Hyperprolactinemia

This episode breaks down the complex etiology and diagnostic pitfalls of hyperprolactinemia, shifting from normal physiologic responses like pregnancy to drug-induced elevations from antipsychotics and prokinetics. We analyze critical laboratory artifacts, detailing how the hook effect masks giant macroprolactinomas and how macroprolactinemia causes asymptomatic elevations. Finally, the discussion explores how to differentiate non-functioning macroadenomas from true prolactinomas, and examines the downstream effects of hypogonadotropic hypogonadism on fertility and metabolic bone disease.