low testosterone/Hypothyroidism

[rohit_786]

I need some help here , i like to first tell some history and then my question.

In last three years back i diagnosed Hypothyroidism due to positive TPO (ab) , if i remember even before diagnosed to Hypothyroid i have week errection and less morning errection but i always thought it is because of stress or lot of work or weight gain but never took it seriously .
Since last three year the problem is even worst i can get errection but ejaculate within minute or less and worrying too much about my sexual performance which make things worst even more . I have been complaining my doctor headaches/dry skin/loss of muscles mass ,brain fog and muscles and joint pain . Since last three years we have been pointing  finger to thyroid and adjusting dose which is also going up and down.I changed many Endo at last , the current endo asked me to do more test, which are hormone test, results are below

Dec 08
Total Testosterone =235 (241-827)
Free Testosterone = 59 (52-99)
LH 3.5 (1.5-9.3)
FSH 1.6 (1.2-18.1)
Prolactin 24
TSH 1.27 (.6-3.5)
FT4 1.37 (0.6-1.8)

My Endo wanted to MRI to make sure there is no prolactinoma, in MRI it came back with 6mm adenoma . She thinks my testosterone level is low because of high prolactin although it is not significantly high.

I had Neurosurgeon appointment on Friday , he thinks they should repeat prolactin couple of times before start bromocriptine as i have quite of side effects like headaches, all the time dizzy and fatigue.

Jan 09 Test result

Total Testosterone 216 (241-827)
LH 4.4 (1.5-9.3)
FSH  2.2 (1.4-18.1)
Free testosterone is waiting
Prolactin 0.2 (3-18)

According to my neuro if prolactin dropped down significantly that means no prolactinoma , and it was slightly elevated because of stress as it s a stress hormone also.

Now question is why my testosterone is low which is still unanswered , i have endo appointment on Monday  but i like to do my own research before i go to him , My questions are below.

1. Is testosterone level low can be because of prolactin and when prolactin went down using drug , does it longer to have testosterone to go up ?

2. My testosterone level can be reason of shrink testes and penis size in width and length ?

3. Is low testosterone can be the reason of following symptoms , muscles mass loss , muscles pain/joint pain and fatigue and last of concentration and low sexual libido and mood swing.

4. I have one daughter and my wife wants more kids , does testosterone therapy is advisible ? if not what could be the treatment .

5. How long will treatment take to improve quality of life and give me sexual life back

6. Can be possible my Free T3/T4 are in mid normal , can be reason for those symptoms , should i ask my Endo to increase my levoxyl or start little bit of T3 , any experience in this side ?

[rohit_786]

That is what my neuro said my prolactin was not very high but my Endo said if you have signs of microadenoma then prolactin went down because of bromo , so still have a chances of pituitary dis-order but i am not very convince so she stopped bromo for a month to see level as my prolactin did go down to 0.2  now after taking 1 month of bromo (2.5)mg).
Is there any other male dealing with similar issue ?

[estrelinha]

I meant Transferrin Saturation (TS) and ferritin levels for haemochromatosis (don't think it is but TS is important to measure even if ferritin is normal).
About prolactin could be the cause (if it was much higer) but in my opinion it wasn't high enought to give low testosterone, but you really have a microadenoma....(so still a possibility).., I would go to an urologist just to be sure nothing else is missing......

[rohit_786]

Yes doctor did test Cortisol level which came back normal above range  and also tested Ferritin level for Iron . I have not seen Urologist for testicular dis-order as per my Endo , it seems like a pituitary dis-order issue which are causing low testosterone. She stopped Bromocriptine for a month to see if my prolactin increase above normal range to confirm prolactinoma.

I am going to start exercise to see if that help me as i am not doing it for last 4 years or so.

[estrelinha]

Low levels of testosterone are linked to muscle and bone loss, coronary artery disease, diabetes, depression, erectile dysfunction and loss of self-esteem.

The problem here is to diagnose the cause of low testosterone:
1 - could be, high prolactin can give low testosterone
2 - Yes
3 - yes
4 - It depends if you are really low testosterone , usually it is low when the levels are lower then 200 (so you're borderline) and when men have testosterone levels between 200-350, should repeat the test (total and free testosterone), so you're still waiting for the free testosterone, so may be you need to repeat again.
5 - It depends
6 - Your thyroid values are normal

Did you go to an Urologyst (to see if you have Testicular Disorders)? Have you tested for adrenal hormone cortisol, iron in blood (Haemochromatosis)?