Increased thyroid-stimulating hormone response to thyrotropin-releasing hormone in hyperprolactinemic women

The TSH response to TRH and basal thyroid function were studied in 21 unselected women with hyperprolactinemia. The mean serum free T4 (FT4) concentration was significantly lower in hyperprolactinemic women than in normal women. The mean basal TSH concentrations were similar, but the incremental TSH response to TRH was significantly greater in hyperprolactinemic women than in normal women. Increased dopaminergic inhibition of TSH release has been reported in hyperprolactinemic women. The low serum FT4 concentration in hyperprolactinemic women may be the result of increased dopaminergic inhibition of TSH release, and the increased pituitary TSH reserve may reflect increased TSH storage due to dopaminergic inhibition of basal TSH release. Alternatively, though less likely, the low serum FT4 concentration may be the result of direct action of PRL on the thyroid, and the low FT4 concentration may, in turn, lead to the increased pituitary TSH reserve.