Elevated Prolactin

by KJ
(Australia)

I am aged 53 and have elevated prolactin which has shown up in my previous 3 blood tests over an 18 month period. I was advised by a gynaecologist to have an MRI to see if a tumor on my pituitary was the cause. I have not proceeded with the MRI as I was told the only way to rid myself from the tumor would be a medication with many side effects, which I am not prepared to take.

I am progesterone deficient with very heavy, painful periods which I have recently begun using progesterone cream for. My question is, what causes high prolactin levels in the first instance and does it have anything to do with my hormone levels being so unbalanced for so long? I have spoken to several doctors now with no satisfactory answers. Can you please help as I feel I have reached a dead end?

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Elevated Prolactin

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Oct 06, 2009
 Elevated Prolactin
by: Wray

Hi KJ, High prolactin can be caused by several factors, apart from a tumour. Low progesterone levels, a lack of protein, in particular the amino acid tyrosine, high oestrogen which stimulates it's production, certain drugs increase prolactin production, in particular the contraceptive Pill due to it?s high oestrogen content.

There is some evidence that stress contributes to high prolactin levels. If as you say you are deficient in progesterone, with heavy bleeding which indicates high oestrogen, I would imagine this is the cause. Progesterone suppresses prolactin, as does the neurotransmitter dopamine. The amino acid L-tyrosine is the precursor to dopamine, it could be there is a lack of tyrosine in your diet or high stress. Dopamine is synthesised in nervous tissue and in the adrenals from tyrosine. Noradrenaline and adrenaline are then synthesised from dopamine. These two, together with cortisol, make up the ?stress? hormones. With a high level of stress dopamine levels will drop. The two B vitamins B3 and folic acid are needed for the conversion of tyrosine to dopamine. It would be advisable to take 500g/day tyrosine (in the morning) to start with, increasing by the same amount until the optimum dose is reached. (It is safe to go up to 5000mg/day). Take 100mg B3 and 300mcg folic acid too (no need to increase these). Both these act as co-factors in the conversion of tyrosine to dopamine. I've pasted below info from Medline.

  • People with the following conditions may have high
  • prolactin levels:
  • Chest wall trauma or irritation
  • Hypothalamic disease
  • Hypothyroidism
  • Kidney disease
  • Pituitary tumor that makes prolactin (prolactinoma)
  • Other pituitary tumors and diseases
  • Certain medications can also raise prolactin levels, including:
    Antidepressants
    Butyrophenones
    Estrogens
    H2 blockers
    Methyldopa
    Metoclopramide
    Phenothiazines
    Reserpine


    Apart from taking the tyrosine, I would suggest at least 200-300mg/day of progesterone. I've found for heavy bleeding anything less will not help. In fact one woman who wrote to me was using 900mg/day in a cream form as prescribed by her doctor. This stopped the heavy bleeding very quickly, but at my suggestion she reduced the dose to 600mg/day but to use it hourly. This was also effective. She reduced it herself to 400mg/day, also hourly, and only then did she have a normal period and this was after six months of progesterone use. Take care, Wray
    • Oct 20, 2009
    		 Many thanks
    by: KJ

    Thanks Wray, you have no idea how helpful your reply is. I only recently started on Dr John Lee's progesterone cream but am not sure if I should use it continually during my cycle until my levels come up or just day 14-26. I am currently using a pea size amount twice daily. Is this enough to counteract my prolactin problem? Hopefully, with your advice regarding tyrosine I will see some positive results. Once again, many thanks.
    Oct 25, 2009
    		 Elevated Prolactin
    by: Wray

    Hi KJ. Glad it was of help. I suggested 200-300mg/day progesterone, I've found anything less does not help with heavy bleeding. This amounts to 6-9ml of Natpro per day, which would need to be doubled with the cream you are using, as it contains only 16mg progesterone per gram. The 'pea' size you're using would amount to about 1ml of cream, twice a day. This would be giving you a total of about 32mg progesterone per day. I doubt this amount would make a difference! You are heading for menopause, hence the heavy bleeding, so I would suggest you ignore your cycle and use the cream every day. Even during peri-menopause I did, as my symptoms came back in the days I didn't use it, not something I enjoyed! Take care, Wray
    Jun 18, 2010
    		 BE YOUR OWN DOCTOR
    by: KARIS from Australia

    Hi Wray, So excited to tell you that after using progesterone cream now for 6-7 months my Prolactin levels have halved. After a very heated debate with a "female" gyny last year because of her lack of knowledge regarding thinking outside the square when it comes to pre menopause & menopause symptoms, and insisting, without success, that I embark on HRT, I am happy I took charge of my own issues with great success.

    I would like this story to be read by all women who suffered as I did for many years with estrogen dominance. We MUST be our own Doctor with regard to our health as mainstream Practitioners are ignorant to Natural solutions,especially in Australia.

    Thank You Wray for all your help & advice.
    Jun 22, 2010
    		 BE YOUR OWN DOCTOR
    by: Wray

    Hi Karis You've no idea how delighted I am! It's a pity so few know about progesterone and how it works in us. Something I forgot to mention previously, prolactin is the hormone involved in the production of milk. It's suppressed by progesterone during pregnancy, after birth progesterone levels drop sharply, prolactin is no longer suppressed, so milk production starts. Very simple really! So please don't forget stress also drops both progesterone and dopamine levels, so if stressed use more cream, and possibly take tyrosine too, to raise dopamine levels. And yes, it's essential to take charge of our own health! Take care Wray
    Jul 24, 2010
    		 Elevated prolactin and low progesterone
    by: sandra

    I have a high prolactin level which is 29.4 and a low progesterone which is 3.1 and I have been taking some drugs and since last month when I saw my period was on the 19 and now I have not seen it and I have gone for test it was negative. Please what do I do?
    Aug 01, 2010
    		 Jul 24, 2010 Elevated prolactin and low progesterone
    by: Wray

    Hi Sandra Not knowing how long your cycle normally is, it's difficult to know if it's just a glitch or if it's normal for you. You don't say what drugs you are on, as some can contribute to a high prolactin level, including contraceptives. But as you have high prolactin/low progesterone please follow the advice I gave Karis in the comments above. Take care Wray
    Nov 16, 2010
    		 Prolactin Levels
    by: DA

    Hi...Just wanted to know if you knew of any vitamins or herbs that would lower prolactin levels. I spoke with my doctor today about vitex and she said that I could give it a try, but that it probably won't lower my levels to where it should be. I was told about bromocryptine, but would prefer not being on any medication at all...I have a micro adenoma on my pitutary gland which elevates my prolactin levels. I just want to make sure I know all of my options before deciding on what to take. Thanks
    Nov 19, 2010
    		 Prolactin Levels
    by: Wray

    Hi DA Agnus castus has been used for many problems which women suffer from, PMS, mastalgia, menstrual irregularities, fibrocystic breasts, increasing lactation and more. In days gone by it was used by monks to reduce sexual desire, hence it's name 'chasteberry'. It can also reduce prolactin levels, which in turn can cause luteal phase dysfunction, with subsequent problems in embryo implantation. But because it has a mild oestrogenic action, levels of 17 beta-oestradiol can increase. One study found mild ovarian hyperstimulation syndrome occurred in the luteal phase. Agnus castus doesn't contain progesterone. It's active constituents are the essential oils limonene, cineol, pinene, and sabinene. The iridoid glycosides aucubin, agnuside, and eurostide. The flavonoids casticin, kaempferol, quercetagetin, orientin, and isovitexin. And the diterpenes vitexilactone, rotundifuran, and 6-beta,7 beta-diacetoxy-13-hydroxy-labda-8,14-dien. It also contains several fatty acids, including oleic acid, linoleic acid, palmitic acid, and stearic acid. Please see here, here, here, here, here and here. Oestrogen increases mitotic and secretory activity of several cells in the pituitary, but particularly the proliferation of lactotrophs or prolactin cells. The most frequent symptom is hypogonadism in both genders. High prolactin inhibits the secretion of FSH and GnRH which leads to hypogonadism. In women this suppresses the ovulatory cycle causing irregular periods, anovulation, with subsequent difficulty in falling pregnant, and a possible loss of libido and breast pain too. In some women, menstruation may disappear altogether. A high level of stress causes dopamine levels to drop and prolactin to rise. A lack of protein in the diet, leads to a deficiency in the amino acid tyrosine. Tyrosine is the precursor to dopamine, a drop in tyrosine levels causes dopamine levels to drop, which stimulates prolactin release. There is evidence that prolactin is involved in tumourigenesis, so reducing the prolactin level could well cause the adenoma to shrink. Progesterone causes an increase in dopamine by suppressing prolactin and oestrogen, see here. Consider taking tyrosine too. Please avoid bromocryptine if you can. Take care Wray
    Nov 19, 2010
    		 Prolactin Levels
    by: DA

    Thanks Wray! So I'm thinking that I'll take vitamins B, vitamin B3 and folic acid (for the tryosine)...and some progesterone. Does progesterone come in a capsule? I would hate to have to get a shot every time I need some :) Do you have any other suggestions? I would love to hear them...thank you so much for all of the information.
    DA
    Nov 23, 2010
    		 Prolactin Levels
    by: Wray

    Hi DA Pleased it was of help! I was a bit vague about giving you info on progesterone, sorry! Progesterone does come in a capsule, but oral progesterone is the least effective delivery system. For more info please see the page we have on Progesterone application methods.
    No need to get a shot of it either, very painful by all accounts! So that leaves the suppositories or creams, I prefer the latter as it can be used anywhere. I recommend 100-200mg/day, dependant on symptoms. I suggest you try the 200mg/day initially, as you need to reduce the prolactin, plus any excess oestrogen stimulating it's production. For more info on the cream see here. But before you consider using it, please see this page on Oestrogen Dominance first. Take care Wray
    Feb 28, 2011
    		 Progesterone & Prolactin
    by: KJ from Australia

    I found after using progesterone for several months my prolactin levels decreased to normal levels. I feel I needed to oppose the oestrogen with the progesterone to do this. This of course was after a gynacologist had almost convinced me that I was suffering with a pituitary tumor. After much research myself, I was sure the oestrogen was the culprit. I was right! Of course the so called 'Professional' WOULD NOT AGREE. How sad for her future patients. Or should I say Victims?
    Mar 17, 2011
    		 High Prolactin and High Testosterone
    by: Neveen

    The high prolactin in the comment caught my attention. I have been having issues for almost five years. Left breast grow bigger than the other along with really bad pain, ultrasound and mammogram revealed nothing is wrong. My period is almost gone, hair lose like you wouldn't believe. Really bad pelvis pain, can't sleep for month on an end and other strange symptoms. Finally after going in circles I was told that I have high prolactin and high testosterone and only after I pushed my doctor to test me. I have been searching the internet and I came across using progesterone cream and I did order some. I am wondering if it would help with me the high prolactin and the high testosterone and how often and how much I should be using it. What other herbal supplements i should be using to help as well. I am currently taking matformin for insulin resistant; I am talking 1000mg per day. Just started a few months ago which has helped a great deal? Thanks so much for this site. It is a great help.
    Mar 25, 2011
    		 Progesterone & Prolactin
    by: Wray

    Hi KJ I couldn't agree more with your sentiments! It's good to hear back from you with a positive report that the progesterone helped. Oestrogen increases mitotic and secretory activity of several cells in the pituitary, but particularly the proliferation of prolactin cells. I've found two more papers which might interest you, see here and here. The first papers shows how stimulating the proliferation of prolactin cells causes a tumour! Take care Wray
    Mar 25, 2011
    		 High Prolactin and High Testosterone
    by: Wray

    Hi Neveen Progesterone does suppress excess prolactin, KJ also supports this as she tried it. Oestrogen increases prolactin, as it increases mitotic and secretory activity of several cells in the pituitary, but particularly the proliferation of prolactin cells. Please read the papers I've given to others on this page. Oestrogen also causes water retention and inflammation, hence the pain in your breast. Rubbing a progesterone cream on the breast does help. But please make sure you use sufficient, I recommend 100-200mg/day progesterone. I've found anything less merely exacerbates symptoms, as it ramps up oestrogen. This leads to Oestrogen Dominance and more adverse symptoms. As you say your period is almost gone you are now in Peri-menopause. This page gives info on how to use progesterone. The hair loss is due to excess testosterone, you say yours is high. Testosterone also causes Insulin Resistance.
    By using progesterone it will reduce your testosterone levels, plus it does help stabilise blood glucose slightly. These are further papers on testosterone, it's essential you suppress it, see here, here, here, here, here here, here, here, here, here and here. There are many nutrients which reverse IR, there's no need to take the Metformin if you choose this route. Incidentally, I do hope you've been given vitamin B12, as Metformin reduces levels, see here. Thanks for the kind words! Take care Wray
    Apr 02, 2012
    		 Prolactinoma
    by: Lauren - Australia

    Hi Wray

    I just want to thank you so much for your information on prolactinomas and natural treatment on this page, I have really struggled to find information on this and this was the first thing I have ever stumbled across that has given me a better understanding of how it all works, Endocrinologists seem so limited in what they tell you and even the natural hormone doctors over here seem to be lacking in knowledge but still charge a criminal amount for a consultation!

    I am 24 years old, in early 2011 things started to go downhill.. I felt it was hormonal as I had been having issues for a few years already with no answers from doctors, except "stay on the pill" and so I went off the pill (and will never use it again) and my periods completely stopped! I had crippling anxiety and depression (which I had never suffered from before) and terrible fatigue. I refused antidepressants, didn't feel that was the problem. I had to stop working, lucky I have a supportive husband. After occasionally leaking milk from my breasts doctors diagnosed a prolactinoma.. Blood test showed the prolactin level to be around 2000 and MRI showed 4mm tumour on the pituitary. Endo put me on Dostinix (Cabergoline), no one could tell me anything about how this prolactinoma had come about, only that it suppressed my other hormones.

    Just prior to this, during the time I was trying to find out what was wrong, I went to a natural hormone doctor over here who found I had hardly any progesterone or oestrogen (saliva tests) and put me on Progesterone/Pregnenolone troches (only available with script here) which made a massive difference to me, but he had completely missed the prolactinoma which didn't give me much confidence. Endo advised me to go off the troches while trialling Cabergoline to allow the hormone levels to naturally return, which I did.

    Nine months after starting Cabergoline my periods have returned, fatigue is slowly improving and anxiety has greatly improved but I am not too happy about being on this medication long term, even though I am on a low weekly dose. I am trying to convert my whole lifestyle to healthier options. I still suffer from terrible PMS, I haven't been able to shed the 10kgs I have gained over this time despite introducing a lot more exercise and I have the majority of the Oestrogen Dominence symptoms. I had been thinking of going back on progesterone and other natural alternatives and I was so happy to find your site!

    I have just ordered your progesterone cream and I am going to trial that with tyrosine, as you suggested above, and go off the Dostinix (there doesn't seem to be any immediate danger in doing this, the doctor was quite happy for me to do so e.g. if I became pregnant).

    Any other suggestions you could offer for my situation?

    Many thanks,
    Lauren
    Apr 02, 2012
    		 Prolactinoma
    by: Wray

    Hi Lauren I'm delighted you read the other comments above, it makes my life far easier! I seem to repeat myself endlessly. It seems by all accounts that you have been low in progesterone since puberty. Which probably means your oestrogen was high. As this stimulates the lactotrophs to multiply, and secrete more prolactin, it wouldn't surprise me to find it was the oestrogen which caused the prolactinoma. Which of course would increase your prolactin levels still further. As you're wanting to come off the dostinix and start progesterone, please have another prolactin test done. Then once you start the progesterone you will have a bench mark to note any progress. If you have terrible PMS, an indication your oestrogen is too high, progesterone too low, I feel you should use no less than 200mg/day progesterone, you might need more. Please see these comments here for encouragement. Normally I recommend using the progesterone following your cycle, but if you find when stopping it prior to bleeding you get bad Oestrogen Dominance it might be worth considering using it daily for 2-3 months through any bleeding too. I've found this ensures progesterone becomes the dominant hormone, and suppresses any excess oestrogen. It will also suppress excess prolactin if you still have too high a level. It's easy enough to follow your cycle again, we have more info about this on our page How to use progesterone cream. Tyrosine is essential too, I'm happy you're going to try that. We have more info on how to take it on our page Natural Antidepressants. One other thing, please have a vitamin D test done. The B vitamins are important for the conversion of tyrosine into dopamine, but even more essential is vitamin D. The rate limiting step in dopamine synthesis is the enzyme tyrosine hydroxylase. Insufficient levels of vitamin D inhibit tyrosine hydroxylase, resulting in a disturbance in the dopamine pathway. Unfortunately Australia has a daft policy of covering up when in the sun, nothing could be more dangerous to our health. Vitamin D levels are low in Australia, it's vital for the normal functioning of every cell. Vital too for pregnancy and the growth of the foetus, see here, here and here. continue below.
    Apr 02, 2012
    		 Prolactinoma Part 2
    by: Wray

    Hi Lauren And more here, here, here, here and here. These are excellent videos to watch too, see here and here.
    Even as far back as 1947 10,000-20,000iu's were suggested, see here. So when you do fall pregnant, please make sure your levels are high. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth, Birmingham Hospital and Vitamin D Links websites. Blood levels should be 70-100ng/ml or 175-250nmol/L and not the 30ng/ml or 75nmol/L most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although the latest research indicates it should be 10,000iu's per day, see here. Finally we do have a page on Pregnancy you could look through, plus this one here. Take care Wray

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