Pituitary problems, latest results

[Anniewoz1]

This arrived today, can anyone shed any light please ?

This is the 2nd part of the letter :

“ I reviewed Elizabeth today and found her TFT’s to be rather odd. The first thing I have done is have them repeated. Her free T4 was low as you can see at 10.5pcmol/l but with a TSH that was normal!. One would have expected the TSH to be much higher if it was a primary hypothyroidism. This biochemical picture would suggest the possibility of a secondary hypothyroidism. To investigate this further I have checked her prolactin and FSH and will proceed to an MRI of her pituitary if required.

She also has a mild lymphocytocis for which I have repeated her blood count and vit d levels were sub optimal

[Anniewoz1]

Can someone advise how to add another photo please!

[Marymary7 in reply to Anniewoz1]

You have to write a separate post if you want to add a second photo. You could amend your post by hand typing the other results in your writing? You seem to have all the main things here but it could be you need to add more as you have a complex looking post.

To edit and add words you go to the word 'more' at the bottom of the post and click.

[jimh111]

It's OK and sensible to check other pituitary hormones (prolactin and FSH) before doing an MRI for possible secondary hypothyroidism. This is unlikely, usually the TSH would be much lower. Your endo should have checked fT3 also as both fT3 and fT4 supress TSH. Since you were previously hyperthyroid it is more likely that this period of hyperthyroidism down-regulated your hypothalmic pituitary thyroid axis. You could look at previous fT4 / TSH results to see if they are consistent with this. Other causes could be depression, severe dieting or disruption from endocrine disrupting chemicals (too difficult to confirm). In any event if your pituitary checks out OK (or if it doesn't) you will need your thyroid hormone titrated according to signs and symptoms rather than TSH. You will most likely need some liothyronine as TSH stimulates T4 to T3 conversion in tissues such as the brain. Bringing fT3 levels back to normal with levothyroxine is unlikely to be successful as T3 in brain and other tissues will be deficient. Thus, you may need higher fT3 levels, towards or just above the fT3 upper reference limit.

[Gambit62]

Anniewoz! - please note that your surname is visible in the above photo - actions for today - pts 8 and 9 - you may want to replace the photo and also remove the name from the details of the text.

[Anniewoz1 in reply to Gambit62]

Thank you