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Hypothyroidism or pituitary problem?
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Hypothyroidism or pituitary problem?

Hello,
My TSH is 7.5, has been around 2.5 for years, went to 6.5 last year, back down to 4.5 last April, now up to 7.5.  FT4 is in the normal range (1.0). I have no symptoms at all of hypothyroidism or hyperthyroidism except perhaps with slightly high cholesterol (195). I am hardly ever tired, very high energy and weigh 155, 6ft tall, exercise 3 hours a week. I am a 43 year old male, my 43 year old brother had a pituitary tumor removed at 37. My mother died of cancer at 51, my aunt of brain tumor at 5. Any thoughts?
My doctor wants me to take a prescription to lower the TSH.
Thank you
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1382849_tn?1337552730
Dear JDP67
I would definitely obtain a MRI dedicated to the pituitary gland in order to rule out primary hyperthyrodism caused by pituitary tumor. I would also double check thyroid function with t3 measurement to make sure it is not a secondary hypothyroidism.
5 Comments
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Avatar_m_tn
Thank you .  Why do doctors seem reluctant to test FT3 and FT4?
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Avatar_m_tn
I just had a blood test taken to determine if there is a high presence of prolactin which, according to the doctor, would perhaps warrant an MRI.  Is the level of prolactin an accurate indicator? I have a "comprehensive" blood test done every 6 months but I am surprised that we have to request all these extra readings in order to get them.  Why don't they just test everything on a blood test, not just one or two things? Thank you
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Avatar_m_tn
Hello Dr. Prevedello
Prolactin came back OK. I still am reluctant to take 25mg synthroid since I have no symptoms of any kind. My FT4 is 1.4. What do you think?
Thank you,
JDP67
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1382849_tn?1337552730
Prolactin can be normal in patients with pituitary adenomas. It sometimes increases, but not necessarily.
Like I said, I would like to see all the thyroid markers first. If total T4, free t4 and t3 are normal, then there is no need for replacement in a asymptomatic patient in my opinion.
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