thyroid prob. caused by pituitary microadenoma?

[tornadochaser]

I'm going for a repeat TSH today because my previous test was a little off.  The Dr. said it could have been a fluke and says it's his policy to repeat tests prior to prescribing treatment.  Okay, I respect that approach.  However, I explained to him that my thyroid has always been barely in the normal range, but he still wants to repeat.  I told him about my microadenoma (small tumor on the pituitary gland that causes hyperprolactinemia or in other words, I lactate ALL the time.)  He ordered an MRI and thankfully, the tumor is the same size.  However, he did not want to treat the hyperprolactinemia with Parlodel or Dostinex (rx'd by my OB/GYN during pregnancy or else I wouldn't have been able to sustain my 3 pregnancies and have my 3 beautiful children. My OB/GYN is now retired).  So here's my question:  Can the pituitary microadenoma cause hypothyroid problems?  I have EVERY thyroid symptom in the book, but as I said, my TSH keeps coming back barely normal.  I exercise daily on the treadmill for 30 minutes going 3.5 mph and on an incline, eat less than 1200 calories a day and STILL can't lose weight!  I am 5'7" and 167 pounds-the heaviest I've ever been.  I only weighed 140 pounds when I got pregnant with my 1st child, lost the weight down to 150, lost it again after baby #2 down to 150lbs and now after baby #3 (he's 16 months) I'm struggling at 167lbs!  I've lost 2 pounds in the past six weeks in spite of my desperate attempts.  Keep in mind, I also chase my 3 little tornadoes all day, so I am by no means a couch potato--I don't even like TV!  I am tired all the time, even though I get 7-9 hours sleep at night.  Please help!  I want to feel great again, not tired and depressed.  My children deserve to have me the best that I can be.

[GravesLady]

If you don't get any answers here its because we don't know. If you haven't already, you might go to the doctor forum and ask Dr. Lupo at http://www.medhelp.org/forums/show/120 or
at left of page almost top, under "Thyroid Disorders" in red click on "thyroid" it will take you to the forum.




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[Super_sally888]

Hi,

If your pituitary adenoma is causing a thyroid problem it won't show up with testing just TSH.  This is becuase in case of pituitary related thyroid problems TSH is normally low, but the thyroid hormones are also low (this is becuase the pituitary is not releasing enough TSH to stimulate normal thryoid hormone production).  To detect this they should also test FT3 and FT4 which are the active thryoid hormones.

Please ask your doctor to order a full thryoid panel, which will include FT3 and FT4.

In some cases thyroid symptoms can precede abnormalities in the blood test levels.  So if your doctor is open minded he may be willing to consider low dose thyroid replacment hormones (with monitoring) to see if it makes a difference to your symptoms.

If he won't maybe you need to see if you could get a second opinion.    Have you been seen by an endocrinologist?

Hope you can get some answers.

Sally

[Super_sally888]

What do you mean barely in range?  What are the actual numbers?
TSH for a woman should ideally be 1 - 2.  If it is higher than 3, treatment is likely warranted.

[GravesLady]

Hyperprolactinemia can be the result of a variety of reasons, but rarely is there more than 1 reason in a single person. May present symptoms due to hormonal imbalance or mass effects.  
Pituitary Microadenoma such as tiredness or restlessness, to more serious symptoms, such as headaches, vomiting, or dizziness
Cause of  pituitary macroadenomas is unknown.

There are several types of pituitary microadenomas, Thyroid hormone-producing tumors is just one, classified based on whether they produce hormones or not. A pituitary microadenoma that makes one or more of the pituitary hormones is called a functioning pituitary microadenoma. A pituitary microadenoma that does not make hormones is called a nonfunctioning pituitary microadenoma. Each type of functioning pituitary microadenoma causes different symptoms, depending on the type of hormone that is being produced.

Thyroid hormone-producing tumors may be large and may spread. They sometimes also make growth hormone and/or prolactin.
Thyrotroph adenomas secrete thyroid-stimulating hormone (TSH), also known as thyrotropin, which results in hyperthyroidism without TSH suppression. These adenomas usually warrant surgery, and tumor removal is often followed by radiation



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