Ineffectiveness of pyridoxine in evalution and treatment of the hyperprolactinemic amenorrhea-galactorrhea syndrome

  • Thomas J. Goodenow
    Division of Endocrinology and Metabolism, Department of Medicine, The Ohio State University Hospitals, Columbus, Ohio, USA
    Search for articles by this author
  • William B. Malarkey
    Reprint requests: Dr. William B. Malarkey, Room N-1111, The Ohio State University Hospitals, 410 W. 10th Ave., Columbus, Ohio 43210.
    Division of Endocrinology and Metabolism, Department of Medicine, The Ohio State University Hospitals, Columbus, Ohio, USA
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.


      Pyridoxine hydrochloride (vitamin B6) has been proposed as a diagnostic and therapeutic agent for patients with amenorrhea and galactorrhea associated with elevated serum prolactin levels. Therefore five normal premenopausal women and nine consecutive patients with amenorrhea, but with no other evidence of pituitary tumor, were given 200 to 300 mg of pyridoxine IV. Mean serum prolactin and growth hormone concentrations did not change significantly from baseline following the infusion in either group. Eight of the nine amenorrhea patients had elevated serum prolactin levels and were treated with oral PDX for 91.0 ± 10.1 (S.E.) days, including 42.0 ± 8.2 days at a maximum dosage of 600 mg. per day in divided doses. Mean serum prolactin concentrations of the eight patients at completion of therapy (82.6 ± 19.1 ng. per milliliter) did not differ significantly from the pretreatment value (69.1 ± 18.4 ng. per milliliter). No subject acquired normal prolactin levels, and in two patients the serum prolactin levels increased during treatment. Galactorrhea diminished very slightly in three of the seven lactating patients but was unchanged in the remainder. Amenorrhea persisted throughout pyridoxine treatment in all eight patients. While receiving 600 mg. per day, three patients complained of headaches, lethargy, and lightheadedness which subsequently resolved when the PDX was discontinued. Thus, pryidoxine does not appear to be a useful agent for evaluation or treatment of the galactorrhea-amenorrhea syndrome.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Malarkey W.B.
        • Jacobs L.S.
        • Daughaday W.H.
        Levodopa suppression of prolactin in nonpuerperal glactorrhea.
        N. Engl. J. Med. 1971; 285: 1160
        • Malarkey W.B.
        Nonpuerperal lactation and normal prolactin regulation.
        J. Clin. Endocrinol. Metab. 1975; 40: 198
        • Thomer M.O.
        • Besser G.M.
        • Jones A.
        • Dacie J.
        • Jones A.E.
        Bromocriptine treatment of female infertility: Report of 13 pregnancies.
        Br. Med. J. 1975; 4: 694
        • Mroueh A.M.
        • Siler-Khodr T.M.
        Ovarian refractoriness to gonadotropins in cases of inappropriate lactation: Restoration of ovarian function with bromocryptine.
        J. Clin. Endocrinol. Metab. 1976; 43: 1398
        • Kleinberg D.L.L.
        • Noel G.L.
        • Frantz A.G.
        Galactorrhea: A study of 235 cases, including 48 with pituitary tumors.
        N. Engl. J. Med. 1977; 296: 589
        • Del Pozo E.
        • Varga L.
        • Wyss H.
        • Tolis G.
        • Friesen H.
        • Wenner R.
        • Vetter L.
        • Uettwiler A.
        Clinical and hormonal responses to bromocriptine (CB-154) in the glactorrhea syndromes.
        J. Clin. Endocrinol. Metab. 1974; 39: 18
        • McIntosh E.N.
        Treatment of women with the glactorrhea-amenorrhea syndrome with pyridoxine (vitamin B6).
        J. Clin. Endocrinol. Metab. 1976; 42: 1192
        • Delitala G.
        • Masala A.
        • Algna S.
        • Devilla L.
        Effect of pyridoxine on human hypophyseal trophic hormone release: A possible stimulation of hypothalamic dopaminergic pathway.
        J. Clin. Endocrinol. Metab. 1976; 42: 603
        • Foukas M.D.
        An antilactogenic effect of pyridoxine.
        Br. J. Obstet. Gynaecol. 1973; 80: 718
        • Marcus R.G.
        Suppression of lactation with high doses of pyridoxine.
        S. Afr. Med. J. 1975; 49: 2155
        • Sinha Y.N.
        • Selby F.W.
        • Lewis U.J.
        • Vanderlaan W.P.
        A homologous radioimmunoassay for human prolactin.
        J. Clin. Endocrinol. Metab. 1973; 36: 509
        • Grodsky G.M.
        • Forsham P.H.
        An immunochemical assay of total extractable insulin in man.
        J. Clin. Invest. 1960; 39: 1070
        • Canales E.S.
        • Soria J.
        • Zarate A.
        • Mason M.
        • Molina M.
        The influence of pyridoxine on prolactin secretion and milk production in women.
        Br. J. Obstet. Gynaecol. 1976; 83: 387