TRT and Macroprolactinoma (Brain Tumor)

[sundevil87]

Hi all,

I just read the sticky from Megatron and I found it very helpful, but have a few questions for clarification. For my background, I was diagnosed w/ a 2cm macroprolactinoma (brain tumor by pituitary gland) last year. The only hormones that were being affected were my testosterone and prolactin (I didn’t have my estrogen tested). My initial levels were 45ng/dL for my Testosterone, Serum (Normal Reference Interval 348-1197) and 455.6ng/mL for Prolactin levels (Normal Reference Interval 4.0-15.2).

My endo put me on cabergoline 0.5mg 2x a week to try and get my prolactin down, which was supposed to bring my test up. It brought my prolactin down a lot (to around 58 or so) but my test didn't change. She then gave me the option to get on test, which I did around late February of this year. I'm on Axiron and do one pump under each arm daily, and have been doing this daily for the last 4 months or so.

My last blood test from a month ago showed an improvement in my Testosterone, Serum to 95ng/dL which is better, but is still extremely low. My prolactin went down a little bit to 42. I'm definitely feeling the effects of the test, my libido has increased 10 fold and I've been putting on muscle and getting stronger without even lifting.

I saw my endo last week and my tumor shrank a lot (over 50%), I asked her about Estrogen and she told me she would test for it on my next blood test. She said if it is high she wouldn't recommend an estrogen blocker but that if I wanted it she would prescribe it. Also, after reading the sticky I'm definitely going to switch from the Axiron to the injections. I still have a couple of questions for you guys as it seems a lot of you are more familiar w/ hormones, etc. than most endos. 1. Do any of you know how AI's interact w/ Prolactin levels (I suspect my estrogen is super high and I will have my endo prescribe AI's for me, I'll see when I get the blood test done though)? 2. On my last blood test (over 2 months ago) my hematocrit was fine, should I still be donating blood so this doesn't get out of hand in the future? 3. My endo told me not being able to have children was possible after going through with the TRT, also my nuts haven't really shrank that much and I've been on Axiron for 5 months or so. I read that some people use HcG & other stuff to combat this, do you know any effects on prolactin caused by HcG and other stuff?

I'm very glad I found this forum. The tricky part for me is that my endo is very well respected when it comes to treating pituitary tumors, but she doesn't seem that brilliant when it comes to TRT. She does seem very willing to get me whatever I think I need though. She told me one of her other patients was a bodybuilder who had a traumatic brain injury that shut down his pituitary and he basically tells her what he needs in regards to TRT. It's also a little tricky for me because a lot of the stuff I need to take I need to know how it affects prolactin, as that is what is suspected to have caused my tumor.

Thanks for reading my essay and for all your help,

 

[Megatron28]

Here are a few thoughts:

- Why not try to get your Prolactin levels into the normal range? Even leaving it in the 40's would likely have a strong effect on your erections and cause your Natty Testosterone to be low (I know you aren't Natty anymore).

- Definitely check your Estradiol. Normally high TT is what causes the Testosterone to aromatize into Estradiol. Your TT is still VERY low, but it is possible that is due to aromatization. Gels are known to aromatize a lot. But as you said, getting on injections would be ideal for you. Continue to monitor estradiol for as long as you are on TRT.

- Donating blood is always a good idea if you don't suffer from low iron/ferritin issues. It saves lives. The docs like to say it is like "changing your oil". And it will help keep you hematocrit from ever being a problem. It is better to prevent high hematocrit rather than treat it.

- Many guys on TRT have managed to have children. Taking hCG would help maintain testicular size and function. Atrophy doesn't happen overnight. It is a slow gradual process. Other than increasing Estradiol, I do not know of any direct effects hCG has on Prolactin.

 

[sundevil87]

Thanks for the helpful reply.

The end goal of my treatment w/ the endo is to get my prolactin into normal levels. The endo said this could take awhile as my tumor directly affects it. She said as my tumor gets smaller and smaller the prolactin should keep dropping. She has been upping my prescription for cabergoline (dostinex) to go after the tumor harder. The side effects are pretty shitty on it, but I can handle it and it seems to be doing it's job as my tumor has shrank so much. My last blood test where my prolactin was 42 was when I was still taking the cabergoline 2x per week. Over the past 2 months or so I've been taking it 3x per week, and soon I'm going to be taking it 4x per week.

 

[Megatron28]

Thanks for the helpful reply.

The end goal of my treatment w/ the endo is to get my prolactin into normal levels. The endo said this could take awhile as my tumor directly affects it. She said as my tumor gets smaller and smaller the prolactin should keep dropping. She has been upping my prescription for cabergoline (dostinex) to go after the tumor harder. The side effects are pretty shitty on it, but I can handle it and it seems to be doing it's job as my tumor has shrank so much. My last blood test where my prolactin was 42 was when I was still taking the cabergoline 2x per week. Over the past 2 months or so I've been taking it 3x per week, and soon I'm going to be taking it 4x per week.

What side effects from Caber do you experience? Just curious. I have used it at .50mg twice a week and I never noticed any negative side effects.

 

[sundevil87]

I've had nausea, random chest pains, weird hot flashes in random parts of my body, vertigo, and sometimes if I stand up too quickly I feel like I'm going to pass out.