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Galactorrhea in subclinical hypothyroidism
1Division of Endocrinology and Metabolism, Jichi Medical School, Tochigi, Japan.
Endocrinologia Japonica
|August 1, 1987
Summary
Subclinical hypothyroidism can cause galactorrhea (milk discharge) even with normal thyroid hormone levels. TRH testing and T4 therapy are key for diagnosis and treatment.
Area of Science:
- Endocrinology
- Reproductive Medicine
Background:
- Galactorrhea, characterized by milk discharge, can present in patients with subclinical hypothyroidism.
- Subclinical hypothyroidism may involve normal serum T4 and T3 levels, with only slight elevations in TSH and PRL.
Purpose of the Study:
- To investigate the link between subclinical hypothyroidism and galactorrhea.
- To highlight the diagnostic utility of TRH stimulation tests and T4 replacement therapy in such cases.
Main Methods:
- Studied 5 patients with galactorrhea and subclinical hypothyroidism.
- Administered TRH stimulation tests before and during T4 replacement therapy.
- Monitored galactorrhea resolution with increasing T4 dosage.
Main Results:
- All patients exhibited exaggerated prolactin (PRL) response to TRH stimulation.
- Galactorrhea resolved with T4 replacement therapy (150-200 mcg/day).
- PRL response remained elevated even after TSH normalization during T4 therapy.
Conclusions:
- Subclinical hypothyroidism should be considered in unexplained galactorrhea, even with normal thyroid function tests.
- TRH stimulation tests are crucial for detecting exaggerated PRL response.
- T4 replacement therapy's effect on galactorrhea helps differentiate from pituitary microadenoma.