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    What causes low BP, heart palpitations and lightheadedness when diagnosed with prolactinoma?

Posted on Mon, 3 Aug 2015 in Brain Tumor
Question: I was diagnosed with a prolactinoma 8 years ago and after treatment with bromocriptine have had 2 children (youngest is nearly 4). Last November my GP sent me back to my endochronologist as I had not been taking bromocriptine or any other meds since prior to falling pregnant. My bone density and B12 came back as low so I was put on a contraceptive pill. This was altered to a lower dose pill after continuing side effects. I came off the pill after continued side effects and was put on Cabergoline (1 dose per week). Side effects worsened including low blood pressure, anxiety, heart palpitations and lightheadedness. I also had a holter monitor test which came back OK. I came off the Cabergoline for a few weeks and was then put on Bromocriptine (once daily) however I was still having lightheadedness and palpitations so was advised to stop treatment again. That was nearly 5 weeks ago and I am still having episodes of lightheadedness and heart palpitations (though not as severe) as well as a period (most recent was 1 week ago). I had bloods done 2 weeks ago and thyroid, kidney & liver all came back normal but iron was low (came back as 6 when normal was classed as 10-30 & saturation was 8% with normal being 15-45%) I have also had 3 ECG since November - all of which were OK. I am over having these symptoms all the time and just want to get better so I can properly look after my family. Is there anything you can suggest as to what I can do or what else might be causing this trouble?
Answered by Dr. Erion Spaho 1 hour later
Brief Answer:
Stereotactic Radiosurgery is a effective treatment option.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Your symptoms seem to be a mixing of iron deficiency and drugs side effects.

If I was your treating Doctor, I would suggest in your case stereotactic Radiosurgery about prolactinoma, or pituitary adenoma and correction of iron deficiency.

Radiosurgery reduces significantly high levels of prolactin, improving this way your symptoms.

Hope this helps. I remain at your disposal for further questions and clarifications.

Take care.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Erion Spaho 27 minutes later
Thanks for the response. How long do iron supplements take to stabilise iron levels and how long do the effects of cabergoline/bromocriptine on the prolactinoma last for?
Answered by Dr. Erion Spaho 3 hours later
Brief Answer:
Iron levels should normalize in few months.

Detailed Answer:
Welcome back.

Iron supplements should stabilize iron blood levels in about two to three months,.

Treatment with carbegoline/ Bromcriptine on prolactinoma results in shrinkage of tumoral mass in almost all patients, blood levels of prolactin reduce in about 2/3 of patients and results last several months to few years.

Follow up of prolactin level is needed monthly to assess the effectiveness of treatment.

Hope I helped you.

Best regards.
Above answer was peer-reviewed by : Dr. Raju A.T
Answered by
Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3850 Questions


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