raised prolactin, low free T4 in 15 year old

[Lec1977]

Hi

My daughter is being investigated for high prolactin levels. Latest bloods were

FSH (Roche E170) 5

FreeT 4(RocheE170) 12.1 LOW

LH (Roche E170) 11

Prolactin (RocheE170) 778 HIGH (has been as high as 1300)

TSH(RocheE170) 1.5

Symptom: extreme fatigue, low mood, rapid moods swings, menstrual cycle has changed from 28 days to 35-40 days.

Current diagnosis’ : Tourette’s, FND (functional neurological disorder), depression

Current medication: fluoxetine 20mg

Strong family history of thyroid problems - paternal nan, aunt and female cousin, maternal nan and great aunt

I’m aware that fluoxetine can increase prolactin but with her other bloods and symptoms is that a red herring.

Any advice on what could be the cause and what I should be talking to her consultant about (further investigations/treatment etc) please?

Thank you

[SlowDragon Administrator]

High prolactin extremely common with autoimmune thyroid disease

For full Thyroid evaluation she needs TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Blue horizon will test under 18’s

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

Tips on how to do DIY finger prick test

healthunlocked.com/thyroidu...

BH also offers private blood draw at clinic near you, or private nurse to your own home…..for an extra fee