Too Low TSH? and does it cause high prolactin in a man

[ainslie]

Hi

Just had some bloods done and my hormone doc (not thyroid expert) says my TSH is too low and my labs show my Prolactin too high. I read that low TSH is normal if on Thyroid meds but wanted to be armed with the proper answer for him when we meet this thursday as he may want to cut my thyroid meds. I am Erfa 3 grains. I dont know why my Prolactin is high , I read that there can be a connection with hypothyroid but if I am on meds presumably that doesnt apply? All advice welcome please.

TSH 0.01 Range0.27-4.2 mU/L

Free T4 17.2 Range 12-22 pmol/L

Free T3 4.51 Range 3.1-6.8 pmol/L

Prolactin 470 Range 86-324 mU/L

Ferritin 105

Vit D 175

B12 889 Range 145-569 pmol/L this reads false high because I have Polycythaemia

[greygoose]

Well, it does apply if you are under-medicated. And, those results suggest under-medication. Your FT4 is only about mid-range and your FT3 less than mid-range. The FT4 is lowish because you're taking NDT with T3, but most hypos need the FT3 higher than that.

Your TSH is also low because of the T3. That's what T3 does, suppressed the TSH because you don't need it anymore. And, if your doctor doesn't know that, he should go back to med school.

Given that you're taking 3 grains of Erfa, your FT3 is surprising low, so I have to ask:

1. how do you take your Erfa? Do you take it on an empty stomach and wait at least an hour before eating, etc.?

2. How do you do your tests? Do you leave a gap of 8 to 12 hours between your last dose of Erfa and the blood draw?

[ainslie in reply to greygoose]

Hi Grey GooseThank you for your message, I take my thyroid with my hydrocortisone and DHEA and Pregnenolone on rising and eat about 30 mins later, I chew the tablets, I was considering increasing to 3.5 grains?. I thought my FT3 was a bit low considering 3 grains but I then read most on meds are on 4-6 grains?. That might have been on Stop the Thyroid Madness possibly.

I test at 9am fasting and last thyroid dose would be previous morning around same time.

[greygoose in reply to ainslie]

If I were you, I'd give up reading on STTM, they talk a load of rot!

OK, so we have two problems, there:

1. Taking your HC, DHEA and pregnenolone at the same time as your Efra is going to seriously compromise absorption. They should be taken at least two hours away from thyroid hormone.

I understand that HC needs to be taken early morning, so how about taking your Erfa at night? You can take it any time, but at least 2 hours away from all the rest. And, it's best if you take it either one hour before food, or two hours after.

2. If you left a gap of 24 hours between your last dose and the blood draw, you actually have a false FT4 and a false FT3 - they're both probably a bit higher than that. It's a gap of 24 hours for T4, but as you cannot separate the T4 from the T3 in Erfa, it's best to just leave 8 to 12 hours.

I somehow doubt that most people are on 4-6 grains - although they would be if they take it like you do! lol We have a lot of people on here just on 2/2.5 grains. But, the important thing is, you need what you need, so forget what other people take, and just find the right dose for you.

[ainslie in reply to ainslie]

thank you for all that info, I think it was Hertoghe who told me to take it all in the morning, never thought about taking the erfa at night, I will try it, hopefully it wont affect my sleep as I dont sleep as well as I would like, I will try it and retest, so If I take it around 11pm and test at around 8 or 9am, interesting never heard of that

[radd]

ainslie,

It's the other way around, ie high TSH correlates with elevated prolactin. Prolactin is directly influenced by TRH that encourages TSH, but controlled by prolactin inhibitor factor. There are other influencing hormones too.

gg has already given you good advice re thyroid hormones. I would just add you may find better utilisation if you split dosed Efra.

Is polycythaemia cause genetic or secondary?

[ainslie in reply to radd]

Hi RaddThanks for info, the Polycythaemia is primary ie Vera, I wonder if that would have any effect on the Prolactin, its odd its so high

[radd in reply to ainslie]

ainslie,

I'm sorry to hear that.

I don't know anything about blood cancers but your suggested link is worth investigating because this person considered a connection too. ... .

'I have recently read that prolactin production is high up on the pathway which includes JAK2 function' healthunlocked.com/mpnvoice...

.

So I googled prolactin + JAK2 gene and came up with loads of hits involving mice which all need interpreting as are a bit beyond my pay grade.

google.com/search?client=sa...

[ainslie in reply to radd]

thanks Rad for kind words, I am used to it now, diag 2010.and thanks for looking out that info on the possible connection, I will have a good read of the links and ask on the other forums I am on for PV and see if anyone else has knowledge