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  • What type of imaging for pituitary gland/hypothalamus?

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    Old 05-14-2013, 11:00 PM   #1
    swingerofbirch
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    What type of imaging for pituitary gland/hypothalamus?

    Hi, I am 30/M. I had a number of issues that led me to ask my doctor to test my testosterone level. The first time it was tested the level was about 100. The second time a few months later it was a little over 200. It somehow doubled, and I don't know how or why.

    In between those two testing, I saw an endocrinologist. She was very young and seemed uncomfortable discussing the subject. She tested the two hormones people always talk about that come from the pituitary gland, and both of them were low. She said that this likely meant something was wrong with the pituitary gland and she was going to put me on testosterone. I wanted them to double check that nothing was wrong with my testicles as when I was 15 I had a cyst on my testicle diagnosed by ultrasound. I knew that I still had that cyst, and it felt like many more had developed. They did the ultrasound and found several small cysts in the epididymis, but they didn't seem to think I should do anything about them.

    I got the prescription for testosterone. At the time I was 29, and I thought I would have to be on it for life, and I read about how it would decrease my own natural testosterone, shrink the testicles, etc. And it still didn't seem like they could tell me what was causing the problem.

    So, I asked about an MRI for the pituitary gland. I had previously had an MRI when my doctor though I might have symptoms of MS. My PCP said that that MRI would be enough to look at the pituitary gland.

    The problem with that MRI is that I have Tourette's and panic disorder. When i was in the MRI machine having to stay still made my anxiety sky-high and I ended up not being able to stay very still. It was pretty awful. In fact the first time, I had to give up, and I had to convince the insurance to give me a second chance.

    It was only a 1 tesla MRI without contrast and according to the radiologist's notes, there was motion blur. But when my PCP asked the radiologist to look a the MRI, the radiologist said the pituitary gland didn't appear to have a tumor, but that again there was motion blur.

    My doctor doesn't want to prescribe another MRI, even though I've found a place nearby that does 3 T MRIs so that hopefully it would be a faster exam.

    I guess my question is: Does that sound reasonable to do? My doctor thinks my insurance will refuse it, but I'm pretty good at haggling with them. I'm also curious if there is a different type of MRI that is done for the pituitary gland/hypothalamus or if all brain MRIs check everything that can be checked?

    Also, has anyone had any experience with Clomid instead of testosterone? I've looked into that as an alternative to lifelong testosterone, but my doctor thinks it causes mood issues and wouldn't be good for me. But I'm not sure how up-to-date he is on this.

    Thank you!

     
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    Old 05-15-2013, 05:23 AM   #2
    ladybud
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    Re: What type of imaging for pituitary gland/hypothalamus?

    The MRI is the best test to look for a pituitary adenoma, a small benighn tumor of pituitary that can crowd out the cells producing FSH and LH which stimulaye testosterone production. The other option would be to measure the other pituitary hormones and see if one is high, like prolactin, indicating a probable adenoma. Small adenomas can be treated medically, and if prolactin is high, suppressing it may improve your testosterone production. I have not heard of using Clomid in males, but that's not to say it would be out of question. I would just ask for sedation if MRI is done. And try to find an open MRI that can do the brain. Nothing special needed for pituitary.

    Last edited by ladybud; 05-15-2013 at 05:25 AM. Reason: added

     
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    Old 02-24-2014, 01:18 AM   #3
    xPEARR
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    Re: What type of imaging for pituitary gland/hypothalamus?

    MRI is the best imaging technique to detect any abnormality.

    why not ask for sedation? As for me, I slept throughout my MRI scan as I feel restricted and I have half day school, so i literally went in and just black out on my own. I am not sedated.

     
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    Old 02-24-2014, 01:23 AM   #4
    xPEARR
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    Re: What type of imaging for pituitary gland/hypothalamus?

    MRI is the best imaging technique to detect any abnormality.

    why not ask for sedation? As for me, I slept throughout my MRI scan as I feel restricted and I have half day school, so i literally went in and just black out on my own. I am not sedated.

     
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