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Thyroid Problems/Hypothyroidism and high prolactin


QUESTION: Hello Doctor,

I was diagnosed with Hashimoto's 10years ago.I'm now 24 and I'm male.I began with the 50 pill of levothyroxin and switched to 75 three years later.Now I still take 75.The problem is that my Tsh has gone up to 1.73. It was 1.3 ten months ago.My heartbeats are constantly at 70, they were 80 before.For a year now I have depression and I have stopped seeing my friends and going to college because I feel depressed.I'm tired all the time.I have gained 17 kg in 4 years.My LDL is 135 and my Total cholesterol at 210.My prolactin is 27 when the reference range for men is from 0 to 15 .Free T4 is 10 when the reference range in my blood tests is from 8 to15, so its on the low end.My exam from ultrasound showed the same nodules as usual (nothing unusual compared to 3 years ago).I believe I need to increase the pill and take 88, but my doctor says that as long as my TSH is lower than 2.7 then 75 is good.So I think something is wrong with all that.I would like to have your opinion on that and some advice.
 Also, please tell me : why is my prolactin so high?Even women have less than 25 unless they're pregnant and I'm male and I have 27.I read somewhere that maybe I have high TRH because of Hashimoto's, which would explain that.Should I worry?How can I convince my doctor to change my pill?
Thank you very much for your time.

ANSWER: Hello Arnold,
Warm welcome to you!
TSH value of 1.73 is completely normal. Please send your height, weight and approx how many calories you consume per day. If possible get the following tested, Total Testosterone, Blood urea nitrogen, serum amylase. Many times in hypothyroid patients increased prolactin is seen. I think weight gain is due to hyper secretion of prolactin and there is no need to change dose of levothyroxine. You first get the above said tests done. Its essential for coming to a diagnosis. Any problems associated with eyes you are experiencing? Is there any particular incidence which caused depression? or does the depression exists without any reason?

Thanking you!

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QUESTION: Thank you very much for your quick response.  I weigh 97kg and eat about 2000 calories per day.I measure 190cm. My doctor has kept my blood tests but I remember that I checked my urea and it was normal, as well as my lipase, and transaminases and amylase, sodium, B12, blood sugar.I don't have eye problems.Everything was normal apart from prolactin and vitD which was less than 5 when normal range is 30-100.My hemoglobin was 13 . What still bothers me is prolactin.If it is caused by my thyroid, shouldn't I find a way to treat it?  Thanks a lot for your time and help.I appreciate it.
By the way does prolactin counteract dopamine and cause mild depression?

Hi Arnold!
Its very typical for hypothyroid person to have low vit D and elevated prolactin. Please take vit D supplements. It very important for proper thyroid functioning. Also you can take cabergoline to control the prolactin levels. Yes increased prolactin can cause depression.

Thanking you!

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Dr.Shrinidhi Kulkarni


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KIMS, Bangalore

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