Blood results and do not agree docs diagnosis

[NI2345]

Hi

I went to my doc after feeling very run down, tired, low sex drive, in need of much more sleep, shorter tempered and finding it much more difficult to lose fat through diet and exercise. I had a full blood panel. All results were normal other than hormonal. Here are some of the notable results:

TSH 4.73mU/L (range 0.27-4.20)
Prolactin 656 uIU/ml (range 86-324)
Testosterone 10.8 nmol/l (range 7.6-31.4)
DHEA 9.4 umol/L (range 2.6-7.7)

As you can see, high prolactin, high TSH, low testosterone, high DHEA. To note I am a 24yr old male, in very good health and good level of fitness.

I was referred to an endo, and had more blood tests:

I then had fasted tests first thing in the am after a good nights sleep:

TSH 2.86 uIU/mL (range 0.35-4.94)
Prolactin 310 mU/L (range 86-324)
Testosterone 19.1 nmol/l (range 9-30)
DHEA 6.2 umol/L (range 2.8-12)

He told me I'm within ranges and sent me packing. I had a second test with the same doc for prolactin and TSH only and they were similar to the second set.

I understand Im within range, but also feel ranges are a bit useless, they completely ignore I'm a healthy 24year old male. Also I'm still having problems I had before.

I asked about treatment such as dopamine agonists, whilst he agreed it was relevant, he said with levels within range, better to come back in 6 months and retest, which I am not willing to wait, I'd prefer to self medicate under this particular circumstance.

Have full blood tests if you feel any other figures are relevant. Would appreciate any advise (not just see another doctor if possible - I will likely do so, but its very expensive to do so and want to minimise this).

Thanks

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[Dalubaba]

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[solace21]

Hi,
   It appears your symptoms are sub clinical to be seen by the diagnostic tests. You could get an MRI of the brain and T3/T4  levels and check if they are Ok. Most likely, those will be also alright. Also have you checked your cotisol level ?
May be I would guess you need to get more sleep, try to sleep by 10 PM and get up early if required. Reduce your exercise level if you are overdoing it. Also trim down a bit of your protein intake. Do some breathing and relaxing exercises to refresh your brain. Rest I think would get settled on their own.

Solace

[NI2345]

Thanks solace

I did have my glucose done. It measured 5.2nmol/L fasting and 5.1 non fasting.

Oestradiol was 45pmol/L
Shgb was 36nmol/L

Only supplements I take are whey protein.

[solace21]

Hi,
   Thanks for the feedback. A few more things I would like you to look at :

Have you done a complete blood glucose test?, if not please do it. You need to check both fasting as well as postprandial glucose levels, it may appear silly, but it is very important.

If glucose levels are Ok, next, you should take a closer look at your adrenal glands to see if anything wrong with them. Monitor also your blood pressure closely.

And finally, may be you need to do an MRI of the brain  to see if pituitary is in order, since in the first readings, your FSH, DHEA and Prolactin are all on high side, the common factor being the pituitary gland.

Have you also got your readings on SHBG and Estrogen levels ?. Since your testosterone levels in the first readings are on low side, higher values of these can also affect good health. By the way are you taking any food supplements as a part of your body building activity, sometimes these can also alter an otherwise balanced hormone levels.

I am writing all these since you are not willing to wait for six months as per your doctor's advice. In any case, I strongly advise you against any self medication.

Solace

[NI2345]

Thanks for reply Solace

My diet is very healthy and always has been. My other readings such as cholesterol and zinc etc are perfectly healthy. My BMI is high but that because I work out, it's around 26.5. But in terms of body composite its an inaccurate reading for me, I'm low in bodyfat.

Medications - none at all.

Sleep - I used to sleep 5-6hrs per night on weekdays 7-8 on weekends. Now I recently need much more 6-8 weekdays and 8-9 weekends.

My issue is, there is no change in lifestyle to be made for the levels to naturally occur. And even 310 level is on the high side, and even though the doc says prolactin shouldn't fluctuate much, it is for me it appears.

[solace21]

Hi,
   Since your readings are on a boarder line high, doctors may not give you any medicine. For boys, a two fold increase in prolactin is not considered a problem at all, I hope they are right and that it may get adjusted by itself just by a change of life style as you have already seen through your second set of readings. Therefore, it will be worth waiting for a period of six months and do a retest if symptoms persist.

How many hours of good sleep do you get every day? I hope you take reduced carb in your diet and also take more fruits and vegetables. What is your BMI status? Are you on any medications? As regards thyroid health , I feel it is better to take readings of T3/T4 at least once, since TSH alone may not indicate how functional the thyroid is.

You can also consult a dietitian in the mean time and check up if you need to make any modifications in your diet in the context of the health readings. You may also check if  your zinc intake in particular is adequate.

Solace