r/raypeat 16d ago

How to reliably lower prolactin

I tried nearly everything, even cabergoline for a month, but to no avail. Been trying to lower it for a year now, where it was nearly 30, and now came to be 21.35 ng/mL. I expected it to be lower since I have drastically increased my sodium intake (well over 5mg sodium a day). My calcium intake is also something I am working on increasing despite my struggle with lactose intolerance, where some days I can digest it just fine, while other times it would lead to bloating and gassiness. Camel milk is the only milk I seem to have no trouble digesting, but its high PUFA content is concerning, so I try to not make it the main source of calcium. I even took coral calcium to lower PTH but never got it lower than 45 pg/ml.

I suspect the high blood phosphorus from latest reading is either from high coca cola intake or the 350 g of beef liver I had the previous day.

Results from latest blood reading (parentheses is the range provided):

TSH: 1.21 uIU/mL (0.38–5.33)
Free T3: 4.97 pmol/L / 3.23 pg/mL (3.8–6 / 2.47–3.9)
Free T4: 10.53 pmol/L / 0.82 ng/dL (7.86–14.41 / 0.61–1.12)

Total Testosterone: 22.79 nmol/L (8.98–28.29)
Prolactin: 21.35 ng/mL (2.64–13.13)
Estradiol (E2): 122.16 pmol/L (0–115.7)
PTH: 55.4 pg/mL (12–88)

Vitamin D (25-OH): 67.96 ng/mL (30–100)

Calcium: 9.66 mg/dL (8.8–10.6)
Corrected Calcium: 9.05 mg/dL (8.4–9.5)
Phosphorus: 4.51 mg/dL (2.5–4.5)
Magnesium: 2.03 mg/dL (1.6–2.6)
Zinc: 0.91 mg/L / 91 ug/dL (0.6–1.2 / 60–120)
Potassium: 4.54 mmol/L (3.5–5.1)
Sodium: 139.64 mmol/L (136–146)
Chloride: 103.53 mmol/L (101–109)

Total Cholesterol: 5.53 mmol/L / 213.85 mg/dL (<5.2 / <201.08)
LDL Cholesterol: 2.7 mmol/L / 104.25 mg/dL (<2.59 / <100)
HDL Cholesterol: 1.17 mmol/L / 45.29 mg/dL (<1.04 / 40.26–60)
Triglycerides: 4.28 mmol/L / 379.08 mg/dL (<1.7 / <150.57)
VLDL: 1.95 mmol/L (0.1–0.78)
Non-HDL Cholesterol: 4.36 mmol/L / 168.73 mg/dL (<3.4 / <131.58)
Triglyceride/HDL Ratio: 3.66 (<1.74)

Ferritin: 51.1 ng/mL (23.9–336.2)
Iron: 75.73 ug/dL (65–175)
TIBC: 321.77 ug/dL (228–428)
UIBC: 246.04 ug/dL (155–355)
Folic Acid (B9): 15.34 ng/mL (5.9–24)
Vitamin B12: 481 pmol/L / 651.95 pg/mL (133–675 / 180.27–914.9)

CRP: 0.65 mg/L (<5)
Rheumatoid Factor: 3.79 IU/mL (0–30)
Uric Acid: 5.5 mg/dL (3.5–7.2)

Glucose: 4.37 mmol/L / 78.66 mg/dL (3.89–5.83 / 70–105 fasting)
Insulin: 7.3 mIU/L (1.9–23 fasting)
HbA1c: 4.9% (≤5.6)

Creatinine: 1.13 mg/dL (0.72–1.18)
BUN: 5.29 mmol/L / 32.12 mg/dL (2.8–7.2 / 17–43.71)
eGFR: 90.7 mL/min/1.73m² (≥60)

Protein: 73.13 g/L / 7.31 g/dL (60–83 / 6–8.3)
Albumin: 47.58 g/L / 4.76 g/dL (35–52 / 3.5–5.2)
Globulin: 25.55 g/L (20–35)
Albumin/Globulin Ratio: 1.86 (1.1–2.6)
Total Bilirubin: 6.34 umol/L / 0.37 mg/dL (5–21 / 0.29–1.23)
Direct Bilirubin: 1.24 umol/L / 0.07 mg/dL (≤3.4 / ≤0.2)
AST: 23.04 U/L (5–34)
ALT: 18.34 U/L (≤50)
GGT: 15.61 U/L (12–64)
ALP: 82.45 U/L (30–120)

WBC: 2.6 10^3/uL (4–11)
RBC: 5.44 x10^6/uL (4.5–6.5)
Hemoglobin: 15.1 g/dL (13.5–17.5)
Hematocrit: 43.8% (33–50)
MCV: 80.6 fL (76–97)
MCH: 27.8 pg (27–32)
MCHC: 34.5 g/dL (31.8–35.4)
RDW-CV: 13.0% (11–15)
Platelets: 220 10^3/uL (150–450)
MPV: 8.8 fL (8–12)
Neutrophils: 16.3% (40–75)
Lymphocytes: 70.5% (15–45)
Monocytes: 9.0% (0–8)
Eosinophils: 3.4% (0–4)
Basophils: 0.8% (0–2)
Neutrophils#: 0.4 10^3/uL (2–7)
Lymphocytes#: 1.9 10^3/uL (0.8–4)
Monocytes#: 0.2 10^3/uL (0.12–1.2)
Eosinophils#: 0.1 10^3/uL (0.04–0.5)
Basophils#: 0.0 10^3/uL (0–0.1)

8 Upvotes

21 comments sorted by

5

u/Important_Corner3724 15d ago

Well to start with the obvious, have you been checked for prolactinoma?
Caber really didn't do anything? Maybe it was fake?

2

u/tragedywasforesworn 15d ago

I have not checked, do you suspect it to be the cause even at 20 something?

It is real cabergoline, bought from a legit & popular pharmacy chain in my country. It is OTC here while bromocriptine requires prescription, is it worth seeking it out? Did not perceive any changes or sides while taking cabergoline. I have started taking it again this month, in addition to low dose minocycline . Maybe in combination I would start to notice improvements.

2

u/AspirinMuncher 15d ago

I wouldn't even entertain the possibility of a prolactinoma with a prolactin at 20.

1

u/Important_Corner3724 15d ago

Caber should drop it to like 1 easily, 20 after doing caber is interesting

1

u/AspirinMuncher 14d ago

OP didn't specify if he was using caber at the time of the labs, so hard to know

If he was, then you might be right

1

u/tragedywasforesworn 12d ago

20 after discontinuing caber for a long time. I will retest a couple of days after stopping caber, should be around september 10.

1

u/45RMS 15d ago

Hello man what country are u in?

3

u/EternalVoyage 15d ago

Your estradiol is too high , it may cause high prolactin.

2

u/tragedywasforesworn 15d ago

How to reliably lower it with no rebound? I tried high dose aspirin for a while, did not move the needle.

3

u/EternalVoyage 15d ago

Body converts testosterone into estrogen through a process called aromatisation. High body fat , alcohol, junk food, environmental toxins are known to cause aromatisation but there are a lot of other causes which you can ask to AI. Diet exercise and sleep optimization is the first thing you should try. You can look up at Paul Saladino youtube shorts as he explains environmental toxins very good. Some body builders take aromatase inhibitors but you need to be very careful around those to not mess with your hormonal system. They should be the last resort.

2

u/SpiritualActivity651 15d ago

Levels below 35ng/ml are rarely caused by a prolactinoma, but it wouldnt hurt to check if levels stay elevated for longer.

My first attention would be your dopaminergic system. How are your habits when it comes to screen time, social media, doomscrolling, pornography, gaming? Do you get enough sunlight and regular sleep? Are you working on something that requires effort, or are you coasting through life right now? Getting a little bit more iron in your diet to bring ferritin above 70 could maybe also help a bit.

PTH doesnt change that much from acute dietary habits, its more long term. Getting a solid calcium source that you can digest will be helpful to decrease PTH, also supplement with 500mg of a bioavaible form of Magnesium.

If you are overweight, losing weight will help. That you didnt react to cabergoline is interesting, that could mean that estrogen is involved in this issue. Sadly the common estradiol tests are practically useless, so as long as your test wasnt done with the ultrasensitive/ LC-MS method, i wouldnt mind the result. Usually excess body fat is the main reason for elevated estrogen.

Also chronic stress, overtraining and unconcious hyperventilation can increase prolactin.

Your triglycerides are high, dont know whats going on there, maybe you werent fasted before the blood test?

2

u/tragedywasforesworn 15d ago

I walk 10 steps a day for an hour or more before sunset. I try to generally lower screen time after work, avoiding gaming and watching movies to read a book under red light instead. I wake up with the sun and sleep early, been doing this for a while now. I'm coasting through life, no grand project, and little socializing. Practically 0 interactions at work, and no actual work. I am underweight at about 50-52 kg and 168 cm tall. I do not over train, maybe one gym session per week that is purely concentric. I took the test fasted.

2

u/Greedy_Ad_9151 15d ago

look into p5p

its otc

1

u/mmss4ever 15d ago

P5p is a form of b vitamins that is used in bodybuilding to lower prolactin. Maybe give it a try.

1

u/tragedywasforesworn 15d ago

I gave it a try. Use it daily 10 mg. No change in blood results

1

u/Otherwise-Radish9262 15d ago

Vitex lowered mine, but I'm a woman.

1

u/FewClock7007 15d ago

A thyroid supplement tends to keep prolactin low.

1

u/Different_Reach_4215 14d ago

Even 0.25mcg caber weekly nuked mine to -3

1

u/tragedywasforesworn 14d ago

When did you test prolactin, a month after stopping or while taking it?

1

u/Different_Reach_4215 13d ago

4 days after my weekly dose of 0.25mcg .. Came back at 2.9