Waiting to see Endo in Sept. Abnormal Prolactin. Any ideas how to medicate til then as still feeling terrible

[MissT21]

January

Serum TSH level 6.3 mu/L [0.4 - 5.5]

Outside reference range

Serum free T4 level 13.9 pmol/L [11.0 - 26.0]

Borderline hypothyroid results.

Suggest repeat in 4-6 weeks and check thyroid Abs.

March

Serum TSH level 3.9 mu/L [0.4 - 5.5]

THYROID PEROXIDASE ANTIBODY 122 iu/mL [< 50.0]

Outside reference range

April

Serum TSH level 4.3 mu/L [0.4 - 5.5]

THYROID PEROXIDASE ANTIBODY 121 iu/mL [< 50.0]

Outside reference range

High titre TPO Abs, consistent with autoimmune

thyroid disease.

May

VITAMIN D 70.5 nmol/L

VITAMIN D GUIDELINES (Total 25-OH Vitamin D, inc D2+D3)

<25 nmol/L Deficiency: High dose treatment and long

term maintenance dose required.

25-50 nmol/L Insufficiency: long term maintenance dose

required

50-75 nmol/L Adequate: lifestyle advice

>75 nmol/L Optimal levels

Serum TSH level 3.2 mu/L [0.4 - 5.5]

Serum vitamin B12 level 371 ng/L [190.0 - 910.0]

Serum ferritin level 64 ug/L [22.0 - 133.0]

Serum folate level 11.2 ng/mL [4.6 - 20.0]

14th June

Serum TSH level 2.7 mu/L [0.4 - 5.5]

Serum prolactin level 1040 mu/L [102.0 - 496.0]

Outside reference range

Macroprolactin has been excluded as a cause of spurious

hyperprolactinaemia by PEG precipitation.

Significantly raised prolactin

Suggest repeat to confirm.

Outside reference range

30th June

Serum TSH level 2.8 mu/L [0.4 - 5.5]

Outside reference range

MENOPAUSAL HORMONE PROFILE

Serum LH level 4.7 u/L

Serum follicle stimulating hormone level 9.6 u/L

Serum oestradiol level < 100 pmol/L

Female Ref Ranges: FSH(U/l) LH(U/l) OEST(pmol/l)

Follicular phase 2-10 2-10 130-500

Mid-cycle phase 14-60 520-1470

Luteal phase 2-10 2-10 110-620

Post-menopause >30 >30 <100

Serum prolactin level 906 mu/L [102.0 - 496.0]

Outside reference range

any suggestions from reading this?

[radd]

MissT,

Hyperprolactinemia (elevated prolactin hormone) can be caused by a pituitary tumor but as previously advised the pituitary produces Thyroid Stimulating Hormone (TSH), which stimulates your thyroid gland to produce thyroid hormones. TSH also acts back on the pituitary gland and stimulates it to produce prolactin and in some people a high TSH can promote elevated Prolactin levels.

T4 is too low and TSH is swinging high & low probably due to Hashi attacks as you are positive for thyroid antibodies TPOAb. Hashi attacks can give you an itchy sore throat and flu like symptoms & sweats which can be mistaken for menopausal hot flushes.

Vit B12 is too low. Are you supplementing ?

LH and FSH look fine. Estradiol looks slightly low. Oestrogen starts reducing as your ovaries gradually stop producing eggs. A raise in FSH & LH would indicate start of menopause which you don't have.

You haven't been medicating Levothyroxine long and are still trying to reduce TSH to around 1.0. Supplementing 100-200mcg selenium daily will help with thyroid hormone conversion and reduce TPO antibodies, and optimising all nutrients and iron levels will aid thyroid function.

Members have found a gluten free diet helps to reduce antibody level and help suppress Hashi attacks.. Eventual optimal thyroid hormone replacement will help suppress attacks further.

.

Hyperprolactinemia

hormone.org/patient-guides/....

.

Hashimotos

thyroiduk.org.uk/tuk/about_...

.

Thyroid//Gluten Connection

chriskresser.com/the-gluten...

.

Selenium

press.endocrine.org/doi/ful...

[MissT21 in reply to radd]

Thanks for such for the info. Will get some B12, I am taking selenium. Going back to see Doc next Thurs see if she will incease Levothyroxine.