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Thyroid Diseases

Possible Pituitary Problem

01/15/2010

Question:

I`ve been having lots of problems for awhile now. The symptoms match what you would have if you had hypothyroidism or adrenal insufficiencies.

No doctor seems to know what`s wrong with me. I`ve had lots of blood work done. My TSH is normal and my thyroid hormones are very low in range. I also have a low cortisol result. I`m wondering if there could be a pituitary problem.

TSH 2.19 (0.40-4.20) Free T4 1.0 (0.8-2.7) Free T3 2.9 (2.1-4.4)

Cortisol 6.5 (6.0-25.0)

ACTH Stim Test Results (performed 1 1/2 weeks after first cortisol test) Cortisol, baseline 6.6 Cortisol, 30 min 20.4 Cortisol, 60 min 23.8

My doctor says everything`s fine. But I definitely don`t feel fine. And from what I`ve read, a low cortisol level that raises significantly during a stim test can indicate a pituitary problem.

Answer:

Most symptoms related to hormonal disorders are nonspecific; meaning that they overlap with symptoms caused by lots of other non-hormonal disorders. What you have provided here as the results of your hormonal evaluation are all within normal range, however, based on other clinical information not communicated here, further testing may or may not be warranted. I would suggest reviewing your problems with an endocrinologist face to face. 

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Response by:

Marzieh  Salehi, MD Marzieh Salehi, MD
Assistant Professor of Endocrinology
College of Medicine
University of Cincinnati