Microadenoma or not?

37 yo female 5'9" 160lbs
Hx Graves Disease 2000 - 2006 treated w/ PTU & synthroid
2002 - 2 miscarriages
2003 - Prolactin 47 - MRI 3mm x 4mm diffuse area of decreased enhancement on left posterior in the anterior aspect of pituitary = microadenoma. Dostinex 2 months - pregnant.
2005 - TSH low (PTU/synthroid); Prolactin normal; GH slightly increased 6.3; IGF-1 normal; MRI - no evidence microadenoma
2008 normal TSH; Prolactin 4
2009 - 20lbs weight gain from 2006 post baby to present
          Aug '09 Increased TSH start 25mcg Synthroid
          Ear fluid/2 double ear infections/ear pain - internal and cartilage Sept '09 to present
          Sept '09 wedding rings too tight to wear w/o fear of having cut off
          December '09 start Chlorthalidone 12.5mg/day for hypertension
          January '10 increase Chlorthalidone to 25mg/day for hypertension
          January '10 MRI - question of 6mm x 3mm diffuse area of decreased enhancement on left posterior pituitary - not visible on coronal images - certainly not definitive diagnosis
           January '10 - Prolactin 22 (normal)

Long story short - I'm wondering what to do with the recent MRI that says question of microadenoma and not a definitive diagnosis. My NP who ordered the test wasn't concerned and indicated that if it's there its so small and not growing much - perhaps we could repeat MRI in a year. I'd rather not have to wait a year for an answer if there's a chance the microadenoma could cause my recent problems with hypertension; weight gain; rings not fitting; ear pain, etc?

How do I go about getting a more definitive diagnosis? If microadenoma is there and hormone levels are normal do we need to continue to monitor? Do I need a specialist?

Thank you.

[Nassim Abi Chahine, MD]

what about the latest GH levels?

[gravesagain]

Oops - I think it said "posterior in the inferior aspect of pituitary"