High Prolactin levels

Medical Q&A [Moderated]
1

Hello Docs,

First of all thanks again for the great content you guys put out. I want to ask a question regarding a high prolactin reading I got during some lab tests I had.

I’m a male, 30yo, 175cm/5’88 height. 114kg/252lbs, 115cm/45inch waist.

After running mostly Powerbuilding templates, I switched to BBII 8 months ago with great success.

During the last 3 months, however, I have noticed a significant drop in performance in the gym, as well as lower energy levels, and slightly less quality sleep (duration has been constant at 7-8 hours, though). My weight hasn’t changed that much but have gained some muscle size thanks to BBII template!

I first started lowering the volume of the workouts, but even then session RPEs have stayed relatively high, specially for leg days. Felt that something was off and decided to go to the doc. He ordered very comprehensive lab tests, and I even convinced him to check apoB and LipA levels. Everything was relatively well except for some slightly off hormone levels:

  1. TSH 4.45 uUI/ml, reference value is 0.4 - 4
  2. Prolactin 23.8 ng/ml reference value is 2.1 - 17.7
  3. FSH 1.5 mUI/ml, reference value is 1.4 - 18.1 for males Things like LH, oestradiol, total testosterone, and free testosterone were all within the reference value (I’m very well aware of BBM stance on checking these values and I’m on the same page!).

The doc ordered me to take Dostinex/Cabergoline to lower it. He didn’t seemed worried about why my prolactin was higher than normal. Now, I don’t want to nocebo myself too much thinking about it, but my question is, should I get a second opinion and dig deeper into the potential causes?

Thank you so much!

2

This is a bit complex to be giving individual advice via the forum and is generally more appropriate for individual consultation.

However, my general impression here is that you likely dug yourself into a bit of a hole with training, and need more substantial modifications (and, importantly, more time) to dig yourself back out. Based on the information provided here, I would probably not have ordered most of these tests on you, I do not think that cabergoline is necessary, and I do not think further/follow up medical testing is necessary in the short term.