Secondary adrenal insufficienc

Hormones
1

Hi

So , my labs tell me I have really low cortisol

And it matches up with hypopituitarism etccc...

My doctors havent quite clued in yet

I was basically arguing with my endo saying

I think I have a pituitary tumor

I've learned that they don't believe you

Anyways,

Thanks for listening

2

Did you take the pill before taking the tune test Dexamethosone or something like that? If so it suppose to lower. But if you did not take pill they need find out if you have Addison disease? Keep on them.

3

thanks Kim

no pill, I've never taken the pill, I've heard too many stories about how it causes certain things

like cancer (possibly)

yes well see

thanks

4

Pituitary tumours are very rare. Even adrenal tumours are rare. Your GP (PCP) will see a very few cases of adrenal tumour in the course of a career and typically no more than one case of pituitary disease, ever. So it is not really surprising that it takes a while to spot, especially "inactive" tumours. Obviously your endo is a specialist and is far more aware of the possibilities. NB that if you really DO have a pituitary tumour, they are almost always benign and although in the skull, they are outside the brain so not a brain tumour.

Nobody is going to do anything without evidence and the most useful test is a synacthen test. You get give a small injection of ACT hormone, the signal hormone that your pituitary should send to your adrenals to provoke cortisol production. If nothing happens, the problem is your adrenals : if it does (i.e., cortisol is produced) then maybe your pituitary hasn't been asking.

Either way, the treatment is cortisol replacement - hydrocortisone and/or prednisolone. An operation is only done if essential and then only to stop matters getting worse, it rarely fixes the problem.

5

Small error above: when I said "inactive" (pituitary tumour), I should have said "non-functional", These cause the pituitary not to do its job of sending signals to the major endocrine organs to do the grunt work. ("Functional" tumours are a lot easier to spot, like when a man produces breast-milk [prolactinoma], Cushings, Acromelagy etc etc).

6

thanks for your reply

however my cortisol is low enough

I do not need the ACTH test

I already have only a little ACTH and

if I took the test , I would probably have less

I have already spent weeks researching it

those tests are only effective if you have

adrenal Adison's , which I don't

7

I probably had a functiomal tumor

but now I have hypopituitarism

8

If you had a functional tumour, there would be no 'probably' about it.

In real medicine, no tests mean no evidence means no diagnosis means no treatment.

9

I have had lots of tests

its okay

10

if you really want to understand

the acth test depletes the adrenals

so I'm going to avoid it

11

Hi there may I ask what your situation is Roddy. You seem very knowledgeable. Is it really that rare to have a pituitary tumour if they have a forum on it and all of us have one? It seems more common now  I personally have two other friend that have a pit tumor.  With today’s stress levels of everything  I can more issues with Cortisol etc.