Research - Prolactin and Celiac Disease

There is so much to say on this subject, but I'll limit today's post to just one recent article. If you haven't heard of prolactin, then you probably haven't considered breastfeeding a baby.  Various natural lactation boosters are available on Amazon.com to help women keep breastfeeding or to start the flow if it didn't properly start.  But did you know that prolactin is also implicated in the disease process of women who have autoimmune issues? A new article focuses on this emerging field of study. 
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Lots of jargon in this one.  But it's pretty clear that the point is, prolactin can hurt someone with an autoimmune disease. 

Prolactin and Autoimmunity
Front Immunol. 2018; 9: 73.
Published online 2018 Feb 12. doi:  10.3389/fimmu.2018.00073
PMCID: PMC5816039 (free full text)
VĂ¢nia Vieira Borba, Gisele Zandman-Goddard, and Yehuda Shoenfeld
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816039/



Excerpt:
PRL and Celiac Disease

Celiac disease is a gluten-sensitive autoimmune enteropathy where both adaptive immunity and innate immunity are involved in its development (111). Serum PRL levels were positively correlated with disease activity, degree of mucosal atrophy, and with the serum concentration of anti-endomysial antibodies. Recently, a longitudinal study revealed diminished levels of PRL after 6 months following a gluten-free diet. The evidence of decreasing PRL simultaneously with the decline of anti-transglutaminase antibodies suggests a direct connection with a gluten-free diet and hormone levels (112).

PRL and Autoimmune Thyroid Disease

Autoimmune thyroid diseases comprise mainly two disorders, Grave’s disease and Hashimoto thyroiditis (113). Hyperprolactinemia was found in 20% of patients with autoimmune thyroid disease and had double the frequency among hypothyroidism patients. Around 90% of Hashimoto’s thyroiditis patients presented significantly higher PRL levels in association with decreased cortisol titers (114). The role of dopamine agonists in the treatment of autoimmune thyroid disease is yet to be determined.
Definitions:

PRL = prolactin, best known as the hormone that produces breast milk in lactating women, but now thought to also have a hand in triggering autoimmune illness

enteropathy = disease of the small intestine

mucosal atrophy = the damage that is visibly done to the small intestinal lining
'serum concentration of anti-endomysial antibodies'  = you can see that on a Celiac test, called  EMA

anti-transglutaminase antibodies = the most common screening test for Celiac

Hashimoto thyroiditis = when the immune system attacks the thyroid, common in Celiac disease

hyperprolactinemia = too much prolactin

'decreased cortisol titers' = adrenal insufficiency, but not quite Addison's disease

'dopamine agonist' = A drug, OTC chemical (nootropics), or natural extract that attaches to dopamine receptors and activates them, but not dopamine itself. 

Dopamine - Dopamine is a stimulant and has been observed to scale down immune reactions.  It can be a stimulant drug, or it is made by the body in times of need.  Some drugs merely encourage the body to release more dopamine (ie. phentermine, a diet drug).

The main point being that when you go on a gluten free diet, assuming you have Celiac disease, or at least a high EMA level, the effects of the diet are more far-reaching than just stopping the gut lining damage.  The diet reduces prolactin levels, making other autoimmune problems also less likely. This is good news for women who have autoimmune problems, but less good news for the majority of women who want to bear children and naturally breastfeed. 

It's not clear whether the diet merely normalized prolactin levels when they were to high, or whether it always reduces prolactin.  The study referenced in the article only talks about the effect of the GFD on prolactin in children with Celiac.  So we should be cautious about making assumptions that are too large.   The deeper you go into this science the more often you bump into B-cells and their regulation by the body.  It's worth noting that a hypothetically autoimmune condition known as ME/CFS ("chronic fatigue syndrome") has recently done a clinical trial whose purpose seems to have been a drug induced "B cell restart" of some sort.  But they're not sure yet why that plan didn't work. We may be looking at similar illnesses from different angles, and I applaud all these efforts.

There is also a group of people who have "silent" Celiac, and may be helped by knowing this.  They have no symptoms of gut problems.  But if you look at their small intestinal lining with an endoscope, you find damage, villi flattening.  Some of then never have a positive blood test.  Some of them may have been screened as a child and may resent the restrictions.  This is proof that the GFD is still helping them, not just to avoid gut problems, but also to avoid developing other autoimmune illness.  And that goes double for women with Celiac, who often have an unavoidable exposure to prolactin during pregnancy and lactation. 

If you believe this is important information for your health, please discuss it with your doctor.  And if you have any ideas to add to the conversation, please comment.  Connections between Celiac and Thyroid problems are common, and between Celiac and autoimmune illness, including plain old Arthritis.  Live better today.

Disclaimer: I am not a doctor or a scientist.  I'm a blogger.  If you have health questions, you should consider all sources of information, including your doctor, and you shouldn't change things unless you have good reasons to do so and have discussed them with a trained medical professional.  In my experience, the best doctors will react with interest when you bring them information like freshly published studies.  But I should warn you that some MD's may react with scorn.  My health outcomes have been much better since my doctor and I have been researching my condition, but your results may not match mine. 

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