Wednesday, March 24, 2010

Struggle

One of the huge questions I had for my doctor with my recent test results was "Can I get pregnant with a prolactin level of 38"- down from 47.  He indicated that every women is different and there are more factors than simply lowering your prolactin even though that plays a major part.  He also mentioned that you need to stop drinking, caffeine, etc. and start maintaining your body and nutrition.  I have started taking my vitamins again religiously and I have also started exercising again.  I am not a doctor so I cannot say what is adequate for every women.  My first piece of advice is start with an ovulation predictor so you know when your most fertile dates are.  Secondly, cabergoline can be increased slowly if you consult with doctor and your results have not changed research shows - pituitary network association that certain patients will need to increase their dosage ever slow slightly as your body may not respond to the lighter dosage.  Remember I am not a doctor so make sure to consult with your physician.  My physician and stipulated that when I want to get pregnant in the months prior increase my pill by a half to help in decreasing.   I have been trying to get my levels down for almost 2 years due to the simple fact that my previous doctor was not increasing my dosages properly and I was simply sitting on the fence.  Now that I have increased my dosage I have seen significant results in 2 mths.  Many patients have had some success in increasing the medication enough to rid their body of the tumour as I have done some research via the pituitary network association but remember each individual is different and your doctor should okay everything prior.  In addition, we each have different bodies so you basically need to work with what you feel comfortable with and your doctor as well.  I have been very happy with the results lately as I am well aware that my levels are starting to move.  Breathe of the fresh air but you need to stay on top of your medication and health.  I have also started changing my diet.  Less processed foods and more organic and healthier alternatives.  I think that we consume too much preservatives and it can't hurt.  So I am thinking that if my doctor would of increased my dosage several years ago and switched immediately to cabergoline (dostinex) I probably would have had results sooner but they usually like to take baby steps.  I have noticed that I still do get the stuffy nose late at night which my GP doctor recommended I take a reactine to help.  So my daily dosage of vitamins includes the USANA essentials or a multi-vitamin and vitamin B6 (check your dosage of vitamin b6 though I take 50mg a day) as sometimes too much is not healthy either. So the answer to my original question was that every women is different but you can get pregnant with a prolactin level of 38 as I have conceived with a prolactin level of 41 but it's much more difficult.  This is my experience and everyone is different so there is no true answer to the question. 

Pituitary Network Association

Summary of Important Points (Quoted from Pituitary Network Association Website)


Prolactin levels allow the important distinction between a true prolactin producing adenoma and a nonfunctional adenoma with stalk effect to be made with relative security in most patients.

Patients with prolactin secreting pituitary tumors (prolactinomas) should be treated as first line with Dopamine agonist therapy, while nonfunctional or other tumors should not.

Surgery may still be necessary in a prolactinoma and is almost always needed as first line treatment in patients with other functional pituitary tumor types.

Because the hormonal systems of the pituitary are complex, a wide variety of clinical syndromes can be caused by tumors. However, because the majority of pituitary tumors are either prolactinomas or nonfunctional tumors, the symptoms of those two types (menstrual disruption, infertility, galactorrhea, headache, and/or visual disturbance) should raise the issues of a pituitary tumor in patients who complain of one or more elements of that constellation.

The cognitive and psychosocial disruption exhibited by patients with pituitary tumors is real and should be viewed as manifestation of physical disease that can be amenable to appropriately directed therapies.

Although women with pituitary tumors may be diagnosed by their obstetrician/gynecologist, ultimate treatment of such tumors should be carried out under the joint care of an endocrinologist and neurosurgeon

Increase in dosage

I haven't posted for quite some time.  Since the test results I have decided to keep increasing my dosage as my doctor stated that if I was interested in getting pregnant in the next few months I should consider doing.  So I have now increased to 2.5 pills twice a week.  I have noticed that I have been feeling better.  I seem to have more energy.  I guess since my hubby and I will be trying again come May I should start getting used to the ovulation saliva predictor.  I have heard some pros and cons about this type of predictor but as recommendation of the doctor I have decided to try.  It was 100 CAD and what the heck go to town.  The thing that is nice about it is that you never have to buy more predictor indicators for the kit.  So my fingers are crossed for another excursion.  I do admit that I have my negative thoughts.  I hate to have the disappoint again.  The emotional run of trying to conceive is exhausting.  But I will remain as positive as I can. 
We did discuss if this doesn't work perhaps we should start reviewing fertility drugs, etc.  So I know there is one more option after this but I am hoping HOPING that we don't have to go that route.