemestane and replace with something like 10mg pregnenolone and 5mg DHEA taken twice a day. Exemestane is well-known to be able to cause liver issues in the 25mg/day doses. It is not your blood testosterone that matters but your tissue levels, especially the brain. DHT is the true androgenic antidepressant and low dose DHEA can effectively raise DHT in the brain and other tissues. EstroBan should be able to control estrogen on its own. I would do that regimen for 2-3 weeks and then retest for liver/creatinine.

Thank you very much. This sounds like a good idea. I'm gonna try to taper off the exemestane and see if pregnenolone & DHEA can produce the same androgenic antidepressant effect.

Was your doctor able to prescribe it or did you get it from one of the online pharmacies? Also, did you notice positive benefits as your prolactin went down?

Both. A doctor did prescribe it initially but I also re-supplied via online.

I haven't really noticed any major benefits / symptoms from low prolactin yet. The thing that is most noticeable for me is the androgenic antidepressant effect, as haidut called it, of testosterone / DHT. I can feel it psychologically when my testosterone is low. But I am hoping that with lower prolactin, I will not have to rely as much AI's keep my testosterone levels up.

This is not a symptom of estrogen - in fact inhibiting the aromatization of testosterone can cause this.

Interesting. That's not what I expected. I'll have to look into this further.
 
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I was able to normalize ALT by taking antibiotics. Excess gut bacteria was the cause in my case. Did you take bromo of 2.5mg daily for 3 months with no breaks? I heard Ray said it causes some issues when taken long term.
 
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franko

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I was able to normalize ALT by taking antibiotics. Excess gut bacteria was the cause in my case.

Good to know. I might try antibiotics down the line if nothing else works.

I'm going to get new bloodwork soon since I stopped taking exemestane and been using pregnenolone and DHEA and it seems to be working about as well. I will soon see if the exemestane was the cause of the high ALT.

Did you take bromo of 2.5mg daily for 3 months with no breaks? I heard Ray said it causes some issues when taken long term.

Yes. It's been about 4 months now of 2.5mg/day. Still taking it. I haven't had any noticeable issues or side-effects.

Might cut the dosage in half after next bloodwork. And then might try to wean off it completely and see if my prolactin stays down.
 
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franko

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I think it is worth trying to drop the exemestane and replace with something like 10mg pregnenolone and 5mg DHEA taken twice a day. Exemestane is well-known to be able to cause liver issues in the 25mg/day doses. It is not your blood testosterone that matters but your tissue levels, especially the brain. DHT is the true androgenic antidepressant and low dose DHEA can effectively raise DHT in the brain and other tissues. EstroBan should be able to control estrogen on its own. I would do that regimen for 2-3 weeks and then retest for liver/creatinine.

Posted new bloodwork here: Bloodwork April 2016 — Low T: Revenge Of The Pituitary
I'd appreciate your thoughts, @haidut.
 

haidut

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Posted new bloodwork here: Bloodwork April 2016 — Low T: Revenge Of The Pituitary
I'd appreciate your thoughts, @haidut.

I think it shows hypothyroidism. Until the TSH comes down, the pituitary will be overactive and thyroid low, so not much testosterone would be synthesized. Cortisol and estrogen are usually high in this state, so this contributes a lot to the symptoms you are getting including burdened liver. I would try to work with the NDT dose to lower TSH. The liver protocol some other people mentioned may not be a bad idea either.
 

Dopamine

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Chronic nicotine significantly lowers prolactin and estrogen. Lowers TSH and LH. Stabilizes testosterone and dopamine. Raises brain pregnenolone and progesterone levels...

I have heard of some pro bodybuilders getting gyno and high estrogen/prolactin symptoms from steroids then clearing it up with nicotine. Nicotine has been shown in studies to inhibit breast aromatase.

From Anthony Roberts (author, bodybuilder)
One really weird thing that I did awhile back was that I started getting slightly painful nipples (gyno) from a cycle where I was using some pretty high doses of steroids that aromatize to estrogen. I didn't have any aromatase inhibitors on hand, which is kind of a silly mistake on my part. This was awhile ago, and the soonest I was going to be able to get my hands on some Arimidex or whatever was a week.

Nicotine, however, is a well known inhibitor of the aromatase enzyme, and that's one of the reasons women who smoke have lowered estrogen levels. Anyway, I went to the drugstore and got some nicotine gum and used that until I could get a proper aromatase inhibitor. My gyno pain and symptoms went away in about two days. It's not perfect, and was poor planning on my part, but it worked.
 
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Parsifal

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I have heard of some pro bodybuilders getting gyno and high estrogen/prolactin symptoms from steroids then clearing it up with nicotine. Nicotine has been shown in studies to inhibit breast aromatase.

From Anthony Roberts (author, bodybuilder)
Do you think that it would do it more than caffeine?
 

Greg says

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Yes. It's been about 4 months now of 2.5mg/day. Still taking it. I haven't had any noticeable issues or side-effects.

How is your experience of taking Bromo? Do you notice any change in symptoms/mood from it? When do you take it?
 

Dopamine

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Do you think that it would do it more than caffeine?

I think they work very similarly in a lot of respects and I have been using both. I find caffeine way more stimulating physically and more prone to giving me problems like cold hands/feet, trouble sleeping, appetite suppression... I can get stronger dopamine effects from nicotine at lower doses so I have never found it overstimulating. They are both unique in their own ways. I would guess that nicotine is more potent at lowering estrogen and raising dopamine. by the way I get my caffeine from coffee and my nicotine from vaping.
 
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franko

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How is your experience of taking Bromo? Do you notice any change in symptoms/mood from it? When do you take it?

I take it before bed. Which, I think is the doctor-recommended time to nullify any drowsiness side effects. But I have never noticed a drowsiness effect.

Honestly, I've never really noticed any effects from it. I just know it's working from blood tests. I don't have any pain or tenderness in my nipples anymore — that could be due to low prolactin — but it's tricky because any changes could have also been due to the changes in my testosterone or estrogen levels as I have been experimenting with AI's and supplements.

Or, maybe my dosage is not high enough to produce side effects.
 
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I take it before bed. Which, I think is the doctor-recommended time to nullify any drowsiness side effects. But I have never noticed a drowsiness effect.

Honestly, I've never really noticed any effects from it. I just know it's working from blood tests. I don't have any pain or tenderness in my nipples anymore — that could be due to low prolactin — but it's tricky because any changes could have also been due to the changes in my testosterone or estrogen levels as I have been experimenting with AI's and supplements.

Or, maybe my dosage is not high enough to produce side effects.

You are supposed to take bromo in the morning. It is dopaminergic and dopamine peaks in the morning.
 

paymanz

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In studies using bromo for diebetes also they use it in morning ,because it also has good effect on circadian rhythm when taken at that time.
 

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