Pituitary gland

[nved]

Is my pituitary gland looking normal? I had an MRI of my brain and it was normal but i didn't look specifically for the pituitary.

[nved]

Yes my TSH and FT4 are back to normal after cessation of a medicine. I will test all the pituitary hormones and their target hormones to see if there is something, otherwise no need for pituitary MRI, thanks for your responses!

[rumpled]

If you had symptoms, I would say to pursue further. If you find you have strange symptoms later, then I would try to get a dynamic MRI next time.

Some times spots can be artifacts (errors on the MRI) or just weirdness in anatomy - as well I am not a doctor. But nothing you are saying or in your tests really makes pituitary a likely issue at this time.

[nved]

A neuroradiologist saw the mri and he told me the dark spot i was concerned is a partial voluming by the carotid and not a pituitary adenoma, he said like you mentionted, only a dynamic mri would show if there is a microadenoma because clearly i dont have macroadenoma

[rumpled]

Your TSH is low, but not indicative of central - aka pituitary - hypothyroidism. I have it and my TSH is .000x.

In general, those with pituitary issues tend to have a lot of symptoms that are not resolved by medications, like high blood pressure or acne (as examples) or strange growth, weight changes (again, examples). It can vary so widely the symptoms go on for pages. Some have a few, some have many. It is not related to the size of the lesion.

The pituitary MRI is called a dynamic MRI which also covers the brain but is a technique where the contrast is given during the MRI so the uptake is recorded so smaller lesions have a better chance to show up.

If you are only seeing a neurologist, the doctor simply will not know how to evaluate a possible pituitary issue. Your testing is not comprehensive enough to cover a possible pituitary issue. Not every lesion is hormone secreting - it can also be something like a rathke's cyst or non-functioning tumor. It may need monitoring to see how it all shakes out. If you are concerned, it is best to get to a pituitary center.

[nved]

I went for the MRI by myself and i didnt know there is a specific MRI for the pituitary so a had a brain MRI instead!

[nved]

To add to this, in the brain MRI slices i noticed a hypointense region after gadolinium administration in my pituitary about 5mm but the height of the gland is normal and the report of the radiologist was clear except my inflamed maxillary sinus.

[nved]

I had low FT4 with normal TSH back in August and again in December, now it has normalized, and i suspect an antidepressant medication i was taking was the problem because when i quit it went back to normal.

[rumpled]

Do you have a specific reason that you suspect you have a pituitary disorder?

[nved]

Yes male and also have Ulcerative Colitis

[rumpled]

The TSH is abnormal now - the new range is .3 to 3.0 (put in place years ago, but somehow the labs don't have it!).

Per the ranges, the other tests are normal. I am assuming you are male per your profile.

[nved]

Had another blood test done and the results are:
TSH 3.22 (0.4-5.0)
FT4 1.2 (0.8-2.0)

Also tested gonadotropins
LH 4.8 (1.2-9.4)
FSH 5.0 (1.0-13.1)

[nved]

The height of the pituitary in sagital images is within normal range i think, it is about 6-6.5mm i dont know if that says anything

[rumpled]

I have had pituitary surgery. It happened after the surgery. But before the surgery with my tumor, my TSH would have super wide swings and it was near impossible to regulate my thyroid. Compounding that, I had thyroid nodules on both sides, surgery 20 years apart to remove half for different nodules and enlargement, Hashimoto's, and was hypothyroid anyway. So yes, I was and am being treated.

My doc likes FT4 (and FT3) on the upper ends of the range and I always felt better when my TSH was lower. As far as pituitary goes though, my best guess is that your thyroid is not indicative of a thyroid issue.

[nved]

My tsh was 2.6 and ft4 0.7 in August and now it was 2.5 and ft4 0.9

[nved]

No i have an appointment with an endocrinologist later in that month. I guess i will have more blood work to see what causes it. How did you find out that you had central hypothyroidism?

[rumpled]

I know people who have had pituitary MRIs and had them read as normal, and later found out they were not... so I tend to take that with a grain of salt.

TSH is a pituitary test so if it is normal (and the lab is using the new ranges) then that can be indicative that things are ok. For instance, I have central hypothyroidism and my TSH is .0004 or .0007 - or .000 something.

Are you being treated for the thyroid?

[nved]

I asked a neurosurgeon and he said if it was something in my pituitary gland it would have been mentionted in the report. My symptom is low-normal T4 and normal TSH

[nved]

It was a HEAD/BRAIN MRI, and it didnt mention anything about my pituitary gland, and everything was clear.

[rumpled]

This is a patient forum and we cannot/should not comment on MRIs.

If you had a report, I might give my layman read on it (aka best guess), but that would be about it. Did you get a copy of the report? Do you have pituitary type symptoms?