High prolactin... prolactinoma?: Hi, I have just... - Thyroid UK

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High prolactin... prolactinoma?

Novaka profile image
19 Replies

Hi,

I have just received my latest blood results and my prolactin is almost double the "normal" limit. My free T4 seems to be in range and I have a vitamin D and folate deficiency.

My prolactin has been elevated for four years with an absence of periods and milk from the breasts (no pregnancies). My doctor doesn't seem to think this is too much of an issue, but I feel the lack of fertility should be issue enough let alone the underlying cause.

Medication has been ruled out as the cause previously as my medicine was altered or stopped for sometime and my prolactin was retested etc. It is actually steadily increasing over time.

I wondered at this level is it possible the increased secretion is due to a prolactinoma or are the levels too small? Does anyone have any personal stories to share?

Thank you! :)

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Novaka
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19 Replies
Mouldyoledoll profile image
Mouldyoledoll

Have you had an MRI scan of your head?

Novaka profile image
Novaka in reply toMouldyoledoll

No I haven't :)

researcherUK profile image
researcherUK

There are several reasons for elevated prolactin levels to include certain medications and an MRI as Mouldyoledoll suggested to rule out any growth on the pituitary gland.

There is a correlation between thyroid problems mainly Hypothyroidism and Hyperprolactinemia and a stronger association between hyperprolactinemia and the immune system.

Some fertility issues and hypothyroidism also go hand in hand.

pituitarysociety.org/patien....

T4 levels are not enough to rule out hypothyroidism. A full thyroid profile with T3 and thyroid antibodies thyroglobulin antibodies (TgAb), thyroperoxidase antibodies (TPOAb)

Novaka profile image
Novaka in reply toresearcherUK

Hi, I did write a letter to my GP requesting the full panel a few weeks ago as my TSH has always been between 3.0-3.7 and I have a basal temp of 35°C. I have many other symptoms of hypo.

I'm thinking at this point if I can gather the money I will possibly order a private full thyroid panel just to rule it out properly. Would it be a good idea to pursue the prolactin first?

The only other diagnosis I have is Ehlers Danlos Syndrome and I don't believe there is any correlation.

researcherUK profile image
researcherUK in reply toNovaka

Personally, I'd start by addressing the thyroid and any auto-immunity first. Your Temp is very low at 35C and your TSH is showing is slightly elevated and an indicator of a struggling thyroid. Your vitamin D levels are very low as well. This needs to be addressed.

Can you push so your GP can authorize the full thyroid and antibodies as well as B12, Ferritin, and CRP?

Otherwise, there are two reliable finger prick tests: 1/ Blue Horizons which is 'Thyroid plus 11', 2/ Medichecks have 'Thyroid check ultra'.

Either one of those tests will give you a full thyroid profile and the status of thyroid autoimmunity.

Plus, CRP, an inflammation marker which might come high, along with the levels of ferritin and B12. Often with an existing auto-immunity, both Ferritin and B12 will come low. However, I would not be surprised with your high prolactin for your Ferritin levels to come high. Prolactin decreases hepcidin, which can increase blood iron levels. Your genetic background with a confirmation of auto-immunity might lead to early multiple sclerosis.

Totally avoiding gluten will help with auto-immunity and there is scientific evidence to suggest that high levels of selenium can also reduce prolactin levels as well as thyroid anti-bodies.

Once prolactin levels start to drop your estrogen levels kick in again and you'll start to ovulate. To conceive and to maintain a pregnancy, your thyroid levels ought to be optimal.

I hope this helps!

Novaka profile image
Novaka in reply toresearcherUK

Heya thanks for the detailed reply. I did try to push for the full panel but they only ran free T4. In my request I included all of the ones you mentioned.

I had B12 done previously which was 300 in a range of 180-900 or something like that. So low, but not low enough for concern.

I was prescribed 20000UI of vitamin D a day for two weeks, but I still feel awful! I can't stay awake for a full day at all. It's horrible but to keep going back and being the one to ask for tests, in starting to feel like a hypochondriac 😣

researcherUK profile image
researcherUK in reply toNovaka

One very important thing to keep in mind....you are not a hypochondriac. You are simply very ill. You'll start to feel better when all your layers of illness are unfolded and addressed and treated properly, one at a time, in order for your systems to become functional again.

Your B12 is way too low and this is another thing to add to your list of supplements. With auto-immune diseases and with hypothyroidism, optimal levels of b12 are the higher end of the range and it is acceptable to have them a tiny bit above, 900-1000.

Keep taking the loading dose of Vitamin D and take it with your main meal as it needs fat to be absorbed.

Keep pushing and have another appointment with your doctor and explain in details that you may be suffering from an underlying immune disorder; otherwise, three things to keep in mind:

1/ the possibility to self-medicate

2/ the learning curve and the trial and error that go with it and until you balance all your biochemistry levels.

3/ the expenses that go with it.

You are very welcome!

Novaka profile image
Novaka in reply toresearcherUK

Hiya I should have mentioned I take multi vits and fish oils as well as daily Vit B tablets. So I would have expected to see my levels higher too. I have a 20 minute appt with a more sympathetic Dr on Wednesday. I'm trying to put a list of things to discuss together at the moment.

I know we will be addressing the recent blood tests and the response to the Vit D treatment, how do you think I should bring up the other things?

researcherUK profile image
researcherUK in reply toNovaka

It is very good idea to prepare a list of what you'd like to draw his attention to. Explain the link between auto-immunity diseases and high prolactin levels and that yours are nearly double the top of the range and that you suspect that you may have Hashimoto's.

There is one way to find out and that's to do a full thyroid profile which includes T3 levels and antibodies. Also, the link between good thyroid levels, mainly T3 and the ability to conceive and to maintain the pregnancy until term.

This should be a start.

Try to present facts and persist with your rationale and as much as you can try not to get emotional.

Then explain the fatigue, how you feel, and the compromised quality of life at your young age.

Furthermore, the stress generated from your strong desire to have a family and the inability to conceive might add a toll on your relationship/marriage.

Besides with your genetic condition and the remain untreated immune conditions could develop into MS.

Novaka profile image
Novaka in reply toresearcherUK

I was asked to get a repeat prolactin test to ensure it wasn't an anomaly (even though it's been high for years!)

I had my blood drawn yesterday and the results are already online in less than 24 hours. That's weird because it took 15 days last time.

This time my levels were:

Serum prolactin level1083.7 mu/L

Abnormal result< 400mu/L

researcherUK profile image
researcherUK in reply toNovaka

Thanks for sharing. Good call to repeat the test but as you can see your prolactin levels have increased again. Have you spoken with your doctor since you got the new results?

Novaka profile image
Novaka in reply toresearcherUK

I am seeing her tomorrow morning : )

I only just got the letter asking me to get the repeat test, so I'm actually really happy they are back so quickly as it means the newest result can also be discussed tomorrow!

researcherUK profile image
researcherUK in reply toNovaka

Very good news :-) and Good Luck! I have a feeling that based on those recent results/test, they are likely to assess other things for you.

Novaka profile image
Novaka in reply toresearcherUK

Hi researcher, I have posted an update below :)

SlowDragon profile image
SlowDragonAdministrator

High prolactin can be caused by hypothyroidism

emedicine.medscape.com/arti...?

Would recommend full testing via Medichecks or Blue Horizon

thyroiduk.org/tuk/testing/p...

TSH, FT3, FT4, TT4, both TPO and TG antibodies and vitamin D, folate, ferritin and B12

All thyroid tests should be as early in morning as possible and fasting. This gives highest TSH and most consistent results

List of hypo symptoms

thyroiduk.org/tuk/about_the...

Novaka profile image
Novaka

Just wanted to update everyone as I know people find these threads helpful when they are researching their own issues. Here is what has occurred since the time of me starting this thread:

1. Followed advice of members here and pursued prolactin investigations.

2. Repeat tests were persistently high so GP ordered brain MRI.

3. No lumps or tumours detected on scan, so referred to endocrinologist with a six month wait.

4. Saw endo today and have been prescribed 250mg Cabergoline to combat the hyperprolactinemia. Yay! I also have a long-term prescription of vitamin D.

5. I questioned if this treatment would help with the overwhelming fatigue and tiredness I feel, or if that was a result of EDS. He said it was unlikely, but has requested some further blood tests.

I recognise the TFT thyroid tests, B12, folate etc. However he has put down for them to test cortisol and FSH. I have had numerous tests over the years of navigating this health minefield and these are two that I have never come across or had; can anybody expand on why he might have requested these please?

He asked for me to have my blood taken today, however it was 4pm at the time and I know from experience that time of day can significantly impact TSH, in a country where the TSH parameters are already so tight. So I am going first thing Monday morning instead; which will also give a more accurate picture of the prolactin and cortisol levels!

lily82 profile image
lily82 in reply toNovaka

hey. It's always good to post updates like this, it's helpful.

I had some bloods taken a while ago, and my endocrinologist is repeating the thyroid and prolactin levels, as they showed some abnormalities. Showing that I'm hypothyroid.

I haven't had a proper period in 6 month, and so that's another reason to test the prolactin.

I am also going first thing Monday morning for bloods. So good luck!

Savourysuprise profile image
Savourysuprise

hi, just joined this to search up about prolactinoma’s. I’m 17, I had my bloods done just before my 16th birthday, and the bloods come back as 1190mu/L. They did the bloods again to make sure, and because they were around the same level, they referred me to have an MRI, (I also explained symptoms of migraines, headaches. With tunnel like vision.) When my mri came back, they explained I have a Micro Prolactinoma. At 16, finding out I have a tumour was scary, I was feeling better when they said most Tumours on the pituitary gland are Benign. Because of the size of the tumour, it wasn’t ’big enough’ to refer me to the neurologist, so they referred me to the endocrinologist. About 1 month later, I received a call from the endocrinologist, he was explaining that I don’t need to go on any medication, that the tumour won’t grow and the levels will decrease naturally. So 2023 was a stressful year.

January just gone, I needed my bloods done for something else, but I asked if they could do my prolactin levels, as I never stopped having my migraines ext.

my recent bloods have come back as 1073mu/L, when I got told they were still high, I’m overthinking to my self, asking why I got told they would go down naturally, and that they clearly haven’t. I now have to Wait till July for my endocrinology appointment, to tell me what the next steps are, February-July is a long way away, for me to be stressing, and they tell me in July that the bloods are normal, and it’s normal to live with a tumour. In my opinion, it’s 100% not normal to live with something that may be growing in my head.

Ask for an MRI if you haven’t yet had one, peace of mind at the least…

Good luck to you x

helvella profile image
helvellaAdministrator in reply toSavourysuprise

Sounds like the reassurance ("levels will decrease naturally") consisted of empty words. Even if that might be true for many others with similar presentations, it clearly isn't for you.

If you want replies, I suggest you write a brand new post. This reply, however relevant and pertinent, will likely be missed my many simply because the thread is so old and replies tend to be much less visible than original posts.

If you do post, do you have any thyroid results to add?

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