Are prolactin levels of 715 mU/L high for a male? Feelings of low libido and depression,

Posted , 4 users are following.

Hi,

Came across the forum whilst researching high prolactin.

I have had a blood test and I do have elevated prolactin of 715 mU/L (range 98-324).

I have spoken to my GP and he was completely unconcerned about the prolactin. He did question me about my low libido and depression and proceeded to prescribe 37.5mg of Venlafaxine.

  1. Are my elevated prolactin levels a concern and could such a level lead to low libido and feelings of depression?
  2. Am I right to be worried about my Doctor? From my limited internet research, I fail to see how a SNRI would help with my low libido and, whilst rare, could even further elevate my prolactin.
  3. I’ve read that prolactin and dopamine have an inverse relationship and so was wondering could that potentially mean my feelings of depression and lack of direction are stemming from low dopamine levels? If that’s reasonable then I’m curious why the doctor would prescribe a SNRI and not a dopamine agonist (Cabergoline) or a NDRI (Wellbutrin) - if this assumption is correct then I will be asking my GP this on my next visit. But I’m all ears to any opinions/guesses.

Thank you for your time and assistance.

Sam

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8 Replies

  • Posted

    Hi Sam,

    My prolactin levels were a lot higher than that (I am female and have a prolactinoma). Stress and certain drugs can also cause mild increases in prolactin. Might be a good idea to ask your doctor about it and possibly recheck in a couple of months. I certainly don't think it is sensible to jump straight to starting on a dopamine agonist without a proper diagnosis, you need an MRI scan first. That way they can see if there is anything going on with your pituitary and monitor response to treatment, my prolactinoma has shrunk from 11mm to no longer visible on MRI.

    It must be frustrating not knowing what is going on, I think you are right to speak to your GP about it.

    Chutney x

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    • Posted

      Hi Chutney,

      Thank you for your reply and for sharing your experience.

      I will be pressing the doctor for more action/answers on my next visit as I do feel fobbed off at the moment. I would like to give the doctor the benefit of the doubt but can find no reason why he'd prescribe Venlafaxine so quickly - given it could impact my libido and possibly my prolactin.

      Happy to hear your prolactinoma is under control. Best of luck in the future.

      Sam

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  • Posted

    Yes, your prolactin is too high. The Pituitary Institute gives the reference range for men as 45-375mU/L (2.2-19 ng/ml).

    Has your testosterone been measured? (ref range male 8.4-28.7 nmol/L). Your cortisol and thyroxine also need to be measured. If you get another out-of-range figure, your GP should recognise that that it needs an endocrinologist to evaluate the total picture.

    Superficially at least, it looks like your GP is treating the symptoms, not the disease. (Excuse the hyperbole!)

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    • Posted

      I forgot to say... you need an anaemia check too. (But caution, not a lot of docs are aware that low testosterone causes anaemia in men [says my endo] so iron tablets nor B12 injections will not fix it in this case).

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    • Posted

      Hi Roddy999,

      Thank you for your message.

      Re Pituitary Institute: I'm unable to find a website for them. Did you mean the Pituitary Foundation?

      My testosterone and thyroxine looks fine but haven't checked cortisol levels yet.

      TSH 2.15 mIU/L (0.27 -4.2)

      Free T3 4.51 pmol/L (3.1-6.8)

      Free Thyroxine 18.4 pmol/L (12-22)

      FSH 5.76 IU/L (1.5-12.4)

      *LH 8.74 IU/L (1.7-8.6)

      Oestradiol 98.3 pmol/L (41-159)

      Test 18.4 nmol/L (8.64-29)

      Free test 0.263 nmol/L (0.2-0.62)

      My free testosterone isn't great but that's down to my high SBHG (59.7 nmol/L).

      I will seeing the GP again this week as I'm really unhappy about the Venlafaxine he's prescibed (yes, I agree, he seems to be ignoring the underlying cause and just giving out pills) and will ask to be referred to an endo for the high prolactin.

      Have you experienced high prolactin? If so, how did you bring them into range?

      Thanks.

      Sam

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    • Posted

      yes, Foundation, sorry.

      No, I had low everything, opposite end of the chart from you. I had the same problem with GPs not accepting that they can't expect to know the far ends of every bell curve for every condition, that's why we have consultants. By the time I finally got to see an endo, my situation was not at all good. Fortunately I made an excellent recovery.

      I wouldn't waste time asking the GP for a cortisol test, leave that to the endo. After you've actually got an endo appointment, you could maybe suggest to the GP that the endo might find it useful to see what it was. Of course they will do all the tests again but that is useful if it shows any changes.

      You need to be aware that the high prolactin may itself be a symptom but if it is 'just' a control system fault, then there seem to be effective drugs for that. If not, then it is not serious.

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  • Posted

    The more I think about it, Sam, the more I believe strongly that you need to insist that your GP refers you to an endocrinologist. Your prolactin levels are way out of the normal range. That should have been enough.

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  • Posted

    Don't bother with a GP for this. Ask your GP to refer you to an endocrinologist of go find a great endocrinologist yourself, get a referral to him or her and that person will run all the required tests and more to the point, will correctly interpret the results.

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