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Friday, March 26, 2010

Hyperprolactinaemia

I don't even want to imagine what kind of weight I could be gaining if I wasn't training like I am!

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Clin Endocrinol (Oxf). 1998 May;48(5):547-53.

Increased body weight associated with prolactin secreting pituitary adenomas:
weight loss with normalization of prolactin levels.

Greenman Y, Tordjman K, Stern N.
Institute of Endocrinology, Tel Aviv-Elias Sourasky Medical Center, Israel.
Comment in:  Clin Endocrinol (Oxf). 1999 Feb;50(2):271.

OBJECTIVE: Hyperprolactinaemia in humans may be associated with a high prevalence of obesity but the nature of this link is poorly defined. The aim of this study was to establish the relationship between hyperprolactinaemia and body weight in patients with prolactin-secreting pituitary tumours. DESIGN: We conducted a retrospective study of prolactinoma patients treated at the Endocrine Institute of the Tel Aviv Medical Center, Israel, during the period 1989-1996. Patients with clinically non-functioning pituitary macroadenomas (NFA) served as the control group. Data on demographic parameters, body weight before and during treatment, clinical presentation including history of weight fluctuations, tumour size as measured by computed tomography or magnetic resonance imaging, modalities and response to treatment, and pituitary function before and during treatment were recorded from medical files. PATIENTS: Forty-two patients with prolactinomas (PR) and 36 patients with clinically non-functioning macroadenomas (NFA) comprised the study population. RESULTS: Mean weight was 93 +/- 3.4 kg and 78 +/- 2.7 kg in male patients with PR and NFA respectively (P = 0.0007). Recent weight gain (8 to 22 kg) was a presenting symptom in 13 PR patients, whereas only one NFA patient had this clinical presentation (P = 0.001). Seventeen PR patients lost weight (mean change -8.3 +/- 1.5 kg, range -2-28 kg), during prolactin lowering therapy, 11 of whom had entirely normalized prolactin levels. Fourteen of the 18 patients who did not lose weight still had elevated prolactin levels (P = 0.01). Weight loss in patients with PR could not be attributed to altered pituitary function nor to compression of the third ventricle. In contrast to PR, no significant weight loss was observed in NFA patients. CONCLUSION: Weight gain and elevated body weight are frequently associated with prolactinomas regardless of a mass effect on the hypothalamus or pituitary function. In this series, weight loss was recorded in 70% of prolactinomas patients and in 90% of male patients who normalized their prolactin levels. We propose the inclusion of hyperprolactinaemia in the differential diagnosis of endocrine obesity and weight gain.

3 comments:

Cyclin' Missy said...

Do you know for sure yet whether you have a pituitary tumor? I hope not! At the same time, I hope you do find the source of your problems so it can be remedied.

Not fun to deal with health issues. I respect you a lot for continuing to train despite the obstacles!

Donna said...

Nope. Don't know for sure yet, but since it's not my thyroid causing the high prolactin levels, there's a 30% chance it's a tumor. It's not fun to deal with, but I'll get through -- it's like I'm training while pregnant!

sharla said...

health issues have a sneaky way of cropping up.
Better to work through them, then to let them consume your life.

(If it happens to be a tumor and they suggerst radio-surgery, talk to me, I had it for a benign meninginoma that was found as a fluke)

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