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Prolactinoma - What else can cause elevated prolactin levels?

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There are a few conditions other than prolactinomas that may be associated with hyperprolactinemia. As prolactin is regulated by dopamine , medications that interfere with this substance in the brain can cause elevated prolactin levels. Drugs prescribed for psychiatric and gastrointestinal disorders may raise prolactin levels to greater than 200 ng/ ml. Other drugs that can cause mild elevations of prolactin levels include estrogens and verapamil, a drug used to treat high blood pressure.

An underactive thyroid or inadequate thyroid hormone replacement can also raise prolactin levels, as can kidney disease, pregnancy, stress, and chest trauma.

Causes of Hyperprolactinemia

  • Prolactinomas
  • Medications (phenothiazines, metoclopramide, risperidone, selective serotonin reuptake inhibitors, estrogens, verapamil)
  • Stress
  • Pregnancy
  • Hypothyroidism
  • Kidney disease
  • Chest trauma

Most patients with medication-induced hyperprolactinemia will have prolactin levels between 25 and 100 ng/ml (rarely up to 250 ng/ml). If an elevated prolactin level is due to a medication, the level will usually return to normal 3-4 days after the drug is stopped. It is not possible to determine the cause of an elevated prolactin from the blood level alone. Even if you have a high prolactin level caused by a medication, do not stop any of your medications without first consulting your doctor.