My Prolactinoma Experience Can Benefit You – Recently, my physician determined I have a prolactinoma – a kind of tumor of the anterior pituitary gland, in the lower central part of the brain, discoverable by a combination of blood test and Magnetic Resonance Imaging (MRI). He prescribed, and I have just started taking a medication called bromocriptine mesylate. My symptoms include typical and atypical elements because another condition was masking the diagnosis of prolactinoma. It is for this reason that my experience may benefit you.
Something Is Not Quite Right
From Fall of 2008 until early Spring of 2009, I experienced several health issues that taken separately, might seem insignificant. I visited my family doctor about one week after my left knee started swelling. The knee muscle was stiffening and my left leg was weakening. Also, my left hip joint hurt. Once my wife had to help me out of the bathtub – the situation could no longer be ignored.
Pseudogout. But Wait! A Lurker…
The doctor suspected, but was able to discount, gout. Pseudogout was the next suspect. My doctor ordered a regimen of ibuprofen. At a later visit, he would add colchicine to decrease swelling, and hopefully pain yet further. But before that, I revisited the doctor with additional difficulties. Would these be further symptoms of pseudogout? Or would they indicative of something else?
A Physician Who Knows His Stuff
I was having daily headaches, and my libido had suddenly diminished. The speed of onset of the latter symptom caught the attention of my physician. He ran a blood test for thyroid, but suspected something else he chose not to mention. The next day I received a telephone call. Unexpectedly, it was the doctor.
‘Mr. Summers, your prolactin bloodlevel is out of whack. You may have a tumor of the pituitary gland in your brain. I have scheduled an MRI scan for you.’ The doctor reassured me that in this case the word tumor did not indicate cancer. He then hung up.
What If Left Untreated?
The tiny pituitary is an amazingly versatile gland which secretes a number of important hormones that regulate growth and other bodily functions.1 Sometimes the pituitary grows larger than it should. When that happens, excess prolactin may be produced. There are two reasons for concern in this:
1) An increase in prolactin stimulates milk-production, even in males, and it can diminish libido and fertility. Allowed to continue, permanent infertility can result.
2) The growing pituitary gland lies near the optic nerve. As its size increases, it can put pressure on the nerve, causing a reduction in peripheral vision. In time, temporary or even permanent blindness can result!2
The MRI examination, taken at the University of Virginia (UVA), led to a report from my physician, which I quote, in part, here:
“Mr. Summers: …Your MRI does show what we expected- a “pituitary adenoma”. …I’d recommend starting the medicine– bromocriptine (2.5 mg tablet, start with just 1/2 tablet daily until you see me…”
Bromocriptine (a dopamine agonist) is one of two commonly used medications to treat prolactinomas. Bromocriptine is widely used, because it is relatively inexpensive, while doing the job it was designed for. Another medication that is frequently used is cabergoline. It produces fewer side-effects, but is considerably more costly, and hence is the second medication of choice. These medicines regulate prolactin formation, returning most patients to relative normalcy. Symptoms usually completely reverse. In the small (perhaps 10 – 20%) number of instances medication doesn’t work, doctors resort to successful surgical procedures.
What You Can Learn from My Experience
I was hit by two health disorders nearly simultaneously. One briefly masked the other. Be aware that the same thing could happen to you. Be conscious of the functioning of your own body. For most people, headaches may not mean much. For me, they were at total variance to my normal health pattern. Especially Be aware of sudden changes. It was this that alerted my physician.
I have always been impressed with my physician. You should be, too. If not, maybe you have not found the right one. It may be that a physician who is neither very young nor very old is usually best. One who has much clinical experience, but who keeps up with the latest developments definitely is best. A physician with University ties might be a good choice. The call is up to you. May you seldom have need of your excellent family physician!