Mary,
If you check Ruth Lawrence, pg 68, Ruth gives reference ranges for
prolactin at different phases of a woman's life. Term pregnancy is
200-500ng/ml; lactation levels range from 200 (first 10 days) down to
30-40 (second half of first year). You can see how high 900 is compared
to this. Nevertheless, the presenting symptoms/problems of a
prolactinoma are usually anovulation/infertility, and/or galactorrhea.
Loss of libido is not uncommon. The greatest risk seems to be a
potential to apply pressure to the optic nerve, which might happen with
larger tumors.

From what I'm reading, the issue is less about levels of prolactin than
about size of the tumor. A larger size with risk to vision would justify
continued treatment. FYI: Bromocriptine, with its attendant risks, might
be a better choice for a lactating woman (monitored carefully to not
shut down lactation) than cabergoline, which tends to have "permanent"
effects. I have also wondered if our anti-galactogogue herbs such as
sage might do the same thing. I'm not sure that anyone has ever checked
to see if sage reduces prolactin levels, but that is what has been
assumed, and it might actually have potential for such situations.

Here is a quote per Jan's recollection: "Autopsy studies indicate that
25 percent of the U.S. population have small pituitary tumors. Forty
percent of these pituitary tumors produce prolactin, but most are not
considered clinically significant. Clinically significant pituitary
tumors affect the health of approximately 14 out of 100,000 people."
http://neurosurgery.mgh.harvard.edu/prolacti.htm

~Lisa Marasco

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