Skip to main content

Falsely High Prolactin level: A Diagnostic Pitfalls

Prolactin (PRL) is a hormone produced by the pituitary gland in the brain that plays a role in lactation and reproduction.  The elevation of serum PRL levels (hyperprolactinemia) has multiple etiologies that can be divided into physiological, pharmacological, and pathological causes. 
There are several potential reasons for a falsely high prolactin level in a blood sample. Prolactin levels of women were significantly higher in the morning than those in the evening. Prolactin is secreted in a circadian and pulsatile pattern. Serum prolactin level reaches its maximum in the early morning hours, returns to the normal value one hour after waking up, and is lower in the evening than that in the morning. Prolactin is often measured in the early morning hours along with other tests that require fasting and is affected by the physiological morning peak. So, it can be falsely higher than the normal range and can lead to further unnecessary investigations. 
Certain medications can falsely increase prolactin levels. For example, antipsychotic medications, some antidepressants, anti-hypertensive drugs, and acid-reducing medications, can also potentially cause elevated prolactin levels.
Underactive thyroid gland (hypothyroidism) can disrupt the hormonal balance in the body, leading to elevated prolactin levels.
Intense physical activity or emotional stress just prior to blood collection can stimulate the release of prolactin, leading to a falsely high result. It's important to be in a relaxed state during blood collection to minimize the risk of stress-induced prolactin elevation.
Recent sexual activity or nipple stimulation can cause a temporary increase in prolactin levels. Therefore, blood samples taken shortly after sexual activity or nipple stimulation may yield a falsely high prolactin level.
It is recognized that a substantial proportion of patients found to have raised prolactin (PRL) level on a single testing is subsequently found to have normal PRL levels. Though this is often attributed to stress or medication factor, it should be noted, that PRL secretion displays diurnal variation. It is recommended that screening for hyperprolactinemia includes three specimens be obtained at 20- to 30-minute intervals in mid-morning. Each sample can either be analyzed separately or be pooled into a single specimen. When a drug-induced rise in PRL is suspected, PRL sampling should be repeated after withdrawal of medications for at least 72 h, if possibile. 
It's important to note that a single blood test indicating high prolactin levels may not be enough for a definitive diagnosis. Further evaluation, including medical history, physical examination, and additional testing, may be necessary to determine the underlying cause of hyperprolactinemia. 

Comments

Popular posts from this blog

Keep Your Eyes Safe: Tips for Preventing and Managing Eye Flu or Pink Eye

Eye flu , also known as conjunctivitis or pink eye , is a common eye infection that affects millions of people worldwide. It can be caused by various factors, including viruses, bacteria, allergens, and irritants. While eye flu is typically not a severe condition, it can be highly contagious and uncomfortable. This article aims to provide you with essential tips on how to care for and prevent eye flu, ensuring your eyes stay healthy and vibrant. Eye flu occurs when the conjunctiva, the thin membrane covering the white part of your eyes and the inner surface of your eyelids, becomes inflamed. This inflammation leads to red, itchy, and irritated eyes, often accompanied by watery or sticky discharge. If the cause of eye flu is viral or bacterial, it can spread rapidly through direct or indirect contact with infected eye secretions. Care for Eye Flu: Frequent Handwashing: Regularly washing your hands with soap and water can prevent the spread of eye flu, especially if you have been

Effects of Alcohol Consumption on Next-Day Blood Test Results

The impact of alcohol consumption on different blood tests can vary depending on several factors, including the amount of alcohol consumed, individual metabolism, and the specific blood test being conducted. Heavy drinking close to the time of the blood test may have a more significant impact than moderate or light drinking earlier in the day. Here are some common blood tests and how alcohol consumption may affect them: Lipid profile: Alcohol consumption (especially excessive intake along with oily meal), can increase lipid levels, including triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and total cholesterol in blood. While alcohol consumption doesn't have a significant direct effect on LDL cholesterol and total cholesterol, it can indirectly impact level of both by increasing triglyceride levels. It is generally recommended to avoid alcohol consumption for at least 24 hours before lipid profile tests to obtain accurate resul

Iron Deficiency Without Anemia: a diagnosis that matters

  Iron deficiency without anemia refers to a condition where there is a decrease in the body's iron stores, but the individual's hemoglobin levels are still within the normal range, and they do not meet the diagnostic criteria for anemia. Anemia is a condition characterized by a reduced number of red blood cells or a decrease in the amount of hemoglobin in the blood, which can result in fatigue, weakness, and other symptoms. Iron is an essential mineral that plays a crucial role in carrying oxygen in the blood and supporting various physiological processes in the body. Iron deficiency can occur due to inadequate dietary intake of iron, poor iron absorption by the body, increased iron demands (such as during pregnancy or growth spurts), or chronic blood loss (such as from menstruation or gastrointestinal bleeding). Iron deficiency without anemia can occur in the early stages of iron depletion when the body's iron stores are becoming depleted, but the hemoglobin levels have