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Does Uncontrolled Hypothyroidism Cause High Prolactine Level In Body?

Posted on Sat, 16 Apr 2016

Question: Hi, My Wife has been detected for Hypo Thyroid (test reading 12). We visited Endocrinologist as she was also having high prolactine. Actually she was detected prolactine before also prior to both babies as she was not able to conceive due to this. Post medication prolactine was controlled and she conceives. Few days before she observed discharge from the breasts and when visited Gyno she gave medicine for prolactine. Now before taking thyroid medicne we consulted endocrinologist and showed all previous reports upto last 8 yrs reflecting high prolactine, he advised to go for MRI Scan. Pls advice should we go for MRI for prolactine or it may be due to Thyroid.

Answered by Dr. Ajish TP (1 hour later)

Brief Answer:
Uncontrolled hypothyroidism can cause high prolactin

Detailed Answer:
Hi,

Welcome to HCM.

Thanks for posting the question. I understand your concerns.

Prolactin can be elevated in hypothyroidism. It will return to normal immediately once hypothyroidism is controlled. If prolactin levels is not normalized after controlling hypothyroidism it is advised to take an MRI pituitary as prolactin is secreted from pituitary.

It is not correct to take prolactin medications before doing an MRI brain. So if your TSH is high, take thyroid medication and repeat a TSH and Prolactin after 1 month. If TSH is normal and Prolactin is high then do an MRI brain and decide on treatment of prolactin.

Hope I have answered your question. If you need any further clarification please feel free to ask. Upload your thyroid function and Prolactin blood reports.

Regards
Dr Ajish TP

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajish TP (1 hour later)

Hi Doctor,

Thanks for the reply.
Have gone through the MRI scan and got the reports this afternoon. As per report its normal. (Regret to mention wrongly earlier to go for MRI or not as we went for it..Instead i want to ask was it necessary...as we got tense when heard of MRI).
One month before she has taken medicine for prolactin as advised by Gyno. (from 31st Dec one tablet once a week - cabergolin .5mg)
As per recent test done last week, prolactin was normal but thyroid(tsh) was high, hence gone to Endo Doctor for consultation.
Parallelly Doctor who prescribed for MRI scan has also given medicine for Thyroid as "thyronorm 75mcg" once a day empty stomach.
Am attaching MRI scan report for reference.
Pls advice further.

Answered by Dr. Ajish TP (13 hours later)

Brief Answer:
No need to start prolactin medications

Detailed Answer:
Hi,

Welcome back

If MRI is not showing any tumour in pituitary there is no need of any treatment unless breast discharge is very severe.

You can continue thyroxine and recheck prolactin and TFT after 6 weeks.

Regards
Dr Ajish TP

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Ajish TP (32 hours later)

Hi,

Have referred to the doctor with reports...as per him since there is no detection of tumour in MRI..it means size of tomour can be less than 2 mm. He has prescribed cabergolin 1.5mg & thyronorm 75mcg for next 4 weeks and repeat test (prolactin & TSH) to advice further.

Hope this is ok and can continue with it.
Just want to go for second opinion on it.

Thanks
Regards
xxxxxxxx

Answered by Dr. Ajish TP (15 hours later)

Brief Answer:
See detailed answer

Detailed Answer:
Hi,

Welcome back.

The endocrinologist is saying this because your wife has already taken cabergoline before.

The indications for starting cabergoline in galactorrhea ( breast discharge) and high prolactin are

1. Size of pituitary tumour more than 1 cm or having some pressure symptoms ( severe head ache, vision problems, etc)

2. Absent menstruation

3. Severe spontaneous breast discharge

4. Planning for pregnancy

If you have a pituitary tumour, once you are started on cabergoline, the size will decrease or disappear within few weeks. That is why we will start on cabergoline only after MRI. Since you have already started on cabergoline before this could be a small pituitary tumour which has decreased size and now not detectable by MRI.

So you can continue with the medications and repeat TFT and prolactin after 1 month

Regards.

Dr Ajish TP

Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar