I am a 47 years old male and my endo claims that my pituitary gland has shrunk and therefore the hormone it secretes reduces though she can't offer any explanation as to why this happen.
I was diagnosed as having low in FT4 and am in the 1st week of medication on Levo starting at 12.5mcg/day. I don't feel any improvement as yet.
The one that that i notice is this above pattern when I will feel extreme tiredness at first then follow by hunger. The funny thing is when I feel hungry I am not as tired as before, this pattern repeat throughout the day
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gedebe
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She's not playing safe at all because a too low starter dose could make you worse, rather than better. At your age, she should have started you on 50 mcg. And, if she doesn't even know that, then I doubt she knows enough to ever make you well. Can you see someone else?
When the pituitary shrinks it may result in pituitary hormone deficiencies. Thyroid Stimulating Hormone (TSH) is a pituitary hormone that encourages secretion of thyroid hormones. If you have been diagnosed with Central Hypothroidism you should have been started on a 25mcg or 50mcg dose of Levothyroxine.
Blood sugar issues are common in people with low thyroid hormone . If you post thyroid hormone and any other pituitary hormone test results complete with ranges (numbers in brackets) members will comment.
I assume you've had an MRI that has shown that your pituitary has shrunk? The pituitary gland secretes lots of different hormones so have you've had a full pituitary panel (bloods) done? Sadly not all Endo's are conversant with pituitary/adrenal issues so it's important to see one that is.
I wonder how your doctor knows your pituitary has shrunk?
Did you have an MRI scan 20 years ago that could be used for comparison with a current one? Have you had a recent MRI scan showing a small pituitary?
Do you have a history of having full thyroid panels tested over a period of years showing lower and lower levels of TSH and/or lower and lower levels of Free T4 and Free T3?
Your pituitary may be small now, but it may always have been small. Do you have a history of poor health and low stamina throughout life?
I'm guessing here that your TSH is low, and that as a result you have had your blood tested for Free T4 and Free T3, and they have come out as low too. If this is the case then you have a condition called Central Hypothyroidism. "Ordinary" hypothyroidism, is referred to as Primary Hypothyroidism, and although the treatment for Central and Primary Hypothyroidism is the same (replacement of the missing thyroid hormones), the testing to monitor your condition and your treatment will be slightly different from the ordinary type of hypothyroidism.
Knowing exactly what was tested is essential if you are going to be able to get adequate testing in future and adequate and correct treatment for whichever condition you have.
I think doctors try to keep their explanations of suspected conditions as simple as possible, but sometimes they dumb down their explanations so much the end result is meaningless and unhelpful.
My TSH is normal but FT4 is low, that prompted my endo to check on my pituitary gland using mri. Combining low FT4 with a small observed pituitary gland, my endo conclude that the reduction of FT4 is due to a shrunk gland, i guess.
Yep...I have days where I have energy and am not hungry but more days of fatigue with constant hunger...I thought it was my subconscious trying to find energy in food but the hunger is very physical....would love to know why and how to manage it...weight gain has become a problem now..
Hypothyroidism affects our ability to make glycogen, the body's way to store sugar for use as energy later on, making us very dependent on eating plenty of carbs for energy, so we need to eat because we can't rely on our body to store energy. This also leads to diabetes and problems producing insulin as we constantly spike our blood sugar by eating to get energy, and eventually fatiguing our body's ability to produce insulin. Vicious cycle. For some people diabetes has been reversed by correcting the lack of thyroid hormones.
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Feeling tired, (thyroid, testosterone)
Feeling constantly tired and no energy 
FED UP FEELING TIRED.
Feeling down and tired all the time
So tired I feel sick !!!!
