by Carlo Raj, MD

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    Let’s talk about hyperprolactinemia and the different reasons as to why you might then develop this. A functioning lactotrophic… remember that lactotrophic means prolactin. Also keep in mind that a lactotroph is a somatomammotroph. A prolactinoma due to overexpression… here we go, if you haven’t memorized it already, we have a pituitary tumour transforming gene, PTTG. Do not forget this, why? Because a prolactinoma of all of the hormones that come out of a functioning adenoma in the anterior pituitary, prolactin’s number one, PTTG. Another reason or another cause of hyperprolactinemia yet once again is primary hypothyroidism. The question that I get often times from students is, well, “Dr. Raj, why could this not be secondary hyperthyroidism?” Well, technically perhaps... and so, you think if it was secondary hyperthyroidism, that means that my anterior pituitary, decreased TSH and you would have increased TRH thus increase in prolactin. One would think that there will be hyperprolactinemia. However, in primary hypothyroidism, you have combined, concerted effort, but TRH and TSH… remember, all these cells within anterior pituitary mixed up and so, therefore, there is enough influence on that lactotroph to release prolactin… primary hypothyroidism. What else may cause hyperprolactinemia? Whatever may then cause decreased dopamine influence on your lactotrophs. How? Damage to your dopaminergic neurons, drugs, antipsychotics… remember, schizophrenia means too much dopamine; antipsychotics is a dopamine antagonist, may result in hyperprolactinemia, look for galactorrhea in a female. The stalk section that we talked about earlier. If the stalk has been severed or lesioned or you have a non-functioning adenoma compressing the stalk, you’re not going to deliver dopamine effectively. It will result in hyperprolactinemia. Or benign, you might have a craniopharyngioma, sometimes referred to in your sella as being like crank oil in consistency. May result in, once again, increased release...

    About the Lecture

    The lecture Hyperprolactinemia by Carlo Raj, MD is from the course Pituitary Gland Disorders.

    Included Quiz Questions

    1. Prolactinoma
    2. Primary hyperthyroidism
    3. Increased TSH and TRH
    4. Non-functioning lactotrophic adenoma
    5. Depletion of dopamine
    1. Primary hypothyroidism
    2. Damage to hypothalamic dopaminergic neurons
    3. SSRIs
    4. Severed pituitary stalk
    5. Craniopharyngiomas
    1. Lactotroph macroadenoma
    2. Metastatic breast cancer
    3. PRLR mutation
    4. Chronic kidney injury
    5. Primary hyperthyroidism
    1. Hypergonadism
    2. Amenorrhea
    3. Infertility
    4. Decreased bone density in lumbar spine
    5. Headaches
    1. Hypothyroidism
    2. Hypogonadotropic hypogonadism
    3. Hyperprolactinemia
    4. Lactotroph macroadenoma
    5. Chronic kidney disease
    1. Acting as a dopamine agonist
    2. Increasing clearance
    3. Decreasing TSH
    4. Decreasing TRH
    5. Decrease expression of PTTG

    Author of lecture Hyperprolactinemia

     Carlo Raj, MD

    Carlo Raj, MD

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