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Prolactin

Hormone/ Element
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Report in 4Hrs

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At Home

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No Fasting Required

Details

Measures prolactin hormone to evaluate pituitary tumors, infertility, or galactorrhea.

₹149₹605

75% OFF

Prolactin Test Information Guide

  • Why is it done?
    • The prolactin test measures the level of prolactin, a hormone produced by the pituitary gland that stimulates milk production in the breast
    • Evaluates unexplained infertility or difficulty conceiving in both men and women
    • Investigates abnormal breast milk discharge (galactorrhea) not related to pregnancy or nursing
    • Assesses symptoms of pituitary disorders such as pituitary adenomas (prolactinomas)
    • Evaluates menstrual irregularities, absence of menstruation (amenorrhea), or light periods
    • Monitors patients taking medications known to elevate prolactin levels (antipsychotics, antidepressants, metoclopramide)
    • Assesses sexual dysfunction or reduced libido in both men and women
    • Investigates symptoms suggestive of hypothyroidism or other endocrine disorders
    • Typically performed in the morning (8-10 AM) after at least 30 minutes of rest, as prolactin levels are naturally higher in early morning hours
  • Normal Range
    • Women (Non-pregnant, not breastfeeding): 2.7-29 ng/mL (or 2.7-29 μIU/mL)
    • Men: 2.0-18 ng/mL (or 2.0-18 μIU/mL)
    • Pregnant women: 34-386 ng/mL (levels increase throughout pregnancy)
    • Note: Reference ranges may vary slightly between laboratories; always consult the specific laboratory's reference range provided with results
    • Low prolactin (<2 ng/mL): Generally not clinically significant; normal finding
    • Normal prolactin: Suggests normal pituitary function and no hormone-related abnormalities
    • Elevated prolactin (>30 ng/mL): Indicates hyperprolactinemia; may suggest pituitary tumor, medication effect, hypothyroidism, or other pituitary/endocrine disorders
    • Units of measurement: ng/mL (nanograms per milliliter) or μIU/mL (micro-international units per milliliter); laboratories may use different units
  • Interpretation
    • Mildly elevated prolactin (30-200 ng/mL): May indicate early pituitary adenoma, medication side effects, hypothyroidism, or chronic kidney disease; requires further investigation and possible repeat testing
    • Moderately elevated prolactin (200-500 ng/mL): Strongly suggests prolactinoma or significant pituitary pathology; warrants pituitary MRI and endocrinology consultation
    • Markedly elevated prolactin (>500 ng/mL): Indicates large prolactinoma or severe pituitary dysfunction; urgent imaging and specialist evaluation recommended
    • Factors affecting prolactin levels:
    • Physical stress, emotional stress, and sleep deprivation can elevate prolactin
    • Medications (antipsychotics, certain antidepressants, metoclopramide, domperidone, estrogen) can raise prolactin levels
    • Hypothyroidism increases TRH (thyrotropin-releasing hormone), which stimulates prolactin secretion
    • Chronic kidney disease impairs prolactin clearance, leading to elevated levels
    • Chest wall irritation from trauma, shingles, or surgical scars can stimulate prolactin release
    • Recent breast stimulation, physical activity, or anxiety during the test may falsely elevate results
    • Clinical significance: Elevated prolactin is the most common cause of secondary infertility and amenorrhea; it inhibits GnRH (gonadotropin-releasing hormone) secretion, suppressing reproductive hormones
    • In men, elevated prolactin may cause erectile dysfunction, decreased libido, and reduced sperm production
    • Prolactinomas are benign pituitary adenomas that account for approximately 40% of pituitary tumors; most respond well to medical treatment
  • Associated Organs
    • Primary organ system: Endocrine system; prolactin is produced by lactotroph cells in the anterior pituitary gland
    • Secondary organs affected: Mammary glands (breast tissue), reproductive system (ovaries, testes), hypothalamus, and thyroid gland
    • Conditions associated with elevated prolactin:
    • Prolactinoma (pituitary adenoma secreting prolactin) - most common pathological cause
    • Hypothyroidism - elevated TRH stimulates prolactin production
    • Chronic kidney disease - decreased prolactin clearance by kidneys
    • Polycystic ovary syndrome (PCOS) - mild prolactin elevation common
    • Liver cirrhosis - impaired estrogen metabolism and altered dopamine effect
    • Chest wall pathology - irritation or trauma can trigger prolactin release
    • Infertility (primary or secondary) - prolactin inhibits GnRH and gonadotropin secretion
    • Amenorrhea and oligomenorrhea - suppression of menstrual cycles
    • Sexual dysfunction and decreased libido in men and women
    • Galactorrhea - inappropriate breast milk production or discharge
    • Potential complications of hyperprolactinemia:
    • Large prolactinomas may cause vision problems (bitemporal hemianopia) due to compression of optic chiasm
    • Pituitary apoplexy - sudden rupture or infarction of pituitary adenoma causing acute symptoms
    • Osteoporosis - hypogonadism from elevated prolactin reduces bone density
    • Increased risk of certain estrogen-sensitive malignancies (theoretical concern, controversial)
  • Follow-up Tests
    • If prolactin is elevated (>30 ng/mL):
    • Repeat prolactin test - confirm elevated result, as stress and other factors can temporarily raise levels
    • TSH (thyroid-stimulating hormone) and free T4 - evaluate for hypothyroidism
    • Comprehensive metabolic panel including renal function - assess kidney function and liver disease
    • Pregnancy test (hCG) in women of reproductive age - pregnancy naturally elevates prolactin
    • Pituitary MRI with contrast - visualize pituitary gland and detect prolactinomas or other tumors
    • Other pituitary hormones - LH, FSH, ACTH, GH, TSH to evaluate overall pituitary function
    • Testosterone (in men) - assess hypogonadism secondary to elevated prolactin
    • Estradiol and progesterone (in women) - evaluate hormonal status
    • If prolactinoma is diagnosed:
    • Endocrinology consultation - specialized management of pituitary disorders
    • Visual field testing - evaluate for optic chiasm compression from large tumors
    • Monitoring prolactin levels - typically every 3-6 months initially, then annually if stable
    • Repeat MRI - assess tumor size and response to treatment (typically at 6-12 months, then annually or as clinically indicated)
    • Bone density testing (DEXA scan) - assess osteoporosis risk from chronic hypogonadism
    • Related complementary tests:
    • Semen analysis - if male infertility suspected
    • Pelvic ultrasound - assess ovarian structure in women with amenorrhea or infertility
    • Antisperm antibody test - if autoimmune male infertility suspected
  • Fasting Required?
    • Fasting: No
    • Fasting is not required for prolactin testing; food and drink do not directly affect prolactin levels
    • Special instructions and patient preparation:
    • Schedule test in early morning (8-10 AM) - prolactin levels are naturally highest in the early morning hours
    • Rest for at least 30 minutes before blood draw - physical activity and stress can transiently elevate prolactin
    • Avoid breast stimulation - do not manipulate or stimulate breast tissue before test as this elevates prolactin
    • Wear comfortable, loose-fitting clothing - minimizes stress and chest wall irritation
    • Minimize stress and anxiety - emotional stress elevates prolactin levels
    • Medications to discuss with provider:
    • Do NOT stop medications without physician approval; instead, inform provider of all medications being taken
    • Medications that elevate prolactin (inform provider if taking): Antipsychotics (haloperidol, risperidone, quetiapine), antidepressants (tricyclic, SSRIs), metoclopramide, domperidone, verapamil, opioids, estrogen/oral contraceptives
    • Medications that lower prolactin (inform provider if taking): Dopamine agonists (bromocriptine, cabergoline), levodopa, lisuride
    • Other preparation requirements:
    • Inform healthcare provider if female patient is pregnant - prolactin rises progressively during pregnancy
    • Inform provider if breastfeeding - breastfeeding significantly elevates prolactin levels
    • Avoid caffeine excessively - may indirectly affect stress-related prolactin elevation
    • Ensure adequate sleep night before test - sleep deprivation increases prolactin

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