Advice - Pituitary and Sex Hormone Levels

[anonymous45]

Hi again to all of you helpful people!

Having added a private (medichecks) blood panel to my latest results, I would like some advice regarding the results, and my next steps.

A second cortisol test ruled out Primary Adrenal Insufficiency, and hence I did not have a Short Synacthen Test done. The only result of interest from the blood tests before this appointment was a slightly raised prolactin level - relevant only because low libido is an ongoing symptom.

Test results of significance:

DHEA-S - 4.78 umol/L (5.73 - 13.4)

Prolactin - 328 mIU/L (86 - 324) ALT Unit 15.4 ug/L (4 - 15)

SHBG - 56.2 nmol/L (18.3 - 54.1) [Sex Hormone Binding Globulin]

I note that the recommended reference range for DHEA-S is slightly higher for 20-29 year olds, being 7.56 - 17.28 umol/L. I have also seen that for a young male, prolactin should ideally be 4 - 10 ug/L which is equal to 85 - 210 mIU/L.

Testosterone, Oestradiol, LH, FSH, Albumin are all normal. Free Androgen Index and Free Testosterone are also in range, but on the lower end of it (for my age bracket). I imagine this is primarily due to higher SHBG levels.

I am consdering supplementing DHEA to raise my DHEA-S into the normal range. But I am also persuing the slightly elevated prolactin with my GP (who will liaise with the endo).

My question is this: In the month or so before I next see my GP, would DHEA supplementation be advisable? Do any of you have knowledge of the potential cause of these slightly abnormal results?

Note: I take 75mcg Levothyroxine, and am currently euthyroid (TSH 0.9, fT4 24.1, fT3 5.6 [3.5 - 6.5] ). I am having Vitamin D, Parathyroid Hormone (PTH) tested as a precaution due to slight elevation in serum Calcium. A Coeliac (TTG) test was asked for by my GP also.

[Hidden]

I would ask them to test prolactin as you could have a prolactinoma. What was your latest cortisol result? You say they have ruled out primary adrenal insufficiency but you could still have secondary where the issue is with your pituitary gland. Have they done an ACTh blood test?

[anonymous45 in reply to Hidden]

Prolactin tested twice - both times just over the normal range. But 1.5x the upper ideal level. Could be a small microadenoma, but could also be the low DHEA.

ACTH not tested, so no idea if my low cortisol was due to pituitary or other reason. Too expensive to do privately. Second cortisol was above 400nmol/L which means my adrenal glands are at least capable of producing enough cortisol.

[Angel_of_the_North]

If you are in the UK, you cannot legally supplement DHEA as it is a class C drug - you need a prescription. It can be impounded and you can be fined if you import it - it's classed the same as anabolic steroids. Daft, but true.

[anonymous45 in reply to Angel_of_the_North]

Thanks for the heads up - did not realise that! How bizarre, I'm guessing it was classified under a blanket legislation of drugs/supplements used by bodybuilders?

Melatonin being POM in the UK was a surprise to me, but I have to admit this is the first time I've seen a naturally occuring hormone listed as scheduled/classified.

I guess I'll just have to wait for a prescription if the endocrinologist concurs with my findings!

[Angel_of_the_North in reply to anonymous45]

I'm not saying you can't get it, but that it is not legal. You'll find it here under Prasterone: gov.uk/government/publicati... and this is what happens when you import it: casemine.com/judgement/uk/5... the guy did get another review after paying for a barrister, but I don't know what happened (apart from a lot of expense). I get it on prescription.

[engo]

Hi

I'm currently undergoing tests for hyperparathyroidism.

From my reading up on the subject (google Norman Parathyroid Centre) - calcium level should never be raised above normal - however doctors tend to have the approach that if the level is only slightly raised then it should just be monitored.

Low Libido is one of the symptoms of hyperparathyroidism in a list of symptoms given by above source. Obviously there may be other causes or contributory factors.

Hope you get to the bottom of it soon.

[anonymous45 in reply to engo]

Hey thanks for the reply. I luckily had a parathyroid hormone blood test which revealed a result perfectly in the middle of reference range. My calcium level had fallen a little, just enough to take it into the reference range. I think the high prolactin had a lot to do with the raised calcium.

I'm not closer to revealing the root cause of my issues, but the current suspect is malfunctioning pituitary gland. I'm experimenting with cabergoline to reduce the raised prolactin level. I'm also taking DHEA since my DHEA-S level was quite low and well below the reference range for my age bracket.

Thank you for your kind message, and I wish you the best possible outcome of the PTH test