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Just brainstorming...advice please...
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Just brainstorming...advice please...

Okay, I've posted before with no response.  Hopefully, somebody will answer this one.  I've just been diagnosed with thyroid problems, a slightly elevated TSH level of 3.31.  In August, it was 3.76.  I just started 50mg of Synthroid.  I had a brain MRI recently for other reasons, but the report says this...."small areas of low-signal pituitary gland and I feel this is likely all volume averaging IF there are no clinical findings for pituitary microdenoma.  Also, on my most recent blood work, before the synthroid, my T3 was 32.2 (32.0-48.4) (I'm thinking it's on the low side??) and T4 8.06, which seems right in the middle.  So, my question is this, what now?  I have noticed my thyroid gland in my neck is swollen and can't tell if it's since I started the synthroid, which I have been taking only 2 wks.  I'm not seeing a specialist, just my gyno.  I had been to a nuerologist who was checking me out for other things and found this in through the blood work.  So, should I go to a specialist?  Should I even worry about any of this?  The findings of the pituatary gland concern me.  But, maybe I'm just being a hypochondriac?  I just don't feel right and still don't feel good.  Would the synthroid make me tired?  I'm really really tired, STILL.  And seem to be more depressed.

ANy ideas, suggestions or advice would be greatly appreciated!
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Hi there...I would definately ask for a referral to an endocrinologist who will understand your MRI reading better than a gyno as they specialize in the endocrine glands. It kind of sounds like your gyno started you off on a high dosage for your TSH level, I am surprised you weren't started on 25 instead. An endo will also understand your T3 levels better too because if you are low in T3 you might need to be supplemented with the T3 as well as some T4 meds. Good luck.
I am so sorry your  post got missed .. WELCOME TO THE THYROID COMMUNITY !!!

I would agree with above poster.  See an Endocrinologist along with an ENT as well as your OB/GYN as starters if you have that appt in place.

Believe it or not (and not to frighten you) but a goiter can increase dramatically in size even when on synthroi and uncommonly, but can, get huge!  My friend had a benign nodule treated with synthroid and it grew to the size of a melon!  She had a Total Thyroidectomy and it was totally benign but grew huge in a matter of weeks after starting Synthroid.

So I think better safe than sorry and let the specialists in the thyroid area assess it as you couple it with your other healthcare areas, too .. see if they all can communicate it with one another .. tough to do but can happen if you push them all to talk to ea. other.

Please keep us posted and thanks for stopping by!

Cheryl - co cl thyroid
I agree about seeing an endo.

Starting at 25 mcg would have been more reasonable with your TSH level.

Make sure to get FREE t3 and FREE t4 next time. They are more accurate than just T3/4.
Hi.  Like the above responder said, starting you at .50mcg's is a little high.  The lowest dose is .25mcg's and it's the recommended starting dose.  Your body needs 4-6 weeks to adjust to each dose before moving up. About the pituitary gland, if there was a tumor, then it would be removed surgically and hormone replacement would be added to replace any hormones that were lacking. Since there is no tumor, the only treatment I know of is to supplement any gland that is off with hormone replacement.  There are 6 hormones controlled by the anterior pituitary gland.  These are:

Human Growth Hormone(HGH)
Thryoid Stimulating Hormone (TSH)
Adrenocorticotropic Hormone(ACTH)
Follicle Stimulating Hormone (FSH)
Luteinizing Hormone (LH)
Prolactin (PRL)

If your pituitary gland is unable to send the right messages, it would be a good idea to have your doctor (or preferably an endocrinologist), check these other glands. One more thing, sometimes low thyroid people also have low sex glands. (I am low thyroid and have low testosterone).
Hope I could help,
I think you have gotten a lot of good advice.

Personally, I would go to ONE of your doctors and ask for a Free T4, a Free T3, and a TSH soon, and look at cutting your Synthroid back.

If you can get in to see an Endo soon, that's great, but a lot of times they are booking two months out.    

It's not normal to run thyroid tests two weeks after starting thyroid meds, but in your case it might not hurt.
On her  CT report ...

What is this:  pituitary microdenoma ???

Anybody know ?  My nodules were on the thryoid and called adenomas .. overgrowth of thyroid tissue = not cancer.

micro means small .. so would it be:

---->  a non-cancerous small overgrowth on the pituitary gland?

And, I agree 50mcgs may be alot to start off with for you .. I'd ask about cutting back and/or getting labs tests earlier than usual.

My tsh on 75mcgs is 1.8 .... on 88 it is 1.3 and on 100 it is 0.667 ... I get anxiety anything below the 1.8 reading.

Thanks for your comments.  I appreciate all of the advice.  I am going to look up an see what kind of dr.  I can find around here and then try and get an apt.

I think the microadenoma is small growths on the pituatary gland.  But I think the MRI radiologist wasn't sure if it was that or just 'volume averaging''??  It was confusing.  I'm just confused.

Oh well.

Thanks for your support and advice.

Most pituitary masses/tumors are benign (non cancerous and do not spread). I've read that what actually happens is a growth/mass/tumor whatever you will call it, grows closely to the pituitary gland (which is very small).  It then presses on the pituitary gland, so the gland cannot properly function. This causes the glands that are controlled by the pituitary to underproduce hormones.  Micro means small, while macro means large.
Did you know that this website also has an Ask a Doctor Forum.  Mark Lupo, M.D. answers a limited number of Thyroid related questions each day.  Here is the link:

I don't know much, but for what it's worth, I've read that TSH is an accurate measure of thyroid function, with one exception, i.e. when there is a pituitary malfunction.  The pituitary is messing up the thyroid hormones, not the thyroid.  So maybe, just maybe,  your doctor is addressing the wrong gland with medication.

I was curious so I googled pituitary microdenoma.  Here's what I learned....
A pituitary microadenoma is a benign tumor less than 10mm in size.  Here's the website I went to (it had lots on information on this subject)...

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