You need to see a Dr that's a pretty high prolactin level. It's possible you could have Prolactinoma
Appreciate the feedback. I don't think I am there yet..
These pituitary tumors (also called adenomas) secrete excessive amounts of prolactin and are the most common type of pituitary tumor seen clinically. Prolactin is the hormone that stimulates milk production by the breasts. Prolactin-producing tumors exist "silently" in up to 5-10% of the adult population. Prolactinomas generally have very different presentations in women and in men. In women, relatively small elevations in prolactin cause irregular menstrual periods or complete loss of menses (amenorrhea), ability to ovulate (remain fertile) and may cause milky discharge from the breasts (galactorrhea). In addition, women may have a reduction in their sex drive. The normal prolactin level is < 20 ng/ml. In most women the tumors are detected when they are small (microadenomas) and the prolactin level is only moderately elevated (30 - 300 ng/ml). In contrast, in men prolactinomas are usually not detected until they are large (macroadenomas), most have prolactin levels over 500 ng/ml. Most men diagnosed with a prolactinoma have some degree of loss of sex hormone production. They may also have visual loss (from compression of the optic nerves or optic chiasm) and/or headache. A minority of patients with large tumors may have bleeding into the tumor (pituitary apoplexy) causing relatively sudden onset of headache, visual loss, double vision, and/or pituitary failure.
DIAGNOSIS
Hormonal Diagnosis
The diagnosis of a prolactinoma is confirmed by demonstrating persistently elevated blood levels of prolactin. A prolactin level of over 150-200 ng/ml is almost always due to a prolactin secreting pituitary adenoma. In all patients with suspected pituitary tumors, a complete pituitary hormone evaluation should be performed. This testing is especially important in patients with potentially large tumors who are likely to have some degree of pituitary failure (hypopituitarism). It is important to note that moderate elevations of prolactin (30 - 200 ng/ml) can occur as a result of several other causes, which must be excluded prior to invoking a pituitary tumor. The most common causes are listed below:
- pregnancy or in the post-partum period
- stress (discomfort, exercise, low blood sugar)
- low thyroid function (hypothyroidism)
- kidney failure
- liver failure
- medications (such as anti-ulcer and antidepressants)
- "stalk effect"
The "stalk effect": This may be seen with any disease within or near the pituitary gland and stalk that interferes with the delivery of dopamine (a neurotransmitter) from the hypothalamus to the prolactin secreting cells of the pituitary. Therefore, other types of pituitary adenomas, craniopharyngiomas or other tumors or masses may cause modest elevations in prolactin.
The "hook effect": In patients with very large prolactinomas, the initial prolactin level may be read erroneously as normal or only mildly elevated. In such patients, it is important to confirm that the laboratory performed multiple dilutions of the blood sample to avoid this error known as the "hook effect". When dilutions are performed on such a blood specimen, the actual prolactin level may be much higher.
