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Prolactin

Related tests: FSH, LH, testosterone

Common Questions

1.  What other tests may be done to evaluate an elevated prolactin?

Testosterone (levels will usually be low in a male when prolactin is high), FSH, and LH (to help evaluate ovulation and fertility), an MRI scan (to show pituitary enlargement and help locate a tumour), and an eye examination (to evaluate visual disturbances).

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2.  If I have an elevated prolactin, why is my doctor testing my thyroid?

Increased levels of prolactin are often seen in people with hypothyroidism (although they do not cause it). If you have hyperprolactinaemia, your doctor will most likely test you for hypothyroidism.

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3.  How are prolactinomas treated?

Prolactinomas are usually treated with medications that act like dopamine (such as bromocriptine or cabergoline). Treatment can reduce prolactin levels and symptoms and restore fertility, but the medications may have to be taken for several months or years. Surgery is sometimes necessary if the prolactinomas are large or not responding to treatment. This surgery is delicate and requires an experienced surgeon. Sometimes, despite medication and/or surgery, the prolactinoma will return.

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4.  What is Macroprolactinaemia?

Macroprolactinaemia is a term used to describe the condition where the majority of the circulating prolactin is found to be bound to an antibody, so called big big prolactin. Big big prolactin or macroprolactin has limited bioactivity and its presence would be suspected in cases with elevated prolactin levels without the symptoms of prolactin excess. Most laboratories can perform a procedure to remove the antibody bound fraction of prolactin and thus estimate the true active fraction of the circulating prolactin.

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