Magically Disappearing Prolactin(?) And Other Labs

[bodacious]

Hey all!

So I posted this question a couple of weeks ago, because I've been suffering from symptoms that seem to match the description of low prolactin.

I ordered a prolactin test privately and the results came back as 713 mU/L (33.63 mg/mL, which I think is the more common unit on this forum). My GP seemed a bit skeptical of the result, and ordered another test to confirm it. The results of the second test were 350 mU/L (16.5 mg/mL), which my GP assured me is pretty normal.

I explained to my GP that I believed I was suffering from reduced thyroid function, based on my low heart rate, low body temperature, recent weight gain, thinning hair, and very dry skin. She agreed to run a test for T3 and Free-T3 to put my mind at ease (because my T4 was normal).

Results of my recent blood tests are below, taken over 3 days in a 2 week period.

I have a bunch of questions about all of this, and would love some feedback from the group—particularly if you can share some relevant insights from Ray.

Prolactin questions:

• I've had two prolactin tests that were massively different. Why is that? My prolactin seems to have dropped from 33.63mg/mL down to 16.5mg/mL in just 12 days (I've had two separate blood tests taken). NOTE: I've been supplementing with 100mg of B6 per day for the past week, which might have had an impact.
• Is it common to see such a wide flux in Prolactin levels?
• Is 16.5 still too high? I'm sure Ray mentioned in a KMUD interview that he's never seen a man with prolactin over 8 who was happy with his health. Am I right in saying then that the sub-clinical value of 16.5 is still too high, despite not being defined so by medicine? I know @haidut has said that if you have high prolactin, you're probably not healthy.
• Could this have been lingering for years? As a child I had ferocious psoriasis, and as a teen I had enlarged glands in my chest which went away after a few months. Psorisis is associated with high serum prolactin. Could I have had elevated prolactin all of this time, or is it pretty uncommon in kids?
• Any other tips/advice/info related to lowering prolactin that might help?

Thyroid questions:

• Is temp. and pulse still the best way to gauge thyroid?
• Can someone please give me a definitive answer for RHR and athletes?
• What would Ray say about my thyroid levels?
• Why isn't TSH super high if prolactin is high? I thought these two correlated quite strongly, but my TSH doesn't seem to be out of range in the same way that my prolactin levels are.
• Why isn't Testosterone super low if prolactin is high? As above, I thought there was a negative correlation between prolactin and Test, but it seems to be unaffected.
• Can topical NDT help thinning (not bald) hair?

Autoimmune questions:
I know the people on this forum hold a different view of autoimmunity from the mainstream medical view. I've suffered from Psoriasis to varying degrees throughout my life and have the following questions:

• Any sense in the TH1 vs TH2 dominance argument? I read this in Datis Kkharrazian's thyroid book (which I didn't really rate). We all have either T-Helper 1 or T-Helper 2 dominance, and knowing which category you fall into can help you better manage your immune system. Does that make sense in a bioenergetic view of the body?
• Can cytokines block Thyroid from entering the cell? I have no references for this, I read it in Datis Kkharrazian's thyroid book. He said that elevated Cytokines (which would be present during an autoimmune flare up like one experiences with psoriasis) can physically block T3 from entering the cell. If this is the case, then how the heck does one start to fix a problem like Psoriasis from a bioenergetic perspective?
• What problems do chronic cortisone treatment bring? As a kid, I had years of treatment for Psoriasis, with Hydrocortisone and coal tar (among other things). I've read Hans Selye's The Stress of Life in which he describes the GAS. Would chronic use of hydrocortisone cause the enlarged adrenals and diminished thymus seen in the general stress response?
• If so, how easily is it reversed? If the answer to the above is affirmative, how can one go about reversing the physical changes demonstrated in the GAS?
• Any other info? I'm still trying to understand the bioenergetic view of autoimmunity, having being told the "your body is attacking you" rhetoric my whole life. Can anybody help me understand why this community generally doesn't accept that view?

If you made it this far without going to watch cat videos on YouTube, thank you!

Here are the lab results as promised:

I've provided the NHS (National Health Service) normal ranges for reference. They might differ in your country.

T3 1.5
Free T3 4.8 (NHS range: 4—8.3)
Free T4 13 (NHS range: 10—24)
TSH 3.6 (NHS range: 0.4—4.5)
Testosterone 20.9 (NHS range: 10-38 nmol/L)
Calcium 2.32 (NHS range: 2.2-2.6 nmol/L)
Prolactin 713 *, 350** (NHS range: 86—324 mU/L)
Prolactin 33.63*, 16.5** (NHS range: 4—15 mg/mL)

* Test one
** Test two

 

[goodandevil]

From "cytokines in inflammatory bowel disease"

"Cytokines have a crucial role in the pathogenesis of inflammatory bowel diseases (IBDs), such as Crohn's disease and ulcerative colitis, where they control multiple aspects of the inflammatory response. In particular, the imbalance between pro-inflammatory and anti-inflammatory cytokines that occurs in IBD impedes the resolution of inflammation and instead leads to disease perpetuation and tissue destruction. Recent studies suggest the existence of a network of regulatory cytokines that has important implications for disease progression. In this Review, we discuss the role of cytokines produced by innate and adaptive immune cells, as well as their relevance to the future therapy of IBD." Could be more related to gut health and the liver vs hormone transport, with pufa as a counding factor. I think ray peat approach is more a surfeit of cellular energy vs dominance of certain compoments of the immune system. What times of day were the tests done?

 

[bodacious]

What times of day were the tests done?

Tests were all taken around 9am, about an hour after I woke up

 

[bodacious]

Could be more related to gut health and the liver vs hormone transport, with pufa as a counding factor

Thanks for the info. I think it's quite generally accepted (in naturopathic communities) that psoriasis has it's roots in gut/liver health. The ways of achieving that seem to conflict with one another though. John Pagano has a famous book on Psoriasis, in which he relies on fasting and "essential" fats, among other things.

 

[Parsifal]

This topic needs more attention.

 

[Drareg]

I would obviously have diet in check,enough calories,avoid things that can upset bowels.

It looks like B6 worked for you in relation to prolactin. Peat only recommend 10 mg every now and again.
100mg is a lot of b6 ,it might be safer it if it happens again to use lisuride, some have had great success with this.
As per Peat he would say your tsh is a little high still. Reverse T3 would be interesting to know in your case.

I'd say your diagnosis from teens is spot on, probably hypo also in teens causing prolactin.
How is your psoriasis and health in general since lowering prolactin?

 

[PakPik]

Could I have had elevated prolactin all of this time, or is it pretty uncommon in kids?

From my understanding, anyone including kids, suffering from chronic inflammation/stress condition would have high prolactin. Per Selye's book, its value is not that fixed and two different readings can have substantial difference. (For example, circadian rhythm and the sleep quality the night before the test can alter the results)

Any other tips/advice/info related to lowering prolactin that might help?

The main regulator of PRL status is dopamine (through the D2 receptor); good vitamin C status is important for dopamine's control of prolactin. Serotonin both powerfully stimulates PRL release (through the 5HT2 receptor) and decreases dopamine (through the 5HT2A receptor). Dopamine inhibits serotonin production.
Estrogen is another good stimulator of the pituitary, increasing PRL, and cortisol increases estrogen synthesis.
The thing is, you need to check what are the factors influencing all these interactions in your body. This is what I find interesting: psoriasis points to chronic inflammation, which could have been brought about by a myriad of things, and chronic inflammation is inevitably tied to the stimulation of immune cells such as Mast cells, etc. Mast cells are particularly implied because they are one of the basic universal alarm immune system cell. The problem is, mast cells for example are able to release dozens upon dozens of inflammatory mediators, such as serotonin, PUFA eicosanoids, cytokines, histamine, growth factors, etc. Psoriasis has a lot to do with chronically activated mast cells:

Is there a role for mast cells in psoriasis? - PubMed - NCBI
"Besides promoting inflammation, mast cells may attempt in some circumstances to suppress the inflammation and epidermal growth but the regulation between suppressive and proinflammatory mechanisms is unclear. Psoriasis is characterized by epidermal hyperplasia and chronic inflammation where tryptase- and chymase-positive MCTC mast cells are activated early in the developing lesion and later the cells increase in number in the upper dermis with concomitant expression of cytokines and TNF superfamily ligands as well as increased contacts with neuropeptide-containing sensory nerves. Due to the intimate involvement of mast cells in immunity and chronic inXammation the role of mast cells in psoriasis is discussed in this review."

"... These cellular interactions are crucial for the development of skin inflammation, such as in the psoriatic lesion, where mast cells are activated early in the lesion development followed by the increase in MCTC mast cell number and in morphological contacts between sensory nerves and mast cells. In addition, mast cells show critical plasticity in the expression of cytokines and other TNF family ligands, a feature which strongly suggests that mast cells are involved in the immunoregulation in psoriasis. In the chronic psoriatic lesion, mast cells accumulated in the upper dermis are in the state of activation and they constantly produce proinflammatory mediators which
promote perpetuation of the lesion.... An important question to be answered is when and how mast cell functions as a proinflammatory cell and when and how as an immunosuppressive cell. It is also possible that mast cells attempt to maintain skin homeostasis by preventing excessive inflammation and epidermal growth but fail in this task."

IL-33 augments substance P-induced VEGF secretion from human mast cells and is increased in psoriatic skin. - PubMed - NCBI
"The peptide substance P (SP) has been implicated in inflammatory conditions, such as psoriasis, where mast cells and VEGF are increased...These results imply that functional interactions among SP, IL-33, and mast cells leading to VEGF release contribute to inflammatory conditions, such as the psoriasis, a nonallergic hyperproliferative skin inflammatory disorder with a neurogenic component."
"Psoriatic plaques contain increased levels of VEGF compared with normal skin (18–20). VEGF is a major proangiogenic factor involved in many inflammatory diseases (21). The VEGF 121 isoform is particularly increased in psoriatic plaques (22) and VEGF is also increased systematically in severe psoriasis (22, 23). Genetic studies have shown that several different VEGF polymorphisms are associated with an increased risk of developing psoriasis (24, 25). Mast cells can secrete VEGF in response to IgE (26, 27), and to corticotropin-releasing hormone (CRH) (28), secreted under stress"

• Is temp. and pulse still the best way to gauge thyroid?

Peat says that easiness to fall asleep and sleep quality, the ability for nerves to relax, lack of cramps and tension is very telling about metabolic rate, in conjunction with temps and pulse. Temps and pulse can give (false) nice results, but without meaning metabolism is good. (Some people even test the Achilles tendon reflex, but I've never done that. Peat likes that test Assessment of the Thyroid: Achilles Tendon Reflex (Woltman’s Sign) – Functional Performance Systems (FPS)).
(I talked about this issues here Dementia - How To Cure)

What would Ray say about my thyroid levels?

A person can have the nicest TSH value and be dangerously sick; TSH is downregulated by a host of factors, including chronic high stress hormones, aging, starvation, etc...

Why isn't TSH super high if prolactin is high?

From studies, TSH isn't necessarily high when PRL is high. More important factors are dopamine and serotonin influences, as mentioned above.

Can cytokines block Thyroid from entering the cell?

Let me share some info well summed up (source: The Truth About Why Your Thyroid Hormones Are Low (Low T3 Syndrome) - Selfhacked)

"Inflammation and Oxidative Stress are the Most Common Causes of Low Thyroid Function

Assuming you’ve taken the recommended tests, you’ll see if you have high thyroid antibodies. If you do then this indicates an autoimmune condition and that’s the most likely reason your thyroid hormones are lower....
If you don’t have thyroid antibodies, then the next most likely scenario is inflammation and oxidative stress.

Most people who feel fatigue and also have a lowish level of thyroid hormone think that this is the cause of their fatigue.

However, the likely truth is that low thyroid hormones are not the cause of their problems, but a side effect of a larger issue.
The real cause has to do with chronic inflammation more often than not. IL-6, TNF and other cytokines decrease thyroid hormones. (R, R2, R3)

Therefore, inflammation is causing you to have a sluggish thyroid AND also feel fatigue. Your thyroid isn’t actually the main cause of fatigue itself.

IL-6 also causes an increase in reverse T3 (an inactive form of T3). (R)

IL-1b and Interferon gamma/Th1 dominance also decrease the enzymes needed to make T3 (IL-1b is more significant). (R)

IL-1b can make the thyroid hormones you do have be less effective because it decreases the receptors it binds to. (R)

What this means is your thyroid hormone levels can seem normal, but you’re still not getting energy that you should from a given level of thyroid hormone.

This is possibly why taking thyroid hormones may make some feel a bit better even if their levels are normal – because they require more thyroid hormones to function at the same level as someone who has normal receptors.

Another study found that the reason IL-6 decreased thyroid hormones was because of oxidative stress. (R)
...
So what we see is that inflammation and oxidative stress are the root causes of thyroid problems, in the absence of antibodies.
People with thyroid antibodies usually have elevated inflammation in general, so it’s likely that these people experience a triple whammy of antibodies, inflammation and oxidative stress."

What problems do chronic cortisone treatment bring? As a kid, I had years of treatment for Psoriasis, with Hydrocortisone and coal tar (among other things). I've read Hans Selye's The Stress of Life in which he describes the GAS. Would chronic use of hydrocortisone cause the enlarged adrenals and diminished thymus seen in the general stress response?

Corticoidsteroids are problematic since they suppress the immune system. The immune system needs to be regulated, not supressed. What I'd do in a situation like yours is find ways to regenerate the thymus, and all the immune components, support good endocrine function, find the things that are spiraling inflammation out of control (for example, there're papers with lists of stimulators and stabilizers of mast cells), and block the key inflammatory mediators without suppressing the good function of the immune system - this last thing is where the subtleties come into play. That would help me to build good immunity, let my tissues heal and not be hyper-reactive. The longer the inflammation lingers, the more "tired" the immune system gets, and the more tissue damage accumulates, bringing with it more stimulus to the immune system, in a vicious circle. That's called the immunodeficiency of chronic inflammation and/or chronic infection.

That's what I've done for myself.

Any other info? I'm still trying to understand the bioenergetic view of autoimmunity, having being told the "your body is attacking you" rhetoric my whole life. Can anybody help me understand why this community generally doesn't accept that view?

I suggest reading Peat's autoimmunity newsletter https://raypeatforum.com/community/attachments/autoimmunity-copy-pdf.323/

I hope this helps :)

 

[mayweatherking]

prolactin should be less than 7.............. thyroid, 100grams of protein/day, 50 vitamin D (for calcium to absorb to lower prolactin) are all things i am working on my self..............

 

[bodacious]

@PakPik Thank you so much for taking the time to provide all of that info.

Update: I bought some NDT but decided against taking it. I feel like the problems I've been having are due to years of excessive stress (working 60 hour weeks to build my business).
Taking thyroid would just be another way of masking the core problem: my lifestyle.

The Stress Of Life by Selye was an important read for me.

To raise dopamine I'm supplimenting taurine. But I'm also learning new skills again (juggling, just now) and spending more time around people.

To reduce seratonin I'm eating more gelatin, but I'm also working less and avoiding stress

I'm making an effort to get back into physical shape, and I'm meditating regularly again.

I've felt for a long time that my lifestyle was out of sync with nature, I just ignored it.