Question about MRI

[Ozzieandharriett]

Hi, I have secondary Adrenal Insufficiency, last 5 years, and my endo ordered a Pituitary MRI to look for a tumor. I also have been suffering from vertigo recently recently and saw an ENT without any relief from the Epley maneuver. I received a copy of the MRI and am not sure if it is normal or not? I don't have another appointment with my endo until June. She is from a large teaching hospital in Philadelphia and booked 6 months ahead of time and I missed my appointment due to snow.Any comments or suggestions would be greatly appreciated.   THANKS SO MUCH!!!

MRI BRAIN W/ AND W/O CONTRAST
FINDINGS:

Findings:



There is slight asymmetry of the pituitary fossa and pituitary gland,
being greater in vertical height on the left side, but the
infundibulum deviated towards that side. Though there is a suggestion
of slightly decreased contrast enhancement in the lateral most aspect
of the left side of the pituitary fossa, I do not see a discrete mass
to definitively suggest a pituitary microadenoma.

Impression: No definite abnormality, asymmetric sella..  

[rumpled]

If you have other issues, and it is well managed, then a nice low dose of HC is ok, but if you have ongoing chronic issues, then you may need a slightly higher to moderately higher daily dose to compensate. The issue is that while too little is horrible, too much on the other hand, can turn around and bite you in the rear too. It can make your muscles weak and your bones weak too.

I would see your endo or get on a wait list for a neuro-endo.

DHEA is a funny thing. It is a precursor hormone so it converts to T or E. So you may be quickly converting. I take 25mg and in the beginning I converted all to T (this was not making me, a female, happy at all). It took a while to get my T, E and then my DHEA to balance out. So low levels need replacement, but it is 1/3 the issue if you get my drift... I would not give up but play around with doses and more importantly, make sure you take it at night.

We must live in the same region - we have snow predicted too. UGH.

[Ozzieandharriett]

Thanks,
I am going to call her. She only has me on 15mg of hydrocortisone and I am exhausted. I also am in chronic pain and need meds for 3 past spinal surgeries, stenosis, herniated discs, SI Joint dysfunction. This doesn't help with the exhaustion. I haven't seen the endo  in over 6 months.
The endo thought my adrenal insufficiency was caused from spinal injections,  but, my cortisol levels never improved. I had a Metyrapone test a year ago and went into crisis. Luckily I was in the hospital. I failed miserably  and had to stress dose for a week to get my cortisol back up. I really think this must be related to my adrenal insufficiency. I also have low DHEA.  I tried to supplement but it never went up, so I gave up.

I hope this is the end of your snow. We have it predicted for St Pat's day! We have an Airedale pup with cabin fever. He is a wild man!

[rumpled]

Oh - DANG snow.

[rumpled]

If the doc *just* reads the impression, it sounds like it is all hunky dory, but I bet you if you sent that off to a specialist, he would find a tumor.

Something has to be pushing the stalk off to the side. If the MRI was not dynamic (does not sound like it per the report) then tinier lesions don't show up as well so the radiologist sort of sees something but prefers to err on the side of caution, that being there is nothing. Beats me.

MRIs have a 3mm slice so you can have a 3-4mm thing sitting between the slices.

If your doctor is smart, the testing will continue.