Plump pituitary

[Kelbelle237]

I had an MRI woth contrast and it showed a plump pituitary. Can that cause tension headaches in the middle of my forehead,  I have to turn my head slowly or the pain gets sharp, then i vomit...I get so dehdryated I even vomit after drinking water or nasea liquids, I throw up meds too. I end up in the er where they give me nausea pills that dissolve, THEY ARE GREAT!  I am so weak and out of it, they have to give me iv fluids and steriod similiar to prednizone that gives me a boost of enegry Also, my eys are so sensitive i wear sunglasses in my dark bedroom with a towel over the sunglasse??? i need help from yall. everyonr rlse is stumped and all my test come bqck negqtive. i can post all test results if you need them

[rumpled]

Oh - they gave up on the arms! I had a friend with bad veins and they ended up using her foot...  talk about stress!

Ah the EMG... not a favorite test... something akin to torture.

Let us know results!

[Kelbelle237]

Yes, they were doing an acth stimulation test, but the nurse had a problem getting enough blood or a good vein. Three nurses tried to find veins and they all struck my nerve, so I had two arms hurting. Also, if they would have finished the test, the results wouldnt be correct due to stress and such. I haven't been back yet, just had EMG?? the one where they poked muscles with needles. I hope this pain goes away. My endo said I cant take test yet because I am on steroid pack for my hands

[rumpled]

Great that you are at a pituitary center!

Were there other pituitary tests run - you have results for a CMP - which can be nice for ancillary information, but the main show would be the hormones.

If you run a cortisol, usually one runs an ACTH with it - and it is a fussy test to get correctly. For low cortisol, your sodium and potassium appear to be ok - in fact, usually sodium tends to be low when cortisol is low so that is nice for you hopefully it will help you stay out of trouble. Did the doctor run any other adrenal hormones like renin, aldosterone or DHEA sulfate?

Usually the symptoms of a crisis like you had occur when sodium drops and potassium spikes (but in some people, like me, potassium can also drop - so I would get a copy of your tests from the hospital). Did the doctor advise you on an emergency *kit*, medic alert bracelet and the like, as well as what to do in case of illness and stress dosing so you can keep yourself healthy?

[Kelbelle237]

I am seeing an endo at Baylor Pituitary clinic. She ran some test yesterday at 8 am and we already got the results. She said she would of liked to see my cortisol around 11-14 or so. She is putting me on hydrcortisone, I am posting labs and mri


Component Your Value Standard Range Units
GLUCOSE 88 65 - 100 MG/DL
BLOOD UREA NITROGEN 7 8 - 25 MG/DL
CREATININE 0.7 0.6 - 1.3 MG/DL
EGFR AA 115 >60 ML/MIN/1.73
EGFR 95 >60 ML/MIN/1.73
SODIUM 146 133 - 146 MEQ/L
POTASSIUM 5.0 3.5 - 5.3 MEQ/L
CHLORIDE 108 97 - 110 MEQ/L
CO2 30 18 - 30 MEQ/L
CALCIUM 9.4 8.5 - 10.5 MG/DL


Component Your Value Standard Range Units
CORTISOL TOTAL 7 2 - 25 UG/DL


Narrative

EXAMINATION: MRI of the Sella with and without contrast.


HISTORY: Mild hypogonadotropism
COMPARISON: None
TECHNIQUE: Thin section images of the sella consisting of coronal dynamic
T1, sagittal and coronal T1 pre/post contrast, coronal T2. Whole brain
DWI/ADC.
Intravenous contrast: Omniscan 11 cc

FINDINGS:
The size of the pituitary gland is somewhat full for the age of the
patient, but there is no asymmetry or focal abnormal signal intensity or
enhancement within the gland. The gland does not extend significantly into
the suprasellar cistern.

The stalk is in the midline. The posterior pituitary bright spot is in the
normal location. No abnormality of the cavernous sinuses, optic chiasm, or
imaged portions of the brain is seen.

A developmental venous anomaly is noted incidentally in the right frontal
lobe.


IMPRESSION:
Fullness of the pituitary gland suggesting hypoplasia versus normal
variation. Otherwise unremarkable.
Component Results

There is no component information for this result.
General Information

[rumpled]

If the pituitary MRI was not correctly (as in a dynamic MRI) or the radiologist is not associated with a pituitary center or is not used to reading pituitary MRIs, you may want to get to a pituitary center so that you can get a proper evaluation of your films and tests.

Pituitary lesions can certainly cause headaches and migraines - it is a very common complaint (and poorer doctors will say it is not related, but they are).

The vomiting can be related - absent seeing tests - it is hard to say - but that sounds like if I was guessing that you have secondary Addison's since corticosteroids are what bring you out of it. They need to give you replacements on a regular basis and tell you to up your sodium in your diet to compensate for what your body cannot do....

I would go to a pituitary center - I then doubt your tests will come back negative. Pituitary testing is not easy - lab error and patient error can be a factor in the testing and if the doctor does not do the testing at the proper time of day (ie 8am fasting) then the tests are not valid anyway. Tests have to be chilled, spun, kept cold etc and it can be complex to be accurate results.

Please find a neuro-endo at a pituitary center - find a large university center or large hospital center with a pituitary center. Always get copies of you tests and scans.