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Compensated hypothyroidism presenting with galactorrhoea.

S Shilo1, H J Hirsch

  • 1Endocrine Clinic, Shaare Zedek Medical Center, Jerusalem, Israel.

Journal of Internal Medicine
|August 1, 1990
PubMed
Summary
This summary is machine-generated.

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Mild hypothyroidism can cause galactorrhoea (milky nipple discharge) even when compensated. This case highlights that breast symptoms may occur with subclinical thyroid dysfunction, emphasizing the need for thorough evaluation.

Area of Science:

  • Endocrinology
  • Reproductive Medicine

Background:

  • Compensated hypothyroidism, characterized by normal thyroxine (T4) and triiodothyronine resin uptake (T3RU) with mildly elevated thyroid-stimulating hormone (TSH), can present with subtle symptoms.
  • Galactorrhoea, or abnormal milk production, is often associated with hyperprolactinemia, but its link to mild thyroid dysfunction requires further understanding.

Observation:

  • A 36-year-old female presented with breast tenderness and mild galactorrhoea.
  • Initial laboratory results showed T4 of 5.8 mcg/dL, T3RU of 22.5%, mildly elevated TSH (6.5 mU/mL), and prolactin (26.1 ng/mL).
  • A thyrotropin-releasing hormone (TRH) test revealed an exaggerated TSH response (up to 43 mU/mL) and a significant increase in prolactin (to 161 ng/mL).

Findings:

  • Treatment with levothyroxine (T4) normalized TSH and prolactin levels.

Related Experiment Videos

  • The galactorrhoea resolved following T4 therapy.
  • This case demonstrates a direct correlation between compensated hypothyroidism and galactorrhoea.

    • Implications:

    • Galactorrhoea can be a presenting symptom of compensated hypothyroidism, even with only mildly elevated thyroid-stimulating hormone.
    • This finding underscores the importance of considering thyroid function in the differential diagnosis of galactorrhoea.
    • Early diagnosis and treatment of hypothyroidism can effectively manage associated symptoms like galactorrhoea.