High prolactin and weight gain
Prolactin is a hormone whose blood values are very low, except in pregnancy. But some dysfunctions and pathologies can raise their levels, let us see which and possible treatments. The term hyperprolactinemia means a concentration of prolactin – a hormone secreted by the endocrine glands – in the blood superior to that which is considered the limit threshold, which is equal to 20 nanograms per liter.
Secreted in excess, prolactin can lead to a condition known as endocrine obesity. With prolactin levels normalized, weight loss occurs in 90% of patients receiving treatment for conditions causing high prolactin, as well as drugs correcting prolactin levels (results yielded by this study).
There are medications your doctor can prescribe to lower the level of prolactin in your blood by acting directly on the pituitary gland. Among these we mention Dostinex, very effective but with some side effects including headaches.
Dopaminergic agonists, drugs that mimic the action of dopamine, a physiological inhibitor of prolactin secretion by pituitary cells, normalize hormone levels independently of the mechanism that triggers hyperprolactinemia. They can also determine the reduction in tumor volume (shrinkage or “wrinkling” effect). The therapeutic effect disappears after discontinuation of treatment.
The dosage varies depending on the case; during the treatment there may be side effects such as nausea, headache, hypotension, dizziness, nasal congestion, constipation, an empty head, which however tend to regress with continued treatment and only rarely require its suspension.
Drugs augmenting prolactin, weight gain and Dostinex
The increase in body weight that accompanies the use of some widely prescribed atypical antipsychotics is a cause for dissatisfaction and discontinuation of treatment. Concomitant use of certain antidepressants or mood stabilizers, which may themselves lead to weight gain, may contribute to exacerbation of excess weight. Obesity promotes the development of diabetes, dyslipidemia, high blood pressure, gallstones and joint problems. Weight gain is an unwanted side effect that is difficult to manage.
Aripiprazole has been associated with low weight gain in clinical trials, has little effect on prolactin secretion and is not associated with significant QT prolongation. Ziprasidone does not cause (or little) weight gain; only a slight elevation of prolactin has been reported with high doses. However, the prolongation of QT observed with ziprasidone appears to be greater than with other atypical antipsychotics but less than with thioridazine (Melleril). The placing on the Swiss market of new antipsychotics could be interesting in relation to the risk of weight gain and the risks inherent in the increase of prolactin.
A prolactin test is only indicated when galactorrhea, disturbances of the menstrual cycle or sexual disorders occur under antipsychotics. Prolactinemia can reach five to ten times the norm in a patient treated with an antipsychotic, rarely more than one.
In the rare situation where the continuation of the drug is essential, the administration of dopaminergic agonists such as Dostinex has proved effective, at the cost of a risk (low) to trigger or exacerbate psychotic symptoms (read here to learn more on the subject).
Dostinex effects in diabetes type 2 and insulin resistance
This study has shown that the dopaminergic action of cabergoline can be a useful accessory in management of blood glucose, lipid synthesis and insulin resistance in patients with type 2 diabetes mellitus. The exact mechanism of Dostinex in addressing these problems is not clear; however, in 65% of patients there were achieved measurable results after 6 months of treatment.
The blood sugar level increases with the increase of body fat. In this context, it is not glucose that supplies energy to the muscles, but fat, which leads to an increase in glucose (or sugar) in the blood. As a result, the pancreas produces a higher amount of insulin in an attempt to reduce excessive blood sugar levels, but there comes a time when it cannot produce more than enough. At that point, blood sugar is no longer regulated by insulin, which leads to hyperglycemia and the development of diabetes. Thus, in obese subjects, diabetes is actually a consequence of being overweight. The effects of Dostinex in individuals with overweight and obesity can help normalize blood sugar levels and insulin sensitivity, thus contributing to prevention of diabetes type 2, or improving clinical image in patients with diagnosed type 2 DM.
Conclusion. Is Dostinex the ultimate weight loss drug?
When considering the use of Dostinex as a part of a medicated weight-loss plan, it is important to take into account the following points:
- The primary purpose of Dostinex is regulating the level of prolactin secreted by pituitary gland. Since excessive levels of prolactin are associated to overweight and obesity in both sexes, lowering of this hormone and stabilizing it at normal levels inevitably leads to weight loss.
- The accessory effects of Dostinex reported in specific literature also include normalization of blood sugar levels and increasing sensitivity to insulin, which in its turn indirectly leads to loss of extra weight in patients with pre-diabetes or diabetes conditions.
- Being a dopamergenic agent, cabergoline, the active substance of the drug Dostinex, can act as an appetite suppressant, which promotes healthier weight in certain individuals. Thus, weight loss is achieved on the level of neurotransmitters.
- In rare cases, Dostinex is appointed as part of antidepressant and antipsychotic therapy in order to balance off the side effects of SSRI drugs, most common of which is weight gain.
The take home message is that, used as a part of well-calculated therapy appointed by a certified healthcare provider, Dostinex can help achieve meaningful results in weight loss and general regeneration of health.