Do high prolactin levels indicate a failing thyroid ?
Please see below for my most recent blood test results :
TSH - 3.78 (0.27 - 4.2)
FT4 - 18.4 (12 - 22)
FT3 - 6.3 (3.1 - 6.8)
Cortisol (7:45 am) - 242 (133-537)
DHEA 2.5 (0.26-11)
Prolactin - 586 (102 - 496)**
Vit D - 120 (50 - 200)
B12 - 121 (25.1 - 165)
Folate 3.5 (2.9 - 14.5)
Iron - 22.6 (6-26)
Ferritin - 19 (13 - 150)
TIBC - 53 (41-77)
Saturation - 43% (20-55)
Haemoglobin - 114 (115-155)
ALT 9 (10-35)
Bilirubin 15 (0-20)
I don't know and I don't have a thyroid but I see you have low morning cortisol and DHEA as I do. I am trying to find out what that means including in relation to thyroid results. I hope you get the correct answers.
Yeah me too - it has been low for YEARS and I suspect it has been quietly picking up the slack for my struggling thyroid.... which is why I am trying to work out if I am hypothyroid?
I have a feeling that the issue for me is in my brain i.e. Hypothalamus/ Pituitary and so it has been like having a faulty thermostat that never really registered how hypo I am.
Same here but no thyroid. Hypo for years while they said I was on too much T4 but didn't give me a solution until I got my DNA tested and found I was a poor converter then they gave me T3 which has helped. I am getting a cortisol test tomorrow so results will be interesting. It's already gone down a bit but will need to see if there's a pattern over time. I'm sure they should be doing further adrenal tests tbh but I'll see what tomorrows results say.
If you're a poor converter with poor AM cortisol, have you tried Paul Robinson's method with your T3 - CT3M?
Thank you yes. I have read his first two, have finally got on to T3 but very tightly controlled by endocrinologist but I am intending to (and have sometimes) take T3 following that method. Difficult to wake up thoughbbut I am working on it! I need to get book 3!
You need an alarm clock in the beginning, later it becomes a habit. You have your meds ready by the bed so you just take them without switching the lights on and go back to sleep?
Have you found CT3M useful samaja ? What time do you take your dose?
I take mine at 5 am at the moment but at 4 in winter (don't change my body time when the clock changes, find it easier than faffing with the adjustments) and in some ways it's a necessity with a supressed TSH and HPA axis dysregulation but I find that my cortisol is something that is hugely dependent on stress (no suprises here) and (more surprisingly to me) on the sex hormones imbalance I had or really the combination of them both.
Your ferritin is dire.
NICE
Clinical Knowledge Summary > Anaemia - iron deficiency
Last revised in September 2023
Serum ferritin level is the biochemical test that most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
cks.nice.org.uk/topics/anae...
And your haemoglobin is also out of range low.
TSH and Prolactin often rise and fall together. Not a strict lockstep but a broad, general tendency for them to change in the same direction.
helvella thanks for your input - much appreciated.
TSH and Prolactin
Ok got it although - I have never had prolactin levels anywhere near this - in fact my Medichecks and other record shows levels of 399, 363 and now 586 against a range of 102 - 496.
Granted those other values are on the higher side of the range but never over.
My question is given how borderline this TSH result is at 3.78 and excellent levels of T4 / T3 BUT how symptomatic I am (LOTS of anxiety/ cold hands feet in middle of summer, fatigue etc) do I now start medicating ?
Iron & Ferritin
Re ferritin - yes I believe we discussed that in my last post. I have an inherited (heterozygous not double recessive) blood genetic condition like Thalassaemia that means I have low Hg and some smaller blood cells. Apparently it's not symptomatic but I am not so sure, especially when it comes to situations like this.
I had a Hysteoscopy in the last few months which might explain my low ferritin compared to say last year.
BTW would an Iron transfusion be advisable at this point ? Have a telephone appt coming up with my GP and she had previously mentioned it and now I am wondering if I should push for it ?
I really don't know. I think with your existing issues, you need a genuine expert. So push for whatever you can.
Thank you - I actually requested a private referral and she is dragging her heels and I suspect has arranged another triage call just to dissuade me - these GP's don't realise that I still have to work to pay my bills.
So infuriating as it would cost the NHS nothing if she just gave me the referral, but I suspect their negligence would also be then discoverable.
Cannot advise about a transfusion but if you need a real specialist I can give you a name if you DM me.
Thanks ! will do 
You need to test BOTH TPO and TG thyroid antibodies for autoimmune thyroid disease
High thyroid antibodies and hyper prolactinoma often go together
Vitamin levels
Folate is also extremely low
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance
Difference between folate and folic acid
healthline.com/nutrition/fo...
B vitamins best taken after breakfast
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose
Post discussing different B complex
healthunlocked.com/thyroidu...
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
Post discussing how biotin can affect test results
healthunlocked.com/thyroidu...
helvella.blogspot.com/p/hel...
Do you supplement vitamin D?
link about hypothalamic-pituitary function in patients with thalassemia
pubmed.ncbi.nlm.nih.gov/162...
On the whole, this study has shown several derangements of the hypothalamic-pituitary function in thalassemia. This emphasizes the need for careful endocrine surveillance in this disease.
Interesting that is the double recessive full blown condition.
I have sickle cell trait so a smaller percentage of my blood cells are mis-shapen.
I suspect however that is still not very advantageous as I can see from my Iron studies.
That being the case I have lived with low iron, ferritin and Hb my whole life.
I am however concerned about the prolactin / thyroid/ cortisol mess that I have been dealing with for over a decade now, as that is when I feel my health really tanked.
When I was living in Paris a doctor there thought my pituitary was involved and an Endo in London carried out a short synachthen test which I just passed apparently.
The issue is that NHS doctors in London are just HORRIFICALLY scary and refuse any kind of treatment and will often just flat out refuse private referrals ???
You can choose to see who you like privately
But first you need both thyroid antibodies tested
Ultrasound scan of thyroid if both antibodies are negative
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...
Gluten intolerance is often a hidden issue too.
Request coeliac blood test BEFORE considering trial on strictly gluten free diet
And look at saliva cortisol and DHEA test
regeneruslabs.com/products/...
portal-app.inspira-regeneru...
Roughly where in U.K. are you
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists including at least one who’s a pituitary and adrenal specialist
SlowDragon
I typed out a much longer question earlier but no responses so made a much simpler post (this one).
So to answer your question antibodies were tested;
- Thyroglobulin Antibodies - 14.8 (0-115)
- Thyroid Peroxidase Antibodies - <9 (0-34)
- I have been clean of supplements for these tests for months, however I usually take Thorne 2 a day or Thorne B complex and then take extra B2,B6,B9 & B12 in the form of Thorn Methygaurd (1/2 a cap 4x a week)
- I have never had my Thyroid scanned and I suspect NHS will not do it in this instance but I do MRI's once every year or so, which I suppose is helpful in this instance.
- I have saliva cortisol and DUTCH test in the past and when I was at my most ill was almost flatlined (2014/ 2015). As I recovered it became clear my cycadian rhythm was disrupted i.e. low AM cortisol and then slightly high at night. I am a night owl and have HORRIBLE INSOMNIA.
- The prolactin may be a result of that insomnia and disrupted cycadian rhythm.
- Based in London
High prolactine highly correlates with high oestrogen and high oestrogen impacts thyroid. I wonder whether you are in peri or meno and what your sex hormones (and especially progesterone) are doing according to your DUTCH test and now.
Thanks this is VERY useful. My hormone doc has been monitoring my sex hormones for YEARS as I have always had insanely high oestrogen so this also makes sense.
It would seem like there might be a few things contributing to my high Prolactin i.e. thyroid, oestrogen, cortisol and insomnia.
I was fairly sure you were going to say so to be honest 😀 because everything you were describing through this thread paints a constant picture of progesterone deficiency/oestrogen dominance and all the associated problems of which thyroid often becomes one as well. I could also make a few other guesses based on the fact that I am a night owl and have low cortisol too though I have Hasi and no blood conditions.
Lol - off to read some of your threads.
Any advice or experiences you could offer would be greatly appreciated !
It's been now 10 years of my thyroid journey and lot's have changed since I joined the forum. Not sure how up to date my threads are. I am more active on Facebook nowadays because I belong to various thyroid and hormone groups there and find it easier to navigate between the info I am constantly gathering in one place. If you want to learn more about the prolactin and sex hormones side of things there are some great groups you could join.
Thanks - do you mind if I DM you for those links ?
DM away 🙂
TSH and prolactin are both stimulated by TRH, so there is a kink. There are other reasons prolactin may be high but I don't know anything about them.Your signs and symptoms strongly suggest hypothyroidism but your thyroid hormone levels are good. I wouldn't waste any more money in blood tests, I don't think your thyroid gland is failing. The only way to find out if you are hypothyroid is a trial of thyroid hormone. It will be difficult to find a doctor who will prescribe.
I had severe hypothyroidism with perfectly normal hormones. I responded to large doses of hormone and after many years found it was due to endocrine disrupting chemicals. I give details here ibshypo.com/index.php/acqui... .
jimh111
I thankfully do have a private Hormone Dr willing to prescribe and she was the one who actually suggested combo T4 &T3 (T4 75:T3 15 mcg) but I could not understand why as my previous results from May looked like this:
TSH - 1.9 (0.2-4.2)
T4 16.3 (12-22)
T3 4.6 (3.1-6.8)
So we agreed to test again a month or so later leading to the results above.
I had also previously been on Metformin and stopped because I ran out, and it was then that I realised that Metformin had been masking a possible high TSH.
This is what they looked like a year before (2023) on Metformin:
TSH - 1.33 (0.2-4.2)
T4 - 18.9 (12-22)
T3 - 4.6 (3.1-6.8)
Can I ask what you are now taking ?
I'm taking 50 mcg levothyroxine plus around 45 mcg liothyronine. My case is complex because after a decade of needing very high doses my pituitary no longer secretes sufficient TSH. Having sorted my endocrine disruption I shouldn't need thyroid hormone but unfortunately my pituitary is now underperforming.How dod you respond to thyroid hormone? Did you notice a clear improvement? Your thyroid is working fine, any small impairment would not explain your substantial symptoms.
This is what I found out when I researched the topic:
"Prolactin can affect the thyroid. Prolactin and thyroid function are interconnected through the hypothalamic-pituitary axis. Elevated levels of prolactin, a condition known as hyperprolactinemia, can sometimes be associated with hypothyroidism (underactive thyroid).In hypothyroidism, increased levels of thyroid-releasing hormone (TRH) are produced by the hypothalamus to stimulate the thyroid gland to produce more thyroid hormones. TRH also stimulates the pituitary gland to produce more prolactin, leading to elevated prolactin levels. Therefore, treating hypothyroidism can often normalize elevated prolactin levels."
So maybe if you get your TSH level lower, the prolactin level will also be lower. If not, you may need a comprehensive evaluation, including thyroid function tests and an assessment of other potential causes to determine the underlying reason for elevated prolactin levels.
TSH is high but both fT3 and fT4 are also high. Not likely she can get her TSH lower if she's not taking levothyroxine. Taking more might push her fT3 above range instead of lowering TSH.
You're right about that. But she still needs to investigate why this is happening.
gabkad Capan24 my hunch is that my TSH is off kilter and the thermostat is broken so to speak.
Previously I had a pattern of;
- Low/ slightly elevated TSH
- Fluctuating but often low/ slightly below mid-range T4
- Fluctuating but mainly low T3
See snapshot of my spreadsheet from testing over last 10 years or so.
Low thyroid can result in elevated prolactin. However, that's not your problem.
They need to do an MRI to see if you have a prolactin secreting microadenoma in your pituitary gland. There is also a test, triple bolus, to determine if you have a tumour that is secreting prolactin. It's nasty. I went through it and maybe they don't torture patients anymore. There's medication to suppress prolactin production although it has some side effects. Are you producing anything from your nipples? That's a sure sign that prolactin is high.
You need to get an ophthalmologist to test your visual fields. If the tumour is large enough it can put pressure on the optic chiasma and affect your vision.
Aside from that you are anemic. That's a whole other problem that needs to be addressed.
gabkad - thanks and yes I did some reading on high prolactin, but thankfully no secreting here.
I also read that stress can increase prolactin and I have had a stressful few months.
It also made me wonder if this is something my body does in times of stress but I hadn't previously caught it. It was only by chance that I decided to do a Medichecks Ultimate belts and braces test as I was tired of feeling tired.
I still believe that my very low 7:45 am low Cortisol and Iron may be implicated in this, and that is causing my Thyroid to pick up the slack in anyway it can hence the HPA Axis dysfunction as my thyroid struggles more and more to make hormones to keep me going.
I also checked my historical results for Prolactin and they're as follows (range = 102 - 496);
April 2018 - 339
Oct 2021 - 363
July 2024 - 586*
So it appears that I have been high up in the ranges for some time, so it's possible that my thyroid has also been struggling during that time.
Regardless, you still need to be investigated. Your doctor has resonsibilities. Don't make excuses for the doctors. I realize that nobody wants to be diagnosed with a microadenoma. But these things exist and the sooner it is diagnosed and treated, the better.
I don't know how old you are, but having a microadenoma prevents a woman from becoming pregnant. I know someone who has one of these and she had to take medication to suppress prolactin secretion in order to become pregnant.
Forgot to say yesterday that I probably have about 5+ MRI's including one done as recently as this Feb/ March that a doctor could reference if needed as I have a yearly MRI for another condition so I might ring my Neuro Nurse to see what they can add.
Thanks for reminding me.
High prolactin and SHBG related to thyroid?
Too Low TSH? and does it cause high prolactin in a man
High prolactin 
Hypothyroidism and prolactin 
Another study showing in range TSH causes infertility
