Prolactin is a hormone synthesized and secreted by the pituitary gland, a small organ located at the base of the brain. While it is most known for its role in stimulating milk production in women after childbirth, it also influences metabolism, immune function, and reproductive health in both men and non-pregnant women. When blood levels of this hormone become consistently elevated, a condition known as hyperprolactinemia occurs. Managing and reducing these high prolactin levels often involves a combination of lifestyle changes, careful review of medications, and, when necessary, medical intervention.
Understanding the Causes of Elevated Prolactin
The reasons for elevated prolactin levels can generally be categorized as either temporary or persistent. Temporary, or physiological, elevations occur in response to normal bodily functions or external stimuli, including pregnancy, sleep, nipple stimulation, and significant physical or emotional stress. Intensive physical activity, such as endurance training, can also cause a transient rise.
Persistent, or pathological, hyperprolactinemia is often due to an underlying health condition that disrupts the brain’s regulatory mechanisms. The most frequent cause is a prolactinoma, a non-cancerous pituitary tumor that directly produces excess prolactin. Other endocrine issues, such as primary hypothyroidism, can increase prolactin because the resulting rise in Thyrotropin-Releasing Hormone (TRH) stimulates its release. Chronic diseases affecting the liver or kidneys can also lead to elevated levels by interfering with the body’s ability to clear the hormone.
Essential Lifestyle Adjustments
Managing chronic stress is a foundational step in regulating prolactin, as the stress hormone cortisol can trigger its release. Engaging in regular relaxation techniques, such as mindfulness or meditation, can help mitigate chronic stress effects. Ensuring adequate rest is also important because poor sleep increases overall stress and disrupts hormonal balance.
Dietary adjustments can support the body’s natural inhibition of prolactin, which is primarily mediated by dopamine. Consuming foods rich in the amino acid tyrosine (e.g., lean meats, eggs, and legumes) provides the building blocks for dopamine synthesis. Stabilizing blood sugar by reducing refined sugars and processed foods is also beneficial, helping prevent insulin resistance linked to higher prolactin levels.
A consistent sleep routine is relevant since prolactin levels naturally peak during sleep. Establishing a regular sleep-wake cycle and ensuring the bedroom environment is conducive to deep rest supports the body’s natural hormonal rhythm. Individuals who engage in intense exercise should consider moderating their routine, as overtraining can contribute to persistent elevations. Avoiding non-essential chest wall stimulation, which reflexively triggers prolactin release, may also be a helpful measure.
Navigating Medication and Supplement Effects
Many common medications can inadvertently raise prolactin levels by interfering with dopamine signaling. Drug classes frequently implicated include certain antipsychotics and antidepressants (SSRIs), which block dopamine receptors or alter dopamine metabolism. Medications for high blood pressure and some treatments for acid reflux or nausea can also elevate prolactin. Any discussion about altering a necessary prescription drug must occur under the direct supervision of a healthcare provider.
Specific vitamins and herbal remedies support lower prolactin levels. Vitamin B6 is a cofactor in dopamine synthesis, and supplementation helps reduce prolactin, particularly in cases of drug-induced hyperprolactinemia. The mineral zinc also plays a role in hormonal balance and can be obtained through foods like oysters, beef, and pumpkin seeds. Vitex agnus-castus (Chasteberry) is an herbal remedy that may interact with dopamine receptors to help normalize prolactin secretion, especially in women with mild elevations.
Clinical Diagnosis and Medical Treatment Options
The initial step in clinical management involves a blood test to measure the serum prolactin level, often requiring a fasted sample taken after a period of rest to avoid temporary physiological spikes. If the level is high, a healthcare provider will investigate other causes, such as checking thyroid function and ruling out pregnancy. They may also test for macroprolactin, a large, inactive form of the hormone that can cause a falsely high reading without producing symptoms.
If the cause is not attributable to medication or hypothyroidism, a magnetic resonance imaging (MRI) scan of the pituitary gland is ordered to check for a prolactinoma. The standard first-line treatment for persistent hyperprolactinemia, particularly when a prolactinoma is present, involves dopamine agonists. These medications, such as Cabergoline and Bromocriptine, mimic the action of dopamine, which naturally inhibits prolactin release.
Cabergoline is the preferred option because it is highly effective at normalizing prolactin levels and shrinking tumors, often requiring less frequent dosing and causing fewer side effects than Bromocriptine. Treatment continues until prolactin levels normalize and symptoms resolve, requiring ongoing monitoring of hormone levels and, for larger tumors, tumor size via repeat MRI. For patients on higher doses of Cabergoline, regular cardiac monitoring with an echocardiogram is recommended due to potential effects on heart valves.