A Benign Tumor: Prolactinoma

What is prolactinoma?

A prolactinoma is a benign tumor which is noncancerous in nature. It is a tumor of pituitary gland that produces an excess of hormone known as prolactin.

What is pituitary gland?

Pituitary is tiny, pea shaped gland which is situated at base of brain behind nose and below the optic nerves. Its main function is to produce various hormones which are responsible for thyroid, ovaries, testes and adrenal gland functioning. The main hormones are LH (luteinizing hormone), estrogen, progesterone, testosterone in males, TSH hormones, ACTH (adrenocorticotropin hormone) and growth hormone.

One of them is prolactin which stimulates mammary glands to produce milk for breastfeeding. Normally the level of prolactin rises at time of breast feeding. But in men and women who are not nursing, the raised level of prolactin in blood give indication of prolactinoma.

How prolactin helps in normal functioning of body?

Prolactin mainly stimulates the mammary glands or tissues to enlarge during pregnancy. Its level normally falls if female doesn’t  breastfeed. Every time the baby nurses, prolactin level rises and maintain the proper production of milk.

What else causes prolactin to rise?

Intake of certain drugs: Drugs that  block the effect of dopamine  which suppresses the overproduction of prolactin. Antipsychotic drugs such as trifluoperazine and haloperidol ( Haldol); metoclopramide, used to treat gastro esophageal reflux and nausea, drugs to control high BP.

Other pituitary tumors: Other tumors arising near pituitary gland may block dopamine and further increase level of prolactin. This include acromegaly (condition of overproduction of growth hormone)

Hypothyroidism:

Condition of less thyroid hormone production results in increase in TRH which raises prolactin level.

Chest:

Due to stimulation of nipple, level of prolactin rises.

Chest wall trauma:  

Injury or accident can cause hyperprolactinemia.

What are the risk factors?

• It mostly occurs in women between age group of 20 to 34.
• Occurs in both sexes, but women are more affected as compared to men.
• Rare in children

What are the complications?

• Vision loss:   Compression of optic nerve due to overgrowth of prolactinoma can cause loss of vision.
• Hypopituitarism: Due to large prolactinoma, pressure  is exerted on normal functioning  pituitary gland. It leads to deficiency of adrenal and growth hormone.
• Loss of bone density: Due to high level of prolactin, loss of bone density leads to osteoporosis.
• Complication in pregnancy: In normal pregnancy , estrogen level increases. If a pregnant woman have prolactinoma than high level of estrogen can lead to growth of tumor.
• Headache

How prolactin secretion is controlled?

• It is controlled by dopamine, a chemical compound released in  the brain.
• In women normal range of prolactin is 25ng/ml, and in males it is 17ng/ml. When this level raises it is known as  hyperprolactinemia.

What are the causes of Prolactinoma?

The exact cause is  unknown. The main cause is prolactin hormon that stimulates breast feeding  and produce milk.

Overproduction of prolactin is due to:

• Under active thyroid gland
• Ongoing irritation to chest
• Pregnancy
• Breast feeding

What are the symptoms?

For women

• Irregular periods
• Lack of menstruation
• Loss of sexual desire  
• Fertility problems
• Breast milk is not formed properly
• Vaginal dryness

 For men

• problem in erection
• loss of interest in sexual activities
• in rare cases, there is breast milk production impotency
• headache, loss of vision

In postmenopausal women symptoms are not present when tumor is small, but when it begins to grow in size, it may cause symptoms like:

• Loss of vision
• Changes in vision
• Headache

How it can be diagnosed?

• Blood test
• MRI
• CT Scan
• Vision test

What are goals of treating Prolactinoma?

• Maintain a normal range of prolactin
• Restore pituitary gland function
• Reduce the size of tumor (pituitary)
• Treat symptoms like vision problems and headache
• Improve the life quality

How it can be treated?

Medicines  which functions like dopamine helps in treating prolactinoma. Drugs like cabergoline,bromocriptine helps to decrease the prolactin production and may shrink tumor.

Surgery:

• Transsphenoidal surgery and transcranial surgery is recommended.
• Radiation therapy in rare cases.

Ayurveda concept:

As per Ayurveda tumor is formed due to Vata and Kapha imbalance. Vata is responsible for irregularity in cell division and Kapha for their growth. Vata pushes Kapha out of balancing resulting in tumor formation. Kapha play effective role, it enters the affected dhatus. Accumulation of apana vayu aggravated in the rasa of purishavaha srota and overflows to rasa and rakta  dhatus. Prana vayu and cvyana vayu affects or relocates to majja dhatu of majjavaha srotas resulting in tumor formation.

Panchkarma Treatment:

• Langhana chikitsa: To eliminate ama doshas or toxins
• Vamana
• Niruha and anuvasana basti
• Nasya 

Planet Ayurveda:

1. KACHNAAR GUGGUL

Kachnaar Guggul is an effective remedy prepared from various medicinally rich herbs  for this pituitary problem. The Kachnaar guggul tablets are blend of different effective herbs- Kachnaar bark (Bauhinea variegate), Triphala (Terminalia chebula, Terminalia bellerica, Emblica officinalis), Trikatu (Zingiber officinale, Solanum nigrum, Piper longum), Varun bark (Crataeva nurvala), Elaichi (Elettaria cardamom), Dalchini (Cinnamomum zeylanica), Tejpatra (Cinnamomum zeylanica leaves) and Guggul (Commiphora mukul).

Dosage- Take 2 tablets,two times a day, after meals with plain water.

2. CURCUMIN CAPSULES

Curcumin capsules are single herb capsules made from a wonderful herb named Curcuma longa.  The herb is frequently used  for various health problems in Ayurvedic treatment.

Dosage- Take 1 capsule two times a day , with plain water, after meals.

3. GOTUKOLA CAPSULES

Gotukola capsules are also used to  relieve the  symptoms of prolactinoma. These herbal capsules are prepared using the authentic and natural extract of the herb Gotukola (Centella asiatica).

Dosage- Take 2 capsules two times a day, with plain water, after meals.

4. PRADRANTAK CHURNA

The Pradrantak churna is prepared  from the special combination of medicinal herbs. The herbs include Lodhra (Symplocus racemosa), Ashok (Saraca indica), Udumbur (Ficus glomerata) and Arjuna (Terminalia arjuna). All of them  are mentioned in Ayurvedic literature.

Dosage- Take 1 tablespoonful two times a day after meals.

5. CHANDERPRABHA VATI

Chanderprabha vati is is made  from a  herbal combination of 37 ingredients  These tablets are effective in treating the symptoms of this disease.

Dosage-  Take 2 tablets,  two times a day, after meals with plain water.