What is considered high levels of prolactin?

galloglass

New member
I've seen a lot of comments about prolactin and am confused. My test scores were:
Prolactin 13.9 (2.0-18.0)
Some posters say prolactin should be around 3.0, whereas others say that it only is to test for prolactinemia, where it would be in the 90s. What's the story?
 
galloglass said:
So how do you lower it with dostinex? and does high prolactin have an effect on T?
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I would expect your GP's to be pretty uninformed, LOL>

Progesterone and prolactin are particularly nasty hormones, in that they cause — much more than estrogen — storage of body fat and mental depression. Prolactin can even cause lactation in men. And, by lowering progesterone and prolactin — just like lowering estrogen — you'll increase Testosterone through various feedback mechanisms.

Prolactin needs to be in the 5's or lower.
 
I did some research on prolactin, as mine last time i checked was almost twice the upper limit.
In males testosterone can lower prolactin, and in women excess estrogen can raise prolactin, I would assume excess estrogen in males can raise prolactin. Wether this is true or not I am not quiet sure as Dr. John hasnt mentioned anything about it being linked to T and E.
 
Dr. John said:
And remember, eating or having sex within 2 hours can take PRL to 30. Not sure what eating WHILE having sex will do.
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I have to stop eatting and having sex for 2 hours? Well.. it's been a good....4 years since I have had sex.. but damn dude, eatting is my new hobby :)

In all seriousness though, I understand that being hypogonadal can raises PRL..? In other words, adding in the missing testosterone can/should lower PRL... Is this correct? I think I am finally getting some hard..4-5mm lumps under/next to the nipple yet my prolactin is 8-9 and e2 is at 23...

I am seeing an anti-aging doc tomorrow, finally, so hopefully he leaves a good impression on me and is more willing to treat the symptoms I have. Then I get to fly out to my aunt's memorial in KC the next day.
 
Dr. John said:
Where do you see that your PRL is elevated? Look at the range.
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galloglass prolactin=13.9(2.0-18.0)

We often face situation where laboratory ranges are questioned.

In regard to Prolactin I do not have anything better than LEF position stated here:

Invalid Link Removed

Prolactin can be elevated in hypothyroidism when TSH is high. Some studies indicate that elevated prolactin may promote breast and prostate cancer growth.

We hear that Dr Shippen likes it at 3

What is your position on Prolactin, Dr John?

LEF position supports prolactin no higher than 2.
If you question their position, please have them change it, you are on their board.

Quote from above link:
Evidently, prolactin levels have a very wide range that conventional doctors would consider "normal." The problem is that few doctors are aware of the dangers of elevated prolactin, and if their healthy patients are in the high "normal" range, they would do nothing to treat this condition. A "normal" range often means a person has a "normal" risk for contracting a disease. Since members of The Life Extension Foundation don't want to have "normal" risk factors, here are some guidelines for those to follow who care about optimal health:

Healthy Female
- Non-pregnant - Prolactin level no higher than 7.3 ng/ml
- Postmenopausal - Prolactin level no higher than 5.0 ng/ml

Female - Breast Cancer Patient
- Prolactin level no higher than 1.8


Male - Prostate Cancer Patient
- Prolactin level no higher than 2.0
========================================================
==========================================================
My prolactin=5.5(2-18)
my prostate is enlarged
 
Dr. John said:
It is elevated TRH, not TSH, as with primary hypothyroidism, that elevates PRL. TSH will also rise due to TRH stimulation.

If your PRL assays at 2, then sometimes it is at "0". Does that REALLY sound good to anyone?

Either way, preferring a tighter range does not mean we give drigs to alter things well within normal range necessarily.

How does compromising Leydig cell and immune function with PRL that is too low sound?

I think many, even in my field, are too quick to treat "normal" PRL. But who knows where the "normal range" will end up.

I also think many have come to believe treating Adrenal Fatigue is the be-all and end-all, even in the presence of severe hypogonadism. You aren't going to successfully treat Adrenal Fatigue while the guy feels rotten from low T, any more than you can successfully treat depression with concurrent hypogonadism without addressing the low T (which often makes the depression go away).
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Thank you for quick response, much appreciated.

My take home, about ranges, if we do not know better we use them.
While making effort at narrowing range we use upper or lower 1/3 or 1/4 laboratory range.
My best guess at the monmet would be that Prolactin would fall in lower 1/4.
range (2-18) would then become (2-6)
============================================

Incidentally if you still follow this thread;
We have some problems when testing Estradiol at Quest.
They have two ulra-sensitives (RIA)(old) and (LC/MS/MS)(new)

Hardasnails had it tested twice
once
Estradiol, Ultra-sensitive (LC/MS/MS)
it show almost no estradiol (<2) when range (<29)

then
Estradiol, Ultra-sensitive
it show his estradiol over the range

Any experience with this ( new) tests.

Noted that only few Quest labs offer those new tests.
 
i didnt meant to pass around non sense, i was just letting OP know of what i have researched people think too high is..

its good to hear doc J's POV ..

phats
 
Dr. John said:
Why would you think such low normal PRL would make your prostate sick? The association, then, would actually point the other way.
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I do not do anything drastic with my Prolactin,
I consider it is still in acceptable range.
I am just aware of it and watching it.
--------------------------------------------------------

I took two bottles of Vitex, not sure if it made any difference,
I did not followed Vitex with blood testing.
 
Dr. John said:
I'll discuss this with Nichols Institute Lab Director when I ge a chance. VERY important issue, thank you.

Of note, E can swing that far. It depends on dosing schedule, genetics, activity level, etc.
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This happened to Hardasnails.
I think his case call for a lot of expertise.
Hopefully one day he decide to:

be systematic with his approach and then go to see you.

--------------------------
How to raise cholesterol?
and generally low hormone levels,
most of hormones.
 
Dr. John said:
In looking at a lab printout just now with a patient, I notice it lists LC/MS/MS as assay methodology.
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Right,
when I look at mine those letters are absent.
I am in NJ and on my test report there is a part where they list all Quest laboratories that were involved in performing my tests, their three letter abreviations and complete name and address.

Each individual test, on right column have three letters indicating laboratory performing test.
-------------------------------------------------------

If one goes to test menu
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there is a pull-down window under REGIONAL LABORATORY

One have to choose laboratory location first an then the desired test.
Here each laboratory also have a three leter codes, unfortunately they do not match letters on the test report.

Put estrodial in search box and search on different laboratories, you come with different
Estrodial, Ultrasensitive
tests.
 
What is the half-life of PRL?

Obviously the levels will rise and fall, but how often does it stay at it's current level?

In other words... does it change greatly every hour or every minute or is it different day to day?

I have hypothyroidism and get small ammounts of white fluid coming out of both nipples.. I mentioned the TRH connection to my doc, and we rechecked the PRL #... both tests were under 10.. so I dunno wtf is going on unless it is spiking?

Also, I am only on 50mcg of synthroid, when we (doc and I) up my dose, will that help?

TSH obviously affects TRH but what else can change it?
 
smc252 said:
What is the half-life of PRL?

Obviously the levels will rise and fall, but how often does it stay at it's current level?

In other words... does it change greatly every hour or every minute or is it different day to day?
I have hypothyroidism and get small ammounts of white fluid coming out of both nipples.. I mentioned the TRH connection to my doc, and we rechecked the PRL #... both tests were under 10.. so I dunno wtf is going on unless it is spiking?

Also, I am only on 50mcg of synthroid, when we (doc and I) up my dose, will that help?

TSH obviously affects TRH but what else can change it?
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Prolactin
Prolactin (PRL): The release of prolactin is controlled by dopamine (Prolactin Release Inhibitory Hormone) produced by the hypothalamus. Prolactin is a polypeptide (small protein) of 198 amino acids (MW ~ 23,000), with 6 cysteines, 3 dissulfide bonds and a half-life (T1/2) of about 10 minutes.
Invalid Link Removed
 
With a 10 minute half-life, how the hell can we rely on blood levels? Does it stay systematic longer?

What else directly affects dopamine besides testosterone, and PRL?
 
smc252 said:
With a 10 minute half-life, how the hell can we rely on blood levels? Does it stay systematic longer?

What else directly affects dopamine besides testosterone, and PRL?
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Prolactin secretion is stimulated by sleep, stress (physical and emotional), and the hypothalmic hormone (TRH). Prolactin secretion is decreased by dopamine analogs such as bromocriptine.
Hypersecretion of prolactin can be caused by pituitary tumors, hypothalmic disease, breast or chest wall stimulation, hypothyroidism, renal failure, acute excercise, stress, eating, and several medications(eg; pheno-thiazines, metoclopramide). Hyper-prolactinemia inhibits gonadothropin secretion and can produce hypogonadism in men and women with accompanying low or inapropriedly "low normal" LH and FSH levels.

Quest Diagnostics
EndoManual_3rdEd_2004 page 311

Prolactin have no known role in male. page 205
 
smc252 said:
With a 10 minute half-life, how the hell can we rely on blood levels? Does it stay systematic longer?

What else directly affects dopamine besides testosterone, and PRL?
Click to expand...

Quest Diagnostics
EndoManual_3rdEd_2004

page 208
describes more diligent prolactin testing.

to much to type, cannot copy from this PDF document.

Think 3days every 30 minutes with indvelling catheterer.
No breast touching, no stress, etc.
 
well, b4 TRT i was 10.4....

my research tells me testosterone lowers PRL and GH can raise it??

if that the case, im 6 wks into my TRT and am now a 20, 2 over the limit?

phats
 
JanSz said:
Prolactin secretion is stimulated by sleep, stress (physical and emotional), and the hypothalmic hormone (TRH). Prolactin secretion is decreased by dopamine analogs such as bromocriptine.
Hypersecretion of prolactin can be caused by pituitary tumors, hypothalmic disease, breast or chest wall stimulation, hypothyroidism, renal failure, acute excercise, stress, eating, and several medications(eg; pheno-thiazines, metoclopramide). Hyper-prolactinemia inhibits gonadothropin secretion and can produce hypogonadism in men and women with accompanying low or inapropriedly "low normal" LH and FSH levels.

Quest Diagnostics
EndoManual_3rdEd_2004 page 311

Prolactin have no known role in male. page 205
Click to expand...



Dr. John said:
Eating, or having sex, can bring PRL to 30. Did you eat within two hours of the draw? How does midrange PRL look now?

PRL of 300 (!) is pathognomic of a pituitary tumor.

I hope this FINALLY gives you guys some perspective. Some of this stuff gets just plain silly: manipulating hormones for no reason whatsoever, when they are well within healthy level. Any time you alter a hormone, you are asking for trouble. THAT is how Interventional Endocrinology should be viewed.
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My take home message:
as long as Prolactin is within range it should be ignored and not manipulated.

If it is within range then: Prolactin have no known role in male. and that includes effects on sex.

This message is copied to my diary as my current view on Prolactin.

Thank you Dr John for your persistence thru many posts when holding your view on Prolactin.
 
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