Past & present test results...can someone help me figure these out?

[Blue727]

To start off, I am a 31 year old male.  Here are my past MRI results and my recent bloodwork.  I have seen over 50 doctors, been to the Mayo Clinic and placed on over 100 different medications since 2003.  I have so many prior posts with all my tests, symptoms, diagnosis's and treatments that I am not going to bore everyone and list them all again, but if anyone is interested they can look at my previous posts.

MRI of the head with and without contrast taken on February 25, 2010;

Indication: Pituitary Adenoma

Comparison: [ ]

Findings: The pituitary is normal is size, however the neurohypophysis is situated to the right of midline. On the postcontrast scans there is a lesser degree of enhancement of the pituitary on the left this measures about 4 mm. The pituitary stalk appears normal and is in midline position. Cavernous sinus appears normal.

The lateral, third and fourth ventricles are normal size and position. The cerebral sulci and cerebellar folia appear norma. There are no foci of abnormal intracranial signal intensity. There are no masses or extra-axial fluid collections. The craniocervical junction appears normal without cerebellar tonsillar ectopia. No restricted diffusion. Normal flow void through both internal carotid arteries and basilar artery. Normal intracranial enhancement. Dural sinuses appear patent. The paranasal sinuses are clear. There is no abnormal signal intensity within the mastoid air cells.

Impression:
4mm suspected pituitary adenoma. It would be helpful to compare this examination to the prior MRI. Otherwise negative MRI of the head.

------ Well I did have a previous MRI with and without contrast from the Mayo Clinic in Rochester, Minnesota. It was taken on September 3, 2008, but it wasn't available to the new MD.

MRI of the head with and without contrast taken on September 3, 2008;

MRI of the head without and with contrast with special attention to the sella. An approximate 4 mm zone of lower T1 signal both before and after contrast within the right pituitary gland. There is some asymmetry of the pituitary gland; however, this appears predominantly due to irregularity of the floor of the sella. This focus of signal change could well be artifactual, however, an adenoma cannot be totally excluded. There are a few tiny foci of increased T2 signal in the white matter of both cerebral hemispheres, which are non-specific for areas of degeneration, ischemia, or demyelination. No evidence of abnormal contrast enhancement.
On September 13th, 2010, I had the following tests done (listed with results and ranges);

Test: My Result:           Reference Range:

IGF - I Electrochemiluminescence 286 64 - 334 ng/mL
IGF - I,  ECL

Prolactin 23.3 NG/ML Male: 2.0 - 18.0

T4, Free 1.0 0.8 - 1.8 NG/DL

FSH and LH
FSH 1.5 MIU/ML

-----FSH Reference Ranges-----
                                 (MIU/ML)
Male: 1.6 - 8.0
----------------------------------

LH 2.4 MIU/ML

    -----Luteinizing Hormone-----
                                 (MIU/ML)
         Male (18 - 69yrs): 1.5 - 9.3
   -------------------------------

Testosterone, Total 524 250 - 1100 ng/dL

Testosterone, Free 82.5 35.0 - 155.0 pg/mL

Testosterone, % Free 1.57 1.5 - 2.2 %

Cortisol, A.M. 18.3 4 - 22 MCG/DL

TSH 2.74 0.50 - 5.00 uIU/mL


I was told by the Mayo that they were 100% positive that this was not causing any of my symptoms. I did not even know what a pituitary microadenoma was until I was done with the Mayo Clinic, but after coming home and reading about it, I realized that it covered so many of the symptoms and problems I had been talking about over the last 5 years. I broke my nose in a wrestling match (which required surgery) and have had horrible problems ever since with everything from anxiety, depression to shaking like a bobblehead doll in the cold.  I have been on well over 20 different medications for anxiety/depression and nothing helps.  Medications do not seem to affect me like they do other people.  I have possible hematomochrosis (way too much iron in my blood), which I read is a huge factor in having either hyperthyroidism or hypothyroidism (I can't remember which one).  However; I cannot get a doctor to even say I have a thyroid problem.  One of the first tests I thought they would do would be a thyroid scan, but I have never had that.  My family has a long history of thyroid problems...Grave's Disease, Thyroid Nodules, etc...

Can you please tell me any thoughts you might have on what I could be dealing with and possibly how to deal with it?  Thanks for taking the time.

[enzymelover]

Did you get both a sagittal and a coronal view of your pituitary, with both MRI's? I can't help but think their is something there, hiding behind the gland, that they can't see.
How can they call a "suspected adenoma" a negative MRI?

I feel for you. You are in a tough spot. The irregularity of the sella floor may be due to your wrestling injury. I suppose it's possible that the misplacement of your pituitary off the midline could be affecting hypothalamus signaling to the gland. Unfortunately, this is something that can't be seen on an MRI.

[lbedford]

I found an article on the NEW TSH test:

New Range for TSH to Diagnose Hypothyroidism
The basic problem that traditional medicine has with diagnosing hypothyroidism is the so-called "normal range" of TSH is far too high: Many patients with TSH's of greater than 2.0 (not 4.5) have classic symptoms and signs of hypothyroidism (see below).

• So, if your TSH is above 2.0 there is a strong chance your thyroid gland is not working properly.

[rumpled]

I was told the same thing, by the same place. If you look around, they are not listed as a pituitary place of excellence - probably because they overlook the obvious.

I would take your MRI and your tests and go elsewhere - and get treated for a prolactinoma or something else. They only ran TSH so it is impossible to comment on your thyroid. TSH is a thyroid test (BTW, they are using an outdated range - it should be .3 to 3.0).

Please go somewhere else.

[testdeprived]

hey blue good to hear fro myou!! you remember me? man, i can relate to you as usual. it looks lie you have gotten nowhere as well. we;ve bot hbeen posting her for quite some time!!

isnt it funny how both of us have all the symptoms of a pituitary adenoma, and then they find one??? unlike you, i went in for the mri with a self diagnosis of a pituitary adenoma!! and guess what they found one!!! idk where yo uare located, but  iam going to see a neuro endo once my new 3t mris results come back. idk who gave you your msot recent blood work but maybe a neuro endo would be good. was this altest mri a 3t with dynamic contrast?
i didnt have them compare my new mri because  i figured it would lead to bias o ntheir parts. jsut do each seperately and then compare the reports.

i possibly have too much iron in my blood as well..it varies. docs dont know why hematocrit and hemoglobin are high, nor do they seem to care.

your tsh is right in the mid range, so that looks ok. keep pushing for the free t3, free t4, reverse t3/t4 gotta get that really.