To Jean in Oregon: Any elevated prolactin level can mean prolactinoma; and levels <100 can even indicate macroprolactinomas. As Keribug indicates, this is highly variable -- there are no absolutes. More important, though, if prolactin is elevated -- even if it's idiopathic with no identifiable organic cause), it needs to be treated, and the meds that do that are bromocriptine (parlodel) and cabergoline (dostinex). It is true that these meds will also shrink a prolactin-secreting tumor. The message that needs to get out there is that if it is a non-functioning tumor, or if it's secreting multiple hormones, these meds alone will be less effective in treating such tumors. Those that are non-functioning may require surgery, and those that secrete multiple hormones may require separate meds to regulate each specific hormone in question and possibly surgery as well. Elevated prolactin levels -- even if NOT due to a tumor, cause other long-term health problems that often "look" like other things. Chiefly, high prolactin suppresses estrogen, and there are lots of adverse consequences of low estrogen: loss of bone mineral density, premature heart disease, loss of libido, vaginal dryness, pain with intercourse -- the same problems of menopause -- even in much younger women. All of my doctors have suggested that I take estrogen -- in the form of oral contraceptives -- to protect bones. The problem is that this is actually WORSE for bones in PRE-menopausal women. There was a huge national study in Canada that found this (I do not have a link or citation handy at the moment). I checked with local experts who concurred, so I went back to all of my docs to share the article and stop the estrogen. I've also been told (in mid-thirties) to take one of the bisphosphonates for bone-building (Fosamax, Actonel). This, too, is DANGEROUS for pre-menopausal women, because there are no studies of these drugs in younger women. They are Category X for pregnancy, and that is why the studies have not yet been conducted (some are underway now, but our institution has refused to participate due to risks to young women and their future unborn babies). These drugs bond to bone, and are released back into the system duing pregnancy. They cause severe birth defects, sufficient that these drugs are contraindicated for women who may become pregnant at anytime in the future. There are also NO studies of long-term use of these meds, because they have not been around for long enough. I've gotten off-track, my apologies. I've spent so much time searching the literature and informing my own doctors -- I do hope some of my work can be helpful to others here! |
