Endocrinology

Ask an endocrinologist. Get answers to endocrinology questions.

Ask a Doctor,
Get an Answer ASAP!

This answer was rated:

I have an ongoing fatigue issue. As part of an endocrine…

I have an ongoing fatigue...
I have an ongoing fatigue issue. As part of an endocrine workup/analysis, I have had the following labs:10-17-2016 Prolactin 22 ng/mL (ref 3-18 --- not sure why this reference range is different from those below)
FSH 13 mIU/mL (ref 1.5-12.4)
LH 12.3 mIU/mL (ref 1.7-8.6)
1-20-2017 Prolactin 13.9 ng/mL (ref 4.0-15.2)
3-10-2017 Prolactin 20.3 ng/mL (ref 4.0-15.2)
FSH 12.4 mIU/mL (ref 1.5-12.4)
LH 11.3 mIU/mL (ref 1.7-8.6)
4-28-2017 FSH 0.8 mIU/mL (ref 1.5-12.4) --- while on a trial of testosterone therapy
LH 0.1 (ref 1.7-8.6) --- while on a trial of testosterone therapy
6-23-2017 Prolactin 20.4 ng/mL (ref 4.0-15.2) --- while on a trial of testosterone therapy
FSH 0.6 mIU/mL (ref 1.5-12.4) --- while on a trial of testosterone therapy
LH 0.1 (ref 1.7-8.6) --- while on a trial of testosterone therapy
9-22-2017 Prolactin 14 ng/mL (no ref range given)
Monomeric Prolactin 13ng/mL (no ref range given)
Percent Macroprolactin 7%
Cortisol 8.7 ug/dL (no ref range given)
ACTH, Plasma 20.2 pg/mL (ref 7.2 - 63.3)
IGF-1 208 ng/mL (ref 67 - 205 ng/mL) - Slight elevation. This was normal on repeat test below just prior to cosyntropin stimulation test (I am missing the actual result).
10-5-2017 Cosyntropin Stimulation Test: 60-minute post-cosyntropin cortisol of 26.7.You'll see that my Prolactin fluctuates across the testing. My endocrinologist ordered what he says is the remainder of the anterior pituitary panel (you will recognize what that entails hopefully in the testing shown above) as a means of feeling confident that no pituitary adenoma is present. I'd like to hear your thoughts on this. It puzzles me that he is comfortable with the last Prolactin score of 14ng/mL when it was 22, then 13.9, then 20.3, then 20.4 prior to that. You'll also see some elevated LH and FSH. I can provide testosterone levels if that is helpful to you. I'm trying to get a sense of what to make of these tests. I'd like to feel confident in his assessment that no adenoma is present and no tracking or follow-up testing will be required.Forgive me if something key is missing. Just ask.Thanks!
Show More
Show Less
Ask Your Own Endocrinology Question
Answered in 14 minutes by:
3/12/2018
DocPhilMD
DocPhilMD, Internist
Category: Endocrinology
Satisfied Customers: 59,640
Experience: Internal Medicine Physician
Verified

Hi, this is Dr Phil, here to assist you. I am Board Certified with over 10 years of experience. I will respond with my answer shortly. Thank you.

Ask Your Own Endocrinology Question

Hi Saul.

Ask Your Own Endocrinology Question
Customer reply replied 4 months ago
Hello. Again, my question is above. :)

You still haven't had that MRI?

Ask Your Own Endocrinology Question
Customer reply replied 4 months ago
No. He seems to think it is entirely unnecessary. I'm wondering if you can help me fish out his logic from above. I want to be prepared to ask germane questions.

Yes, he is saying that because the FSH and LH were suppressed on T therapy then it wouldn't be an adenoma

but who cares!

Your prolactin was high

Ask Your Own Endocrinology Question
Customer reply replied 4 months ago
But then the prolactin was normal again most recently. That's when he did the macroprolactin test concurrently. I take it he did that in case it was high again, so he could see if it was inflated from the mostly inactive, protein-bound type. But it was low anyway at that test. What can one conclude about a fluctuating level? I wonder if he has absorbed that fact.

Possibly

I have NEVER seen a high prolactin in a normal person though

NEVER

Ask Your Own Endocrinology Question
Customer reply replied 4 months ago
Interesting. Very interesting. Give me some sense of your exposure/background. 10 years I see of experience. In what setting? Are you a specialist/endocrinologist?
Customer reply replied 4 months ago
I will send him a new message and possibly seek another opinion from another endocrinologist.
Customer reply replied 4 months ago
I just need this info to help bolster my effort.

I am an internist but I work in a small community

specialist availability is limited

so I have to know everything

I sincerely ***** ***** I have helped you, and that I have earned my 5 star rating today.

Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question).

We can continue here until you are satisfied, simply use the reply box and let me know. Thank you!

DocPhilMD
DocPhilMD, Internist
Category: Endocrinology
Satisfied Customers: 59,640
Experience: Internal Medicine Physician
Verified
DocPhilMD and 87 other Endocrinology Specialists are ready to help you
Ask your own question now
Was this answer helpful?

How JustAnswer works

step-image
Describe your issueThe assistant will guide you
step-image
Chat 1:1 with an endocrinologistLicensed Experts are available 24/7
step-image
100% satisfaction guaranteeGet all the answers you need
Ask DocPhilMD Your Own Question
DocPhilMD
DocPhilMD
DocPhilMD, Internist
Category: Endocrinology
Satisfied Customers: 59,640
59,640 Satisfied Customers
Experience: Internal Medicine Physician

DocPhilMD is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me.

Susan O.USA

Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help.

Mary C.Freshfield, Liverpool, UK

This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!!

AlexLos Angeles, CA

Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult.

GPHesperia, CA

I couldn't be more satisfied! This is the site I will always come to when I need a second opinion.

JustinKernersville, NC

Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around.

EstherWoodstock, NY

Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know.

RobinElkton, Maryland

< Previous | Next >

Meet the Experts:

Dr Adi

Dr Adi

Professor

440 satisfied customers

Director of the Pediatric Diabetes Clinics at UCSF.

MCC. Endo

MCC. Endo

Board Certified Endo

25 satisfied customers

>10 years clinical exp, award winning research as a fellow

Sohaib K

Sohaib K

21 satisfied customers

Consultant at King Faisal Specialist Hospital

Dr. Jon

Dr. Jon

MD

18 satisfied customers

Physician

Dr. Nina Lim

Dr. Nina Lim

Doctor (MD)

13 satisfied customers

Internal Medicine Physician

Dr Eisenbud

Dr Eisenbud

Board Certified Physician

166 satisfied customers

Endocrinology and metabolism practice for 35 years

Family Physician

Family Physician

Doctor

2,592 satisfied customers

Emergency Medicine and Family Practice for over 26 years

< Previous | Next >

Related Endocrinology Questions
Second opinion] I am writing on behalf of my sister, who is
Second opinion] I am writing on behalf of my sister, who is 31 years old. She was concerned with PCOS because her LH and FSH hormone ratio was off on a blood test about 5 months ago. Since then, her d… read more
DocPhilMD
DocPhilMD
Internist
59,640 satisfied customers
I am writing on behalf of my sister, who is 31 years old.
I am writing on behalf of my sister, who is 31 years old. She was concerned with PCOS because her LH and FSH hormone ratio was off on a blood test about 5 months ago. Since then, her doctor has been t… read more
Dr. David
Dr. David
Radiation Oncology Attending Director
Post-Doctoral Degree
13,217 satisfied customers
I need to consult regarding low-T. I'm having sudden episode
I'm having sudden episode of erectile dysfunction. I have done blood test and everything but testostorone is low. … read more
Dr. David
Dr. David
Radiation Oncology Attending Director
Post-Doctoral Degree
13,217 satisfied customers
Due to the low volume of semen ( 1 ml, after 7 days of no
Due to the low volume of semen ( 1 ml , after 7 days of no sexual activity ) , i went to urologiest who requested several tests and ultrasound on the tests .everything was ok including the ultrasound … read more
Dr. SH
Dr. SH
Board Certified Physician
Doctoral Degree
3,323 satisfied customers
Looking for interpretation of lab results, I added symptoms
Hi, Looking for interpretation of lab results, I added symptoms at bottom if that helps. The tests started in December as part of a normal check-up. I have had different doctors and tests, with sympto… read more
Dr. Thomas, MD
Dr. Thomas, MD
2,227 satisfied customers
I just got my bloodwork done, I had earlier complained of
Hi I just got my bloodwork done, I had earlier complained of low libido with a serum test of 454. I am 29 now. I still have a low libido. Plesase interpret the low level of FSH and my test levels for … read more
Dr. Natasha
Dr. Natasha
7,913 satisfied customers
I recently got a set of baseline hormone blood tests before
Hello, I recently got a set of baseline hormone blood tests before starting finasteride, just to see where I stood before starting the drug (my family doctor could not get me in until mid August) I am… read more
Dr. Thomas, MD
Dr. Thomas, MD
2,227 satisfied customers
I had some tests done and thinking about getting hormone
I had some tests done and thinking about getting hormone replacement. here below are the test data. Tests Results Inflammatory Disease Screen IGF-1 胰岛素样生长因子-1 182.0 GH 血清生长激素 <0.05 Other Miscellane… read more
Dr. Thomas, MD
Dr. Thomas, MD
2,227 satisfied customers
I am a 22 year old male who has been taking prohormones,
Hello. I am a 22 year old male who has been taking prohormones, steroids and estrogen blockers in an abusive way for a couple of years. I recently stopped taking everything and have not been feeling w… read more
DocPhilMD
DocPhilMD
Internist
59,640 satisfied customers
Can you please help me understand if my Alpha Subunit test
Can you please help me understand if my Alpha Subunit test came back normal? IT came back as 2.0 Alpha Subunit 2.0 ng/mL Reference Range for Alpha Subunit: Premenopausal Females: 1.5 ng/mL or Less Pos… read more
Dr. D. Love
Dr. D. Love
Doctoral Degree
10,414 satisfied customers
I am a 24 yo male, over last 1- 1 1/2 years have had the
I am a 24 yo male, over last 1- 1 1/2 years have had the following symptoms: fatigue, lack of appetite, weight loss, depression and self esteem anxiety. Dr. finally tested Testosterone and it came bac… read more
Dr. David
Dr. David
Radiation Oncology Attending Director
Post-Doctoral Degree
13,217 satisfied customers
Just had my Urologist fax over the test results. Also, this
Just had my Urologist fax over the test results. Also, this was done in the afternoon. Testosterone Total------158 ng/dl LH----------------------------4.2 miU/ml Prolactin--------------------9.8 ng/mL… read more
Dr. David
Dr. David
Radiation Oncology Attending Director
Post-Doctoral Degree
13,217 satisfied customers
What is the reason, paticularly the #1 reason for men my
What is the reason, paticularly the #1 reason for men my age, 26, of having low testosterone?… read more
Dr Eisenbud
Dr Eisenbud
Board Certified Physician
MD
166 satisfied customers
I have a question about my testosterone. I was wondering if
I have a question about my testosterone. I was wondering if these levels are considered normal: FSH 2.3 IU/L 1.5 - 12.4 LH 1.7 IU/L IU/L Testosterone 250 NG/DL Free Testosterone 123 Estrogens Total 74… read more
Dr. David
Dr. David
Radiation Oncology Attending Director
Post-Doctoral Degree
13,217 satisfied customers
My fasting glucose level is 5.41 and the reference range on
My fasting glucose level is 5.41 and the reference range on the report says <5.1 although the doctor says this range only applies to pregnant women and it should really be <5.5 (mmnol/L) so my l… read more
Dr Eisenbud
Dr Eisenbud
Board Certified Physician
MD
166 satisfied customers
Total Testosterone 229 ng/dl then; 5 days later total T 358
Total Testosterone 229 ng/dl then; 5 days later total T 358 ng/dl plus free T of 49.8 pg/ml I've seen on a few sites that these levels correlate to an average 85-100 year old man. These level were tak… read more
Dr Eisenbud
Dr Eisenbud
Board Certified Physician
MD
166 satisfied customers
Question: Is my estrone too high, LH and FSH too low? Can
Question: Is my estrone too high, LH and FSH too low? Can this be a side effect from androgel? Is this a problem? I am 27 years old male. I have low testosterone. Before using androgel, my total testo… read more
Dr Adi
Dr Adi
Professor
MD
440 satisfied customers
My 25 year old son who has a traumatic Brain Injury 2 years
My 25 year old son who has a traumatic Brain Injury 2 years ago had a blood test on Oct1, 2011 and while most markers were with in normal range his Follical Stimuating Hormone FSH was .8 when normal r… read more
Dr Adi
Dr Adi
Professor
MD
440 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x