Anyone know much about Pituitary problems?

[Penny_babe2001]

As a bit of a follow on from my previous question about blood test results (will copy them below for reference) and trying to understand it all a bit more, I had a recent MRI of brain and cervical spine and one of the things that was noted was an empty sella. I have no other notes on tht as the MRI was for something else, and this was noted on the report as an incidentally type thing.

I know the Pituitary makes the TSH to stimulate the thyroid, and I'm assuming that if my pituitary isn't working (or even there!!) then that would explain the suppressed TSH?

Should I be asking for a referral back to Endocrinology to get this looked at? GP, who gave me the MRI report, didn't mention it, and I didn't ask.

Blood results:

TSH <0.03 (0.35 - 5.5)

FT4 22.2 (10.3 - 22.7)

FT3 5.4 (3.5 - 6.5)

Thanks

[helvella Administrator Thyroid UK]

You are quite right that a non-existent or under-functioning pituitary can certainly be a reason for TSH remaining on the floor.

May I suggest you have a look here:

headinjuryhypo.org.uk/

The main person there posts here from time to time - this is her profile:

thyroiduk.healthunlocked.co...

You might also find this of interest:

ncbi.nlm.nih.gov/pubmedheal...

And right here - have a look at some previous posts:

thyroiduk.healthunlocked.co...

All the best

Rod

[Penny_babe2001 in reply to helvella]

Ohh, that top one is interesting. A lot of symptoms there ) but which are also the same as the Hashimotos I have).

Will sit and read the other links now, thanks

[rosetrees]

I just Googled empty sella. nlm.nih.gov/medlineplus/enc...

It doesn't necessarily seem to mean that your pituitary isn't there or even inactive.

I'm assuming you are on medication of some kind as your T4 and T3 levels look good. Are you taking NDT or T3, which could suppress your TSH?

Just thinking out loud, so don't take what I said as anything more than that.

[Penny_babe2001 in reply to rosetrees]

I've been on Thyroxine for years, currently take 225mcg/250mcg alternating days. Apart from supps (D, B12 and folic acid), that's all I take.

I think that was one of the page I read too when I got home from the GPs, and everything I found lead to empty sella syndrome, but then most pages also said that is very rare

I also have PCOS, so maybe a link there too; I hasn't thought about that before.

Thanks

[Penny_babe2001]

Just reading through one of the links and I remembered that I had a Short Synacthen Test not that long ago and it came back as normal.

Baseline cortisol: 259 nmol/L

250g synacthen givem IM

Cortisol 30 mins: 691 nmol/L

(I have no idea what any of that means!)

TFT at the time was

TSH <0.03mU/L

FT4 27.4 pmol/L

FT3 7.5 pmol/L

(no ranges, but I assume as above as same lab)

[rossilin600]

Hi penny, have you had any head injury or heammoraging in the past as this can cause empty sella. Mine was due to heamoraghing after chilbirth but I was diagnosed with hashi hypothyroid and started levo 25 years ago but have never felt well then about 8 years ago symptons getting chronic ie cfs, fybro and hypoglycemia, tsh was suppressed but had all hypo symptons so pushed for referral to endo, after months of various tests I have been diagnosed as having pituitary disorder called hypopituitarism which in adults they say is quite rare and can take years to show all defects which has caused many mis diagnosis over the years, I am now on 25mg steroids daily for adrenal cortisol and have below the nice guidelines for abnormal growth hormone so am awaiting for red listed self daily injections, the endo has written to gp and informed him to only thyroid test for t4 and t3 as tsh wont change, I have felt so ill for so long now I just hope the injections give me a better quality of life. On a lighter note I am sure that empty sella do not effect everyones pituitary and sincerely hope you are on of these so good luck in your journey and keep us informed.

[Penny_babe2001 in reply to rossilin600]

Sorry for the delay in replying! And thank you for your reply

Nope, no head trauma that I can remember.

When I got my last lot of blood results, the GP I saw did say that Pituitary should be considered depending what came back on the retest. I was quite impressed actually that a GP (and a locum at that) seemed to get it, rather than just say it was all in "normal range" and tell me to go away! Even the Endo has never mentioned it as a potential cause for suppressed TSH. He ordered an SST, but that's adrenals, and cos that came back normal, that was the end of that.

I had an MRI at the beginning of June for suspected MS, but I suppose it's good that it picked up the empty sella as that should open that line of investigation now too; as soon as I bring up the subject with the GP surgery, and probably ask for referral back to Endo.

Just when I think I'm getting to grips on all this and understand (mostly) the whys and wherefores, the goalposts change!!