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Primary hypothyroidism and galactorrhea.

T Onishi, K Miyai, T Aono

    The American Journal of Medicine
    |September 1, 1977
    PubMed
    Summary
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    High prolactin (PRL) levels in women with hypothyroidism are linked to elevated thyrotropin (TSH). Treatment normalized PRL and resolved galactorrhea, suggesting a TSH-TRH-PRL connection.

    Area of Science:

    • Endocrinology
    • Reproductive Medicine

    Background:

    • Primary hypothyroidism is characterized by elevated thyrotropin (TSH) levels.
    • Hyperprolactinemia, or high serum prolactin (PRL) concentrations, can occur in women with hypothyroidism.
    • Galactorrhea, or milk production, can be a symptom associated with hormonal imbalances.

    Purpose of the Study:

    • To investigate the relationship between thyrotropin (TSH) and prolactin (PRL) levels in women with primary hypothyroidism.
    • To explore the potential mechanisms linking hypothyroidism to hyperprolactinemia.
    • To assess the effect of thyroid hormone replacement therapy on PRL levels and associated symptoms like galactorrhea.

    Main Methods:

    • Observational study of 16 women with primary hypothyroidism and high TSH.
    • Measurement of basal serum TSH and PRL concentrations.

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  • Clinical assessment for symptoms such as galactorrhea.
  • Treatment with triiodothyronine (T3) and monitoring of TSH, PRL, and symptoms.

    • Main Results:

    • Ten out of 16 hypothyroid women exhibited high PRL levels.
    • A positive correlation was found between basal TSH and PRL levels.
    • Five patients with galactorrhea experienced resolution of symptoms after T3 treatment.
    • Elevated TSH and PRL normalized following thyroid hormone replacement.

    Conclusions:

    • Elevated PRL in primary hypothyroidism may be mediated by thyrotropin-releasing hormone (TRH) via feedback mechanisms or enhanced response.
    • Hyperprolactinemia and subsequent galactorrhea in hypothyroid women may be exacerbated by factors like delivery.
    • Thyroid hormone replacement therapy is effective in normalizing PRL levels and resolving galactorrhea in this patient group.