Dr. Shaikh Sadaf
Endocrinology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am suffering from abnormal growth of pituitary gland. The doctors were saying that my prolactin and growth hormone level is quite high. They suggested me for surgery. I was afraid for surgery. Then they said to take medicine Cabergolin 0.5 mg two tablets twice a week for three months. But I continued this medicine till now (eight months). I want to take a doctor's advice. I tested prolactin and IGF-1 recently. Prolactin 725 ng/ml (ref. for Female 1.9 to 25.0) and IGF-1 was 702 ng/ml (ref. range 87 to 238), HGH was 5.90 ng/ml (ref. range up to 5.0). Again, I checked recently prolactin 6.01 ng/ml, IGF-1 was 343 ng/ml, and HGH 1.44 ng/ml (ref. range 0 to 18.0). I have attached the medical reports. Please suggest me. Should I continue the same medicine? If yes, then please specify dose and time limit. If you have other suggestions, then please recommend me. Thanks for giving your valuable time.
Thank you.
Hello,
Welcome to icliniq.com.
I read your detailed query and gone through your reports (attachment removed to protect patient identity) and from what you have mentioned, it appears that you have hyperprolactinemia and raised IGF -1 which are being treated with Cabergoline. I would advise you to continue your Cabergoline treatment till your IGF-1 levels also normalize. Pituitary macroadenoma can be treated with either Cabergoline or surgery. Repeat your tests again every four weeks only Prolactin and IGF-1.
Hope you find my advice beneficial. Good luck.
Thank you.
Patient's Query
Thank you doctor,
Please advise me the dose of Cabergoline? Is this treatment possible by medicine only? I am attaching some MRI image file. Please see. Thanks for your valuable suggestion.
Thank you.
Hello,
Welcome back to icliniq.com.
I saw your MRI pituitary and it confirms with macroadenoma of the pituitary gland. Prolactin-secreting pituitary adenomas are quite responsive to Cabergoline. It has to be taken till the tumor has regressed completely. I suggest you take tablet Cabergoline 0.5 mg twice weekly till you retest and your tests show decreased IGF-1. Once both prolactin and IGF-1 have decreased then we will repeat MRI pituitary again. Usually, if the tumor does not decrease in size, then we need to remove the tumor surgically.
Hope you find my advice beneficial. Good luck.
Thank you.
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Endocrinology
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