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Prolactin is a hormone secreted by the pituitary gland that plays a crucial role in stimulating growth and regulating metabolism. Both men and women produce prolactin, and when its levels are elevated, this hormone can cause issues such as reduced sexual drive, irregular or absent menstrual cycles. There are various factors that can elevate prolactin levels, including certain prescription medications, benign tumors, and hypothyroidism. Therefore, it is important to consult a doctor for diagnosis and treatment.
Steps
Change Prescription Medications
Review the medications you're taking. Some prescription drugs can increase prolactin levels. If you're taking one of these medications, it may be the reason for your elevated prolactin levels.
- Dopamine, a chemical in the brain, can help inhibit prolactin production. When you take medications that block or lower dopamine levels, prolactin production may rise.
- Some antipsychotic medications, such as risperidone, molindone, trifluoperazine, and haloperidol, as well as certain antidepressants, can cause this effect. Metoclopramide, a drug prescribed for severe nausea and gastroesophageal reflux, can also increase prolactin secretion.
- Some antihypertensive medications may also contribute, although less commonly, including reserpine, verapamil, and alpha-methyldopa.
Consult your doctor about stopping your medication or switching to an alternative. You should not stop taking your medication abruptly, especially antipsychotics, due to the risk of serious withdrawal symptoms. Therefore, if you wish to discontinue any of these medications, it’s important to discuss it with your doctor first.
- Your doctor may also suggest switching to a different medication that does not cause this side effect.
Ask your doctor about using aripiprazole, an antipsychotic medication. This drug has been shown to effectively lower prolactin levels when used as a replacement for other antipsychotic medications. Ask your doctor if this medication is suitable for you.
- Antipsychotic drugs can increase prolactin levels by inhibiting dopamine, which causes prolactin secretion from the pituitary gland to rise. Long-term use of antipsychotics may lead to tolerance, causing prolactin levels to return to normal, though in some cases, they may remain elevated.
- The medication may cause side effects such as dizziness, palpitations, headaches, stomach issues, weight gain, and joint pain. It may also make you feel unsteady on your feet.
Visit a doctor
Prepare for a blood test to check prolactin levels. If your doctor suspects your prolactin levels are elevated, a test will be necessary. The best method is to take a blood sample. Typically, doctors will ask for a fasting blood test, meaning you shouldn’t eat for 8 hours before the test.
- Doctors may also order this test if you have symptoms such as irregular or absent periods, infertility, erectile dysfunction, reduced libido, or breast tenderness.
- The normal range for non-pregnant women is between 5 and 40 ng/dL (106 to 850 mIU/L), and for pregnant women, it ranges from 80 to 400 ng/dL (1,700 to 8,500 mIU/L).
- For men, the normal level is typically less than 20 ng/dL (425 mIU/L).
- Your doctor may conduct other blood tests to ensure that you do not have underlying conditions such as kidney disease or other issues that could cause elevated prolactin levels.
Inform your doctor if you have recently experienced chest trauma. Chest injuries can temporarily raise prolactin levels, so it’s important to let your doctor know if you’ve had any chest injuries within the past few weeks. A rash or shingles in the chest area can also lead to this symptom.
- Typically, prolactin levels will return to normal once you recover from the chest injury.
Request a test for hypothyroidism. Hypothyroidism occurs when the thyroid gland doesn't produce enough thyroid hormones. If you have this condition, your prolactin levels may be elevated. Your doctor will recommend a blood test to diagnose this disorder.
- If your prolactin levels are high, your doctor will likely check for this condition, but feel free to ask your doctor for confirmation.
- Hypothyroidism is typically treated with levothyroxine medication.
Ask if a vitamin B6 injection is suitable for you. A single dose of vitamin B6 may be sufficient to reduce prolactin levels, especially if the condition is temporary. However, the most effective way is through an intravenous or intramuscular injection, so discuss it with your doctor.
- A common dose is 300 milligrams. Healthcare professionals usually administer the injection into a large muscle (such as the thigh or buttocks) or inject it into a vein.
Apply home remedies
Consider taking 5g of ashwagandha root powder (Indian ginseng) daily. This supplement, also known as Withania somnifera, may help lower prolactin levels. In fact, it also supports male fertility and enhances sexual desire in both men and women.
- Consult with your doctor before starting any supplement regimen.
- Possible side effects include nausea, digestive issues, or headaches when using this supplement.
Supplement with 300 milligrams of vitamin E daily. Simply adding vitamin E to your diet may help lower prolactin levels, especially if they are elevated. It can prevent the pituitary gland from producing excessive prolactin.
- Talk to your doctor before starting vitamin E supplements if you have conditions such as kidney disease or are undergoing dialysis.
- Vitamin E is generally safe, but high doses may cause digestive issues, fatigue, weakness, skin rashes, headaches, blurry vision, increased creatinine levels in urine, and reproductive gland dysfunction (testicles).
Increase zinc intake through supplements. Zinc supplements can help lower prolactin levels. Start with 25 milligrams per day and increase up to 40 milligrams daily if needed. It's advisable to check your prolactin levels again to see if the dosage needs adjustment.
- Ask your doctor about the proper dosage for zinc supplements.
- Possible side effects include headaches, indigestion, nausea, diarrhea, and vomiting.
- Taking more than 40 milligrams daily for an extended period may cause copper deficiency. Also, avoid nasal medication, as it can lead to loss of smell.
Sleep 7-8 hours each night. Lack of sleep can disrupt your body's balance, including hormone production such as prolactin. Aim for a reasonable bedtime to ensure a restful night. Quality sleep alone can help lower prolactin levels.
Treat prolactin-secreting pituitary tumors
Recognize the symptoms of prolactin-secreting pituitary tumors. This type of tumor is located in the pituitary gland. In most cases, the tumor is benign and not cancerous, but it can lead to high prolactin levels.
- In women, symptoms typically include changes in menstrual cycles, decreased libido, and reduced milk production while breastfeeding. In men and women without menstruation, diagnosis is trickier, but low libido (due to reduced testosterone) and possibly enlarged breasts in men may occur.
- If left untreated, the tumor can cause early aging, headaches, and even vision loss.
Take cabergoline to treat the tumor. This is the preferred medication because it has the fewest side effects, requiring only two doses per week. It works by shrinking the benign tumor and lowering prolactin levels.
- Possible side effects include nausea and dizziness.
- Another common medication is bromocriptine, which also causes nausea and dizziness. With this drug, the doctor may gradually increase the dosage to minimize side effects. It is cheaper but requires taking it 2-3 times a day.
- You may need to take these medications indefinitely, but you can stop when the tumor shrinks and prolactin levels decrease. However, you should never stop abruptly; follow your doctor's instructions for tapering the dosage.
Consider surgery if medications are ineffective. Surgery is often the next step in treating this type of tumor. The surgeon will remove the tumor to prevent complications like high prolactin levels.
- If you have a different type of pituitary tumor rather than a prolactin-secreting one, surgery might be the initial treatment option.
Discuss with your doctor whether radiation therapy is necessary. Radiation therapy is a common treatment for this type of tumor, whether benign or malignant. However, its use has decreased and is typically a last resort. Radiation can also cause the opposite effect, where the pituitary gland does not produce enough hormones.
- In certain cases, radiation therapy may be the only option, especially if medications are ineffective and surgery is not a safe choice. In such cases, this treatment method may be required.
- Sometimes only one treatment is needed, but certain tumors may require a combination of treatments, depending on the tumor's size and type.
- The most common side effect is a reduction in pituitary function, leading to insufficient hormone production. Rare side effects include damage to nearby brain tissue, including nerve damage.
