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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Having Atypical Hypothyroidism, PCOS. Could I Have Partial Hypopituitarism With Normal Appearing Gland?

I am a 41yo female with hx of 2 postpartum bleeds (moderate in 1997, severe 2004) with symptoms of possible adrenal insufficiency . My last two a.m. cortisol results were 3 and 8. High-dose ACTH stim testing produced a max cortisol of 21 at 1 hour post infusion. In addition, I have been previously told that I have atypical hypothyroidism and PCOS; however, my last thyroid panel was WNL. After 14 years of declining health, my current MD (Family Practice) is willing to order studies to r/o Sheehan s Syndrome. Should an MRI come first, or could I have mild or partial hypopituitarism with a normal-appearing gland?
Wed, 20 Mar 2013
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Endocrinologist,  's  Response
Hello

Sheehans syndrome is usually characterized by postpartum bleed, lactation failure and amenorhea. You will have pituitary hormone defect. PCOS is usually unlikely in sheehans. Having a possible adrenal insufficiency and atypical hypothyroidism, it would be preferable to have a complete hormonal evaluation and MRI. It can be done any way. Partial hypopituitrism can also be seen in patients with normal pituitary.
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Having Atypical Hypothyroidism, PCOS. Could I Have Partial Hypopituitarism With Normal Appearing Gland?

Hello Sheehans syndrome is usually characterized by postpartum bleed, lactation failure and amenorhea. You will have pituitary hormone defect. PCOS is usually unlikely in sheehans. Having a possible adrenal insufficiency and atypical hypothyroidism, it would be preferable to have a complete hormonal evaluation and MRI. It can be done any way. Partial hypopituitrism can also be seen in patients with normal pituitary.