----------------------------------------------------------- New Message on Pituitary Chat
----------------------------------------------------------- From: bioresearcher Message 1 in Discussion Hi Everyone Quick history on me - I had symptoms of hyperprolactinemia that went misdiagnosed and untreated for +15 years. Finally was diagnosed and put on medication in 2003. Prolactin runs around 60-68 untreated, no tumor visible on MRI or a very sligh hyperplasia noted. Dostinex brought my prolactin down to 0.8. I've got a long history of PMS type symptomsincluding mood swings, hostility, anxiety, and depression etc which are pretty well known now to be associated with hyperprolactinemia. My mood issues were slightly better with Dostinex but have persisted even after bringing my prolactin into normal range. I moved and changed doctors last year and in January 2007 the new doctor decided to take me off Dostinex to see what happens. By May I was back up to 58, so back on Dostinex. However, she's been playing with my dose to see how low she can go. From 2003-Jan 2007 I was on 0.5 mg 2x per week. She currenlty has me on 1/4 tablet (0.125 mgs) and my moods are going way out of control again. I suspect my prolactin is climbing again. My doctors usually blow off my mood complaints and I've had enough!! I've been doing some research on Pubmed about the emotional aspects of hyperprolactinemia and have discovered a number of new papers in the last year. I'll add the citations on the bottom. I've managed to get the full paper in all cases except one .....and this particular one I am VERY interested in reading. I was wondering if anyone knows where I can get a copy? They don't have the full paper on Medline, nor does the publisher have it online yet but I think there are a number of prolactinoma patients here that will be interested in this paper. Georgian Med News. 2007 Nov;(152):41-4. Peculiarities of cerebral hemodynamics and brain bioelectric activity in patients with hyperprolactinemia. [Article in Russian] Beglaryan G, Asryan N. Family Planning and Sexual Health Center, Chair of Gynecology and Obstetrics of Yerevan State Medical University, Health Centre "Nor Arabkir" 28 patients aged from 17 to 38 years old with non-tumor and tumor forms of hyperprolactinemia were examined to study the peculiarities of cerebral hemodynamics and brain electrobiological activity in hyperprolactinemia. The investigation revealed disturbances in cerebral structure activity at different levels of truncus cerebri in overwhelming majority of patients (86.8%). The investigation demonstrated pathologic process in the same structures of C.N.S. More significant changes in the character of electric activity of brain were revealed in the presence of macroadenoma. More permanently repeated symptoms of EEG changes were affections in the region of diencephalic structures of brain and striopallidal complex (of emotiogenic zones of brain), that may be conditioned by the rise of PRL level - one of the main factors in development of stress reaction. PMID: 18175833 [PubMed - in process] Anyway, additional recent papers on this subject for anyone interested: Adv Psychosom Med. 2007;28:21-33. Psychosocial approach to endocrine disease. Sonino N, Tomba E, Fava GA. Department of Statistical Sciences, University of Padova, Padova, Italy. [EMAIL PROTECTED] In recent years, there has been growing interest in the psychosocial aspects of endocrine disease, such as the role of life stress in the pathogenesis of some conditions, their association with affective disorders, and the presence of residual symptoms after adequate treatment. In clinical endocrinology, exploration of psychosocial antecedents may elucidate the temporal relationships between life events and symptom onset, as it has been shown to be relevant for pituitary (Cushing's disease, hyperprolactinemia) or thyroid (Graves' disease) conditions, as well as the role of allostatic load, linked to chronic stress, in uncovering a person's vulnerability. After endocrine abnormalities are established, they are frequently associated with a wide range of psychological symptoms: at times, such symptoms reach the level of psychiatric illness (mainly mood and anxiety disorders); at other times, however, they can only be identified by the subclinical forms of assessment provided by the Diagnostic Criteria for Psychosomatic Research (DCPR). Indeed, in a population study, the majority of patients suffered from at least one of the three DCPR syndromes considered: irritable mood, demoralization, persistent somatization. In particular, irritable mood was found to occur in 46% of 146 patients successfully treated for endocrine conditions, a rate similar to that found in cardiology and higher than in oncology and gastroenterology. Long-standing endocrine disorders may imply a degree of irreversibility of the pathological process and induce highly individualized affective responses. In patients who showed persistence or even worsening of psychological distress upon proper endocrine treatment, the value of appropriate psychiatric interventions was underscored. As it happened in other fields of clinical medicine, a conceptual shift from a merely biomedical care to a psychosomatic consideration of the person and his/her quality of life appears to be necessary for improving effectiveness in endocrinology. The DCPR have been demonstrated to be a valuable tool for psychological assessment in the various phases of endocrine disease from diagnostic to follow-up periods. PMID: 17684318 [PubMed - indexed for MEDLINE] Eur J Endocrinol. 2007 Aug;157(2):133-9. Comment in: Eur J Endocrinol. 2007 Dec;157(6):789. Quality of life is decreased in female patients treated for microprolactinoma. Kars M, van der Klaauw AA, Onstein CS, Pereira AM, Romijn JA. Department of Endocrinology and Metabolic Diseases, C4-R, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. [EMAIL PROTECTED] OBJECTIVE: Most studies on treatment of microprolactinoma have focused on clinical and biochemical outcome rather than on functional and mental well-being. We evaluated this topic in female patients with microprolactinoma, because other pituitary adenomas are associated with decreased quality of life. DESIGN: We conducted a cross-sectional study. PATIENTS AND METHODS: To assess the impact of treatment for microprolactinoma on subjective well-being, quality of life was investigated in 55 female patients (mean age 45 +/- 10 years), treated for microprolactinoma in our center, using four validated, health-related questionnaires: Short-Form-36 (SF-36), Nottingham Health Profile (NHP), Multidimensional Fatigue Inventory (MFI-20), and Hospital Anxiety and Depression Scale (HADS). Patient outcomes were compared with those of 183 female controls with equal age distributions. RESULTS: Anxiety and depression scores were increased when compared with controls for all subscales as measured by HADS, and fatigue for all but one subscale as measured by MFI-20. Patients treated for microprolactinoma had worse scores on social functioning, role limitations due to physical problems (SF-36), energy, emotional reaction, and social isolation (NHP) when compared with control subjects. Important independent predictors of quality of life were reproductive status and anxiety and depression scores according to the HADS. CONCLUSION: Quality of life is impaired in female patients treated for microprolactinoma, especially due to increased anxiety and depression. These increased anxious and depressive feelings might be due to possible effects of hyperprolactinemia on the central nervous system. Failure to recognize this association may adversely affect patient-doctor relationships. PMID: 17656590 [PubMed - indexed for MEDLINE] J Neuropsychiatry Clin Neurosci. 2005 Spring;17(2):159-66. Apathy and pituitary disease: it has nothing to do with depression. Weitzner MA, Kanfer S, Booth-Jones M. Department of Psychiatry and Behavioral Medicine, University of South Florida College of Medicine, Tampa, 33613, USA. [EMAIL PROTECTED] Increasingly, patients with pituitary disease are evaluated and treated at cancer centers. In many ways, these patients resemble patients with other malignant brain tumors. Although the majority of pituitary adenomas are benign, the physical, emotional, and cognitive changes that these patients experience on their well-being is malignant. Pituitary disease causes a variety of physical illnesses resulting from the alterations in the hypothalamic-pituitary-end organ axis. In addition, patients with pituitary diseases may experience many emotional problems, including depression, anxiety, behavioral disturbances, and personality changes, above and beyond the many reactions these patients may have to the myriad of adjustments that they must make in their lives. There is a growing understanding that pituitary patients may experience these emotional problems as a result of long-term effects that the pituitary tumor itself, treatment, and/or hormonal changes have on the hypothalamic-pituitary-end organ axis. The authors present a series of cases, in which patients with pituitary disease were diagnosed and treated for depression and showed little response to the treatment for depression. When the diagnosis of apathy syndrome was considered and treatment implemented, the patients' condition improved. A review of the literature on apathy, hypothalamic-pituitary-end organ axis dysfunction, and treatment for apathy syndrome is included. PMID: 15939968 [PubMed - indexed for MEDLINE] ----------------------------------------------------------- To stop getting this e-mail, or change how often it arrives, go to your E-mail Settings. http://groups.msn.com/PituitaryChat/_emailsettings.msnw Need help? 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