Prolactin, the pesky man-boob-inducing, water retention-promoting, infertility and cancer-causing hormone is all about to get eradicated in this article. 

If you’re reading this article, you either have:

• Symptoms of high prolactin
• Identified high prolactin on a blood test
• Or both

I’m going to show you exactly how to lower prolactin to get rid of these symptoms

Prolactin background

Prolactin is a hormone secreted by the anterior pituitary in small amounts under normal conditions but can be significantly increased due to various reasons.

The normal range for prolactin is 2 to 18ng/mL and anything above 25ng/mL is considered hyperprolactinemia. The optimal range is at 7ng/ml or less.

The half-life of prolactin is about 15-20 minutes, so if you block its synthesis, you can drop it rather quickly.

Let’s discuss some side effects of chronically elevated prolactin.

Side effects of high prolactin

Most common side effects.

Prolactin:

• Reduces libido and lengthens refractory period (R).
• Makes you hypersensitive to stress.
  • Prolactin stimulates the hypothalamus-pituitary-adrenal (HPA) axis (R). It increases CRH and ACTH, which will lead to higher cortisol levels.
• Makes you feel flat.
  • In the long term, prolactin reduces dopamine synthesis, leading to low dopamine symptoms, such as low motivation, drive, focus, etc (R).
• Contributes to insulin resistance.
  • It’s inversely associated with fasting glucose and insulin and insulin sensitivity (R, R).
• Makes you more sensitive to estrogen, by increasing estrogen receptors (R).
• Promotes gyno (R).
  • Gyno is more common among men with a high estrogen-to-testosterone ratio, prolactin also plays a role. Dopamine antagonists, which increase prolactin commonly contribute to gyno (R).
• Decrease beard growth (R).
• Is associated with anxiety, hostility and depression (R, R).
• Lowers testosterone, by inhibiting steroidogenesis (R).
• Contributes to infertility (R).
• Promotes acne (R, R).
• Increases fatigue and daytime sleepiness (R).
• Increases unwanted hair growth, such as on the back and shoulders (R).

Lesser known side effects of prolactin

Prolactin:

• Promotes bone and muscle loss (R)
• Promotes inflammation and fibrosis of the heart, liver and other organs.
• Stimulates the release of parathyroid hormone, which promotes bone loss and calcification. It’s also pro-inflammatory and anti-thyroid.
• Promotes autoimmune diseases (R), including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), multiple sclerosis and cardiomyopathy.
• Stimulates adipogenesis and inhibits lipolysis, which contributes to fat storage (R)
• Increases adiponectin, which increases SHBG, thus lowering free testosterone.

An acute increase in prolactin, induced by a sauna for example, is much less harmful, or might even be beneficial, compared to chronic elevation.

What increases prolactin

Things that stimulate prolactin release include (R):

• Serotonin
  • 95% of serotonin is created in the gut and every kind of gut irritation increases serotonin production.
• Thyrotropin-releasing hormone (TRH)
  • TRH promotes the release of TSH and prolactin. If your TSH is over 2, your prolactin will likely also be higher than it should be.
• Gonadotropin-releasing hormone (TRG)
• Vaso-intestinal peptide
  • It increases with gut inflammation and a low-sodium diet (R).
• Opiates
• Neurotensin
• Substance P
• Oxytocin
• Angiotensin 2

Let me start by giving you the best strategies that you can do to lower prolactin for good. If you just take supplements, but not fix the root cause, prolactin will always rebound. So here is what you do.

How to lower prolactin in men (natural strategies)

#1 Lower estrogen

Estrogen is a potent inducer of prolactin secretion. When patients don’t respond adequately to dopaminergic drugs, adding an aromatase inhibitor is usually more than enough to get prolactin int othe right range and even shrink a pituitary prolactin tumor.

“PRL levels decreased in all patients after CAB + ANA (cabergoline + anastrozole) (mean − 70%, range − 44/− 97%), achieving a normalization of PRL levels in one case. Tumor size decreased in all cases (mean − 47%, range − 24.5/− 68%). No severe adverse effects have been reported, a moderate weight gain has been observed in two cases.” (R)

The main stimulators of estrogen include stress, insulin resistance and inflammation, so focusing on those to lower estrogen is a good start. While fixing those you can also use natural aromatase inhibitors as well as increase the detoxification of estrogen through the liver.

• How to inhibit the aromatase
• How to increase estrogen detoxification through the liver

Additionally, you have to be very vigilant about avoiding estrogenic compounds found in the environment, such as:

• Plastics; found in all plastic products, such as plastic bottles, plates, cups, utensils, food wrapping, etc., as well as in our water, including from natural sources.
• Cosmetic products
• Air (soot and exhaust gas are highly estrogenic); using an air filter if you’re living in a place with dirty air is very important.
• Mold; found in coffee, cocoa, grains, and other improperly stored food. Animals fed moldy grains (which is always) also have mold in their meat, fat, eggs and milk.
• Processed food; containing emulsifiers, gums, red dye, such as red meat, salmon, fruit juice, tomato paste, chili sauce, etc.

#2 Optimize thyroid

The hypothalamus releases Thyrotropin–releasing hormone (TRH), which stimulates the pituitary to release thyroid stimulating hormone (TSH), which signals the thyroid to increase thyroid hormone production, namely T4 and T3.

TRH and TSH are potent stimulators of inflammation and prolactin, so you want to lower it as fast and best you can. There are a variety of reasons why TRH might be elevated, so I encourage you to read this article of mine:

> How to interpret your thyroid test results

Additionally, parathyroid hormone (PTH), which is elevated due to low vitamin D and calcium, also antagonizes the thyroid gland and can lead to an increase in TRH and TSH. Getting adequate sunlight on a regular basis is a great way to increase vitamin D and lower PTH, TRH and TSH.

#3 Lower stress

Chronic stress increases prolactin secretion and also promotes insulin resistance, gut issues, inflammation, estrogen dominance and low androgens.

Most of the time by just lowering stress you can significantly lower prolactin levels. There are so many good, easy and effective ways you can lower stress, which I outline in this article:

> How to lower cortisol

#4 Increase dopamine

Dopamine is the main antagonist of prolactin. The go-to prescription drugs for hyperprolactinemia are dopamine agonists, namely bromocriptine and cabergoline.

A few easy ways to increase dopamine include:

• Destress
• Listen to music
• Get enough sleep
• Exposure yourself to bright light (ideally direct sunlight)
• Get out in nature
• Eat a good amount of protein (dopamine is created from the amino acids phenylalanine and tyrosine)
• Eat a nutrient-dense diet (dopamine synthesis requires many vitamins and minerals)
• Exercise
• Ice bath
• Small wins
• Take dopaminergic herbs, such as Tongkat Ali, Tribulus, Mucuna, Saffron, Catuaba bark, etc.

Check out my article on boosting dopamine for free, easy and effective ways to increase dopamine and lower prolactin:

> How to increase dopamine

#5 Restore metabolic function

When ATP production is low, more calcium is taken up into the cell and magnesium is exported. This leads to intracellular excitation and prolactin release (R).

We want to ensure our bodies are producing optimal amounts of energy (ATP) at all times to export excessive calcium from the cells in order to keep prolactin low.

There are a variety of ways to improve ATP production and some include:

• Moderate intensity or high-intensity interval training to create new mitochondria.
• Eat a nutrient-dense diet to provide all the vitamins and minerals to support mitochondrial function.
• Use ATP-boosting supplements, such as creatine, Rhodiola, elevATP, Cardenosine, etc.

#7 Minimize EMF exposure and damage

The reason for this is that EMF activates the voltage-gated calcium channels (VGCCs) in the body, which allows calcium to enter the cell.

Intracellular calcium is excitatory and stimulates the production of prolactin and it drops ATP production.

EMF is one of the most potent stimulatory of VGCCs, thus it can lead to chronically elevated prolactin if you’re chronically exposed to EMF.

One of the simplest ways to mitigate the damage of EMF is to use 400mg-2g of magnesium per day. Magnesium is a calcium channel blocker.

If you want to learn more about mitigating the negative effect of EMF, check out my article on that subject:

> How to mitigate the damages of EMF 

#8 Increase DHT

DHT, the most androgenic, manly hormone, has been shown to lower prolactin release directly at the pituitary.

8 most powerful ways to boost DHT

If you want to learn how to boost your DHT, check out my article on it:

> How to boost DHT naturally

#9 Don’t hyperventilate

When you hyperventilate, you blow off a lot of carbon dioxide (CO2), which increases prolactin (R).

Having optimal CO2 in your blood allows oxygen to be taken up by cells. Reducing CO2 reduces oxygen uptake into cells, starving the cells. This is known as the Bohr effect.

CO2 is a mast cell stabilizer (where serotonin is kept). Once CO2 drops, serotonin is released from mast cells. Serotonin in turn induces the release of prolactin.

So what you want to do is focus on nose breathing only and optimize your metabolism (to increase CO2 production). If you feel anxious, focus on deep breaths. Once you have inhaled, hold your breath for a few seconds and then exhale slowly. Do this for about 4-6 times and you’ll feel a lot better.

> How to increase carbon dioxide production

#10 Avoid opioids

Opioids, by activating their receptors, stimulate the release of prolactin. Pharmacutical opioid pain killers are the most common causes of high prolactin. They include oxycodone, morphine, fentanyl, tramadol, etc.

Gluten, milk, rice, spinach, soy, cocoa and a few other foods are sources of natural opioids that can activate the opioid receptor (R), but A1 milk and gluten are the two most potent opioid agonists.

Stress also powerfully promotes opioid release in the brain.

But if you’re not getting any negative effects from your high-quality dairy products (A2 cows milk, sheep milk or goat milk), there might be no need to cut it out.

The best natural opioid receptor antagonist is coffee, and it’s not due to the caffeine, but due to the 4-caffeoyl-1,5-quinide (R).

Opioid antagonistic drugs, such as naloxone, are also effective at lowering prolactin (R).

#11 Lower inflammation

Inflammation increases the release of prolactin (R).

To see if you have inflammation, check your hsCRP. If it’s above 0.6, there might be some low-grade inflammation going on somewhere in your body. You can also take a deeper dive and test for IL-6, which is a potent prolactin inducer.

The most common promotors of inflammation are:

• Excess iron and other heavy metals, such as mercury, lead, cadmium, copper, etc.
• Omega 6 fatty acids
• Chronic stress
• Sleep apnea
• Insulin resistance
• Nutritional deficiencies, such as zinc, selenium, fat-soluble vitamins, etc.

Vitamin E, aspirin, anti-oxidant-rich foods, vitamin D, methylene blue, androgens, vitamin C, NAC, glutathione, etc., will help to lower inflammation and prolactin.

Eating gut-irritating foods is often also a major cause of inflammation. Gut irritation and inflammation can be induced by allergic foods, such as dairy, eggs, gluten, pre-biotic rich foods (high FODMAP), rough fibers, eating under stress, not chewing properly, SIBO, SIFO, or some other sort of parasitic or bacterial infection.

#12 Manage anger

Stress promotes prolactin release in a variety of ways.

For example, becoming angry from a humiliating experience increases prolactin secretion (R). It’s not just humiliation that increases prolactin, but anger in general. It also doesn’t have to be a live situation, it can also be due to reliving maddening experiences in your own head.

#13 Avoid drugs that increase prolactin

• SSRIs
  • “Selective serotonin-reuptake inhibitors (SSRIs) have been reported as the most common cause of drug-induced hyperprolactinemia.” (R)
  • Serotonin is a powerful inducer of prolactin release, directly and indirectly by lowering dopamine (R, R).
  • Other serotoninergic compounds, such as Fenfluramine can also cause hyperprolactinemia (R).
• Anti-psychotics since they block dopamine.
• Estrogens
  • This count for both natural and synthetic estrogens. The anti-histamine Cimetidine, sold under the brand name Tagamet among others, increases estrogen by inhibiting its detoxification (R).
• Anti-androgens (R). Cimetidine also has anti-androgenic and anti-dopaminergic effects.
• Certain anti-hypertensive drugs, namely reserpine and verapamil.
• Certain H2-receptor antagonists. Cimetidine, but not famotidine, increases prolactin (R, R). Cimetidine also has anti-androgenic and anti-dopaminergic effects.

#14 Avoid chronic alcohol consumption

Alcoholics’ prolactin tend to be at least twice as high as non-drinkers (R). Even acute alcohol consumption increases prolactin (R).

#15 Don’t sauna too much

Doing a dry suana at 80C increased prolactin 2.3 fold (R). Alternating between hot and cold prevents the prolactin increase (R)

Natural supplements to reduce prolactin in men

#1 Vitamin D & calcium

The parathyroid hormone (PTH) promotes the uptake of calcium. A low calcium diet and low vitamin D levels can increase PTH.

Overactive parathyroid hormone (PTH) suppresses testosterone and increases prolactin (R, R, R). The high prolactin could be due to PTH which suppresses the thyroid and this leads to elevated TRH and prolactin.

#2 Topical progesterone

Progesterone and its 5 alpha-reduced metabolite, 5α-DHP, lower prolactin secretion. 5α-DHP is twice as effective as progesterone at lowering prolactin.

The skin is very rich in 5-alpha reductase, so if you apply progesterone on the skin, most of it will convert to 5α-DHP (R).

I’ve used topical progesterone before specifically for sleep with good results. I use around 10-20mg topically. Higher doses can be used, but start low.

• Progesterone – (IdealabsDC (product: Progestene)

#3 THC

One of the active components of weed, THC, can help to lower prolactin. However, THC is actually estrogenic and once you stop with weed, you get an overshoot of prolactin. Men that have quit weed end up with higher prolactin than men that didn’t use weed.

#4 Methylene blue

Methylene blue is a blue dye and it’s able to lower estrogen-induced prolactin release (R). 

I enjoy using methylene blue for its mitochondrial enhancement, inflammation lowering and nootropic benefits.

I typically use 1-5mg on demand.

• Methylene blue

#5 Tribulus Terrestris

I’m personally a huge fan of this herb. In this human study, 750mg Tribulus Terrestris extract (112.5 mg of protodioscin) supplementation daily reduced the prolactin levels by 60%, from 17ng/dl to 7ng/dl in just 28 days (R). It also increased DHEA and DHT dramatically.

Tribulus is very effective at increase DHEA and DHT, while also lowering prolactin.

For the best results, use an extract high in protodioscin, ideally 120mg daily.

Vemoherb has a good powder product with 60% protodioscin. pic.twitter.com/gQggNgfSsp

— Hans Amato (@HansAmato) January 29, 2023

The best Tribulus product: Vemoherb

#6 Vitamin E

Vitamin E is very effective at lowering prolactin. Doses of 400-800IU can be used daily to lower prolactin. I prefer a mixed tocopherol high in alpha-tocopherol, such as wheat germ extract.

#7 Aspirin

Aspirin can greatly help to reduce the rise in prolactin due to a stressful event (R). When I was very sensitive to stress in the past, I would regularly use 500mg of aspirin on demand.

#8 Zinc

50mg of zinc per day is able to quite significantly lower prolactin in uraemic men, from ∼29ng/ml to ∼11ng/ml (R). Even as “little” as 25mg per day in normal individuals is able to lower prolactin (R).

#9 Ashwagandha

5g of Ashwagandha powder helped lower prolactin in infertile men, while improving fertility (R, R).

#10 Chaste tree

Chaste tree/Vitex can help to lower prolactin, but you got to use the right dose. 120mg of Chaste tree daily will increase prolactin, whereas 480mg can decrease it) (R).

#11 Chamomile

5ml of chamomile syrup twice daily was able to lower prolactin from 38 to 23ng/ml after 2 months (R). The results can likely be replicated by taking 1-2g of chamomile powder daily.

#12 Fructus hordei germinatus

Fructus Hordei Germinatus (aka Mai Ya aka Barley Sprout) is widely used in treating hyperprolactinemia in China (R). Hordinine, one of its active ingredients, are potent pro-dopamine and helps to upregulate the dopamine receptor, D2.

#13 Selfheal

Selfheal lowers prolactin through D2 and DAT modulation (R). Apart from it’s dopaminergic properties, it also has strong antiestrogenic properties (antagonism of the estrogen receptor), which should also help to lower prolactin (R).

#14 Longdan Xiegan Tang

As you can recall, this herb was in my previous testosterone article.

Longdan Xiegan Tang extract suppressed olanzapine-induced increase in plasma prolactin concentration and overexpression of pituitary and hypothalamic prolactin protein. Importantly, LXT restored olanzapine-induced decrease in protein expression of the key components of the TGF-beta1 signaling, TGF-beta1, type II TGF-beta receptor, type I TGF-beta receptor (TGFβ1 is a potent inhibitor of prolactin synthesis and secretion) and phosphorylated SMAD3 in the pituitary and hypothalamus. Further, it antagonized downregulation of pituitary and hypothalamic dopamine D2 receptor (D2R) protein level, and inhibited pituitary estrogen receptor (ER) alpha and ERbeta protein expression.(R)

In summary, it blocks the estrogen receptors in the pituitary, restores TGFβ protein function (which inhibits prolactin synthesis and release and upregulates D2.

#15 Peony-Glycyrrhiza Decoction (PGD)

Peony-Glycyrrhiza Decoction (PGD), a traditional Chinese herbal formula consisting of paeonia (peony) and glycyrrhiza (liquorice) radices, is commonly used to alleviate antipsychotic-induced hyperprolactinemia.

Here are some research on PGD:

• PGD significantly increased the expression of D2 receptors and DAT in PC12 cells (R). Even though PGD increases DAT, the overall effect is still dopaminergic, as PGD lowers prolactin.
  • Drug use, such as meth, which significantly increases dopamine, lowers TH, DAT and D2. “Both postmortem and neuroimaging studies have documented reduced levels of DA, TH and DAT in the brains of chronic METH abusers [7,8,9,10]. In addition, PET imaging studies have reported that METH appears to induce long-lasting decreases in dopamine D2 receptors (D2R) [11] and persistent decreases of 20–30% in striatal DAT [12], and that this reduction can last as long as 3 years after METH withdrawal” (R). Thus PGD can help meth abusers recover.
• PGD reversed decreased serum progesterone to control level (R).
• PGD administration restored the under-expression of DRD2, DAT and TH (tyrosine hydroxylase) resulted from MCP (metoclopramide; a dopamine blocker) in the pituitary gland and hypothalamus (R).
• PGD has been shown to lower prolactin and prolactin-related symptoms in numerous human studies (R).

PGD contains licorice, of which 18β-glycyrrhetinic acid (GA) is a major metabolite. GA has been shown to unblock D2 receptor signaling, and lower 5-HT1A and 2A induced prolactin release (R).

• PDG extract
• White peony extract

#16 Yiru Tiaojing Granule

Yiru Tiaojing Granule lowers prolactin through D2 activation (R).

Paeoniflorin and liquiritin found in Yiru Tiaojing (YRTJ) Granule (a hospitalized preparation) and Peony-Glycyrrhiza Decoction (mentioned above) lower prolactin through dopamine-dependent and independent pathways (R).

Some of the dopamine independent pathways are through inhibition of cell proliferation and induction of mitochondrial pathway-mediated apoptosis in prolactinoma cells (R). 

Furthermore, paeoniflorin (found in Chinese peony) can restore olanzapine-induced downregulation of pituitary and hypothalamic dopamine D2 receptor (D2R) protein expression (R).

#17 Shakuyaku-kanzo-to

Shakuyaku-kanzo-to is a traditional Japanese herbal medicine that is composed of Paeonia root (Shakuyaku) and Glycyrrhiza root (Kanzo) (basically the same as PGD) and is used for the treatment of muscular cramps in patients with normal renal function in Japan.

In the first trial, the prolactin levels decreased by more than 50% with Shakuyaku-kanzo-to (TJ-68) treatment among 5 patients. Plasma prolactin level at 8 weeks was not significantly different with the baseline. Three of 10 patients, who had complained of reduced sexual desire, experienced subjective improvement (Yamada et al., 1997). In the second trial, decreased plasma prolactin level was observed in nine patients treated with TJ-68 and in four, the plasma prolactin decreased more than 50%. Subjective improvement of reduced sexual desire was observed in three patients at 4 weeks (Yamada et al., 1996).(R)

Although the exact mechanism of Shakuyaku-kanzo-to is unknown, it may have a direct inhibitory effect on prolactin release from the pituitary. It also decreased estradiol in rats and this reduction might decrease prolactin levels (R).

#18 Zhuang yang capsule

Zhuang yang increases the rate-limited step in testosterone synthesis (StAR) and can prevent the decline in total and free testosterone (R). Zhuang yang cream is even used to improve erections (R).

Furthermore Zhuang yang has been shown to lower anti-psychotic-induced increase in prolactin.

In the fourth trial, after 8 weeks of treatment with either Zhuangyang capsule (n = 39) or placebo capsule (n = 37) supplemented to risperidone, the serum level of prolactin decreased significantly, while in the control group, the prolactin markedly increased.
…
There was a significant difference (decreased 26.51 ng mL^-1 vs increased 15.56 ng mL^-1) in improvement of serum prolactin in trial group compared with that of control group. This effect of Zhuangyang capsule was not different between male and female groups (Chen et al., 2008).(R)

#19 Jitai tablet

Jitai tablet (JTT) is a commonly used traditional Chinese medicine that has been approved by the China Food and Drug Administration for opioid addiction treatment.

The JTT prescription consists of 15 herbs (with 101 compounds tentatively identified previously).

Our study has shown the following: (1) pre- and post-treatment with JTT were effective at alleviating the wet dog shakes and episodes of writhing (which shows that it has anti-serotonin effects (R)); (2) pre-treatment with JTT inhibited the morphine-induced decreases in dopamine transporter (DAT), dopamine D2 receptor (D2 R) and tyrosine hydroxylase (TH) levels in the striatum (p < 0.01, compared with morphine group) and maintained them at normal levels; and (3) post-treatment with JTT restored the densities of DAT, D2 R and TH in the striatum to normal levels (p < 0.01, compared with morphine group). These results support the notion that modulation of the dopamine system in the striatum may play a role for JTT’s therapeutic effect on the alleviation of opioid withdrawal symptoms.(R)

JTT treatment is not only useful for opioid addiction or rehab, but also many other drugs, such as meth.

Pre-treatment with JTT significantly attenuated METH-induced stereotyped responses, and interdicted METH-induced changes in the levels of DAT, D2R and TH expression. Treatment with JTT after METH administration restored DAT, D2R and TH expression to normal levels.(R)

Point being, JTT upregulates the dopaminergic system, inhibits the serotonergic system and this helps to lower prolactin levels, whether it’s from drug use, stress, excess gaming, social media and porn or whatever that case might be.

#20 Drugs that lower prolactin

The common doctor prescribed ones are Bromocriptine and Cabergoline. Other good ones that also have anti-serotonin effects are Metergoline and Lisuride.

Summary

I’ve given you a lot of tools to lower prolactin. Start by implementing 2 or 3. I’d start with the basicas up top, while adding 1-2 supplements as well.

> Learn how to maximize your dopamine naturally