Man - 21 - High prolactin levels?

[lickitung]

Hello
I am a 21 year old man.
I had erectile dysfunction and terribly low libido for 5 years. (no more morning erections :(, half-solid erections)
I recently decided to go to a urologist to check what is wrong.
He ordered testosterone and prolactin dosing.
Results:
Prolactin 21.67ng/mL (normal<18 in men) but shouldn't it be around 8 at my age?
Total Testosterone: 521 (normal between 100something-1000something) but shouldn't it be around 670-700 at my age?
Therefore I have 2 questions:
1- Do I have a hyperprolactinemia? If so, is a microadenoma of the pituitary possible? (remember it's been 5 years now)
2- Are such levels of prolactin and testosterone in a 21 year old man responsible for all these symptoms?

Thank you and happy new year

[lickitung]

I am 21 so no circulatory problems (due to diabetes mellitus for instance). I eat healthy food and don't think I have any kind of trace element deficiency. And concerning the hormone hunt, I really can't find a reason which would explain me having low free T (therefore high SHBG) or abnormal estrogen levels. I have a question. Do drs count on the erectile dysfunction description to classify it or do they all look the same? I mean not being able to have an erection at all when wanting to have one is something; and having a semi-solid erection whenever you want it is something else; add to that the continuous or intermittent loss of morning wood etc. Does for instance hormone-related ED have a specific profile compared to let's say psychogenic ED? This is truly mindboggling.

[solace21]

Hello,
     Thanks for your feed back.May be in this case, you may also have a look at your free T level and estrogen level and if you find them also within range, leave your hormone hunt to rest. Other things you have to worry about are the quality of food you take, does it contain adequate protein and trace elements like zinc, magnesium etc. and if you have any circulatory problem. If you think you are comfortable on this front also, better stop worrying and be happy.

Solace  

[lickitung]

Hello?

[lickitung]

Hello again,
I have some news. I went to my endocrinologist. He's like the god of endocrinology in my country.
Told him the story and mentioned that I've been to a urologist who downplayed my assumptions, yet still asked for Total testosterone and Prolactin tests in order to make me sleep on my laurels.
My endocrinologist said my prolactin level of 21.67 is in the normal range (:S) because prolactin has its ups and downs during the day and only a value of 40+ in a man should be considered elevated (:S).
My testosterone level (521) is normal according to him too.
He palpated my thyroid and said oh you have a goiter. Let's check your thyroid numbers.
TSH normal FT4 normal Anti-TPO negative
I am not hypothyroid. My endo is abroad now. I'll get back to him on february 7th to show him the results of my thyroid lab tests.
This, I fear, puts a dagger in my THIS IS ORGANIC theory :S
I fear I don't have the courage to push my endocrinologist into further investigations since I idolize him and trust him blindly.
Help?

[Memphis483]

I realized that with all the words that I posted earlier I really didn’t state what I meant to get across. This is simple “Cause & Effect”. Your prolactin is high. Maybe by medical standards, it is only slightly elevated but realistically is should be closer to 9 than 21, right? That means that it is likely >twice what it should be & this is definitely a problem. If ones prolactin is high then the effect is that your testosterone levels (in men, estrogen & progesterone in women) WILL be reduced. Now, that may still be within “normal” range (like my hormone levels) but that means that YOUR testosterone has been reduced and so 521 is certainly NOT your normal. (Maybe someone elses normal, but not yours) This is where the medical community fails us most, lumping us all into a box of normal or outside of normal. Just because one person functions perfectly with a 521 level doesn’t mean you will. ….as a matter of fact, you aren’t, right? So, now you & your Endo will just have to figure out what your Pituitary is trying to tell you :)
I do have a question for you, not to pry…but since I am fortunate to have a cousin that has many of the same issues, we talk. I recently found out that both of us have a few symptoms that are not listed anywhere as being a side effect of having high prolactin. We both stay tired, for me it’s not like I don’t function; I just never feel rested & have been that way since my teens. We both also struggle with constipation.  Also, have you ever had a head injury, even a minor one? I had a wreck on a motorcycle when I was 15 and had a minor concussion. I also fell and hit my head when I was 22, this wasn’t serious but I did hit pretty hard. I guess I will always wonder if either accident was the cause of my empty sella, now my pituitary is displaced by cerebral spinal fluid.
Make sure you post what your Endo has to say! You might think about calling your Endo a week or 2 before your appointment & ask if there will be any new or additional blood work that Dr. will want. You can possibly have that done before the appointment so that you will be able to discuss the results while you are there.  Again, Good Luck!

[lickitung]

Hello again,
Nice to hear from you all, especially Memphis483 :)
I'm surely gonna try my best to find an organic cause for the problem I have (low libido + ED). It's basically, like you said, ALMOST shut down. But my problem is the fact that my testosterone levels are "normal" (?) and prolactin MILDLY elevated. Therefore it needs an experienced endocrinologist.
I'm gonna see my endocrinologist (this dr is a legend, if he can't help i'm doomed) on monday :)
Fingers crossed Prolactin is the culprit!
Cheers