Hiya all,
Not sure if this is helpful to anyone, but I came across it while researching (I have untreated hypothyroid symptoms; my GP won’t recognising them due to “normal” range TSH and I’ve more recently discovered high Prolactin levels).
Has anyone heard of this connection or had any luck using it as part of their case / argument with their GP to consider starting treatment? Wondered if it would be of interest?
Lianne_e,
There have been many members who have tested with high prolactin levels. I actually think there are probably more but prolactin has just not been tested.
I read in your previous post that you have had half of your thyroid removed and FT4 is pitifully low but your TSH refuses to raise (as in central hypothyroidism). However, the connection between elevated prolactin & hypothyroidism isn't due to low thyroid hormones but a raised TSH (pituitary) or TRH (hypothalamus).
Prolactin can rise with pituitary problems such as head injury or tumour (usually benign) or hypothalamus issues. If the issues are secondary such as hypothyroidism prolactin will reduce with thyroid hormone replacement meds. Also addressing reasons such as excessive exercise and/or eating disorders, and I was reading the other day interestingly some medicines effect dopamine levels such as certain BP meds & anti-depressants that alter prolactin levels. Prolactin is essentially the master of breast milk & think of the breast milk connections with certain neurotransmitters.
High levels of prolactin can interfere with the menstrual cycle and fertility as decreases FSH & LH so influencing oestrogen & progesterone production. It will also cause low bone mass if left long term. Sometimes hormones just right themselves so you will need a second prolactin test to ascertain levels remain elevated and if so, then further investigation such as other hormone testing & possibly an MRI.
Regarding your hypothyroidism, did you ever get FT3 tested? If you can't get thyroid meds prescribed members including myself self source & medicate. However, I wouldn't recommend this until your prolactin levels have been investigated to avoid muddying the waters. ThyroidUK (who run this forum) hold a list of thyroid specialists that members have received positive experiences from.
thyroiduk.org/help-and-supp...
Your research paper isn’t well written, and these links explain it all much clearer.
pituitarysociety.org/patien...
.
my.clevelandclinic.org/heal...
Good morning Radd, that’s really helpful, thank you 😊.
I was only made aware of high prolactin because I took a hormone test to check my other levels and prolactin just happened to be included, so I googled it. Does make you wonder how many others have elevated levels but are unaware and if it’s being caused by untreated hypothyroidism. I was taking antidepressants for about a year before the tests, so started to reduce my dose and have now come off them completely. It’s been a few months since I’ve taken any at all, so I’ve ordered another hormone test to see if the prolactin levels have reduced. If there’s still a raised level I’ll have to ask my GP to investigate further. I’ll definitely print of the links you shared, thank you for them, they are really helpful. If my levels are still high, I’ll show my GP and see if they’ll recognise the possibility of a thyroid link in my case. Hopefully it’s another piece of the puzzle.
Edit: sorry I totally missed replying to your question 🤦♀️ …
I’ve added this years complete Medichecks test info and results in my reply to SlowDragons comment below 🙂. I was having menstrual problems, so had the hormone tests that highlighted the raised prolactin, so I retested a few months later to double check and it was higher than before even though the range was lower due to it being a different time in my cycle. I have had a RT3 test also, which is in my results below. It was this in January:
TSH - 3.07 mU/L (Range: 0.27 - 4.2)
Free T3 - 4.90 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine - 18.500 pmol/L (Range: 12 - 22)
These are May’s results, I bounce up and down a bit:
TSH - 2.68 mU/L (Range: 0.27 - 4.2)
Free T3 - 4.23 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine - 15.3 pmol/L (Range: 12 - 22)
My prolactin results were:
January - Prolactin - 558.00 mU/L (Range: 102 - 496)
March - Prolactin - 953.00 mU/L (Range: 102 - 496)
My cortisol was shown to be above range also, so thought it maybe stress related?
Yes high prolactin is (relatively) common
Have you retested full thyroid and vitamin levels recently?
Always test thyroid early morning, ideally just before 9am
Good morning, thank you for responding. I’ve had 2 tests that included thyroid function this year, one as part of testing female hormones and the other the advanced thyroid test. I also had another basic hormone test in between to double check Prolactin and a Cortisol test which is over range.
My thyroid was 3.07 in January and then frustratingly dropped to 2.68 in May, which is my general story. It was below 1 pre-op, my GP at the time said I was nearing hyperthyroid if anything (I felt well) but now bounces between mid 2 up to high 3 on average and has gone up close to 4 once or twice, but my GP says to retest in a few months before doing anything and it will always be lower so they never act.
I have had low B12 and D in the past, so do supplement, which has helped, but I think I need to up my dose a little?
My prolactin was a little elevated in my first test, so I waited and retested and it was higher than before. I’d been taking antidepressants for a year or so, so I’ve come off them now and have ordered another female hormone test to redo this week and will also order another advanced thyroid test before the offer ends, to do at a later date. I’ve also been told I have elevated cortisol. Here’s my past few test results. Do they make any sense to you?
Female Hormones. Test taken 11/01/2022 - early morning, fasted.
Proteins
SHBG - 57.20 mol/L (Range: 32.4 - 128)
Thyroid Hormones
TSH - 3.07 mU/L (Range: 0.27 - 4.2)
Free T3 - 4.90 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine - 18.500 pmol/L (Range: 12 - 22)
Hormones
Hormone Phase - Luteal Phase
FSH - 2.36 IU/L (Range: 1.7-7.7)
LH - 5.43 IU/L (Range: 1 - 11.4)
Oestradiol - 546.00 pmol/L (Range: 82 - 1251)
Testosterone’s - 0.98 mol/L (Range: 0.29 - 1.67)
Free Androgen Index - 1.71 Ratio (Range: 0.2 - 7.1)
Prolactin - 558.00 mU/L (Range: 102 - 496)
Autoimmunity
Thyroglobulin Antibodies - 16.500 IU/mL (Range: < 115)
Thyroid Peroxidase Antibodies - <9.0 |U/mL (Range: < 34)
Adrenal Hormones
Cortisol - 609.000 nmol/L - taken at 8.30am
Range when taken 6am - 10am: 166 - 507
Re-test of hormones to double check Prolactin on 27/03/22
Hormones - Follicular Phase
Oestradiol - 657.00 pmol/L (Range: 45.4 - 854)
Progesterone - 1.17 nmol/L (Range: 0.181 - 2.84)
Prolactin - 953.00 mU/L (Range: 102 - 496)
Advanced Thyroid test. Taken 04/05/22. Before 9am, fasted.
Inflammation
CRP HS - 0.51 mg/L (Range: 0 - 5)
Iron Status
Ferritin 65.2 ug/L (Range: 13 - 150)
Vitamins
Folate -Serum - Sample error
Vitamin B12 Active - 117 .0 pmol/L (Range: 37.5 - 150)
Vitamin D - 60 nmol/L (Range: 50 - 200)
<w25 Deficient
25 - <50 Insufficient
50 - 75 Adequate
>75 - 200 Optimal
Thyroid Hormones
TSH - 2.68 mU/L (Range: 0.27 - 4.2)
Free T3 - 4.23 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine - 15.3 pmol/L (Range: 12 - 22)
Autoimmunity
Thyroglobulin Antibodies 23 IU/mL (Range: < 115)
Thyroid Peroxidase Antibodies - <9.0 IU/mL
(Range: < 34)
Yes Vitamin D, you need to improve to at least over 75nmol - 80nmol
How much vitamin D were you taking?
Ferritin also aim for at least over 70
So look at increasing iron rich foods in your diet
Perhaps get ultrasound scan of thyroid
20% of Hashimoto's patients never have raised antibodies
healthunlocked.com/thyroidu...
Paul Robson on atrophied thyroid - especially if no TPO antibodies
paulrobinsonthyroid.com/cou...
Thank you. I’ll definitely talk to my GP about an ultrasound, I haven’t had one for quite a few years so worth checking. At the time of testing I was taking the Better You D3000 + K2 oral spray, but would miss a day or 2 sometimes, so maybe need to be stricter with myself and take it daily to boost levels more. I more or less stopped in the summer, but will start taking it again now. I was also taking a B12 sublingual 2000ug liquid to boost previous low results.
At the time of the test I was also taking 10ml of Ferrous Fumarate liquid, prescribed by my GP, which provided 90mg elemental iron daily and I also felt I had a pretty good iron in my diet. Was eating loads of greens, literally eating platefuls of spinach and sprouts, red meat once a week, so was surprised my ferritin wasn’t through the roof. My GP told me to stop taking the Ferrous soon after those tests, because they say I was in range, but they won’t recognise ideal range and only the lab ranges.
NHS only obligated to treat vitamin deficiencies
Down to you as an individual to maintain OPTIMAL vitamin levels
High cortisol is common when thyroid is struggling
Adrenals try to compensate for lack of thyroid hormones
Interesting paper, I will read it in a few days time.
There are TRH receptors in the pituitary in thyrotrophs and lactortrophs, so TRH stimulates the secretion of TSH and prolactin. As fT3 and fT4 fall the hypothalamus secretes more TRH and the pituitary more TSH (and prolactin). Both the hypothalamus and pituitary are subject to feedback from thyroid hormones.
We get more prolactin as thyroid hormones fall, this study shows that prolactin increases in so called 'subclinical hypothyroidism'. For most people TSH will rise and if it is high they will be diagnosed with primary hypothyroidism. A minority of people have a pituitary that doesn't secrete as much TSH as it should, perhaps because they have a down-regulated axis. In these cases fT3 and fT4 (both) are low or low normal and TSH is not elevated. I've seen around 100 such patients on the forum over the years and they have quite severe hypothyroidism that does not respond to levothyroxine monotherapy.
It would be very useful to have a study in this group of patients to see their prolactin levels. I suspect they will have high prolactin and reasonably normal TSH indicating that their thyrotrophs are under performing.
Thank you for responding, that’s really interesting. I’ll look into under performing thyrotrophs. Do you think it’s possible that I could fall into this group with my results? I have so much to learn and find GP’s narrow minded opinion on this (TSH in range so you’re fine) so infuriating.
I read your Bio and have IBS also. I’ll take a look at your website :).
Your TSH seems to be in line with your fT3, fT4 so I don't think you have this problem. There can be many reasons for elevated prolactin.
hi I suggest you ask for a referral to an endo. Most GP's are not up to date with their thyroid knowledge. cx
I don't know if this helps but around two years from giving birth to my second child I could still produce milk. My GP sent me to a gynaecologist and he suggested that I had thyroid test. ( I was also having carpal tunnel symptoms and very little sleep due to this, having established that I didn't have carpal tunnel, my GP gave me antidepressants, which I didn't take. )
Subclinical hypothyroidism and hypothyroidism
Paper showing links between PCOS and subclinical hypothyroidism
Not so subclinical hypothyroidism
High prolactin... prolactinoma?
Subclinical Hypothyroidism/Hashimoto's disease 
