The prevalence of hyperprolactinaemia in overt and subclinical hypothyroidism (original) (raw)
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Hyperprolactinemia in association with subclinical hypothyroidism
2011
BACKGROUND Hyperprolactinemia is the most common endocrine disorder in hypothalamic-pituitary axis and has been reported in variable levels in patients with overt primary hypothyroidism. We decided to determine the prevalence of hyperprolactinemia and clinical related symptoms in subclinical hypothyroidism patients. METHODS In this cross sectional study, prolactin levels of 481 subclinical hypothyroid patients were assessed. Prolactin measurement was performed using chemiluminescent immunoassay. Data were collected and analyzed. RESULTS Sixty-two (13%) patients were males and 419 (87%) were females. The mean age of the patients was 32.53±10.13 years. Ninty-eight patients (91 females 7 males) had high prolactin. Prevalence of hyperprolactinemia in subclinical hypothyroidism was 20.4%. (11% in men and 22% in women, p=0.05). There was no correlation between the serum TSH and prolactin level. Clinical symptom prevalence was not different between patients with and without hyperprolactine...
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1981
Hypothyroidism-induced hyperprolactinemia, with or without clinical manifestations, is reported in a short case in addition to the results of basal and thyrotropin-releasing hormone (TRH)-induced prolactin values in primary hypothyroidism. In comparison with an age-and sex-matched group, basal-(P< 0.02) and TRHinduced (P < 0.02) prolactin values are significantly increased in primary hypothyroidism. A review of the literature and the possible pathogenesis of hyperprolactinemia, amenorrhea and galactorrhea are discussed. No correlation could be found between maximal thyrotropin (TSH) and prolactin-increase values.
https://www.ijrrjournal.com/IJRR\_Vol.3\_Issue.6\_June2016/Abstract\_IJRR004.html, 2016
Introduction: Hyperprolactinemia is one of the most rampant endocrine disorders in hypothalamic-pituitary axis. Hypothyroidism refers to state that results in a deficiency of thyroid hormones, including hypothalamic or pituitary disease and generalized tissue resistant to thyroid hormone. Thyroid releasing hormone can causes rise in serum prolactin levels in patients of primary hypothyroidism. Methods: A total of 170 patients presenting to endocrinology clinic for various thyroid related problems were selected. Serum T3, T4, TSH and Prolactin were analyzed by using Benesphera enzyme linked immunosorbent assay kit from Avantor, on Lablife ER2007 elisa reader from Diagnova India. Results: Prolactin level is high in the subclinical hypothyroid patients and hypothyroid patients as compared to euthyroid patients. Conclusion: Hyperprolactinemia was an important feature in patients with newly diagnosed hypothyroid and subclinical hypothyroid patients.
The incidence of hyperprolactinaemia and associated hypothyroidism: local experience from Lahore
Aims The aim of the study was to determine the incidence of hyperprolactinaemia, document the underlying causes and consequences of hyperprolactinaemia, and to investigate the correlation between hyperprolactinaemia and hypothyroidism in a group of patients referred for hormonal profile assessment from local hospitals and clinics. Methods This study includes 1365 subjects (46 males, 1319 females) referred to the Centre for Nuclear Medicine in Lahore, for hormonal estimation to investigate the possibility of an underlying hormonal disorder based on clinical grounds. Serum Prolactin and thyroid stimulating hormone levels were measured using IRMA kits. Results In our study population, the incidence of hyperprolactinaemia was estimated at 4.90 percent. Menstrual irregularity appeared to be the major consequence in females.In male subjects, the major complaints observed were infertility and azoospermia. The incidence rate was the highest in the age range of 22-27 years. Hypothyroidism in hyperprolactinaemic subjects was observed to be 22.7%. Conclusion The incidence of hypothyroidism in hyperprolactinaemic subjects in our study population was found to be signficantly high. Based on the results of our study, we would recommend thyroid hormone estimation in all patients with abnromal serum prolactin.
Pitfalls in the Diagnostic Evaluation of Hyperprolactinemia
Neuroendocrinology, 2019
An appropriate diagnostic evaluation is essential for the most appropriate treatment to be performed. Currently, macroprolactinemia is the third most frequent cause of nonphysiological hyperprolactinemia after drugs and prolactinomas. Up to 40% of macroprolactinemic patients may present with hypogonadism symptoms, infertility, and/or galactorrhea. Thus, the screening for macroprolactin is indicated not only for asymptomatic subjects but also for those without an obvious cause for their prolactin (PRL) elevation. Before submitting patients to macroprolactin screening and pituitary magnetic resonance imaging, one should rule out pregnancy, drug-induced hyperprolactinemia, primary hypothyroidism, and renal failure. The magnitude of PRL elevation can be useful in determining the etiology of hyperprolactinemia. PRL values >250 ng/mL are highly suggestive of prolactinomas and virtually exclude nonfunctioning pituitary adenomas (NFPAs) and other sellar masses as the etiology of hyperpro...
Hypothalamic-Pituitary Function in Diverse Hyperprolactinemic States
Journal of Clinical Investigation, 1974
Thyrotropin-releasing hormone (TRH) administration in four patients resulted in normal TSH release in two patients (one of whom developed galactorrhea after the test), an absent response in the patient with the hypothalamic tumor, and a blunted response in one of the women with a pituitary tumor. The two men had low 24-h mean plasma testosterone concentrations (69 and 30 ng/100 ml) and symptoms of impotence and loss of libido. Five of the women (four with pituitary tumors and one with Chiari-Frommel syndrome)had either low 24-h mean LH concentrations, abnormal LH secretory patterns, or both. These data indicate that patients with hyperprolactinemia encompassing a varied etiological range frequently show loss of the normal sleep-associated increase in prolactin secretion as well as abnormalities in the regulation of the other hypothalamic pituitaryregulated hormones. The finding that the abnormalities in LH, growth hormone, thyrotropin, and cortisol (adrenocorticotrophic) secretion were almost uniformly confined to the patients with the clinically demonstrable hypothalamic or pituitary tumors suggests that the size of the lesion is the critical factor.
The Turkish Journal of Endocrinology and Metabolism, 2020
Objective: Hyperprolactinemia is the most common disorder of the hypothalamic-pituitary axis. It is most commonly caused by a pituitary adenoma. Due to the recent easy availability of over-the-counter medication, many drugs, including herbals have commonly been related to this disorder. Our purpose was to study the clinical presentation and etiology of hyperprolactinemia and to address any changing trend in the etiological profile of this disorder. Material and Methods: This study was a crosssectional observational study on the etiologic spectrum and clinical profile of hyperprolactinemia. A total of 100 consecutive non-pregnant and non-lactating patients attending or referred to the outpatient department of Endocrinology at SKIMS, Srinagar were included. Hyperprolactinemia was confirmed by a serum prolactin level of >25 ng/mL (normal range=1-20 ng/mL). Patients with suspicion of drug-related hyperprolactinemia were advised to stop drug consumption for a minimum of three days (if medically feasible) and retest for prolactin levels as per the Institutional protocol. Hyperprolactinemia in patients whose prolactin levels normalized after stopping drug consumption was labeled as druginduced hyperprolactinemia. Young patients with pituitary adenoma were evaluated for multiple endocrine neoplasia syndrome (MEN 1). The results were compared with those of a study conducted two decades ago at the same center. Results: Galactorrhea was the most common presenting symptom occurring in 64% of subjects (all females), followed by oligomenorrhea or amenorrhea in 60 patients. Both menstrual abnormalities and galactorrhea were seen in 35 patients. Drug-induced hyperprolactinemia was the most common cause seen in 59 patients, followed by pituitary adenoma seen in 31 patients and idiopathic cause seen in only 4% of cases. However, in the study done two decades ago at the same center, microprolactinoma was the most common cause (35.8%), followed by idiopathic hyperprolactinemia (27.8%), with drugs being responsible in only 5% of the cases. Domperidone and levosulpride constituted about 88% of drug-induced hyperprolactinemia. Microprolactinoma was demonstrated in 15 patients, macroadenoma in 16 patients, hypothyroidism in 4% cases, and only one patient had the polycystic ovarian disease. In four patients, no apparent cause could be determined. Conclusion: In our study, drug-induced hyperprolactinemia was the most frequent identifiable etiology, with prokinetics being the most common cause; contrary to previous studies, where pituitary adenoma followed by neuroleptic drugs was found to be the most common. Discontinuation of the offending drug resolved HP in all the patients.
Cureus, 2018
Hyperprolactinemia is a common finding in primary hypothyroidism, but increased prolactin in the setting of subclinical hypothyroidism (SCH) has been scarcely reported in the literature. This is a rare case of hyperprolactinemia due to SCH that resolved with thyroid hormone replacement therapy. The patient was not on any medications known to cause hyperprolactinemia but she was using isoniazid for her latent tuberculosis. Isoniazid therapy may explain breast pain, but there is no reported relationship between isoniazid use causing subclinical hypothyroidism and hyperprolactinemia. A literature review reveals that few cases of galactorrhea associated with subclinical hypothyroidism have been reported. Similar to the reported cases in the literature, our patient's thyroid stimulating hormone (TSH) and prolactin levels returned to normal with levothyroxine therapy.