Hashimoto's thyroiditis + slightly enlarged pituitary

[wwilliams]

I am a 42 yr old female, diagnosed with Hashimoto's 17 years ago, not currently on thyroid meds, used to be on synthroid but haven't been for about ten years.  Symptoms:  serious all over bone, joint and muscle aches, galactorrhea (4 months), amenorrhea (6 months), daily headaches (1+year), trouble swallowing (2 months)plus hoarse voice, frequent sinus infections, hot flashes, sleeplessness, carpal tunnel syndrome, 20 lbs overweight.  I am very active and fit.  Nurse practitioner said my thyroid was slightly enlraged but didn't want to treat because tests normal.  Thyroid panel normal (didn't do antibody test or free t3 though), thyroid scan normal except for one side uptaking more than other side.  Prolactin normal (I am 100% not pregnant).  MRI showed pituitary slightly enlarged at 12.5 mm but no tumor.  I go to a free clinic and they don't want to send me to an endo.  I'm tired of feeling terrible all the time.  Any suggestions?  I'm thinking of trying otc desiccated thyroid and licorice, but concerned I should do something for pituitary or adrenals too.  I already use progesterone cream. Should I make the effort to see an endo doctor or treat myself and see what happens?  

[Mark Lupo, M.D.]

No on the licorice -- can increase blood pressure in certain individuals.

The OTC thyroid products are poorly regulated -- would not do this either.

If you have hashimoto's and the TSH is >3 (which may be 'normal' to many docs) - if may be worth a prescription for thyroid hormone (not OTC).

The enlarged pituitary may need more investigation, but it's good there was no tumor.  Sometimes the enlargement is from hypothyroidism (but usually the labs are very abnormal in these cases).  Rarely, the immune system can cause inflammation in the pituitary as well -- but the important part here is to test other pituitary hormones such as IGF-1 and ACTH/cortisol.