What are the causes and remedy for high prolactin levels?

Q: My daughter is 19 years old and has been having a thinning hair problem. We went through various tests and initially she was diagnosed with androgenetic alopecia. Later she went through endocrinological tests where her prolactin levels were found to be high like 45. Her thyroid is normal. She was diagnosed with hyperprolactinemia and put on B crip 2.5 mg. Her prolactin levels have come down to 25 and her periods are getting back to normal, earlier her periods were very irregular. She doesn't have PCOS. I want to know whether I am on the right path or I need to do more tests. Someone suggested that high prolactin levels could be due to a microadenoma in her pituitary. I am quite confused and would like you to help me out.

A:The issue in your daughter's case is high prolactin levels (hyperprolactinemia). High prolactin is a common problem. Causes include stress, medications sp antipsychotic or antiemetics and prolactinoma. Prolactinomas are usually small tumours in pituitary gland which are benign and respond to medical treatment only. Few of them are large tumours but these also respond to drug. But in prolactinoma, the prolactin levels are usually in hundreds.In your daughter's case the prolactin levels are not very high. I will suggest you to stop Bromocriptine now and repeat prolactin after 4 weeks in fasting condition. Also get her detailed eye examination done as it may point towards pituitary problem. Also get a plain X-ray for sella. In case you find that prolactin level is still high you can go for MRI for Pituitary gland.