Empty Sella - pituitary compressed - is this a ... - Thyroid UK

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Empty Sella - pituitary compressed - is this a problem?

vb2005 profile image
13 Replies

Hi everyone, after MRI of the head i was told that pituitary gland is compressed but a neurologist said it should not be a problem. But i am very ill and decided to test some hormones, could you please tell me if they are OK:

TSH 0.866 (0.27 - 4.2)

fT4 11.04 (9.30 - 17)

fT3 2 ( 2 - 4.4)

ACTH 18.2 (7.2 - 63)

DHEA-S 133 ( 89 - 427)

Many Thanks

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vb2005
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helvella profile image
helvellaAdministratorThyroid UK

vb2005,

Your results suggest that you are not producing an appropriate amount of TSH. The result of that being your FT4 and FT3 levels are low. If your pituitary were to respond properly, you'd expect higher TSH, resulting in higher FT4 and FT3.

I'll not comment on ACTH and DHEA-S as I do not know much about their levels.

One of the observations of hypothyroidism is that in some people the pituitary enlarges (pituitary hyperplasia). Obviously, if your pituitary is compressed it is unlikely to be able to enlarge. However, you'd need someone with good understanding to identify whether the reported compression is a result of it trying to grow. That could happen if you ALSO have primary hypothyroidism - that is, your thyroid is not producing enough thyroid hormone.

Here is a link to a paper reporting a series of cases:

ncbi.nlm.nih.gov/pmc/articl...

At a quick glance, none appears to be the same as yours, but they might provide some general background/interest.

It means that your pituitary can't work properly so you have secondary hypothyroidism (meaning that TSH should not be tested, just free T4 and free T3 to see how you are doing). it probably also means that you won't produce other hormones (including cortisol and sex hormones) and may need replacement meds for those too. I'd look for a hypopit forum - I don't know if there is one on HU.

in reply to Angel_of_the_North

No there isn't!!! You can produce other hormones - I have secondary adrenal insufficiency from Cushing's disease but just need to replace cortisol & thyroxine, he others are fine.

Angel_of_the_North profile image
Angel_of_the_North in reply to

I can't do TSH or sex hormones or cortisol.

vb2005 profile image
vb2005 in reply to Angel_of_the_North

How did you find out that pituitary is causing low tsh? I mean when endocrinologist see low tsh they say - thats fine your body just dont need more t4. Some thyroid gurus like raypeat.com even say that you should have tsh almost 0

Angel_of_the_North profile image
Angel_of_the_North in reply to vb2005

Below range free T4, bottom of range TSH, hypo symptoms, not on meds.

vb2005 profile image
vb2005 in reply to Angel_of_the_North

Hi, do you take something to replace your cortisol, maybe adrenal cortex extract or hydrocortisone. I tried 30-40 mcg t3 but see abolutely no effect positive or negative, i guess t3 will not work without cortisol.

Angel_of_the_North profile image
Angel_of_the_North in reply to vb2005

I take adrenal cortex.

vb2005 profile image
vb2005 in reply to

It seems different people have different hormones affected, my testosteron is at the maximum of the reference range for males, aldosteron and antidiuretic hormone seems fine

Did you have your cortisol levels checked as well? If your ACTH level is high it may be that you're not producing cortisol from your adrenals. It would be worth checking what your cortisol level is - it needs to be done between 8-9am in the morning. Have a look on the Pituitary foundation website pituitary.org.uk If there is a problem with your pituitary it will affect your thyroid levels so that it's your T3 T4 that needs to be checked rather than your TSH.

vb2005 profile image
vb2005

Thank you!

PaulineS here is what i found regarding ACTH on stopthethyroidadness website:

5) What labs will detect hypopituitarism?

-low TSH (below 1.8 for men, below 0.8 for women)

-low ACTH (below 30 for am. Is possible to be secondary with ACTH as high as low 40’s)

Unfortunately i visited endocrinologist and she said - all hormones are in the reference range so she see no problem.

juls profile image
juls

Just had this said to me today, empty sella syndrome. seen on a recent mri scan Taken for something else, the space seen on scan is my piturity gland with CSF round it, so it seems to be leaking into that space ..back to trials and tribulations bloods all done today scan on order for thyroid only went to get bloods for thyroid all checked too brilliant endoc.. least they found i had a brain ? aint got a clue,amazing what they find had mri for a tia and endoc finds this how clever.

vb2005 profile image
vb2005

I am very curious what are your hormone levels. Do you have headaches? I have a book that says that empty sella is caused by increased intracranial hypertension.

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