What Is Hyperprolactinaemia?

The pituitary gland in the body produces prolactin, which is essentially a peptide hormone that plays a very important part in the development of breasts in women during pregnancy and in lactation. The normal levels of prolactin in women are less than 500mlU/L and less than 450mlU/L in the case of men. When the levels of the prolactin hormone in the blood become abnormally high, the condition is known as hyperprolactinemia.

The condition of hyperprolactinemia is normal when the woman is pregnant or is breastfeeding. The condition can also occur due to use of certain medications and sometimes due to disease. Hyperprolactinaemia can affect both men and women causing problems such as irregular periods and the unconstrained production and flow of milk in women and erectile dysfunction, infertility, hypogonadism in men. 

What Are The Symptoms Of Hyperprolactinaemia?

Some of the symptoms of hyperprolactinemia in women include:

• Abnormal lactation or galactorrhea
• Infertility, low bone density
• Irregular or infrequent periods, amenorrhea or absence of periods
• Pain in the breast, production of breast milk even in the absence of pregnancy or even if the woman is not nursing
• Loss of libido, vaginal dryness causing pain during intercourse

In men, the symptoms include:

• Erectile dysfunction, lactation
• Development of breasts or gynecomastia
• Loss of libido, infertility

Both men and women may have headaches which may be caused due to a tumor or prolactinoma in the pituitary gland or due to changes in the vision. 

What Are The Causes Of Hyperprolactinaemia?

The causes of hyperprolactinemia are:

• Formation of a benign or a non-cancerous tumor (prolactinoma) on the pituitary gland
• Diseases that affect the pituitary gland, hypothyroidism or underactive thyroid
• Trauma or injuries to the chest wall or thoracic wall including the upper abdomen, rib cage, and diaphragm or diseases that may have affected this area such as shingles or herpes zoster.
• Diseases affecting the hypothalamus of the brain (tumor, infection of the hypothalamus or trauma)
• Chronic kidney failure, cirrhosis of the liver
• Use of antidepressants (Norpramin, Anafranil)
• Use of antipsychotics (Risperdal, Haldol, Zyprexa)
• Low levels of thyroid hormone (hypothyroidism)
• Antinauseals (Primperan, Lexapram, Reglan), antihypertensives (Covera-HS, Calan, Verelan, Isoptin)
• Acid H2 blockers (Zantac, Tagamet), estrogen

What Are The Things One Should Do To Manage Hyperprolactinaemia?

• Hypothyroidism, due to high levels of the thyroid-releasing hormone can be the cause of increased levels of prolactin, which can cause hyperprolactinemia. So, you should take steps and follow a diet to maintain a healthy thyroid function.
• Research studies show that dopamine, the hormone produced by the brain helps to inhibit the secretion of prolactin. So, eating foods that increase dopamine production can help to reduce prolactin levels. 

What Are The Things One Should Avoid To Manage Hyperprolactinaemia?

• Avoid stress, as stress causes the level of stress hormones like cortisol to increase, which leads to the suppression of the sex hormone gonadotropin-releasing hormone or GnRH, which is also responsible for the secretion of the hormone prolactin. And when prolactin increases it causes hyperprolactinemia. 

What Are The Best Foods For Hyperprolactinaemia?

• Eat a diet that is rich in iodine to support the healthy functioning of the thyroid and this can be beneficial for the condition of hyperprolactinemia.
• Eating a diet rich in vegetables and fruits, especially whole grains, green leafy vegetables, legumes, seeds, nuts, soybeans, cold water fish, etc. are beneficial for lowering prolactin levels.
• Deficiency in the vitamin B6 has been linked to hyperprolactinemia. So, you must eat foods that are rich in vitamin B6 such as bananas, wild salmon, spinach, chicken, and potatoes.
• Foods like beef, shellfish, beans, and turkey that are high in zinc are also beneficial for the condition of hyperprolactinemia and help to decrease the levels of prolactin.
• Eating protein-rich foods like eggs, fish, cheese, beans, chicken, legumes, red meat, and turkey, as the amino acids in the protein help to produce dopamine in the brain which is beneficial for the condition of hyperprolactinemia by reducing prolactin levels.
• Eating ripe bananas, which are a fantastic source of tyrosine, the amino acid which helps in the production of dopamine can help to reduce prolactin levels.
• Apples are a rich source of quercetin which helps in the production of dopamine and reduces the prolactin levels.
• Watermelons are packed with vitamins A, C, and B6 which help to produce dopamine and can be beneficial for the condition of hyperprolactinemia.

What Are The Worst Foods For Hyperprolactinaemia?

• Avoid drinking alcohol, especially beer, as it stimulates the production of prolactin.
• Avoid foods that are high in sugar such as candy, cakes, sweets, processed foods, etc. and foods rich in carbohydrates and refined flour such as white rice, white bread, pasta, etc. as these worsen the condition of hyperprolactinemia.

What Are The Medicines For Hyperprolactinaemia?

What Are The Tips To Manage Hyperprolactinaemia?

• You can manage your stress levels by taking up calming activities like walking, meditation, yoga and following breathing techniques.
• Sleeping well can help to naturally reduce the prolactin levels.
• Supplements like vitamins A, C, and E, minerals such as copper, zinc, and selenium can be beneficial for the condition of hyperprolactinemia.
• Having vitamin B6 supplements of around 300-1000 mg daily can be beneficial for the condition of hyperprolactinemia.
• Vitamin E has antioxidant properties and helps to prevent the level of prolactin from rising.
• Vitex or Chasteberry (agnus-castus) is a herb that can help to reduce levels of prolactin. However, too high a dosage of Vitex can mask a prolactinoma and hence, it is a good idea to check with your doctor before taking Vitex for the treatment of hyperprolactinemia.
• Nourishing the pituitary gland with the help of herbs such as American Ginseng or Panax quinquefolius, Liquorice or Glycyrrhiza spp, Eleuthero or Eleutherococcus senticosus, Schizandra or Schisandra chinensis, Ashwagandha or Withania somnifera can help to reduce the prolactin levels.
• Maca or Lepidium meyenii, an adaptogen helps to nourish the endocrine system and boosts the functioning of an underactive thyroid and helps to lower prolactin levels.   
• Macuna Pruriens which contain L-Dopa can help to reduce the prolactin levels.