Question: I am a 46 y/o white male. I have been diagnosed with low dopamine after a long series of therapeutic phlebotomies to leech out Iron from my body that accumulated due to hereditary hemochromatosis. The symptoms of the low dopamine were very disruptive to my quality of life, leaving me utterly unenthusiastic and slothlike at work, severe restless leg syndrome, et cetera. After the phlebotomies were ceased, some of the low dopamine symptoms have persisted now for over a year, so I assume it is permanent. At my request, after doing research on the subject, My doctor initially prescribed pramipexole which worked miraculously for both the mental sluggishness and severe nightly restless legs syndrome, but it gradually became less and less effective over time, requiring higher doses to be taken earlier in the day until it was no longer effective. Again on my request after doing more research, my doctor switched me to a low daily dose of cabergoline, which took a few weeks to help, but now effectively controls the rls without the augmentation problem that I had with mirapex. The one complaint I have, however, is that I get very severe itching of my scrotum about one hour after taking the cabergoline, and it lasts about 90 minutes. It is so bad that I nearly wound myself with scratching, which I can not seem to avoid doing. Is it time to go to another prescription like levodopa, or possibly go back to mirapex; or should I seek something to alleviate the itching and stay on the dostinex?

I should mention that if I skip a day on the dostinex, I do not have the itching issue, so I am fairly certain of the connection. As well, if I do not take the dostinex for 2-3 days, the restless legs syndrome comes back in full, so I am reasonably certain that I do need to take something for the low dopamine still.