Prolactinoma and Hypothyroidism ??

[lorry_driver]

I am 20 years old and have a Macroprolactinoma. I was diagnosed 4 years ago at only 16, my tumour is 2cm and my prolactin levels at time of diagnosis was 152,000. I was transferred from cabergoline to bromocriptine then back to cabergoline in august this year. But recently I have also suffered really bad constipation, and my gp have prescribed laxido. I happen to know that constipation is one symptom of hypothyroidism. I also have other symptoms such as always being cold. I just wanted to know is it likely that I suffer from both, or can one cause the other? I guess I just want a solution that means I don’t have to take daily laxatives from the age of 20 :S

[Daniel M Prevedello, MD]

Dear Lorry_Driver

I am not saying I am recommending surgery, but it may be something that needs to be considered in your situation. Previous CSF is not a problem.
I will be glad to revise your current MRI free of any charge.

[rumpled]

You need a competent neuro-endo at a pituitary center and treatment. Hemorrhaging is a not a positive sign - please look up pituitary apoplexy. A CSF leak is also not a positive sign.

I would suggest a new consultant and an excellent surgeon. It should have decreased in size on medications and if not, it should have been treated promptly with surgery with a lesion of that size. The patient community has links in the health pages (to the right of the forum) with additional information.

[lorry_driver]

Hey,
I know every time I do to the clinic some sort of thyroid levle or function is always measured, is that to test for hypothyroidism or do I require a separate test?
Thanks for your reply, it was when i was first diagnosised and has not decreased in size over the 4 years but apparently does show signs of  haemorrhaging (which apparently is a good sign? thats what my consultant said anyway). I was going to have some type of surgery 2 years ago, but that was because I suffered csf leakage through my nose at that time, but is stopped by itself within a week (not sure if that changes your option) so would you still recommend surgery, just so I know weather to discuss this with my consultant.

[lorry_driver]

Hey,
I know every time I do to the clinic some sort of thyroid levle or function is always measured, is that to test for hypothyroidism or do I require a separate test?
Thanks for your reply, it was when i was first diagnosised and has not decreased in size over the 4 years but apparently does show signs of  haemorrhaging (which apparently is a good sign? thats what my consultant said anyway). I was going to have some type of surgery 2 years ago, but that was because I suffered csf leakage through my nose at that time, but is stopped by itself within a week (not sure if that changes your option) so would you still recommend surgery, just so I know weather to discuss this with my consultant.

[Daniel M Prevedello, MD]

Dear Lorry_driver

People with pituitary adenomas can have the pituitary gland function diminished due to pressure caused by the tumor. That can cause decreased function of the thyroid gland due to decreased stimulation from the pituitary gland.
The treatment is hormonal replacement with T4 (thyroid hormone).
The other question in your case is about your tumor. In your question you say your tumor is 2cm. It is or it was? If it is 2 cm after 4 years of dopamine agonist, at your age one should consider surgical resection (personal opinion since I am a surgeon).