Prolactin High (Hyperprolactinemia): Macroprolactin, Medications, Pregnancy/Lactation, and When to Image

People search "prolactin 50", "prolactin high but MRI normal", "galactorrhea causes". A raised prolactin has many benign explanations, and macroprolactin can falsely elevate results.

Common reasons for high prolactin

• Physiologic: pregnancy, lactation, stress, sleep.
• Medications: antipsychotics, metoclopramide, some antidepressants, opioids, verapamil.
• Hypothyroidism (check TSH), kidney or liver disease.
• Pituitary adenoma (prolactinoma) if levels are persistently high with symptoms.

Educational next steps

1. Repeat a fasting morning sample; ask lab to check for macroprolactin.
2. Review medications and thyroid status; pregnancy test when relevant.
3. Clinicians consider pituitary MRI for very high levels or when symptoms are significant (headache, vision changes).

Educational use only. Not medical advice.