Varying prolactin levels - could it be a pituitary problem?

[TeggieDaff]

Hey everyone, just looking for some advice! I'm a 19 year old girl from the UK.

So I went to my GP (general practitioner - I think like a family doctor in the US?) about 4 months ago with fatigue, mild weight gain, mood swings, symptoms of depression and anxiety, irregular and very light periods, achy knees and finger joints, dry painful eyes, headaches, sore breasts and no libido. Most of these symptoms I've had for years looking back, it's just until now they've never really interfered with my daily life. Recently I've been in some pretty stressful situations and originally thought I was looking at a mental health (maybe very mild PTSD) diagnosis - the thing is my blood tests have come back abnormal, I'm no longer under any stress (or at least I don't feel at all stressed!) and I just don't feel much better. Also my symptoms started years prior to the stressful events. My doctor seems quite confused by all this, especially after the mental wellbeing team I was referred to reported back that they could see no clinical mental health issues and I was discharged pretty much straight away.

Anyway:

First blood test came back as low T4, normal TSH, prolactin 1200 (range 50-496), normal LH and only just normal FSH. GP assumed possible hypothyroidism and gave me thyroxine.

Second blood test (now on thyroxine) came back as normal T4, TSH and prolactin. TSH had risen compared to the previous blood test which isn't normal from my admittedly basic understanding of endocrinology (I study Biomedical Sciences at university so I know a bit). Different GP stops thyroxine on basis that he thinks I have anxiety that I'm in denial about and am a hypochondriac. Prior to this year I have been to the doctors 3 times in my whole life so I felt that last one was a bit unfair!

Off thyroxine my TSH and T4 remained normal (though both fell) but my prolactin went up to 655.
Four weeks later another blood test showed normal TSH and T4 (slightly higher again) and prolactin once again high at 595.

My GP is now testing me again to check I'm ovulating and has said we should keep an eye on my prolactin but has said she doesn't understand what's going on so it's likely to just be stress - she feels that right now nothings abnormal enough to do anything about beside monitor. She's also suggested possible PCOS but my testosterone is normal (and at the lower end) so it seems unlikely. She's basically told me she knows very little endocrinology but is holding off referring me to a endocrinologist unless my prolactin goes over 1000 again

I feel this is probably something slightly off with my pituitary or HPA axis (meaning an abnormal stress response maybe?) and I was just wondering if anyone had any thoughts. I'm starting to get very fustrated by all these blood tests and doctors visits and the fact that every time it's a different possible diagnosis!

Thank you in advance!!

[rumpled]

I think you are probably more on the ball than your doctor. It does carry hallmarks of pituitary and may or may also be hpa as well as prolactin.

The only hospital in the U.K. That I know that helped my Cushing's peeps was st Bart's and that was a while ago.

Prolactin goes up and down with stress.

[TeggieDaff]

Thank you! My prolactins come back normal this time but I'm definitely not ovulating cos my progesterone, LH and FSH are all wrong!! So I'm getting referred to an endocrinologist. Finally. Hope you're well.