# Pituitary related hypothyroidism/central hypothyroidism - anyone here?



## LMSchune (May 30, 2013)

I'm on a mass binge of online research, which I'm sure my DO would loooove to hear (extreme sarcasm present).

But I'm avidly trying to figure out why I have low/borderline abnormal levels of FT4, FT3 (especially) and low TSH that many traditional endocrinologists/doctors would say shows I am hyper instead of hypo. I read a long time ago about central hypothyroidism, where it is caused by a malfunctioning pituitary instead of the actual thyroid, so lab results will show low TSH and low free Ts.

If I understand correctly, putting it shortly the pituitary gland does not produce the needed amount of TSH to stimulate the T4 production, for multiple reasons, one of which being head trauma that can cause pituitary damage or a pituitary tumor. This strikes me as interesting because I've ridden horses my whole life and have had multiple bad falls resulting in head trauma and many concussions, more than the average for a 24yo woman.

This makes logical sense, at least to me. However, I am not confident about bringing this up to the DO tomorrow when he talks to me about my recent lab work. I have a feeling if I even mention MRI of my head he'll throw me out of his office for being a PITA.

But do any members here have pituitary related hypothyroidism?

http://www.pituitarydisorder.net/central_hypothyroidism.html


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## ChrisP (Oct 29, 2013)

LMSchune said:


> I'm on a mass binge of online research, which I'm sure my DO would loooove to hear (extreme sarcasm present).
> 
> But I'm avidly trying to figure out why I have low/borderline abnormal levels of FT4, FT3 (especially) and low TSH that many traditional endocrinologists/doctors would say shows I am hyper instead of hypo. I read a long time ago about central hypothyroidism, where it is caused by a malfunctioning pituitary instead of the actual thyroid, so lab results will show low TSH and low free Ts.
> 
> ...


Interesting...

It does make sense, though! But I find it weird how your pituitary only is abnormally affecting your TSH. Your anterior and posterior pituitary control tons of more hormones that regulate the body. Are you experiencing abnormal menstrual cycles or more than usual cramps? If so it could surely be your pituitary. FSH is also another hormone that could be affected by a damaged pituitary, also hormones such as LH and HgH.

I would bring it up to your GP, they might think your crazy and maybe being a PITA, but hey; it's your health after all. The only way I knew I had thyroid issues was by BEING a PITA. :tongue0013:


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## LMSchune (May 30, 2013)

ChrisP said:


> Interesting...
> 
> It does make sense, though! But I find it weird how your pituitary only is abnormally affecting your TSH. Your anterior and posterior pituitary control tons of more hormones that regulate the body. Are you experiencing abnormal menstrual cycles or more than usual cramps? If so it could surely be your pituitary. FSH is also another hormone that could be affected by a damaged pituitary, also hormones such as LH and HgH.
> 
> I would bring it up to your GP, they might think your crazy and maybe being a PITA, but hey; it's your health after all. The only way I knew I had thyroid issues was by BEING a PITA. :tongue0013:


As far as menses, yes. Ever since all this started they have been very odd - heavy flow, varying in duration, and not regular; sometimes I have 17 days in between, then 25, then 14...

The only other hormone testing I have had is estradiol and progesterone in May of this year. Not had FSH, LH, or HgH.


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## Pamzilla13 (Sep 9, 2013)

Your situation sounds like mine with the low TSH, low free T3 and low free T4. I have not found an answer. I have been having radical periods for approx. 4years and over that time have become more unable to cope cope with stress and function. I was diagnosed in July of this year and I am currently on Armour and I have to say I do feel better, but not GREAT. In fact, it has been a roller coaster for me. I am not up to my therapeutic dose yet, and hope that I will feel much better by then. My doctor said this was common for women approaching menopause. I am 43 yrs old though. I am on bioidenticals and have been since my mid 30s. For some reason the doctor does not believe it is pituitary because other hormones like LH and FSH would be off...but they are not.

Please post any progress or answers you get from your doc. I am very curious and have not encountered many people with this situation. I have searched the web too and everything points to pituitary...

Hope you feel better soon.


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## Ginav (Jun 7, 2013)

Are you able to find a rheumatologist in your area? I'm told they work with immune systems which involves the female hormones as well. I also saw there are now females who are called metabolism specialists who work with female hormones. I looked for myself and there not that many of them but they are out there. Just a thought!


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## LMSchune (May 30, 2013)

Ginav said:


> Are you able to find a rheumatologist in your area? I'm told they work with immune systems which involves the female hormones as well. I also saw there are now females who are called metabolism specialists who work with female hormones. I looked for myself and there not that many of them but they are out there. Just a thought!


There are one or two rheumatologists in my insurance network, so I am keeping them on the short list. Right now I am starting Vit D and Vit B2 supplementation because I am extremely deficient, but I am certainly pursuing this further.

I have a thyroid support meeting tomorrow and a new member is seeing a chiropractic group for her Hashimoto's treatment, and I will be talking to her about that, as well as a doctor I found in Greenville who is on a thyroid patient recommended list. I can also get LH and FSH testing done through DirectLabs for fairly cheap, so it's likely I will get those done just to see if anything flags out.


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## gammagirl (Nov 18, 2013)

I have the same issue and it is so frustrating that no one I turn to can give me answers. I have taken Synthroid, nature thyroid and now Tirosint. My TSH is suppressed ( last one was 0.06) but my FT3 and FT4 are very hypo. the levels keep getting lower and lower. They are was below the range. I did have all my hormones tested but the only abnormal test was the sex hormone binding globulin which was high and the free androgen which was low. My new endocrinologist said that the FT3 and FT4 might not really be low, they might just be coming out that way because of this binding globulin. I honestly didn't follow what she said. She was just very concerned at how suppressed my TSH is . She said that there is some type of blood spinning test that will give us an accurate read on the FT4, FT3 but i don't remember the name. SHe is supposed to send me the lab slip for that and I will get retested in 4 weeks. I honestly don't know what this could be. It just doesn't make sense


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## LMSchune (May 30, 2013)

gammagirl said:


> I have the same issue and it is so frustrating that no one I turn to can give me answers. I have taken Synthroid, nature thyroid and now Tirosint. My TSH is suppressed ( last one was 0.06) but my FT3 and FT4 are very hypo. the levels keep getting lower and lower. They are was below the range. I did have all my hormones tested but the only abnormal test was the sex hormone binding globulin which was high and the free androgen which was low. My new endocrinologist said that the FT3 and FT4 might not really be low, they might just be coming out that way because of this binding globulin. I honestly didn't follow what she said. She was just very concerned at how suppressed my TSH is . She said that there is some type of blood spinning test that will give us an accurate read on the FT4, FT3 but i don't remember the name. SHe is supposed to send me the lab slip for that and I will get retested in 4 weeks. I honestly don't know what this could be. It just doesn't make sense


It is very frustrating, no doubt. I have found a ray of hope, however, and not to jinx myself, I had an amazing appointment Friday with the doctor's office I mentioned in the previous post.

The PA, who I saw, is a thyroid patient's dream. When I say she got it, I mean she GOT IT - everything about thyroid complications and issues that we talk about here on the forum. We are testing my adrenals, pituitary hormones, checking my thyroid levels once more before we change meds, and I am getting an MRI of the pituitary to rule it out conclusively.

ETA: No MRI. Insurance can suck it.


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## Ginav (Jun 7, 2013)

Have you had any migraines? I did and that was the only way insurance would pay for MRI of the brain. I thought I had something going on with pituitary.


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## gammagirl (Nov 18, 2013)

so I found out that the name of the test that would give me an accurate measure of my FT3 and FT4 is FT4 by dialysis and FT3 by dialysis. The Dr suspects that my Ft4 and FT3 are inaccurately being reported because I might have a hormone binding disorder due to my high sex hormone binding globulin. She wants me to stop taking Cytomel and get tested in 6 weeks. She switched me over to Tirosint which gives me more energy throughout the day but is causing me heartburn and pressure around my chest.


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## LMSchune (May 30, 2013)

Ginav said:


> Have you had any migraines? I did and that was the only way insurance would pay for MRI of the brain. I thought I had something going on with pituitary.


I've battled severe headaches/migraines from a young adult into my twenties. As of late, they have been very infrequent although I do tend to get achy pre-period.

What concerns me is that in that same young adult-twenties period, I've had 'episodes' that were originally written off as vasovagal syncope - doctors that I saw didn't seem too concerned. What I have always found abnormal about these episodes is that 2x I have actually lost my vision entirely for a few minutes. I've NEVER lost consciousness, but my vision would go entirely - either the world would be completely black (first episode) or completely white (last episode in 2010).


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## Ginav (Jun 7, 2013)

I have always been prone to headaches since my 20's also and when I started to go through the thyroid storm this year they increased in severity and frequency. I knew I had Graves but wasn't sure if that was why I had the headaches. I continued to get them after I was on anti thyroid meds. They thought that I needed physical therapy because I was having neck pain as well. It helped somewhat but I was still having to take the meds to avoid. Since my surgery on 11/1 I have had two headaches it was 3-4 in a week. So I believe it has to do with thyroid disease. It sounds as though you may have or had ocular or retinal migraines, where you lose your vision. I never lost my vision but I do have TED and wondered if it could be due to that. I recently saw an Opthamologist who said I am a candidate for what I believe he called critical glaucoma because of pressure behind the lens of my eye so I have to go see another specialist for that. There is a laser procedure they do to reduce that pressure. Have you gone to an Opthamologist? It's amazing what they can find out through our eyes and of course he is very aware of thryoid disease which isn't easy to find. Gina


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## LMSchune (May 30, 2013)

My father has glaucoma and I had some physical signs they were watching closely, but no ophthalmologist seemed concerned when I mentioned those losses of vision to them.


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