Medical Journal of Dr. D.Y. Patil Vidyapeeth (Jan 2019)
A study on thyroid profile and prolactin level in hypothyroid females of a rural population of a developing country
Abstract
Background: In patients with primary hypothyroidism, there are increased levels of thyrotropin-releasing hormone (TRH) which can cause rise of prolactin (PRL) levels and these patients may have galactorrhea. Aims: Considering the clinical importance of hyperprolactinemia in ovulation disorders, sterility, and menstruation disorders, the present study was conducted to observe the prevalence of hyperprolactinemia and related galactorrhea in newly diagnosed hypothyroid females and correlate serum PRL level with thyroid-stimulating hormone (TSH) in hypothyroid females in a rural population of East India. Materials and Methods: This pilot study was conducted in Burdwan Medical College on 200 newly diagnosed female hypothyroid participants after taking institutional ethical clearance and informed consent of the participants. Age and gender-matched 100 controls were taken. Serum TSH, serum free thyroxine (fT4), and serum PRL levels were assessed. A questionnaire was designed for the evaluation of hypothyroidism symptoms for all the participants. These symptoms were galactorrhea, dryness of skin, feeling cold, hair loss, weakness, weight gain, constipation, loss of libido, and menstrual abnormalities. A total number of hyperprolactinemic patients were 42; out of them, 30 females were clinical and 12 were subclinical hypothyroid patients. One hundred and fifty-eight patients had normal PRL level. Results: Significant difference was found between clinical and subclinical hypothyroid females for body mass index (BMI) (P = 0.002), TSH (P < 0.0001), fT4 (P < 0.0001), and PRL (P = 0.002). The prevalence of hyperprolactinemia was 21% in hypothyroid females, 23.07% in clinical or overt hypothyroid females, and 17.14% in subclinical hypothyroid females. The prevalence of galactorrhea is 1% in all hypothyroid females and 1.53% in clinical hypothyroid females. A significant positive correlation was found between TSH and PRL in hypothyroid patients. Conclusions: Incidence of hyperprolactinemia is found to be notable in hypothyroid females including clinical and subclinical hypothyroidism, and hypothyroid females show positive correlation between TSH and PRL levels. Hence, PRL levels need to be assessed in all hypothyroid females.
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