FINALLY - 1 Piece Of The Puzzle Discovered. I Need More Of Your Insight

[Luckytype]

Prolactin.

Dont write me off just with a "duh lucky". Read on a bit.

Long story short 2 years into this battle of multiple physicians refusing to check it because I didn't have gyno. I fought and fought and eventually stretched the truth and said I had intense nipple itch(I did but I had just shaved my chest). I presented as a youthful, healthy, bright but oily skinned young man in his twenties(im 33) and 2 years ago lean and muscular with no sexual dysfunction. Classic book by its cover.
I pushed and pushed and pushed. The PA caved and added CRP and the cortisol test.

Today I finally received my results and I would like some insight.
Background cliff notes:
Chronic exerciser
Aggressive diet cutter
Poor years of nutrition
Stressful job and life until 2 years ago when the "switch was flipped"

Been peating hybrid

33yr old male, weight of 194-201(Up 30 soft pounds since this all crap started) - huge change in body comp sadly.

Todays results
TSH - 2.72 (up from 1.29 in april of 2017)
T4 free .90 (range of .8 to 1.8)
T3 .91 (range of 75-165)
Vit D 27 (down oddly from 39 in april 2017 - though ive been supplementing and tanning here and there)
B12 1700
Test 550 (down from 630 in april 2017)
Free test 19.25 (range of 5-21)
Fr Test %(bound?) 3.5 (1.5 - 4.2)
CRP .47 (range .20 - 10.0
Prolactin 18.2 (range 0 - 17ng/ml)
Cortisol 4 point 24 hour - awaiting salivary
This would explain a ton of things

FINALLY. Since doing the research I have been living a life of trying to lower prolactin via food and lifestyle for about a year now. I am on a gym elimination stint.

At this point its pretty fair to assume I am going to need some assistance here. If I am honest I just can't see these people prescribing even the most common well tolerated things for lowering PRL.

Can I have some suggestions or setups of supplemental things. I am nearly cypro and some metergoline. I am assuming, probably poorly, that cabergoline may be prescribed. The PA may also request bloodwork as a followup in 6 weeks. I would ask to check E levels but will likely hear a "NOPE, no breasts, youre a male etc"

I plan on doing low and slow cardio for a few days a week to start to work down cortisol. My diet is nutrient dense, high in calcium, liver, scallops, ADEK, mag, zinc etc with extra salt in food p5p, Vit E. Calories are good food I really think is dialed in. I feel like I maybe should bump up some of the other vits/mins.

I'm considering:
Thyroid small amounts
Metergoline
Lisuride
Cypro

Curious to successful regime of those who have effectively lowered PRL.



I want my life back, I finally have a piece as to why(assuming its not a prolactinoma).

Thanks a TON for everything so far on this forum.

What a relief...I literally thought I was crazy. THANK YOU!

 

[mayweatherking]

check out magnesium intake, get enough calcium, vitamin D should be between 50 to 60

Blocking Tissue Destruction
Calcium and Disease: Hypertension, organ calcification, & shock, vs. respiratory energy

 

[Luckytype]

So on the VitD thing should I then be megadosing basically? Ive been on like 5k IU a day. Maybe bump to 8k a day? Ive truly been trying my best but I dont know what is using so much of it.

 

[Stilgar]

How’s your gut? Serotinin is a major contributor to elevated prolactin.

 

[Blossom]

Prolactin 18.2 (range 0 - 17ng/ml)

Do you currently take p5p? Peat has mentioned small amounts of B6 (@10mg) for lowering prolactin. I've used b6 myself for this purpose. I highly doubt the medical establishment will do anything at all for a prolactin level of around 18ng/ml. I'm not trying to be negative but generally it seems anything below 50 isn't viewed as being of concern at all by medical workers and you would probably need levels of greater than 100 to get an MRI to see if there is a prolactinoma. I think your prolactin can be reduced with attention to optimizing metabolism. I have a history of prolactinoma myself and have not had to take large amounts of medicine since discovering Peat. Every now and then I take small amounts of bromocriptine or lisuride but generally I can keep it in check with diet, b6 and thyroid.

 

[Luckytype]

How’s your gut? Serotinin is a major contributor to elevated prolactin.

How would I evaluate it? Im regular, consistency of elimination aside from lately is good. I have no digestive issues whatsoever with any foods and generally speaking im rarely gassy. Im doing charcoal and carrot alternated as well.

Do you currently take p5p? Peat has mentioned small amounts of B6 (@10mg) for lowering prolactin. I've used b6 myself for this purpose. I highly doubt the medical establishment will do anything at all for a prolactin level of around 18ng/ml. I'm not trying to be negative but generally it seems anything below 50 isn't viewed as being of concern at all by medical workers and you would probably need levels of greater than 100 to get an MRI to see if there is a prolactinoma. I think your prolactin can be reduced with attention to optimizing metabolism. I have a history of prolactinoma myself and have not had to take large amounts of medicine since discovering Peat. Every now and then I take small amounts of bromocriptine or lisuride but generally I can keep it in check with diet, b6 and thyroid.

I do daily yes. I have been using all the "regular" vitamins in the best form I can as a way to hopefully help this.

To be frank, these idiots hold their "within range" so dearly I am fingers crossed that they see it and "OH NO WE NEED TO HELP HES OUT OF OUR PRECIOUS RANGE". Sadly the PA almost refused to test because its 'not good medicine practice' - k lady. What determines your use of lisuride vs bromo? I have been reaching toward optimizing everything I can for nearly 2 years and have only slowly gotten worse.

 

[Blossom]

To be frank, these idiots hold their "within range" so dearly I am fingers crossed that they see it and "OH NO WE NEED TO HELP HES OUT OF OUR PRECIOUS RANGE". Sadly the PA almost refused to test because its 'not good medicine practice' - k lady. What determines your use of lisuride vs bromo? I have been reaching toward optimizing everything I can for nearly 2 years and have only slowly gotten worse.

Sadly even considering I have a documented history of a pituitary adenoma I have had difficulty getting medical workers to order a prolactin lab test. I've just been checking it myself as needed for the last 3 years. I honestly got tired of begging doctors for the lab test. I'm not sure if this helps any but when ever I have recurring scalp itch, increased hair shedding or breast discomfort that doesn't resolve quickly (within a few days) I start monitoring my temp and pulse. I haven't checked my prolactin in over a year but a couple months ago I started back on thyroid and b6 and my symptoms resolved in a couple days. Earlier on in my Peat journey I needed medicine (although much lower doses than my pre-Peat days) for the same symptoms to resolve. The more time that passes the easier it has become to lower my prolactin with simple things like making sure my diet is dialed in and my thyroid levels are adequate. IIIRC Peat has mentioned a prolactin level of 4-7ng/ml as optimal for males.

 

[Luckytype]

Do you recall why you went on thyroid? Specifically prl?

I think the worst thing for me is the state I live in doesn't allow direct to consumer tests so im SOL as of now. Sounds like youre in one of those states too.

 

[Blossom]

Do you recall why you went on thyroid? Specifically prl?

I think the worst thing for me is the state I live in doesn't allow direct to consumer tests so im SOL as of now. Sounds like youre in one of those states too.

I originally went on thyroid because of hypo symptoms and Peat's emphasis on it as a tool for restoring the metabolism. I think it helps with prolactin in my case by keeping the pituitary in check. By the time I stumbled upon Peat's work I had over 40 years of poor health starting with undiagnosed celiac and malnutrition/malabsorption that impacted my metabolism and hormones and I had progressed to the stage of having some random tumors one of which was on my pituitary so I like to keep my TSH low so my pituitary stays quiet. By taking thyroid I find it helps keep me out of a stress hormone dominated metabolism. I hope that makes sense.

 

[Luckytype]

I really need to find a "flow chart" of sorts of what issues to address first or in what order. Hopefully someone can chime in. I definitely have what are hypo symptoms with regard to fatigue and temps(which havent risen at all) but obviously I have this PRL issue, and id bet the farm a cortisol issue.

I don't know what to do first since my nutrition stuff is basically in order and has been for a long time. Thanks for your inputs so far

 

[Dhair]

I really need to find a "flow chart" of sorts of what issues to address first or in what order. Hopefully someone can chime in. I definitely have what are hypo symptoms with regard to fatigue and temps(which havent risen at all) but obviously I have this PRL issue, and id bet the farm a cortisol issue.

I don't know what to do first since my nutrition stuff is basically in order and has been for a long time. Thanks for your inputs so far

Pituitary dysfunction is rough. Lowering your prolactin may help, but I don't know that it will make you feel 100%. You almost certainly don't have a prolactinoma with your levels. 18 is definitely too high, but not dangerously, worryingly high IMO, and I doubt a doc will prescribe you a dopaminergic drug (due to their incompetence). My prolactin was 6, with a depressingly low T level of 243 ng/dl almost a year ago, and I am almost a decade younger than you. I had my levels checked a month ago, and my prolactin was 13 with a total T level of 264ng/dl. Now, obviously in my case lowering my prolactin won't make me feel significantly better, because when my prolactin was 6, my T was still cripplingly low and I felt awful. Not trying to rain on your parade. It may make a significant difference in your case, especially considering the fact that you are starting with much higher T than me, but you might lower your expectations . Just thought I could offer some insight as our issues seem to be similar. Good for you for finally getting the test done.

 

[Such_Saturation]

Unfortunately I doubt they will do anything for 1 point over range. But what exactly has changed for you personally now that you know you are slightly over the range?

 

[Blossom]

Peat has said (paraphrasing) that he has never seen anyone in good health with a tsh above 2.

Have you ever used Cronometer dot com to track your nutrition?

 

[Blossom]

Have you read through the wiki?
New to Peat: How to get started? - Ray Peat Forum Wiki

 

[Blossom]

From the forum wiki, Ray Peat's response to an email.
"With your TSH so high, you should probably add a thyroid supplement, until you get it down to about 1.0, or less. (The normal range, according to the American Association of Clinical Endocrinologists, is from 0.3 to 3.0.)"

Do you know your cholesterol by any chance?

 

[Luckytype]

Peat has said (paraphrasing) that he has never seen anyone in good health with a tsh above 2.

Have you ever used Cronometer dot com to track your nutrition?

Yep Daily

Unfortunately I doubt they will do anything for 1 point over range. But what exactly has changed for you personally now that you know you are slightly over the range?

Now its because I dont know if its on the way down or up or has been this high. I think the issue other diags have only worsened since the last bloodwork I have.

As far as what has changed? Obviously nothing for the better, but now I have an idea as to why my hair is shedding, im exhausted and cold and overall feeling lower and lower. I have been so optimistic for so long believing just the diet interventions would at least assist...

Have you read through the wiki?
New to Peat: How to get started? - Ray Peat Forum Wiki

I will go through this again in case i missed something

From the forum wiki, Ray Peat's response to an email.
"With your TSH so high, you should probably add a thyroid supplement, until you get it down to about 1.0, or less. (The normal range, according to the American Association of Clinical Endocrinologists, is from 0.3 to 3.0.)"

Do you know your cholesterol by any chance?

It was lowish when it first started (120ish) then I was able to get it up closer to 200+ by april of 2017.

 

[Luckytype]

Pituitary dysfunction is rough. Lowering your prolactin may help, but I don't know that it will make you feel 100%. You almost certainly don't have a prolactinoma with your levels. 18 is definitely too high, but not dangerously, worryingly high IMO, and I doubt a doc will prescribe you a dopaminergic drug (due to their incompetence). My prolactin was 6, with a depressingly low T level of 243 ng/dl almost a year ago, and I am almost a decade younger than you. I had my levels checked a month ago, and my prolactin was 13 with a total T level of 264ng/dl. Now, obviously in my case lowering my prolactin won't make me feel significantly better, because when my prolactin was 6, my T was still cripplingly low and I felt awful. Not trying to rain on your parade. It may make a significant difference in your case, especially considering the fact that you are starting with much higher T than me, but you might lower your expectations . Just thought I could offer some insight as our issues seem to be similar. Good for you for finally getting the test done.

Im really sorry to hear that. What do you think the difference in your case was? Prl functioning independent of your T? Perhaps something is bringing T down but prl is high for a seperate reason. What would your doc think about getting the prl down but maybe trying some Hcg(not sure on your age here aorry)?

I cant help but think my prl has been rising ever since "the day" and now my T and thyroid are suffering. Nothing else makes any sense. Everything has suffered.

I absolutely hate that I have no idea on anything before this range of tests.

I think lucky for us we have things like pubmed, the forum and guys like @haidut

 

[Dhair]

Im really sorry to hear that. What do you think the difference in your case was? Prl functioning independent of your T? Perhaps something is bringing T down but prl is high for a seperate reason. What would your doc think about getting the prl down but maybe trying some Hcg(not sure on your age here aorry)?

I cant help but think my prl has been rising ever since "the day" and now my T and thyroid are suffering. Nothing else makes any sense. Everything has suffered.

I absolutely hate that I have no idea on anything before this range of tests.

I think lucky for us we have things like pubmed, the forum and guys like @haidut

You can read about what caused my problems in a couple threads I started. Basically I was poisoned by doctors. I won't get it into here because I don't want to hijack your thread.
Anyway, for your situation, I think it might be a good idea to try thyroid and low dose lisuride (50-75mcg). If thyroid works for you then you'll be killing 2 birds with one stone because thyroid lowers prolactin. Lisuride is very safe and is easier to obtain that bromocriptine. It also has less side effects.

 

[Blossom]

Anyway, for your situation, I think it might be a good idea to try thyroid

That's what I was thinking too.

 

[Luckytype]

I have been on the fence(waiting until i got some test answers) and talked to many regarding thyroid. I was considering the t3/t4 mix and coupling it with small amounts of cypro(to maybe aid in sleep)and or metergoline here and there. I am aware of the responses with thyroid and dopamine agonists if careless.

This may sound ignorant but could my body be stuck in a crappy feedback loop? To be frank I was hoping for improvement considering how much better i try to treat myself since this all started. I seriously dont get it, it got worse..not even better..