This will be a collective reply to previous posts. I've read several good clinical articles that discuss the importance of fasting PRL levels. The 'gold standard' test for this is repeated testing over a 24-48 hr period through a femoral artery catheter. Easy to see why NONE of us have had this test, which would require hospital admission. PRL is very sensitive to sleep, fasting vs. non-fasting, chest wall trauma (any surgery), breast stimulation, recent intercourse, stress and a host of other factors-- there's a list 3+ pages long in my file. In answer to the question about the stress/ anxiety of a blood draw, YES! It is entirely possible that a level that is 3 points above normal is due to that alone. Just like blood pressure can be elevated by the stress of an MD appointment for some people. Other posters are right, though -- be assertive with your doctors about having periodic repeat tests -- Keribug's change in levels illustrates the importance of this. More important than fasting or not, etc is to test at the SAME lab at the SAME time of day -- so whatever your habit is, choose a routine and stick with it. This minimizes other sources of variation and helps your doctors see what is normal for YOU over time. As many have pointed out, many factors can affect PRL levels, so minimizing the variation of these "other things" is important. Others are also correct that PRL levels below 100 *usually* are not due to prolactinoma -- but there are plenty of exceptions to that on this board! Your best strategy is to educate yourself about symptoms of increasing PRL levels and prolactinomas (headache, visual field changes) and act on any changes you notice. Finally, it is possible and important to treat even idiopathic hyperprolactinemia. Many microprolactinomas are not visible on MRI -- even with contrast -- because they're so "micro". Treatment for symptoms will usually shrink a tumor if one is there, but treatment for PRL itself is identical to treatment for tumor. It is unlikely that six month wait for MRI will have and adverse consequences, too. It can be difficult to see the smallest prolactinomas on MRI, even with contrast, and if you do have one, your PRL level indicates that this would be in the size range that is most difficult -- if not impossible -- to see. The MRI-with-contrast process is no picnic -- see related thread with that title. Unless your PRL really does change over repeated measures, this may not be a procedure you'd want to endure for such a modest elevation and one PRL test. I just had second MRI with contrast (PRL 120), including the strong "something is wrong" sensation described by others over in that thred-- this ostensibly benign contrast agent can do some funky things even when it does not cause the rare and dangerous side effects. I was not anxious, having had same test before with NO discomfort -- this was noticeably different and a sensation unlike any I've ever experienced. Glad to be done! The meds are difficult to take, though, and if my prolactin level was 3 pts above "normal" I would want to watch it through periodic monitoring and would NOT want to take meds for it. At that level, if you are not having any other symptoms, either one of the meds would probably make you unnecessarily miserable. A three-point elevation in levels is entirely within reason due to how sensitive PRL is. The misery of the meds -- plenty of examples on this board -- is not at all worth it, trust me! Watch your levels and if they increase, then you'll be well-armed with good information with which to make decisions about treatment. Good luck! | 