Lab values (Prolactin and estradiol)

[Henna]

It seems that nothing in this life goes easily for me. I got today the lab values, which were taken _before_ any hormones was taken.

To my disappointment the prolactin and estradiol values are well above highest reference range. Part disappointment and part of me is kind of happy, that the internal feeling and understanding of this body is correct. That this body is just so completely wrongly assembled, that who ever put this together, didn't know what they were doing.

Anyways, I'm now again at the bottom of the dark pit, as even when it's nice that estradiol is high, the prolactin is worrisome. It wont come down with HRT, but instead go even more up. And if it goes up too much, well that's the end of HRT then for me 

I wonder what will happen next.

[Sammy]

Have You spoken to endo yet? I dont know if this will be of much help, but my endo told me that it is important to submit Your tests early in the morning, because prolactine and one another item (I dont remember each) tend to fluctuate quite crazily during the rest of the day. In my case androstendione was twice above the normal range - I have not seen my endo yet, but GP told that there is nothing much to worry about.

[Henna]

I haven't talked with doctors yet. Now that I have thought this it makes sense that my prolactin is high, as I already have estradiol in the body.

The different question is why I have estradiol? I have always felt myself more as intersex, even when at least externally I cannot see anything like that and I have no diagnose.

[A]

Honestly, the most likely explanation is faked test results. Estradiol above the maximums and having never noticed sounds very unreal.

[Henna]

I haven't been ever tested for estradiol, prolactin or even testosterone. This is the first time.

I've been reading about the hormones this evening and it is possible for a male body to have very high (I have 8 times higher from avarage "normal" value) estradiol value, but it's associated with cancer and then testosterone should be very high also. But testo I have in the avarage mid range.

I hardly think faked result, can't see what's the point of that for them. This was a private clinic to whom I paid hefty sum of money to get these done. Analyze is being done in laboratory, which I know myself.

It just makes sense in many levels for me.

[A]

By faked results I didn't mean that they willingly made the results fake, but that an error occurred in the testing, making the results different from reality. Incorrect vocabulary, maybe? It can happen with any test, which is why people often have a second test done when one is especially surprising.

And what sort of estradiol levels are you talking about? Eight times what? You have the right to say blood levels here, contrary to medication doses. Because depending on what "average normal value" you mean, I may have completely misunderstood.

[Sarah Louise]

I agree, Labs do make mistakes / errors in their readings.  I haven't had it happen with HRT readings, but I have gotten incorrect A1C readings (diabetes).

[peky]

It seems that nothing in this life goes easily for me. I got today the lab values, which were taken _before_ any hormones was taken.

To my disappointment the prolactin and estradiol values are well above highest reference range. Part disappointment and part of me is kind of happy, that the internal feeling and understanding of this body is correct. That this body is just so completely wrongly assembled, that who ever put this together, didn't know what they were doing.

Anyways, I'm now again at the bottom of the dark pit, as even when it's nice that estradiol is high, the prolactin is worrisome. It wont come down with HRT, but instead go even more up. And if it goes up too much, well that's the end of HRT then for me 

I wonder what will happen next.

and the values are

[muuu]

.

[peky]

Whe you ask for your E,T, P, or wahtever other steroid hormone, make sure you ask for the "free levels" becauyse it is the free leverls of hormone that are the msot relevant OK?

[Shellz]

Whe you ask for your E,T, P, or wahtever other steroid hormone, make sure you ask for the "free levels" becauyse it is the free leverls of hormone that are the msot relevant OK?

I think when you get blood (serum) tests it is always measuring the bound levels. Whilst the free levels are much less it is a pretty consistent small percentage of the bound levels (just a few %). If saliva testing is done, that measures the free levels of hormones  but saliva testing is still relatively uncommon and the reference ranges are quite different to those which we are used to seeing for serum testing.

[Henna]

Estradiol level for me was 0.18 nmol/l (S-E2) with max reference range for a male body 0.15 nmol/l and Prolactin 384 mU/l  (S-PRL) with max reference range for a male body 384 mU/l.

It's not much, but the values correlate each others. I mean the other is not significantly higher than the other.

Also, it doesn't worry me too much now the prolactin, as when estradiol is elevated, the prolactin goes up as well.

I doubt that mistake was done. I have not seen this kind of mistake being made in accredited laboratory in my ten years of professional life. Usually the sample is not usable and there is other strange stuff going on with samples. I cannot get a second test done now, as I have started HRT already. Just have to watch the prolactin levels. I think it's quite easy to tell, if the lab made a mistake or not when I get labs next time done.

Also, when I read what that still quite tiny amount of estradiol does to a male body, everything seems quite familiar. I just have never gone to a doctor about those things, as I have never really cared what happens to this body.

[A]

Ooooh. Then it's pretty normal. Well, not normal, but within the area that's not worrisome. As for the prolactin... I have no idea what that unit is or how high that is, but surely your doctor will know very easily what's dangerous and what's not.

Funnily, your natural estradiol level is more or less what I have with my present HRT. Wait, that's not funny, that's depressing.

[Henna]

The current prolactin is not worrisome, as the highest reference range for a woman is 500 and when pregnant it can reach to thousands. Hopefully I wont reach those figures. The unit is milliunits per litre.

Yeah, these are not worrisome, but just strange figures.

Life is strange...that's for sure...

[peky]

I think when you get blood (serum) tests it is always measuring the bound levels. Whilst the free levels are much less it is a pretty consistent small percentage of the bound levels (just a few %). If saliva testing is done, that measures the free levels of hormones  but saliva testing is still relatively uncommon and the reference ranges are quite different to those which we are used to seeing for serum testing.

True for normal individuals but in the case of XY individual with an abnormaly high E and P rules out a prolactinoma but other tumor(s), drugs, or impared with hepatic or renal function needs to be assed. A hepatic  dysfunction sometimes result in increased abnormal free estrogen. The steroid-binding albumin needes to be assayed on this cases


In any case, the OP reported 0.18 nmol/l for estradiol (S-E2), the 95% Upper limits for males is 0.2 nmoles per liter, so this number is not terribly out of range for a male. As for prolactin the OP quoted at 384 mIU/L, well, that is also wirthin the clinal upper range and thus of no concern. (Normal levels are less than 500 mIU/L for women, and less than 450 mIU/L for men.)

So, perhaps this is much to do about nothing

[A]

Does someone know why most things are in (n/p)mol/L but prolactin is in (m)U/L?

[peky]

Does someone know why most things are in (n/p)mol/L but prolactin is in (m)U/L?

Prolactin levels are usually reported in either pico or nano mol per L.Some labs still use the old milli International Units per Liter(mIU/L). In the old times there were some 10 or so different method for assaying prolactin. Prolactin is a protein, and in humans can occur as a shorter than normal protein, called the small prolactin, and then there is dimer and trimer. Modern test measure the small prolactin (which is the one with biological activity) and report it as nano moles per liter.