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Suggest Treatment For Persistent Pituitary Adenoma
Posted on
Fri, 4 Nov 2016
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 4 Nov 2016
Answered on
Mon, 28 Nov 2016
Last reviewed on
Question : Hi doctori am trying to conceive for the past 7 Months and I have a pituitary adenoma of 5mm.my periods are at times irregular .prolactin level is 15.5 lh is 5.4 fsh is 7.70. I am taking melmet 500mg for the past 10 days in between my cycle came right after 28days. My endocrinologist says its like pcos not necessary that ovaries should have cysts ovaries and uterus normal)so continue for 3 months. I am concerned if I can become pregnant within this that time.
Brief Answer:
Tests
Detailed Answer:
Sorry to learn about your bothersome symptoms.
The pituitary adenoma needs further evaluation to see if it is making any hormones in excess such as GH (Growth Hormone) and ACTH.
Too much of these can result in symptoms similar to the ones you are experiencing.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) IGF1
Midnight Saliva Cortisol
Total Testosterone before 10 am; between day 4 to day 10 of menstrual cycle
SHBG
17 hydroxy Progesterone between day 2 to day 7 of your menstrual cycle; at 8 am
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting.
Correct diagnosis and treatment requires the opportunity to examine the patient so it is good you are seeing an endocrinologist in-person.
I would not recommend getting pregnant until a proper diagnosis has been made
Tests
Detailed Answer:
Sorry to learn about your bothersome symptoms.
The pituitary adenoma needs further evaluation to see if it is making any hormones in excess such as GH (Growth Hormone) and ACTH.
Too much of these can result in symptoms similar to the ones you are experiencing.
When I see someone like you in my practice, I typically order the following blood tests in addition to a detailed physical examination:
CBC (Complete Blood Count, also known as Hemogram; includes Hemoglobin, WBC and Platelet counts)
Electrolytes (Sodium and Potassium in particular)
HbA1c (Glycosylated Hemoglobin = your last 3 months' glucose average). Also known by other names such as GlycoHemoglobin or Glycated Hemoglobin or A1c
Liver function tests (SGOT , SGPT, Albumin, Bilirubin, Alkaline Phosphatase)
Kidney function tests (BUN, Creatinine)
TSH (checks your thyroid)
Free T4 (this too checks your thyroid) IGF1
Midnight Saliva Cortisol
Total Testosterone before 10 am; between day 4 to day 10 of menstrual cycle
SHBG
17 hydroxy Progesterone between day 2 to day 7 of your menstrual cycle; at 8 am
25 hydroxy Vitamin D levels (ideal range 40 to 60 ng/ml = 100 to 150 nmol/liter)
None of these tests require any fasting.
Correct diagnosis and treatment requires the opportunity to examine the patient so it is good you are seeing an endocrinologist in-person.
I would not recommend getting pregnant until a proper diagnosis has been made
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
After looking in to the contra the endocrine said it could be non functional as the hormone levels are normal(early 2013 it was 62 later in 2014 it came down to 32 and now its 15 ) without medication. i taking metformin is it alright to continue? Please let me know will I conceive or am at a greater risk of not becoming pregnant. Because we are planning atleast next year. I would like to know the duration that might take to set this right. I will attach the reports
Brief Answer:
Follow up
Detailed Answer:
I have reviewed the attached MRI report.
1 Pituitary conditions are a complex matter. So it is important you see your endocrinologist in-person regularly
2 Regarding your questions as to whether metformin is ok to take and whether pregnancy/ conception is ok and how long it will take to set things right, will all depend on the final diagnosis.
The following test results are important before a diagnosis can be arrived at:
Total Testosterone before 10 am; between day 4 to day 10 of menstrual cycle
SHBG
17 hydroxy Progesterone between day 2 to day 7 of your menstrual cycle; at 8 am
Follow up
Detailed Answer:
I have reviewed the attached MRI report.
1 Pituitary conditions are a complex matter. So it is important you see your endocrinologist in-person regularly
2 Regarding your questions as to whether metformin is ok to take and whether pregnancy/ conception is ok and how long it will take to set things right, will all depend on the final diagnosis.
The following test results are important before a diagnosis can be arrived at:
Total Testosterone before 10 am; between day 4 to day 10 of menstrual cycle
SHBG
17 hydroxy Progesterone between day 2 to day 7 of your menstrual cycle; at 8 am
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks doctor
Brief Answer:
Best wishes
Detailed Answer:
for good health
Best wishes
Detailed Answer:
for good health
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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