What is hyperprolactinemia?
DISCLAIMER: CONSULT WITH A DOCTOR BEFORE DECIDING ON A TREATMENT PLAN FOR ANY DISEASE OR INJURY.
Hyperprolactinemia is, unfortunately, an under-discussed health problem, especially when it comes to natural treatments and therapies. It can affect both men and women, though it most frequently affects women, especially women who have another co-existing reproductive health problem, such as PCOS. This article will focus primarily on hyperprolactinemia in women, but we’ll also talk about hyperprolactinemia in men, and treatments for both genders.
As its name suggests, hyperprolactinemia is a condition characterized by abnormally high levels of prolactin. Prolactin is a hormone that is not only responsible for breast development and breastmilk production, but also for other lesser-known functions, including regulation of immune response. It may also play an important role in liver health and function, since the liver is one of the primary locations in the body where there are prolactin receptors (along with the gonads, of course, and lymphoid cells in the lymphatic system). This would make some sense, since the liver is one of the main organs of the body that produces and processes certain hormones and nutrients that are necessary for hormone creation.
Symptoms of Hyperprolactinemia
The symptoms of hyperprolactinemia include:
- Estrogen deficiency (symptoms of estrogen deficiency are below)
- Pain during sexual intercourse due to lack of vaginal lubrication
- Higher incidence of urinary tract infection (UTI)
- Absence of menstruation / Amenorrhea
- Mood swings
- Tender breasts
- Hot flashes
- Difficulty concentrating
- Headaches and/or migraines
- Progesterone deficiency (symptoms of progesterone deficiency are below)
- Menstrual irregularities
- Heavy menstruation
- PMS / Premenstrual Syndrome
- PMDD / Premenstrual Dysphoric Disorder
- Tender breasts
- Bloating / swelling
- Painful menstruation / Dysmenorrhea
- Ovarian cysts
- Recurrent miscarriage
- Weight gain
- Mood swings
- Headaches and/or migraines
- Testosterone deficiency (symptoms of testosterone deficiency are below; this symptom may occur in both men and women)
- Decreased energy
- Low libido
- Trouble concentrating
- Erectile dysfunction (in men)
- Loss of lean muscle
- Anovulatory infertility
- Irregular menstruation
- Heavy periods
- Galactorrhea (spontaneous breast milk production outside of pregnancy or the postpartum period when a woman is breastfeeding; may occur in both women and men)
- Breast pain (may occur in both women and men)
- Low libido (may occur in both women and men)
High levels of prolactin are known to interfere with the release of Gonadotropin Releasing Hormone (GnRH) from the hypothalamus. This hormone is responsible for directing the release of luteinizing hormone and follicle stimulating hormone, which in turn are responsible for producing estrogen and progesterone (as well as testosterone, though somewhat indirectly). So, in this way, increased prolactin can interfere with the levels of other better-known human reproductive hormones.
What causes hyperprolactinemia?
Hyperprolactinemia may be cause by a variety of issues, including those listed below:
- Prolactinoma (this is a tumor of the pituitary gland, and is ultimately the cause for up to 50% of hyperprolactinemia cases)
- Chronic kidney disease
- Chronic liver disease
- Recent injuries/points of trauma to the upper chest area (this may include surgeries or injuries to the rib cage, diaphragm, upper abdomen, and some infections like Herpes zoster/Shingles)
- Use of certain pharmaceutical drugs (opiates, SSRI antidepressants, GERD medications, antipsychotics, and medications for ulcers of the digestive tract)
- Synthetic estrogen treatments (such as those given in menopause)
Conventional Medications for Hyperprolactinemia
Normally, I don’t talk about the conventional prescription medications for diseases. But in this case, I thought it was necessary, since the drug that’s generally given to hyperprolactinemia patients may actually worsen their condition considerably. There are a few different drugs that may be prescribed for hyperprolactinemia, but one of the most commonly prescribed is Bromocriptine (brand names: Parlodel; Cycloset). Bromocriptine is a dopamine receptor agonist that contains bromine, a halogen element that competes with iodine in the body’s iodine receptor sites in the thyroid, reproductive organs, gallbladder, and beyond.
Bromine toxicity is already a major problem in many developed countries, since it’s present in drinking/bathing water, in pajamas and clothes, on furniture, in swimming pools, and even sometimes in the air in the form of certain pesticides like Naled. Exposure to bromine not only causes the symptoms of bromine toxicity (you can read more about these here), but also causes and/or aggravates iodine deficiency.
Some of the side effects of bromocriptine include (but are not limited to):
- Hypotension / low blood pressure
- Loss of appetite
- Visual hallucinations
- Heart palpitations
- Difficulty swallowing (this is actually likely due to swelling of the thyroid gland in response to bromine toxicity/iodine deficiency)
- Skin rash / hives
- Internal bleeding
- Loss of coordination
- Heart attack
Iodine deficiency is a major cause of endocrine and reproductive system dysfunction. There’s a long list of health problems (in both men and women) that are related to a deficit in iodine, and/or to bromine exposure. When considering any health problem related to the reproductive system or endocrine system, I immediately consider iodine supplementation as the first-line treatment, since many of these health issues are at least partially, if not completely, resolved by the use of the correct form of supplemental iodine. Besides being a primary line of defense against reproductive and endocrine problems, iodine supplementation is also essential for cancer patients (and is, in fact, a cure for many reproductive organ and brain cancers specifically); since hyperprolactinemia is caused by the presence of a pituitary tumor in 50% of cases, this is especially relevant to this particular discussion. Below, I’ll talk more about how to use iodine correctly as a natural treatment for hyperprolactinemia.
Other conventional treatments for hyperprolactinemia include other dopamine receptor agonists, like cabergoline (Dostinex), lisuride (Dopergin), pergolide (Permax; Prascend), quinagolide (Norprolac), terguride (Teluron), and metergoline (Liserdol). These drugs are known to cause side effects such as nasal congestion, nausea/vomiting, dizziness, depression, faintness, postural hypotension, headache, constipation, mood swings, auditory hallucinations, and more.
Treatments for Hyperprolactinemia
Vitex Berry / Chaste Berry (Vitex agnus-castus)
For women, vitex berry (Vitex agnus-castus) is an important herbal remedy for hyperprolactinemia. This herb can help balance prolactin levels, as well as levels of all of the other reproductive hormones, and is indicated as one of the most important herbs for women’s health during the reproductive years (though vitex berry may also prove beneficial for post-menopausal women with hyperprolactinemia).
Studies have shown that even low-dose vitex berry can be highly effective in the treatment of hyperprolactinemia in women. One study observed that a dose of 40mg of vitex berry, given 3 times daily successfully lowered prolactin levels and relieved the symptoms of mastalgia to an equal extent as bromocriptine, but without any side effects.
A different study on a group of 52 women with hyperprolactinemia, the administration of 20mg of vitex berry for 3 months reduced prolactin release, rebalanced luteal phase progesterone synthesis and release, and shortened the length of the women’s luteal phase. Yet another study suggested that the vitex berry given at a dose of 30-40mg/day was able to reduce abnormally high levels of prolactin by 80%, in addition to helping resolve other symptoms of hyperprolactinemia, such as amenorrhea, oligomenorrhea, menorrhagia, polymenorrhea, problems with the function of the corpus luteum, and cystic hyperplasia. Multiple studies also indicate that women with hyperprolactinemia who are trying to conceive are more likely to get pregnant when they take vitex berry in the months prior to conception than other women with hyperprolactinemia who are not taking this herbal supplement.
The plant’s ability to lower prolactin levels may be due to its dopamine receptor agonist activity in the brain; note that the vast majority of drugs that are prescribed for hyperprolactinemia are also dopamine receptor agonists, so vitex berry may work as a kind of herbal substitute for these pharmaceutical drugs. As a bonus, vitex berry carries little to no risk of side effects, and can be taken over the long term. Women who become pregnant can take the herb for the 1st trimester in order to prevent miscarriage, and then stop taking it for the rest of the pregnancy.
Since hyperprolactinemia often occurs in combination with PCOS, it’s worth mentioning that vitex berry has also been shown to help increase progesterone and estrogen levels, decrease testosterone levels, and reduce the number of ovarian cysts present in women with polycystic ovarian syndrome.
Velvet Bean / Mucuna (Mucuna pruriens)
Mucuna pruriens contains high levels of L-dopa, the natural amino acid precursor to the neurotransmitter dopamine. As such, Mucuna is frequently used as a treatment for problems like addiction, Alzheimer’s disease, depression/anxiety, and other mental health disorders. The presence of L-dopa in Mucuna pruriens also happens to make it a candidate for the treatment of hyperprolactinemia in both women and men. Indeed, studies have proven that this particular herb, through its dopamine-increasing action, can lower abnormally high prolactin levels in addition to increasing testosterone levels in men specifically.
Mucuna pruriens has a mild contraceptive effect in women, as well as a simultaneous fertility boosting effect. Women taking Mucuna for hyperprolactinemia should be aware of this, but should also know that Mucuna doesn’t prevent conception in all cases, and can increase fertility when used at the appropriate times in a woman’s cycle. If, however, you become pregnant while using Mucuna as a hyperprolactinemia treatment, stop taking the herb until after birth (and then, be aware that Mucuna can interfere with breast milk supply, so be prepared to stop taking it until you stop breastfeeding, if needed).
In men, Mucuna pruriens increases fertility. You can read more about Mucuna’s effects in men and women here.
Take a dose of up to 6000mg of Mucuna daily in divided doses. A good dosing schedule is to take 1500mg in the morning upon waking, again at noon, again at 3pm, and the final dose of 1500mg in the evening around 6pm. In addition to Mucuna pruriens, it’s also important to take at least 25mg of vitamin B6, 150-350mg of magnesium, and 15-30mg of zinc (take with a 2mg copper supplement) in order to ensure that the L-dopa in the Mucuna bean can actually get converted to dopamine. Without these nutrients, the body is unable to make the conversion, and the Mucuna pruriens may not be as effective.
Lugol’s Iodine, 2%
As I’ve already mentioned above, iodine supplementation is important for anyone with a reproductive or endocrine disorder, regardless of gender. Lugol’s iodine solution combines molecular iodine with potassium iodide; one type of supplemental iodine feeds the thyroid gland, and the other feeds the reproductive organs. Iodoral is another brand of iodine supplement that combines potassium iodide with molecular iodine.
There are a few different reasons why iodine supplementation is essential for both women and men with hyperprolactinemia.
As many readers will know, iodine deficiency interferes with thyroid function. This is especially relevant to this discussion of hyperprolactinemia, since the thyroid and the reproductive organs share a close relationship, and indeed, thyroid hormones and prolactin are also very closely related. The pathway for both thyroid hormone and prolactin production starts in the same place in the brain: the hypothalamus. First, the hypothalamus secretes thyrotropin-releasing hormone (TRH) in response to decreased levels of T3 and T4 thyroid hormones. TRH can then be converted to both/either thyroid-stimulating hormone (TSH) or prolactin. From here, TSH can be converted to T3 and T4.
But this is an important transitional point. If a person is deficient in iodine, their body won’t be able to convert TSH to T3 and T4 in the appropriate way. So, T3 and T4 levels will remain low, even if TSH levels increase. Note that both TSH and prolactin lower dopamine levels, and the synthesis of both of these hormones is ultimately stimulated by the same physiological status. So, as a person’s body produces more TRH, and thus more TSH and more prolactin, the dopamine levels in their brain will also keep going down.
In this way, a person’s thyroid health directly affects their prolactin levels. Since hyperprolactinemia is commonly associated with the presence of a prolactinoma (a pituitary gland tumor), which is also likely to be a result of iodine deficiency, it didn’t surprise me to find that iodine deficiency plays a major role in the development of this particular problem of hormone imbalance.
Lugol’s iodine solution 2% should be taken at a dose of 20 drops per day (this is a 50mg dose), ideally in the morning or at least before 2pm. It can be rubbed into the skin or taken internally by mixing the drops with a glass of fresh, purified water. Start with 1 drop of solution per day, and work your way up to the 20 drops per day at a pace that feels right to you. Many people experience the symptoms of a bromine detox, which we talk about in more depth here. If you experience these symptoms, stay at the dose you’re taking until they pass, and then continue increasing your dosage.
Be sure to also take the essential supportive nutrients I’ve listed below with your Lugol’s iodine solution. Start these supplements 2 weeks before beginning to take the iodine supplements, and then continue to take them even after you’ve begun taking the iodine:
- Vitamin C – 3000mg/day
- Selenium – 200-400mcg/day
- Magnesium – 150-350mg/day
- Vitamin B2 / Riboflavin – 200-400mg/day
- Vitamin B3 / Niacin – 500-1000mg/day
- Zinc + Copper – 15mg + 2mg/day
- Vitamin K2 OR Vitamin K2+D3 (NOTE: Do not take a plain vitamin D supplement. Read more about vitamin K2 and the problems with vitamin D supplementation here.)
- Sea Water Supplement – Take 1 tsp with every 8 ounce glass of water you drink during the day. Click here to learn about the benefits of supplementing with trace minerals via sea water supplementation.
Vitamin B17 is a well-known cancer cure (at least, outside of the US) with a near-100% cure rate in patients who are given this nutrient before receiving chemotherapy or radiation. Since 50% of hyperprolactinemia patients are diagnosed with their condition due to the presence of a pituitary gland tumor, this nutrient deserved a special mention here. Vitamin B17, which is also known as amygdalin or Laetrile, is able to not only cure, but also prevent, cancer, tumors, autoimmune diseases, and degenerative disease states.
The vast majority of foods in the US (and many other countries, too, for that matter) have little to no vitamin B17 content anymore because the foods have been genetically engineered to contain no seeds. Or, alternatively, we, the Public, have been taught to believe that the seeds are a) bad for you, b) might kill you, or c) aren’t of any nutritional value at all, and that you can and maybe should just spit them out because they’re “not fun to eat”. This is unfortunate, since vitamin B17 is one of the main nutrients present in these seeds. While most seeds with an almond-type shape contain some vitamin B17, including almonds themselves, the richest form of vitamin B17 can be found in bitter apricot kernels. For Americans, bitter apricot kernels generally offer the most accessible form of vitamin B17. Abroad, this nutrient can be found much more freely in supplements as well as in the form of injections given by medical doctors at certain cancer cure clinics.
Vitamin B17 can be taken at a dose of 500mg/day, or at a dose of 20 apricot kernels taken in 4 divided doses (eat only 5 apricot kernels per sitting). Read more about how vitamin B17 works and why you’ve never heard about it at this link.
Pancreatic enzymes are another core treatment for patients with tumors or cancer of any kind. Though pancreatic enzymes are essential for healthy digestion (and therefore healthy absorption of nutrients from food), they are also known to be reabsorbed in the intestines, where they then circulate through the whole body via the bloodstream. There, pancreatic enzymes can target cancerous cells to dissolve these cells’ protective covering, thus making the unhealthy cells visible and vulnerable to the immune system. Since 50% of hyperprolactinemia cases are caused by prolactinoma, a pituitary gland tumor, patients with this specific cause of hyperprolactinemia may benefit from the use of pancreatic enzymes.
Vitamin B6 / Pyridoxine
As I already talked about above, vitamin B6 must be taken with Mucuna pruriens in order to support the conversion of the L-dopa amino acid to the neurotransmitter dopamine. One important connection here, again, is between prolactin and dopamine; when prolactin increases, dopamine levels decrease, and when dopamine levels go up, prolactin levels go down. So, therefore, one can assume that many natural medicines that support the production and utilization of dopamine would help regulate prolactin levels and help bring them back within a normal range.
To illustrate the potential efficacy of vitamin B6, one study observed that vitamin B6 administration, without any other medicines, proved to be nearly as effective as the drug cabergoline in the management of hyperprolactinemia. The patients in the study who received vitamin B6 supplements exhibited a 52% reduction in prolactin levels, an 18% reduction in luteinizing hormone levels, and a 31.5% increase in growth-hormone levels. The patients receiving vitamin B6 suppleents reported no side effects for the whole duration of the treatment, while the patients receiving cabergoline, in contrast, had headaches and hypotension (low blood pressure).
This particular study gave patients a daily dose of 300mg of vitamin B6, which is quite high for long-term use, but it still stands to reason that if a hyperprolactinemia patient were to take 25-100mg of vitamin B6 daily in combination with a medicine like Mucuna pruriens that this may produce the same, if not better, results.
Herbal Medicines for Hyperprolactinemia
Ayurvedic Herbal Treatments
One recent study done in 2021 observed the complete recovery of a 21-year-old woman with hyperprolactinemia caused by a secretory pituitary microadenoma. The woman was diagnosed with the condition following complaints of menstrual irregularities and disturbances. She was treated using Shamana Nasya for the first 7 days of treatment, and then with Shamana Cikitsa for 3 months after that. 6 months after beginning the study, the woman maintained regular prolactin levels and her microadenoma had completely disappeared.
A different case report on a 28-year-old woman with hyperprolactinemia and PCOS demonstrated positive results with the use of the Stanaysodhana Gana combined herbal treatment. By the end of the 3 month treatment period, the patient displayed lower serum prolactin levels, and her menstrual cycle had regularized. The woman’s luteinizing hormone and follicle stimulating hormone levels were also within the normal, acceptable range.
The medicine known as Stanaysodhana Gana includes these herbs:
- Abuta / Laghu Patha / Ponmusutai (Cissampelos pareira)root
- Ginger (Zingiber officinale) rhizome
- Deodar / Himalayan Cedar (Cedrus deodara) bark
- Purple Nutsedge / Nutgrass (Cyperus rotundus) rhizome
- Marsdenia tenacissima root
- Guduchi (Tinospora cordifolia) stem
- Holarrhena antidysenterica seed
- Bitterstick (Swertia chirata) whole plant
- Kutki / Katuka (Picrorhiza kurroa) rhizome
- Indian Sarsaparilla (Hemidesmus indicus) whole plant
The powders of these herbs were combined in equal parts, and then a dose of 6 grams of this mixture, combined in warm water, was taken twice daily on an empty stomach (the medicine was supposed to be taken once in the morning and again in the evening). The herbal remedy was given for a total of 3 months.
Bushen Huoxue – Traditional Chinese Herbal Remedy for Hyperprolactinemia
The Traditional Chinese Medicine (TCM) system is radically different from the Ayurvedic system of medicine in many ways, yet both systems tend to gravitate toward the use of herbal remedies as primary methods of treatment for disease. Bushen Huoxue is one TCM herbal treatment that has been shown to be effective for the treatment of hyperprolactinemia; this remedy includes the following herbs:
- Astragalus / Huang Qi root (Astragali radix / Astragalus aaronii)
- Dong Quai root (Angelica sinensis radix)
- Szechuan Lovage / Chuan Xiong rhizome (Lingustici chuanxiong Rhizoma / Lingusticum acuminatum)
- Tu Si Zi seed (Cuscutae semen / Cuscuta chinensis)
- Mulberry Mistletoe / Sang Ji Sheng stem and branch (Taxilli herba / Loranthus acaciae)
- Xu Duan root (Dipsaci radix / Dipsacus acaulis)
Studies have shown that, for the treatment of hyperprolactinemia and infertility in women caused by this condition, Bushen Huoxue is at least similarly effective in comparison to the currently used pharmaceutical drugs. Not only can it be considered a cure for hyperprolactinemia, but it also has been shown to help prevent recurrence of the condition and to minimize the symptoms associated with hyperprolactinemia.
In addition to being used as a hyperprolactinemia treatment, Bushen Huoxue has been known to help with kidney problems, to support healthy blood circulation, and to help prevent threatened miscarriage / early pregnancy loss.
Nigerian Herbal Remedy for Hyperprolactinemia
In many African countries, herbalism is considered the frontline treatment options for most health conditions, including hyperprolactinemia, due to its accessibility, affordability, and the belief that the local populations have in the healing powers of plants. In Nigeria, one specific remedy consisting of 5 herbs has come to be one of the most commonly prescribed treatments for hyperprolactinemia. This treatment combines the tinctures of the leaves of the following herbs in equal quantities:
- Common Bamboo (Bambusa vulgaris)
- Bitter Gourd / Bitter Melon (Momordica charantia)
- Poison Devil’s Pepper (Rauwolfia vomitoria)
- Cape Fig (Ficus sur)
- Gung / Glorybowers (Clerodendrum capitatum)
A 2013 study successfully showed that, indeed, this traditional remedy lowers prolactin levels, in addition to rebalancing luteinizing hormone, follicle stimulating hormone, and other reproductive hormones such as estradiol back to their normal levels. The researchers observed that this remedy was able to increase estrogen levels in particular, which may be especially relevant to women suffering from an estrogen deficiency as a result of hyperprolactinemia. Women with polycystic ovarian syndrome (PCOS) as well as hyperprolactinemia will be interested to known that bitter gourd is known for its anti-diabetic effects, and that this study also showed that the addition of this plant to this remedy helps reduce and regulate glucose levels.
Other Herbal Medicines for Hyperprolactinemia
There are actually many, many herbs that have been proven to lower prolactin levels or otherwise help support recovery for hyperprolactinemia patients. The list would be too long to include here, so we’ve decided to include a brief list of some other studied herbal treatments for this condition. See the resources for studies with more details on how these herbs work and how they should be taken for hyperprolactinemia.
- Sage (Salvia officinalis)
- Marjoram (Origanum majorana)
- Celery Seed (Apium graveolens)
- Peony (Paeonia spp.)
- NOTE: Peony combines especially well with licorice root for the treatment of hyperprolactinemia.
- Licorice Root (Glycyrrhiza glabra)
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