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Suggest Tests To Determine Pituitary And Adrenal Gland Dysfunctions
Question: Hi what blood test do i need to determine pitruitry and adrenal gland dysfunctions? Diagnosed head injury 10 years ago now have deviated pitruitry stalk.
Symptoms include tiredness, lack of stress/anxiety response, numbness on head esp front, partial seizures most days until 1.5 ago(not on anti seizure medication just less medication) , hypotensive episodes last one about year ago , lack of thought processes/poor cognition and memory
Symptoms include tiredness, lack of stress/anxiety response, numbness on head esp front, partial seizures most days until 1.5 ago(not on anti seizure medication just less medication) , hypotensive episodes last one about year ago , lack of thought processes/poor cognition and memory
Brief Answer:
Need detailed hormonal profile
Detailed Answer:
Hi! Welcome to health care magic! Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all, it is sad to know what you had gone through.
Based on the history you have shared, it seems that pituitary dysfunction leading to hormonal imbalance as well as direct affects of trauma to loss of brain tissue or presence of scar tissue to be directly responsible for these symptoms.
As far as pituitary functioning is assessed, it can be done on detailed hormonal profile like ACTH, FSH, LH, TRH, Cortisol levels, prolactin levels and other hormone suppression tests may also be needed. A detailed evaluation by an endocrinologist should also be done before onset.
Wishing you a speedy recovery. If you have any more questions, feel free to ask. Regards.
Need detailed hormonal profile
Detailed Answer:
Hi! Welcome to health care magic! Thanks for sharing your concerns with us. We will try to help you in best way possible. First of all, it is sad to know what you had gone through.
Based on the history you have shared, it seems that pituitary dysfunction leading to hormonal imbalance as well as direct affects of trauma to loss of brain tissue or presence of scar tissue to be directly responsible for these symptoms.
As far as pituitary functioning is assessed, it can be done on detailed hormonal profile like ACTH, FSH, LH, TRH, Cortisol levels, prolactin levels and other hormone suppression tests may also be needed. A detailed evaluation by an endocrinologist should also be done before onset.
Wishing you a speedy recovery. If you have any more questions, feel free to ask. Regards.
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi many thanks for your response. What other hormone supression tests do you recommend?
Is this conclusion you have come to taking the mri report into account? What is my prognosis do you think, what are the risks with this deviation/tbi ? What physical tests scans do you recommend? Can the pitruitry problem be operated on? In your opinion do you think the low bp/oxygen and seizures could have worsened the original injury? Many thanks for your time regards
Is this conclusion you have come to taking the mri report into account? What is my prognosis do you think, what are the risks with this deviation/tbi ? What physical tests scans do you recommend? Can the pitruitry problem be operated on? In your opinion do you think the low bp/oxygen and seizures could have worsened the original injury? Many thanks for your time regards
Brief Answer:
Needs to be discussed with endocrinologist after reports
Detailed Answer:
Hi! Thanks for such a detailed feedback. Other hormone suppression tests are planned once first reports come and any abnormality is detected. These may include dexamethasone suppression test, short synactin tests and others but these should be planned after discussing with preliminary reports with an endocrinologist in person. Yes, MRI reports are taken into account and let me clarify pituitary is known as master gland and it controls all other glands, so it has affect on almost all the vital systems of the body directly or indirectly so risks is indeed considered high. Though if pituitary tumor, is suspected then surgical optional like transphenoidal and others are considered by neurosurgeons. Physical tests include detailed systemic examination and all relevant systems are examined by endocrinologist and that is the real purpose of visit in person as examination may help further narrow down the diagnosis. And yes low oxygen supply or blood flow can accelerate the damage but for that it has to be very low to be falling in limmits of shock and for that indoor management is needed and that doesn't seem to be problem in your case. Regards.
Needs to be discussed with endocrinologist after reports
Detailed Answer:
Hi! Thanks for such a detailed feedback. Other hormone suppression tests are planned once first reports come and any abnormality is detected. These may include dexamethasone suppression test, short synactin tests and others but these should be planned after discussing with preliminary reports with an endocrinologist in person. Yes, MRI reports are taken into account and let me clarify pituitary is known as master gland and it controls all other glands, so it has affect on almost all the vital systems of the body directly or indirectly so risks is indeed considered high. Though if pituitary tumor, is suspected then surgical optional like transphenoidal and others are considered by neurosurgeons. Physical tests include detailed systemic examination and all relevant systems are examined by endocrinologist and that is the real purpose of visit in person as examination may help further narrow down the diagnosis. And yes low oxygen supply or blood flow can accelerate the damage but for that it has to be very low to be falling in limmits of shock and for that indoor management is needed and that doesn't seem to be problem in your case. Regards.
Above answer was peer-reviewed by :
Dr. Prasad
Hi thanks for that. Is there anything besides the deviated stalk in my MRI report that concerns you? Apparently no tumour was found in the pitruitry scan although post car accident it was enlarged, which perhaps could have been due to trauma/concussion? In latest scan the pitruitry gland size was normal but the stalk was deviated. Could the enlargment have caused this?
Regarding bp it went dangerously low 64/40 last time it happened but i didnt pass out strangely or go into CArdiac arrest. I just felt very very unwell but the nurses drs on ward didnt give me anything fluids etc to try raise it and was low for a while then started to go up . Its been that low 4 times at least in last few years but think may have been caused by medication but i know its made injury lot worse just by how i am now cognitively to before. Ive arranged to have blood tests these ones :
* Full Blood Count. (Haematology profile) including over 10 parameters & ESR
* Electrolytes
* Kidney health information
* A Full liver function test
* Calcium
* Uric acid
* Glucose level
* A full lipid panel including Total Cholesterol, HDL, LDL and triglycerides.
* Iron status panel - Iron, TIBC and transferrin saturation
* Basic thyroid profile - TSH and FT4
ALSO the PLUS V tests...
Vitamin B12
Vitamin D (25OH)
C Reactive Protein
Folate
Ferritin
Are there any others you think are essential besides all thyroid, cortisol and prolactin
Also at the time when they did the mri of pitruitry i had a prolactin of 3000, what does that indicate to you? Then it went back to normal over time (i think anyway!)
Regarding bp it went dangerously low 64/40 last time it happened but i didnt pass out strangely or go into CArdiac arrest. I just felt very very unwell but the nurses drs on ward didnt give me anything fluids etc to try raise it and was low for a while then started to go up . Its been that low 4 times at least in last few years but think may have been caused by medication but i know its made injury lot worse just by how i am now cognitively to before. Ive arranged to have blood tests these ones :
* Full Blood Count. (Haematology profile) including over 10 parameters & ESR
* Electrolytes
* Kidney health information
* A Full liver function test
* Calcium
* Uric acid
* Glucose level
* A full lipid panel including Total Cholesterol, HDL, LDL and triglycerides.
* Iron status panel - Iron, TIBC and transferrin saturation
* Basic thyroid profile - TSH and FT4
ALSO the PLUS V tests...
Vitamin B12
Vitamin D (25OH)
C Reactive Protein
Folate
Ferritin
Are there any others you think are essential besides all thyroid, cortisol and prolactin
Also at the time when they did the mri of pitruitry i had a prolactin of 3000, what does that indicate to you? Then it went back to normal over time (i think anyway!)
Brief Answer:
This rise can be physiological, & you need detailed endocrinologist review
Detailed Answer:
Hi! Thanks for such a detailed feedback. If MRI failed to present any tumor that is a good sign though trauma could have been cause of the deviated stalk in your case. But detailed hormonal profile once the recently ordered routine labs arrive, can guide further towards any signs of small adenoma in pituitary. The ischemia or low BP could have triggered that as you said it, but such prolong ischemia due to low BP or shock could have other manifestations too like focal neurological deficit etc. Isolated pituitary problem is less likely and even if it had been it might have caused under production of pituitary hormones instead of over production. The levels of prolcatin that you have mentioned here can even be raised normally in stress ot trauma and various other physiological conditions. If it had been persistantly raised above 5000 than it would have supported diagnosis of pituitary adenoma or prolactinoma. As for this moment, I would suggest you to wait for those labs to arrive and also get an endocrinologist review to guide you further in this regard after careful examination. Regards.
This rise can be physiological, & you need detailed endocrinologist review
Detailed Answer:
Hi! Thanks for such a detailed feedback. If MRI failed to present any tumor that is a good sign though trauma could have been cause of the deviated stalk in your case. But detailed hormonal profile once the recently ordered routine labs arrive, can guide further towards any signs of small adenoma in pituitary. The ischemia or low BP could have triggered that as you said it, but such prolong ischemia due to low BP or shock could have other manifestations too like focal neurological deficit etc. Isolated pituitary problem is less likely and even if it had been it might have caused under production of pituitary hormones instead of over production. The levels of prolcatin that you have mentioned here can even be raised normally in stress ot trauma and various other physiological conditions. If it had been persistantly raised above 5000 than it would have supported diagnosis of pituitary adenoma or prolactinoma. As for this moment, I would suggest you to wait for those labs to arrive and also get an endocrinologist review to guide you further in this regard after careful examination. Regards.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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