High Prolactin Causes Severe Fatigue.

Ema

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I'm sure that this won't be applicable to everyone with ME/CFS but I thought I would share my experience with high prolactin thus far just in case it could help someone else.

I've had mildly elevated and top of the range prolactin for a couple of years now. I've never thought much about it because most doctors agree that prolactin needs to be in the 100s before it signifies a pituitary tumor. The normal level is 4-30 ng/mL for females (lower for males). However, most reproductive endocrinologists look for a prolactin level lower than 15.

But recently, I started having some symptoms and thought I would do some more reading on the topic.

It turns out that having even mildly elevated levels of prolactin can cause severely debilitating fatigue.

Not only that it can also cause migraines, low sex drive, and cognitive difficulties (probably due to low dopamine). Prolactin and dopamine seem to have an inverse relationship - when prolactin is high, dopamine in the hypothalamus particularly seems to be low. Drugs for hyperprolactimia are usually dopamine agonists like bromocriptine or cabergoline. Some people also have luck using Deprenyl. There is also a study using American Ginseng (which is a less stimulating form of ginseng than Siberian supposedly) to lower prolactin levels.

Prolactin also stimulates autoimmune diseases and there are studies showing that symptoms of diseases such as rheumatoid arthritis and lupus improved by lowering prolactin levels. Prolactin heightens the response of the cellular arm of the immune system (Th1 imbalance).

If you are hypothyroid, you will likely also have high prolactin because they are both regulated in part by TRH from the pituitary. This is a double whammy for anyone trying to lose weight. High prolactin makes it nearly impossible to lose weight. I believe this is because a nursing mother would not be best served to lose a bunch of weight while trying to feed her baby.

Prolactin also seems to be associated with low progesterone and short luteal phases in the menstrual cycle. Women trying to get pregnant are often given drugs to lower the prolactin level because it is almost impossible to conceive with high prolactin.

I have a mildly elevated prolactin level, a very low testosterone level and high IGF-1. This apparently is a clinical picture associated with a pituitary tumor (which are almost always benign) so I am having an MRI (3T) at the end of the month and then I'm starting on prolactin lowering meds to see if I can't straighten this out. My mother keeps telling me that people pay big money to get bigger boobs, but I am SO over it already! :)

So if you struggle with extreme fatigue, weight gain/inability to lose, and low motivation and cognitive function, it might be worth having your prolactin tested to see if this is an issue for you. If you've gotten your other hormones right and are still struggling, it's worth a shot!

Ema
 

heapsreal

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it seems that when researching these neurotransmitters that dopamine seems to be a key to most of them.

Wouldnt it be good if there was a HPA pill that fixed all the neurotransmitters and hormones together.
In reality its like a switch board with wires everywhere, where does this one go, do i cut this one???:confused::confused:
 

Lillybelle

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Hi Ema,
Thanks for that information. Recently I saw both Endocrinology specialist and CFS expert. Neither suggested any such tsts but I have both hypothyroidism and CFS and the symptoms you noted. When I see CFS specialist should I ask for prolactin IGF1 and testosterone tests? What is IGF-1 by the way
Cheers
LB
 

Beyond

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Good stuff, Ema, I have high prolactin in tests from different years and surely it matchs with what you says and how I feel. I managed to get it down in tests with high quaility Mucuna Pruriens extract, however I didnt "cured" with this or anything, I just remember my sexual function improved. I wonder if I should take it again, since my VDR and COMT status ask for it. I am talking about a very significant drop in prolactin, from more than high to optimal range for males.
 

Ema

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I wonder what the best dosage of pantethine would be for lowering prolactin?

I tried Mucuna (but only for about a week) and ordered more but the order got cancelled and by that point I was trying the American Ginseng and didn't want it to get muddled up.

It's interesting that things that are good for the adrenals - pantethine and Am Ginseng - are also good for prolactin.

Ema
 

Beyond

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It's interesting that things that are good for the adrenals - pantethine and Am Ginseng - are also good for prolactin.
Yes. When did you started the Ginseng? Does it aggravate sleep problems? I feel atracted to Korean Ginseng. Strangely in studies done in rats ginseng improves sleep quality and quantity.
 

Ema

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Yes. When did you started the Ginseng? Does it aggravate sleep problems? I feel atracted to Korean Ginseng. Strangely in studies done in rats ginseng improves sleep quality and quantity.
I'd have to check my journal but I would say roughly 3 weeks ago.

I think it is only the American ginseng that has the effect on prolactin but I would have to double check that too.

I have the oversleeping problem for the most part so I was kind of hoping it would help me feel more energy. I haven't noticed any effect either way though. I take 500 mg twice a day.
 

Lillybelle

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I'm sure that this won't be applicable to everyone with ME/CFS but I thought I would share my experience with high prolactin thus far just in case it could help someone else.

I've had mildly elevated and top of the range prolactin for a couple of years now. I've never thought much about it because most doctors agree that prolactin needs to be in the 100s before it signifies a pituitary tumor. The normal level is 4-30 ng/mL for females (lower for males). However, most reproductive endocrinologists look for a prolactin level lower than 15.

But recently, I started having some symptoms and thought I would do some more reading on the topic.

It turns out that having even mildly elevated levels of prolactin can cause severely debilitating fatigue.

Not only that it can also cause migraines, low sex drive, and cognitive difficulties (probably due to low dopamine). Prolactin and dopamine seem to have an inverse relationship - when prolactin is high, dopamine in the hypothalamus particularly seems to be low. Drugs for hyperprolactimia are usually dopamine agonists like bromocriptine or cabergoline. Some people also have luck using Deprenyl. There is also a study using American Ginseng (which is a less stimulating form of ginseng than Siberian supposedly) to lower prolactin levels.

Prolactin also stimulates autoimmune diseases and there are studies showing that symptoms of diseases such as rheumatoid arthritis and lupus improved by lowering prolactin levels. Prolactin heightens the response of the cellular arm of the immune system (Th1 imbalance).

If you are hypothyroid, you will likely also have high prolactin because they are both regulated in part by TRH from the pituitary. This is a double whammy for anyone trying to lose weight. High prolactin makes it nearly impossible to lose weight. I believe this is because a nursing mother would not be best served to lose a bunch of weight while trying to feed her baby.

Prolactin also seems to be associated with low progesterone and short luteal phases in the menstrual cycle. Women trying to get pregnant are often given drugs to lower the prolactin level because it is almost impossible to conceive with high prolactin.

I have a mildly elevated prolactin level, a very low testosterone level and high IGF-1. This apparently is a clinical picture associated with a pituitary tumor (which are almost always benign) so I am having an MRI (3T) at the end of the month and then I'm starting on prolactin lowering meds to see if I can't straighten this out. My mother keeps telling me that people pay big money to get bigger boobs, but I am SO over it already! :)

So if you struggle with extreme fatigue, weight gain/inability to lose, and low motivation and cognitive function, it might be worth having your prolactin tested to see if this is an issue for you. If you've gotten your other hormones right and are still struggling, it's worth a shot!

Ema
Hi Ema, I would be interested to know whether your traditional doctor/specialist has done these prolactin IGF1 tests or whether its a naturopath/functional medecine practitioner. Thx!
 

adreno

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I wonder what the best dosage of pantethine would be for lowering prolactin?
The following might provide some clue. However, it looks like it's necessary to take it IV, which is rather inconvenient.

Preclinical and clinical studies with cysteamine and pantethine related to the central nervous system

1. Cysteamine is formed by degradation of coenzyme A (CoA) and causes somatostatin (SS), prolactin and noradrenaline depletion in the brain and peripheral tissues. 2. Cysteamine influences several behavioral processes, like active and passive avoidance behavior, open-field activity, kindled seizures, pain perception and SS-induced barrel rotation. 3. Cysteamine has several established (cystinosis, radioprotection, acetaminophen poisoning) and theoretical (HuntingtonÕs disease, prolactin-secreting adenomas) indications in clinical practice. 4. Pantethine is a naturally occurring compound which is metabolized to cysteamine. 5. Pantethine depletes SS, prolactin and noradrenaline with lower efficacy compared to that of cysteamine. 6. Pantethine is well tolerated by patients and has been suggested to treatment of atherosclerosis. The other possible clinical indications (alcoholism, ParkinsonÕs disease, instead of cysteamine) are discussed. Vecsei L, Widerlov E. Preclinical and clinical studies with cysteamine and pantethine related to the central nervous system. Prog Neuropsychopharmacol Biol Psychiatry 1990;14:835-862.
J Endocrinol.1990 Mar;124(3):397-402.
The depletion of plasma prolactin by pantethine in oestrogen-primed hyperprolactinaemic rats.

Pantethine was investigated for its potential to deplete prolactin in the plasma and pituitary cells of oestrogen-primed hyperprolactinaemic rats. This compound has been used in the past to deliver cysteamine systemically, through its congener pantetheine, a metabolic precursor for cysteamine. Cysteamine itself, specifically reduces plasma and pituitary prolactin. The addition of pantethine (2-10 mmol/l) to the media of isolated pituitary cells over 4 h did not appreciably alter the intracellular content of immunoreactive prolactin. Moreover, oral administration of pantethine at 0.5 and 1.0 g/kg body weight did not influence the concentration of immunoreactive plasma prolactin. However, the concentration of plasma prolactin fell by 48 and 67%, when pantethine was injected i.p. at 0.5 and 1.0 g/kg body weight, after 4 h. Intravenous administration of pantethine resulted in even greater losses of prolactin, in the order of 50 and 81% depletion for 0.5 and 1.0 g/kg body weight respectively and within 2 h of administration. However, cysteamine was found to be more efficacious than pantethine on a molar basis with regard to depleting the plasma concentration of prolactin in hyperprolactinaemic rats.
PMID:2332716
 

Beyond

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Nah take high quality mucuna pruriens for prolactin. http://www.ncbi.nlm.nih.gov/pubmed/22444229 It also boosts dopamine which its a plus for some (bad for others) depending on genetics and other factors. I have tests proving a dramatic drop in prolactin while on mucuna. Of course, "treating" a symptom alone such as high prolactin, which obviously its a consequence of a larger dysfunction, deficiency or toxicity will prove to be quite useless as indeed it proved to be for me. But its always fun to take aphrodisiacs.
 

Ema

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Hi Ema, I would be interested to know whether your traditional doctor/specialist has done these prolactin IGF1 tests or whether its a naturopath/functional medecine practitioner. Thx!
My doctor is an MD which makes her a traditional doctor but she specializes in Lyme disease and is very open minded which makes her more like a functional med practitioner. The best of both worlds? Hopefully. :)

Ema
 

Ema

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We
The following might provide some clue. However, it looks like it's necessary to take it IV, which is rather inconvenient.
Weird that taking it orally didn't product any effects. I bought a bottle just to see anyway. I've been taking 600 mg twice a day...well below 0.5-1 g/kg body weight. We'll see!

Beyond, I didn't have any luck with my short trial of mucuna even though I know I am low in dopamine. I can't explain that one either.

I am very curious to see how I might do on bromocriptine and/or selegiline but am still nervous about side effects. I also want to get a pituitary MRI just in case first since both my IGF1 and prolactin have been consistently elevated.

Ema
 

Beyond

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Must be you used something crappy, happens all the time with herbs, they should get serious with that. My IGF1 was also surpringly very elevated (I dont feel like having super levels of the mighty Growth Hormone). Something tells me I dont have a pituitary tumour, neither you :D Its just another hormone that doesnt behaves correctly in my body, most probably related to my all-around endocrine dysfunction. Keep in mind progesterone its low in adrenal fatigue (confirmed in my case) and progesterone controls prolactin...
 

Ema

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Must be you used something crappy, happens all the time with herbs, they should get serious with that. My IGF1 was also surpringly very elevated (I dont feel like having super levels of the mighty Growth Hormone). Something tells me I dont have a pituitary tumour, neither you :D Its just another hormone that doesnt behaves correctly in my body, most probably related to my all-around endocrine dysfunction. Keep in mind progesterone its low in adrenal fatigue (confirmed in my case) and progesterone controls prolactin...
It could be I used something crappy but I lean away from that because 1) it was a practitioner brand and 2) I saw it increased my dopamine on testing. It just didn't seem to do anything about my boob problem! LOL.

My progesterone isn't particularly low either. I had it tested last cycle and it was mid-range at day 21 in my cycle. I was surprised since I've been having shortened luteal phases which is typically a sign of low progesterone. Maybe I should up it a bit to see.

How exactly does progesterone control prolactin?

Ema
 

aquariusgirl

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I may have this ass-backwards and I'm too lazy to check...but I thought we were all super dooper low in HGH? so wondering if your IGF1 result is a little out of the ordinary... just can't remember how that test works....