Elevated prolactin is such a common issue and it could be rather difficult to lower it or keep it low.
Part of the struggles to lower prolactin, is to increase dopamine. But increasing dopamine is the easy part. Restoring the dopamine system is the hard part.
The most common way to lower prolactin is to boost dopamine, but often times that doesn’t work too well, unless a drug is used. Also, the dopamine system of a lot of people in our modern society is dysregulated.
A few places we can focus on when it comes to lowering prolactin is to:
- Restore dopaminergic neurotransmission (increase TH (tyrosine hydroxylase), DAT (dopamine transporter) and D2 (dopamine D2 receptor)
- Quick word on DAT. Many drugs increase dopamine by modulating DAT, either by inhibiting it (cocaine) or acting as a substrate (meth). “DAT pathologies are suspected to contribute to disorders, such as depression, attention deficit–hyperactivity disorder, anhedonia, Parkinson’s disease, and addiction. Low DAT availability can contribute to depression and anhedonia” (R). Some herbs below can increase DAT, which doesn’t mean it lowers dopamine, but it can actually help against anhedonia.
- Inhibit estrogen receptors in the pituitary
- Inhibit serotonin receptors
- Lower TRH from the hypothalamus
- Lower parathyroid hormone
Here as 8 herbs that can lower prolactin at the root.
#1 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)  and persistent decreases of 20–30% in striatal DAT , 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).
#2 Fructus Hordei Germinatus
Fructus Hordei Germinatus (FHG), a kind of herb germinating from barley, can significantly increase the expression of D2 receptors and DAT in PC12 cells (R) and can reduce prolactin in mice.
20% of prolactinomas patients did not respond to bromocriptine, but respond to hordenine (found in Fructus Hordei Germinatus), because it lowers MAPK.
It does so by blocking the MAPK (p38, ERK1/2, and JNK) activation and production of inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL-6) (R).
Estrogen is known to stimulate prolactin secretion through the MAPK pathway, which Fructus Hordei Germinatus is know to inhibit.
ERα (estrogen receptor alpha) inhibition abolished E2-induced PRLR upregulation and PRL-induced ERα phosphorylation, and fulvestrant, an ERα inhibitor, restored pituitary adenoma cell sensitivity to bromocriptine by activating JNK-MEK/ERK-p38 MAPK signaling and cyclin D1 downregulation.(R)
So it’s possible that FHG has anti-estrogenic properties.
In this animal model, Fructus Hordei Germinatus has been shown to lower prolactin, prolactin proteins, pituitary growth and increase progesterone and LH when below baseline (R).
For those that have enlarged pituitaries and hyperprolactinemia, this might be just the herb for you.
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).
#4 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).
#5 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.
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).
#7 Zhuang yang capsule
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.(R)
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).
#8 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.
Personally, I would go for white peony extract, Zhuang yang (upregulate StAR and dopamine), Longdan Xiegan Tang (antagonize estrogen receptor and restore pituitary function), Fructus Hordei Germinatus (increase LH, dopamine and StAR) and/or Jitai (pro-dopamine and anti-serotonin).
All of these herbs should improve energy, well-being and sexual drive.
Increasing dopamine in general should help to lower prolactin. Here are related articles;
- How to increase dopamine
- Restore dopamine receptor sensitivity
- The ultimate guide for lowering prolactin
- Quick 10 step guide for lowering prolactin
- Dopamine dream team
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