March bloods - may bloods : advice
I’m 24, 5’11, 172 lbs and looking for some advice from people with experience managing prolactin/e2 on TRT because I’ve been dealing with some mild nipple issues and it’s been stressing me out a bit.
My latest bloods (second pic) vs previous bloods from early March (first pic):
Latest test
- Prolactin: 452 mIU/L
- Testosterone: 46.3 nmol/L
- Free test: 0.907 nmol/L
- Oestradiol: 172 pmol/L
- LH/FSH crashed (<0.3 expected on TRT)
Previous test (March)
- Prolactin: 366 mIU/L
- Testosterone: 75.7 nmol/L
- Free test: 2.077 nmol/L
- Oestradiol: 278 pmol/L
Back then I was running:
- Test E
- 125mg/week
- Injecting 2x weekly
At that time I was dealing with:
- Water retention (especially face)
- Mood swings
- Libido loss
- Puffy nipples
- Anxiety/paranoia over possible gyno
- Pretty bad acne
The nipple discharge was actually worse around 3 weeks ago, but since changing my protocol it has now stopped completely, which is reassuring. I still have some mild puffiness though which is why I’m still monitoring things closely.
My acne has also improved a lot since changing protocol and lowering the dose, which makes me think the higher peaks from the old protocol probably weren’t agreeing with me.
Looking back I honestly think I made the gyno scare way worse in my own head, but the symptoms definitely made me panic.
Since then I changed quite a lot:
- Switched from Test E to Test C
- Lowered dose to 100mg/week
- Injecting M/W/F (3x weekly) to keep levels more stable
Since making those changes I genuinely feel much better overall:
- Mood is more stable
- Less water retention
- Better general wellbeing
- Less acne
- Less “hormonal rollercoaster” feeling
What confuses me is:
- My E2 has come down a lot (278 → 172)
- Testosterone is much lower and more reasonable now
- BUT prolactin has actually gone UP (366 → 452)
Current plan:
- Started Tamoxifen 10mg/day for 4 weeks to hopefully calm down the nipple symptoms/prevent early gyno progression
- Also picked up Arimidex but haven’t fully committed to it yet because I know crashing E2 can be even worse than high E2
I was considering:
- 0.25mg Arimidex twice weekly
- Re-testing bloods after 4 weeks
Questions for people with experience:
- Could prolactin still be reacting to previously elevated estrogen?
- Is mild nipple discharge on TRT always a prolactin issue?
- Would you personally try the low-dose AI approach here or continue lowering dose/waiting longer for stabilisation?
- At what prolactin level would you start considering caber or getting a pituitary MRI?
I know nobody here can diagnose me, just looking for opinions from people who’ve been through similar because I’m trying not to overreact or crash my hormones by chasing numbers too aggressively.