Although I have read this forum for a while now I haven’t posted as the knowledge on here is quite intimidating!! However, I have decided to try to take control of my hwp health as the doctors aren’t helpful. He was diagnosed almost 2 years ago. He has a tremor, right arm. There were other things too but it seems he was diagnosed on things that he had, to me always been like. Maybe I just hadn’t noticed them becoming more pronounced but 🤷♀️. Things like ‘odd gait’, lack of facial expression, lack of swinging right arm, clear ct scan. I can say that his mood was low and had been for sometime. He now takes Ropinirole 8mg and rasangaline 1mg. Daily.
Anyway to start I have run quite a full blood test and would like to know if anybody has had an experience of Ropinirole having an effect on their pituitary gland?
The results of the blood test show surpressed prolactin. It also appears to me that thyroid via the pituitary, as in secondary, is not great although within range.
I would be grateful to learn of others experience if possible. Thank you 🙏🏻
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Yeswithasmile
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Hi, @yeswithasmile, welcome to the most friendly part of the forum 👍😊 Glad to hear from you or anyone else for that matter. None of us are yet in StageX, which is the final "bite" stage, where PwP's start to bite others.
I'm not sure if the pituitary or any other gland gets affected. That's at least not what I have been told by my MDS. The only thing I have been warned about is the obsessive compulsive mania that we might get from taking any dopamine agonist. Also, I have been told that I should watch out for any random episodes of falling asleep without warning.
I would see a primary care physician (PCP). Not your MDS about the pituitary gland problem. They are best suited to diagnose the issue.
BTW, @yeswithasmile, I was just kidding about the "zombie" part 😂😁😋. We are just friendly strangers.
Ahhh pdpatient... I meant intimidating in a good way?!! Lol. I didn’t mean unfriendly. Just I am constantly astonished and lost at some of the threads I read.
Thanks so much for the reply. I really appreciate it. I did a little research and there seemed to be some link about the dopamine agonists but it would seem that the dose would need to be higher. I would go to his neurologist but generally I find them all quite unhelpful and I really don’t have much faith in their willingness, rather than ability, to help quality of life.
We were advised about the compulsive behaviour link but not about the possible narcolepsy!! I’m so grateful you mentioned that! Forewarned and all that.
Lastly, I know you are all friendly 😊. I just haven’t wanted to get lost in information too soon for fear of my head 🤯. Softly softly catchee monkey 😂.
I've been on 8 mg ropinirole, 1 mg rasagiline, along with 5 x 75 mg Stalevo, for at least 7 years, and not found any problems. But, to be fair I've not looked either.
This paper may be of interest to you:
MON-282 Treatment of Hyperprolactinemia with Ropinirole: An Open-Label Dose Escalation Study
Amanda Tsang, FNP-BC, MSN, MPH, Cara Dimino, BS, Alexander G Khandji, MD, Sunil Kumar Panigrahi, PhD, Gabrielle Page-Wilson, MD
"Treatment of hyperprolactinemia and prolactinomas with ergoline dopamine agonists (DAs) can be complicated by intolerance and resistance. Ropinirole (ROP) is a low cost selective D2/D3 receptor non-ergot DA, approved for treatment of Parkinson’s disease and Restless Leg Syndrome, that has been shown to acutely lower prolactin levels (PRL). This study investigated the efficacy and tolerability of long-term ROP therapy in patients with hyperprolactinemia."
It would seem that when the delights of Parkinson’s just aren’t enough then the medication can keep on giving.
Stalevo does not appear to be mentioned much on here. May I ask, you’ve been on it for 7 years, same dose? Was it an addition to the others or a more recent medication?
High level of prolactin reduces the amount of Dopamine. pituitary gland tumour also causes hyperprolactinaemia and subsequently reduction of dopamine. Patients with such condition are normally prescribed a medication named Bromocriptine, originally marketed as Parlodel and subsequently under many brand names, is an ergoline derivative and dopamine agonist that is used in the treatment of pituitary tumors, Parkinson's disease, hyperprolactinaemia, neuroleptic malignant syndrome, and, as an adjunct, type 2 diabetes.
Sadly ,High intensity exercises increase the prolactin level and as a result reduces dopamine.
Circulating prolactin levels increase in the blood during exercise, with the magnitude of the increase approximately proportional to the intensity of the physical activity.
The secretion of pituitary prolactin is under a constant inhibition via dopamine from the hypothalamus. Estrogen is another key regulator of prolactin and increases the production and secretion of prolactin from the pituitary gland. In addition to dopamine and estrogen, a whole range of other hormones can both increase and decrease the amount of prolactin released in the body, with some examples being TRH, oxytocin, and antidiuretic hormone.
Very interesting. Thank you so much for sharing your knowledge with me.
My hwp has surpressed prolactin. He also has suppressed tsh which in turn is surpressing his thyroid. It would seem that the medication maybe be doing a number on his pituitary. It’s easy for him to put all symptoms down to Parkinson’s but it’s isn’t difficult to check these days. Although that said it is knowing what to do about them now. Of course you can add this and that I suppose.
I think consultation with a good endocrinologist would be really helpful. Sometimes the issue arises from the pituitary gland and sometimes from the glands themselves like thyroid or the mammary gland and adipose tissue for prolactin related conditions.
Yes. I think you’re right. I am going to see if I can get his last doctors bloods and for comparison. Then search a decent endo. Thank you. So kind of you to take the time. Appreciated.
Given the foregoing regarding dopamine agonists being used to treat hyperprolactinemia, it stands to reason that a dopamine agonist could also suppress normal levels of prolactin. Confirmation from the literature:
" medications that are dopamine agonists such as bromocriptine or cabergoline will inhibit prolactin secretion and can be used to treat pathologies associated with hyperprolactinemia ... Dopamine agonist medications such as bromocriptine and cabergoline are treatment options for prolactin excess regardless of its etiology...."
After some further reading my interpretation is that it would seem that the suppression would come more from the hypothalamus.
Obviously this along with Parkinson’s already affecting this, it leads me to ask it is common to have other conditions either endocrine or otherwise? I realise this is like ‘homeopathy’ in as such as it’s a drop in the oceans but I’m concerned that other problems will arise and could be attributed to Parkinson’s. In my experience full blood testing is rarely carried out. Especially once you have a Parkinson’s diagnosis. Sort of like a once cap fits all.
Ahhh thanks park_bear but I seriously doubt that!!
I suppose the answer is to ask for copies of all tests and monitor ones that aren’t routinely performed by the doctors. Along the way getting a degree in neuroscience and endocrinology 😂.
I don’t believe good thyroid endo’s exist. They all specialise in diabetes. A worthy direction, of course, but I can’t help but feel they are missing a crucial precursor to comorbidities.
I couldn’t find any direct relationships between the PD and hypophysis( pituitary gland) in terms of pathology except those discussed in the earlier posts but in long term they may indirectly exchange feedbacks and in general affect each other.
This was one. There are others. I assume it is ultimately the feedback loops that are b*ggered both by PD and medication.
All I really know is that hwp is just about to have secondary hypothyroidism which I’m inclined to think is the cause of some of his other symptoms. It sort of makes me wonder what else may exacerbate his physical condition that there may be treatment for. Time will tell.
Your input is appreciated. I have autoimmune hypothyroidism. I do understand the HPT axis. Thanks for the input.
I had read recently a fibromyalgia/ Parkinson’s post. Honestly the more I have looked into thyroid the more I come across Parkinson’s. Medication aside.
T2 diabetes link with thyroid too.
Husband has a garage. No doubt exposed to all sorts of chemicals over the years. Inhaling and topical. Not pesticides generally but who knows what has been in some of it 🤷♀️
I’m sorry you were diagnosed late for diabetes. Although not surprised. In my experience doctors have their tests and their ranges and adhere to convention. This is often damaging and shameful. I do so hope that you’re feeling well now?
Just started on metformin. I think it's a good tool to have on board. I prefer to live holistically, but sometimes a pharmaceutical intervention is the best choice. Nice to chat with someone who speaks the language. Doing okay, thanks for asking.
I agree. Sometimes it’s necessary no matter how hard we try not to.
Glad you’re trying something you believe should help and hope it is. ‘Doing ok’ is usually standard but not altogether accurate for most of us I find.
As for talking the language… I took a quick peek at some of your posts and decided fairly quickly that I’m always going to be a beginner and you’ve moved on to advanced long ago!! Lol.
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