Possible pituitary issue?

[stacey555]

My tsh is always pretty low .62-.67 however my t4 is low and my t3 is low.  So my question is if my t4 is not elevated enough to supress my tsh wouldnt that indicate pituitary-adrenal feedback issues.  I have had awful symptoms noone can explain even my endo because everything falls within normal range.  Weightloss of 40 lbs withiut doing anything different in a matter oa 2-3 months no sleep during this time, areniline rushes and very frequent urination.  Then 40 lb weight gain rapidly within 2-3 months opposite symptoms breathing problems.  I take care of myself and eat right.

[Mark Lupo, M.D.]

If the TSH is low-normal and T4 and T3 are truly low then you need an endocrine evaluation for a possible pituitary problem. Would request a consult.

[stacey555]

I have an appt at University of Michigan in October I think I have a pituitary problem but it is hard to say that to a doctor when they cant figure it out.
Thanks for your input.

[kitty9309]

What are your t3/4 levels?
Are low flagged low or just low in range?

[stacey555]

I do not have the numbers in front of me but my t3 is always flaged low and t4 is normal range low.

[stacey555]

I also have elevated acth for about 5 years now. Outside the normal range.

[kitty9309]

Have you had cortisol or an ACTH Stimulation Test done?
A high ACTH can be seen in Cushing's or Addison's, but a cortisol test would point better to which one.

Are those free t3/4 or total?

[stacey555]

I did have a suppression test done years ago and that came back ok but my acth is much higher now.  I did a 24 hour saliva earlier this year examining my cortisol.  It was high outside the normal range at 8 am normal at 12 below normal at 4 and higher than normal at midnight so it bounces all around.  If they do a 24 hour urine it comess back normal of course because it isnt measuring my extreme highs and lows.  I realizw this is not a normal case that is why I am going to uofm hospital.

[kitty9309]

Now that is getting complicated! Something is out of whack, as you suspect.
You are right about the 24 hour urine.
I hope the new doctors can figure it out for you.
Good luck.

[stacey555]

Hey I have a question for you since you work Ina lab.  Have  you ever had someone test positive for tapeworm?  If so how did yhey traet it?

[laura1967]

It sure sounds like a pituitary problem....google cyclical cushings, cushings syndrome, and addisons. Have you had a recent AM Coritisol blood test? The 24 hr urine cortisol test is becoming obsolete from what i have been reading, because of too many false negative results. The dexamethasone test will show cushings. The cyclical cushings will cause your cortisol levels to fluctuate all over.
Does your doctor have you on a T3 med? I would ask to be put on Cytomel asap to help with hypo symptoms. Just a thought.

[kitty9309]

Hi. Yes, we see this often in the lab.

niclosamide (Niclocide) and praziquantel (Biltricide) are used.

[stacey555]

thanks laura cyclical cushings, now why couldnt my doctors think of this that sounds exactly right especially because I had all addison symptoms less than a year ago.  Thank you I am going to U of M so hopefully they can regulate it somehow.

[stacey555]

My lab recommende alinia do you know if that works?

[kitty9309]

Alinia is not the first drug of choice.

praziquantel (Biltricide) is.

You may ask the doctor why he chose that med.