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Old 01-22-2009, 01:57 PM   #1
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If the pituitary itself is suspect, what are the tests for this?

I'm not sure I know of any studies that look at the pituitary, except maybe TSH. How does one do any kind of diagnostic studies on the pituitary?

 
Old 01-22-2009, 02:17 PM   #2
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Re: If the pituitary itself is suspect, what are the tests for this?

My pituitary is sluggish and my dr. had me get an MRI to see if there were any tumors on it. It didn't show any, but I've read some can be so small they aren't picked up. So not sure what else they can do after that. I know mine is probably causing most of my thyroid problems since it's not working properly.

 
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Old 01-22-2009, 08:46 PM   #3
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Re: If the pituitary itself is suspect, what are the tests for this?

Quote:
Originally Posted by sparkie View Post
I'm not sure I know of any studies that look at the pituitary, except maybe TSH. How does one do any kind of diagnostic studies on the pituitary?
Sparkie,
this is my experience.
My random cortisol fasting a.m. (early) came back 3.3. The doctor dismissed that. (geeze). On to next doc. He saw that result. He did an ACTH stim test.. That tests show whether it is coming from the pituitary or not.
If the ACTH is low and cortisol low, then it is coming from the pituitary. ACTH is a hormone in the pituitary gland that tells the adrenals to work. One thing you don't want to do is to start any kind of HC before you get any of these tests.. including tests for cortisol such as saliva. The hydrocortisone will mess up the test. I did it backwards, and was only off HC for two days when the doctor did the test. Yes, if you have a problem getting your TSH up with meds and it's not happening, then that would be a good indicator. Another doctor missed that one too for me.
I did get sent for a MRI as well. But they can't see hormones on an MRI, only through the blood. THEY say that the ACTH stim test is the final say.

There are other hormones that come from the pituitary such as growth hormone, prolactin, etc, but when it comes basically to the adrenals, the stim test will tell...
Mamie

Last edited by moderator2; 01-23-2009 at 06:12 AM. Reason: posted disallowed website(s)

 
Old 01-23-2009, 12:10 AM   #4
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Re: If the pituitary itself is suspect, what are the tests for this?

With me, my pituatary gland came back abnormal from a test my Endo did on me, so he set me up for an MRI, and there were no tumors....yet if they're tiny, than they wouldn't beable to see them(great...)...anyways, my adrenal/cortisol is always high, and so is my T4...yet my TSH is normal all the time.

 
Old 01-23-2009, 06:13 AM   #5
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Re: If the pituitary itself is suspect, what are the tests for this?

Ohhhh! Good question.

First you have two ways to investigate the pituitary gland, physical structure and hormonal output. Physically the pituitary gland can be looked at with an MRI of the brain. This will show all but the smallest micro-tumor if cancer was an issue. Hormonally you are looking at a mixed and varied bag. For such a small gland the pituitary has its fingers in MANY pies: TSH - thyroid stimulating hormone, FSH - Follicle Stimulating Hormone, LH - Luteinizing Hormone, PRL - Prolactin, GH - Growth Hormone, ACTH - Adrenocorticotropic Hormone, alpha-MSH - alpha Melanocyte Stimulating Hormone, Vasopressin, and Oxytocin.

The most widely felt imbalances are when the TSH and ACTH are off. However when FSH production climbs above and beyond the 2:1 FSH:LH ratio you are looking a polycystic ovarian syndrome... in Women. Prolactin is another common one that can become imbalanced and cause a woman to have discharge from the breast. GH and MSH can also be a factor, but they are not normally threatening in am imbalanced system. Vasopressin is important because it our natural anti-diuretic. Too much and you retain water like a sponge, too little and you have a condition commonly known as diabetes insipidous(sp) I believe. Oxytocin this has a main role in females stimulating uterine contractions and milk release. However it has a side benefit as well working on the nucleus accumbens and amygdala in the brain to promote mental attachment and trust. Too low and anxiety and paranoia may become an issue.

So how does one check on pituitary health?

Standard practice is...
In females: TSH, FSH, LH, Prolactin, GH, ACTH levels can be checked via fasting blood tests with Cortisol and Ft3/Ft4 as a cross check of the TSH and ACTH levels. Males: TSH, GH, and ACTH are often checked. An MRI should be performed if any of these levels are elevated.

MG
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Old 01-23-2009, 07:34 AM   #6
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Re: If the pituitary itself is suspect, what are the tests for this?

Fascinating stuff MKG, thanks so much. I thought I had ACTH done three years ago but apparently not, it was a 24-hour urine to check adrenal function. We'll see what the new MD will test. Here is another curve to throw at you, let's see what you come up with. I have lived in Houston for going on 24 years. I think the vast majority of the population here suffers from allergies, I never have. However, when I had the same situation three years ago as I have now, I had outdoor allergy symptoms. When I walked the dog, I could just feel stuff going into my sinuses making me sneeze. It was fleeting, only a few days, and back to being one of the non-allergy sufferers in this humid terrarium we call Houston. They started again yesterday with the sneezing. Definitely not an outright cold, but I can tell I am reacting to something in the air again. I am actually pretty amazed that I am going through the same course as I did three years ago. Hyper symptoms, 5 days later a bad sore throat, 2 days later allergy symptoms, weight loss. All in all though, this time things don't seem as extreme, well, except for the trip to the ER with tachycardia, elevated BP, and palpitations, but this time, thank goodness, I am getting through it better with Lopressor. I don't have the brain fog like last time and am not walking in circles either.

 
Old 01-23-2009, 07:46 AM   #7
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Re: If the pituitary itself is suspect, what are the tests for this?

Sparkie,

Increased allergies and development of allergy symptoms are a known symptom/side effect of Hashimoto's. If you have one autoimmune response it often triggers or stimulates others. Allergies are just one of many autoimmune responses.

MG
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Old 01-23-2009, 09:00 AM   #8
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Re: If the pituitary itself is suspect, what are the tests for this?

Interesting....

I noticed my asthma has become much worse over the past 3 years, and I have Hashimoto's. I went from exercise-induced asthma only, to needing an inhaled steroid everyday... now I wonder if my thyroid is playing a role there.

As for pituitary stuff, how often does empty sella cause pituitary hormone problems? I was told my pituitary is slightly squashed, due to a partially empty sella. They did a MRI (no tumors spotted) and did some hormone testing, and was told it was all normal. But LH (and something else which I forget, FSH?) I recall being on the low end of normal. Would a lowish LH mean anything? I don't recall all the rest of my tests, or if LH in males actually is important or not.

 
Old 01-23-2009, 09:51 AM   #9
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Re: If the pituitary itself is suspect, what are the tests for this?

FSH and LH are more female dominant hormones and mainly associated with female fertility... but they impact male fertility as well. For everyone's benefit:

In sexually-mature (post puberty) females, FSH acts on the follicle to stimulate it to release estrogens. So it is the estrogen TSH if you want a thyroid perspectie on its function.

LH in sexually-mature females, results in promotion and stimulation of ovulation and it stimulates follicle post ovulation to develop into the corpus luteum, which secretes progesterone. This process is cyclic, estrogen and progesterone ebb and flow monthly for women of child bearing years.

So how do these pituitary hormones effect a male?
FSH in males acts on spermatogonia to stimulate the production of sperm. Testosterone plays a role in this as well.

LH in males acts on the interstitial cells of the.. I will keep it scientific... testes, stimulating them to synthesize and secrete testosterone. LH in males is also known as interstitial cell stimulating hormone (ICSH).

So men with low LH and FSH may have fertility issues due to lack of proper sperm stimulation and production.

MG
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Last edited by mkgbrook; 01-23-2009 at 09:52 AM.

 
Old 01-24-2009, 01:08 PM   #10
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Re: If the pituitary itself is suspect, what are the tests for this?

Quote:
Originally Posted by mkgbrook View Post
Ohhhh! Good question.

First you have two ways to investigate the pituitary gland, physical structure and hormonal output. Physically the pituitary gland can be looked at with an MRI of the brain. This will show all but the smallest micro-tumor if cancer was an issue. Hormonally you are looking at a mixed and varied bag. For such a small gland the pituitary has its fingers in MANY pies: TSH - thyroid stimulating hormone, FSH - Follicle Stimulating Hormone, LH - Luteinizing Hormone, PRL - Prolactin, GH - Growth Hormone, ACTH - Adrenocorticotropic Hormone, alpha-MSH - alpha Melanocyte Stimulating Hormone, Vasopressin, and Oxytocin.

The most widely felt imbalances are when the TSH and ACTH are off. However when FSH production climbs above and beyond the 2:1 FSH:LH ratio you are looking a polycystic ovarian syndrome... in Women. Prolactin is another common one that can become imbalanced and cause a woman to have discharge from the breast. GH and MSH can also be a factor, but they are not normally threatening in am imbalanced system. Vasopressin is important because it our natural anti-diuretic. Too much and you retain water like a sponge, too little and you have a condition commonly known as diabetes insipidous(sp) I believe. Oxytocin this has a main role in females stimulating uterine contractions and milk release. However it has a side benefit as well working on the nucleus accumbens and amygdala in the brain to promote mental attachment and trust. Too low and anxiety and paranoia may become an issue.

So how does one check on pituitary health?

Standard practice is...
In females: TSH, FSH, LH, Prolactin, GH, ACTH levels can be checked via fasting blood tests with Cortisol and Ft3/Ft4 as a cross check of the TSH and ACTH levels. Males: TSH, GH, and ACTH are often checked. An MRI should be performed if any of these levels are elevated.

MG
MG,
My results from two different labs

First lab Sodium 148 (135-145)
Potassuim 5.9 )3.5-5.2)

second lab
sodium 140 (135-146)
potassium 4.3(3.5-5.3)


Now he also decided to do a ACTH and cortisol test one me. He said it did not matter if I was on HC or not because it leaves your system so quick.
So I did it. But did not take HC that morning.
ACTH 8, previously it was <5
morning cortisol 7.5
FSH 55.3 (32.0-116.3) I'm post menopausal He told me my ovaries were toast. That was nice. True but........
LH 18.1 (5.0-52.3)
aldosterone 7 (< or = to 28)
renin 3.6

TSH 0.09
Free T4 1.7 (0.8-1.8) drawn on 8 days of 125 Levoxyl.
Free T3 324 (320-420)

Now which lab to believe about my sodium and potassium, I don't know.
ONCE AGAIN, HE says like the other doctor that I don't have secondary AI. HE told me to stop taking the HC.
Say my aldo and renin are just fine.
I pee all the time. Since he does not believe I have this disease, no florinef for me. If I need it I don't know.
that drop from 137 to 125 mostly took me out of hyper. But I am still so uneasy inside that I can't focus on anything.. Maybe I am not taking enough HC. I don't know.. What are your thoughts?
And when he gave me my lab slip, he marked TSH only.. OMG.. He believes he can get that up.
I may have to travel.. But I don't know where.....
I'm going to go out of my mind.. He also told me he does not believe in Adrenal fatigue. I have to call and make some excuse to get him to write a script for Levoxyl because he only gave me samples. Because it just might take that long to find a new doc..

thanks,
Mamie

 
Old 01-24-2009, 01:54 PM   #11
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Leo8 HB User
Re: If the pituitary itself is suspect, what are the tests for this?

Interesting, my endo really did think there was something wrong with my Pituatary gland as these were my results...

T4: (always high)
Adrenal/Cortisol: (always High)
Prolactin: Abnormal
Testosterone: Abnormal
Pituatary Gland: Abnormal
Glucose: Abnormal

But regarding my results from the Pituatary Gland, Glucose, Testosterone and Prolactin, they then came back 'normal' the next time.

Anyways, i myself had an MRI and i really thaught it would of showed something wrong, but nope, they said my pituatary gland was normal...Although like you mentioned above there is a slight chance they could be Micro Tumors....but the question is, what test is there that can show that they are Micro Tumors, if they are?

Besides that, i recently had an Iodine uptake and Scan, and the Stationary Proble/knee device showed that my levels were high, and the scan showed that my Right side of my Thyroid is larger than the left....my GP doesn't know if that's normal or not, but he said my levels being high certainly is abnormal As to why i'm seeing my endo based on these 2 new results in 2 weeks....

Hopefully i can get an answer, and i'm not gonna pass up the fact that i could possibly have micro tumors, as it is possible, if rare....but maybe i might have a mild goiter which is causing all of this, as my right side of my thyroid is larger. Anyways, The main reason why the doctors are scratching their heads is because my TSH always comes back normal from the blood tests.

Last edited by Leo8; 01-24-2009 at 01:58 PM.

 
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