pituitary or not??

[sopranomom]

For the last 3 and a half years, I have been having periodic dizzy spells that feel like a vaso-vagal episode but are unrelated to any stress and often occur out of the blue when I'm sitting down. They occur in a cycle that seems menstrual in nature except that I am a post menopausal woman. I have been tested for neurological, cardiac and endocrine problems and most have been normal with the following exceptions. My aldosterone, prolactin and saliva cortisol levels are slightly increased (dexamethosone corrects the cortisol). I occaasionally have SVTs and I have a colloidal cyst on my thyroid that swells and recedes in an opposite cycle to the dizzy spells. The MRI of my pituitary shows an 'empty sella turica' which, on the internet, seems to be dismissed as something that obese women with high blood pressure get and there's no treatment. I am overweight but that seems to be related to my problems as I have gained 20 lbs over the last two years with no change in my eating habits and with joining a gym and exercising 2-3 times a week. Any ideas about treatment or diagnosis? I also had a slightly abnormal 5H1AA and because of that an octreotide scan for which the results are not back yet.

[alexburton]

have you had a midnight cortisol test?

what about urinary 24hr cortisol test?

when you say slightly increased are they still in range?

do you have any other symptoms? like fatigue and weakness

have you had your thyroid checked?

[sopranomom]

The salivary cortisol was done at 11PM. I think I had a 24 hr urine cortisol when this started but don't have the results with me. My prolactin is 21.6 and my LH is 55.2, both slightly above post menopausal ranges for the lab that was used. The ACTH is normal. My Aldosterone was 8 (upright). The thyroid antibodies, T4, T3 uptake etc were within normal range. My TSH changes depending on the time of the month, which doesn't make sense to me. Before all of this happened (1999) it was measured at 3.98, but recently it was 3.4 and then two weeks later (when the nodule had subsided) it was 1.7. I had it measured, coincidentally, on the day that I had a dizzy spell in May and it was 1.37. My renin levels were 1.3. My hemoglobin was slightly decreased and iron storage levels were very low but that's probably due to donating blood too regularly and I'm on iron therapy now. All other tests, the rest of my CBC, chemistrys, Urine and plasma catecholamines, HgbA1C, FSH, CA125 are all within normal range. I am a lab tech. Thanks for your input.

[sopranomom]

I didn't answer all of your questions. I am constantly fatigued and cold although this summer, I was having sweating spells both with and without exertion. My hair is falling out in clumps and eyebrows and other body hair have thinned alot. Luckily, I started out with very thick hair so it's not that noticeable. I also have developed some facial hair which is annoying but not overwhelming. My memory, which has always been great is not as dependable as it used to be and as I am an actress and singer in my spare time, it has become an issue. My singing is affected when the thyroid nodule swells.

[alexburton]

I didn't answer all of your questions. I am constantly fatigued and cold although this summer, I was having sweating spells both with and without exertion. My hair is falling out in clumps and eyebrows and other body hair have thinned alot. Luckily, I started out with very thick hair so it's not that noticeable. I also have developed some facial hair which is annoying but not overwhelming. My memory, which has always been great is not as dependable as it used to be and as I am an actress and singer in my spare time, it has become an issue. My singing is affected when the thyroid nodule swells.

sounds like you have symptoms of cushings disease

any stretch marks that appeared along with your other symptoms?

what have you been diagnosed with so far?

[sopranomom]

I have not been diagnosed except with empty sella syndrome for which there is no treatment recommended. I was told that the dexamethasone suppression test ruled out Cushing's.