New bloodwork. Still failing to lower prolactin and others.

[franko]

Seeking opinions on how to deal with my high prolactin (and likely high tissue estrogen) high RBC and high ALT, and my elevated Hematocrit & Creatinine.

Also, high Cholesterol & Triglycerides and C-Reactive Protein (CRP).

Male, 27 yrs old
5'11" 200lbs

Symptoms
• constipation (remedied with thyroid)
• fatigue/social anxiety/depression (remedied with exemestane via higher testosterone)
• minor gynecomastia
• male pattern balding
• belly fat
• burst capillary or spider vein-type things near armpits and upper thighs
• heavy coughing at night lately (remedied with benadryl)

Daily Supplements
• 25mg exemestane
• 1 grain thyroid
• 400 IU Vitamin E
• 500:100 mcg Vitamin K2 MK4:MK7
• 4800 IU Vitamin A
• 300mg Magnesium
• 10mg Zinc
• 5 sprays SolBan
• 40 drops Energin

Diet
• Carbs: ~300g
• Fat: ~45g
• Protein: ~85g

Here are my bloodwork test results and a chronometer overview of a typical day's diet over this past month (click the gear in the top right corner and select 'View Full Resolution'):

Note that my Testosterone, Estradiol, LH, FSH and SHBG is with daily exemestane because that's how I've been treating my low T. Before using AI's, I had T levels of around 400 and normal LH & FSH.

Note that my relatively good thyroid numbers are with daily thyroid because that's how I've been treating constipation. Before thyroid, I had a TSH of 4.6 and normal T4 and T3.

Note about my diet: Now that I've actually gone to the trouble of measuring it, I don't think my protein was that high before. It was not that big of a difference keeping it to around 90g per day. The biggest difference was probably that I was eating much lower fat and had to compensated by eating much more carbs than typical. 100g of fat (from saturated fat sources like dairy and beef) in a day was probably typical in my previous diet.

You can see my previous bloodwork results here: viewtopic.php?f=15&t=6584&p=106315

 

[answersfound]

post 113366 Seeking opinions on how to deal with my high prolactin (and likely high tissue estrogen) high RBC and high ALT, and my elevated Hematocrit & Creatinine.

Also, high Cholesterol & Triglycerides and C-Reactive Protein (CRP).

Male, 27 yrs old
5'11" 200lbs

Symptoms
• constipation (remedied with thyroid)
• fatigue/social anxiety/depression (remedied with exemestane via higher testosterone)
• minor gynecomastia
• male pattern balding
• belly fat
• burst capillary or spider vein-type things near armpits and upper thighs
• heavy coughing at night lately (remedied with benadryl)

Daily Supplements
• 12.5mg exemestane
• 1 grain thyroid
• 400 IU Vitamin E
• 500:100 mcg Vitamin K2 MK4:MK7
• 4800 IU Vitamin A
• 300mg Magnesium
• 10mg Zinc
• 5 sprays SolBan
• 40 drops Energin

Diet
• Carbs: ~300g
• Fat: ~45g
• Protein: ~85g

Here are my bloodwork test results and a chronometer overview of a typical day's diet over this past month (click the gear in the top right corner and select 'View Full Resolution'):

http://imgur.com/a/1S1pl

Note that my Testosterone, Estradiol, LH, FSH and SHBG is with daily exemestane because that's how I've been treating my low T. Before using AI's, I had T levels of around 400 and normal LH & FSH.

Note that my relatively good thyroid numbers are with daily thyroid because that's how I've been treating constipation. Before thyroid, I had a TSH of 4.6 and normal T4 and T3.

Note about my diet: Now that I've actually gone to the trouble of measuring it, I don't think my protein was that high before. It was not that big of a difference keeping it to around 90g per day. The biggest difference was probably that I was eating much lower fat and had to compensated by eating much more carbs than typical. 100g of fat (from saturated fat sources like dairy and beef) in a day was probably typical in my previous diet.

You can see my previous bloodwork results here: viewtopic.php?f=15&t=6584&p=106315

Broda Barnes typically started larger men and women on 2 grains, so I would definitely increase the dose given that your TSH is still above 1. You want TSH under 1. I think prolactin decreases as TSH comes down. Also I would consider Haidut's Pansterone supplement. Since you are young, you could do just 5 mg topically each day. This should help reduce estrogen. Or you could do 30-50 mg pregnenolone per day. It's up to you as to what you are comfortable with. Also I don't see any Vitamin D? And you didn't mention temperature and pulse, which is more important than lab work usually.

 

[haidut]

post 113366 Seeking opinions on how to deal with my high prolactin (and likely high tissue estrogen) high RBC and high ALT, and my elevated Hematocrit & Creatinine.

Also, high Cholesterol & Triglycerides and C-Reactive Protein (CRP).

Male, 27 yrs old
5'11" 200lbs

Symptoms
• constipation (remedied with thyroid)
• fatigue/social anxiety/depression (remedied with exemestane via higher testosterone)
• minor gynecomastia
• male pattern balding
• belly fat
• burst capillary or spider vein-type things near armpits and upper thighs
• heavy coughing at night lately (remedied with benadryl)

Daily Supplements
• 12.5mg exemestane
• 1 grain thyroid
• 400 IU Vitamin E
• 500:100 mcg Vitamin K2 MK4:MK7
• 4800 IU Vitamin A
• 300mg Magnesium
• 10mg Zinc
• 5 sprays SolBan
• 40 drops Energin

Diet
• Carbs: ~300g
• Fat: ~45g
• Protein: ~85g

Here are my bloodwork test results and a chronometer overview of a typical day's diet over this past month (click the gear in the top right corner and select 'View Full Resolution'):

http://imgur.com/a/1S1pl

Note that my Testosterone, Estradiol, LH, FSH and SHBG is with daily exemestane because that's how I've been treating my low T. Before using AI's, I had T levels of around 400 and normal LH & FSH.

Note that my relatively good thyroid numbers are with daily thyroid because that's how I've been treating constipation. Before thyroid, I had a TSH of 4.6 and normal T4 and T3.

Note about my diet: Now that I've actually gone to the trouble of measuring it, I don't think my protein was that high before. It was not that big of a difference keeping it to around 90g per day. The biggest difference was probably that I was eating much lower fat and had to compensated by eating much more carbs than typical. 100g of fat (from saturated fat sources like dairy and beef) in a day was probably typical in my previous diet.

You can see my previous bloodwork results here: viewtopic.php?f=15&t=6584&p=106315

Couple of things. ALT is still high but not in the ranges where it would mean liver damage. Taking taurine, glycine, caffeine, vitamin K2, theanine, biotin, thiamine, riboflavin, etc have all been shown to lower ALT. The first 4-5 of the list are especially powerful.
Your free testosterone is high while your total testosterone is close to the lower end of normal. Despite what you may hear on boards, it is your total testosterone that matters and the higher the free testosterone the less able it is to get into the cell and do its good. Given that LH/FSH are high it suggests gonads are not producing enough hormone and your pituitary is pushing them to produce more. Hypothyroidism is one known cause and the fact that your cholesterol is high confirms that not much of it is converted into steroids. The high RBC could be from the high free testosterone but it's hard to tell while you are taking exemestane.
Anyways, I think taking care of that ALT is worth it and the exemestane is likely not doing you any good so you can probably drop it. Given the high prolactin and low total T, something like bromocriptine could have a much bigger effect on your health. Have you talked to your doctor about getting some bromo, especially considering he knows you have high prolactin?

 

[tara]

post 113366 • heavy coughing at night lately (remedied with benadryl)

There could be other things going on with this, but low CO2 and coughing can be mutually reinforcing. Holding breath just until it starts to get uncomfortable after every time you cough, and from time to time when you think of it, can be one way to help interrupt this. Also ensuring mouth stays shut at night, by mechanical means if it is not habitual. I used tape for a while to retrain this.

I used to get dragged out dry coughing for a couple of weeks after a cold, and now it is usually much shorter.

Have you been eating such a low calorie diet for a long time? It may be that a little more thyroid supp would be helpful down the track, but I would be concerned about boosting thyroid more with a low fuel/nutrient supply. Low calorie dieting can contribute to reduced thyroid function and related disregulation of other hormones. If you try push thyroid up without adequate fuel, the body may take defensive action to counteract it.

 

[franko]

Broda Barnes typically started larger men and women on 2 grains, so I would definitely increase the dose given that your TSH is still above 1. You want TSH under 1. I think prolactin decreases as TSH comes down. Also I would consider Haidut's Pansterone supplement. Since you are young, you could do just 5 mg topically each day. This should help reduce estrogen. Or you could do 30-50 mg pregnenolone per day. It's up to you as to what you are comfortable with. Also I don't see any Vitamin D? And you didn't mention temperature and pulse, which is more important than lab work usually.

I will consider upping thyroid to 2 grains. Perhaps I will try it and see if I feel a difference.

I actually have Pansterone already but it irritates my skin — been meaning to inquire about that — might be the DMSO. Will look into that further.

I'm taking EstroBan now so Vit D should be covered with that. I've never noticed any changes when supplementing Vit D and had a blood test once that showed normal levels so I haven't been very enthusiastic about it.

I take my pulse occasionally and usually get between 70-80 bpm. I haven't tracked temperature in quite some time. When I haven't eaten in several hours I feel and get cold hands and feet so I don't need a thermometer to tell me that. But perhaps it would be useful to get a baseline temp reading every now and then.

Thank you for your input.

 

[franko]

Couple of things. ALT is still high but not in the ranges where it would mean liver damage. Taking taurine, glycine, caffeine, vitamin K2, theanine, biotin, thiamine, riboflavin, etc have all been shown to lower ALT. The first 4-5 of the list are especially powerful.
Your free testosterone is high while your total testosterone is close to the lower end of normal. Despite what you may hear on boards, it is your total testosterone that matters and the higher the free testosterone the less able it is to get into the cell and do its good. Given that LH/FSH are high it suggests gonads are not producing enough hormone and your pituitary is pushing them to produce more. Hypothyroidism is one known cause and the fact that your cholesterol is high confirms that not much of it is converted into steroids. The high RBC could be from the high free testosterone but it's hard to tell while you are taking exemestane.
Anyways, I think taking care of that ALT is worth it and the exemestane is likely not doing you any good so you can probably drop it. Given the high prolactin and low total T, something like bromocriptine could have a much bigger effect on your health. Have you talked to your doctor about getting some bromo, especially considering he knows you have high prolactin?

I will incorporate those supps for liver support / lowering ALT. Some of them I already have or am already taking so that will be easy enough.

My doc actually prescribed bromocriptine a while ago and I still have it. And since I just got bloodwork, now would be a good time for me to try taking it consistently — the prescribed dosage was 2.5mg per day — and get tests again in a month or two in order to see what effect it has. I am motivated to try a different approach so I think will try dropping the exemestane and adding the bromo and see what happens.

Thanks!

 

[franko]

post 113429

post 113366 • heavy coughing at night lately (remedied with benadryl)

There could be other things going on with this, but low CO2 and coughing can be mutually reinforcing. Holding breath just until it starts to get uncomfortable after every time you cough, and from time to time when you think of it, can be one way to help interrupt this. Also ensuring mouth stays shut at night, by mechanical means if it is not habitual. I used tape for a while to retrain this.

I used to get dragged out dry coughing for a couple of weeks after a cold, and now it is usually much shorter.

Have you been eating such a low calorie diet for a long time? It may be that a little more thyroid supp would be helpful down the track, but I would be concerned about boosting thyroid more with a low fuel/nutrient supply. Low calorie dieting can contribute to reduced thyroid function and related disregulation of other hormones. If you try push thyroid up without adequate fuel, the body may take defensive action to counteract it.

For me the coughing started with a cold and has lasted a couple weeks. The anti-histamine helps a lot but I will experiment with those C02 methods as well.

I actually didn't realize I was eating low calorie until I tracked it. I'm not consciously trying to eat low calorie I assumed I wasn't because I am eating when hungry and eating till I'm full, but I guess I have been eating semi-low calorie for a long time. I think the high fat content probably contributed to lower calories in my diet because of the satiation, so I think I will be getting more calories now that I'm getting more carbs. I will keep tracking to make sure I am getting enough calories, especially before upping the thyroid, if I even do that.

Thanks!

 

[James_001]

What is your exemestane dose? thanks

 

[goodandevil]

Increase vitamin A?

 

[franko]

Couple of things. ALT is still high but not in the ranges where it would mean liver damage. Taking taurine, glycine, caffeine, vitamin K2, theanine, biotin, thiamine, riboflavin, etc have all been shown to lower ALT. The first 4-5 of the list are especially powerful.
Your free testosterone is high while your total testosterone is close to the lower end of normal. Despite what you may hear on boards, it is your total testosterone that matters and the higher the free testosterone the less able it is to get into the cell and do its good. Given that LH/FSH are high it suggests gonads are not producing enough hormone and your pituitary is pushing them to produce more. Hypothyroidism is one known cause and the fact that your cholesterol is high confirms that not much of it is converted into steroids. The high RBC could be from the high free testosterone but it's hard to tell while you are taking exemestane.
Anyways, I think taking care of that ALT is worth it and the exemestane is likely not doing you any good so you can probably drop it. Given the high prolactin and low total T, something like bromocriptine could have a much bigger effect on your health. Have you talked to your doctor about getting some bromo, especially considering he knows you have high prolactin?

I have created a new thread with my latest bloodwork: [bloodwork] Bromocriptine Lowered My Prolactin. Alt & Creatinine Still High. | Ray Peat Forum

I would greatly appreciate your thoughts again, @haidut.

 

[franko]

Increase vitamin A?

I got a Vit A blood test and it was actually high. See above post for that update / bloodwork.

What is your exemestane dose? thanks

25mg/day