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Empty sella syndrome, Thyroiditis - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Average Posted in: Thyroid Problem and Hormonal Problems
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
Doctor :   hi
Doctor :  
how can i help you?
User :   hi
Doctor :  
please proceed with your health query
User :   in FNAC it was diagonised "Folicular Hyperplasia" and in RAIU it has been diagonised "thyroiditis'
Doctor :  
ok
User :   I am confused. today two more blood test are conducted
Doctor :  
ok
User :   Cortisol and Prolactin
Doctor :  
what were the blood tests for?
Doctor :  
ok
User :   my T3 and T4 are now normall but TSH is 0.01
Doctor :  
ok
User :   earlier T3 and T4 were inflated and TSH was 0.05
User :   repeat test is due on 20th Dec
Doctor :  
ok
User :   can u guide me?
Doctor :  
sure.
Doctor :  
i will help you our
Doctor :  
the cortisol levels and prolactin levels are to see the problem related to our infertility
User :   In MRI I have partial empty Sella
User :   OIC
Doctor :   and regarding TSH levels, the normal values 0.3 - 0.5
User :   i am not been regarding the infertility
Doctor :  
the MRI scan needs to be interpreted my a neurologist for the empty sella syndrome
User :   for this only they have recommended prolactin and cortisol
Doctor :  
ok
Doctor :  
this is because the pituitary gland regulates these two hormones also
Doctor :  
in case there is abnormality found in them too
Doctor :  
then the empty sella that is found on MRI can be investigated further
User :   then what will be the treatment
User :   does it relate to cyst or tumor
Doctor :  
there is no specific treatment
Doctor :  
the treatment depends on resolving the symptoms that arise
Doctor :  
the empty sella thatis seen in MRI is only aMRI finding
User :   two neurologist are taking as simple migraine
Doctor :  
it wil need more investigations to confirm
User :   one neurologist told me that I have cyst area
Doctor :  
wait for the cortisol and the prolactin results to come back
User :   and refered me to neuro surgeon
Doctor :   ok
Doctor :  
have you consulted the neurosurgeon?
User :   yes
Doctor :  
ok
Doctor :  
what did he say?
User :   who in turn told me that i might have tumor before which must have disolved
Doctor :  
did he take look at the MRI images?
User :   yes
Doctor :  
ok
User :   he said no need to worry. get the proclatin and cortisol blood tes
User :   if higher result then worry otherwise no need to worry
Doctor :  
so your query regarding the empty sella and possible cyst there is resolved after seeing the neurosurgeon
Doctor :   just wait for the results to come back
User :   so this has made me more confused as different neuro has different opioin
Doctor :  
relax now, do not jump into any conclusions
User :   ok
Doctor :  
the neurosurgeons opinion is more reliable
Doctor :  
go ahead and folow his instructions
User :   but what about FNAC and RAIU conflicting reports
User :   fine
Doctor :  
the FNAC showed "Folicular Hyperplasia"
Doctor :   which was confirmed by the RAIU as thyroiditis
Doctor :  
in folloicular hyperplasia, when the RAIU scan is done
Doctor :  
it wil show pockets of active iodine uptake
Doctor :  
and those areas will have more thyroid hormone secretion
Doctor :  
and present as thyroiditis
Doctor :  
now is your doubt clear?
Doctor :  
they are two different studies giving you the two different answers
Doctor :  
which are related to each other
Doctor :  
do not get confused reading the reports and drawing out your own conclusions.
Doctor :   have you followed what i have said?
Doctor :  
are you there?
User :   sorry i was on phone
Doctor :  
are you there? have you folowed what i have said?
Doctor :  
ok
User :   yes
Doctor :   Is there any thing else I can help you with?

User :   now endo has stopped all medicines till 20th Dec thyroid profile test report
Doctor :   ok
Doctor :  
that is probably as your TSH levels came back low
User :   earlier there was swealing and it was painfull but now the sweling has subsidized and there is no pain also
Doctor :  
so they stopped medicines to see if TSH levels increase after stopping the medications
Doctor :  
also by then the cortisol and prolactin reports also will be available
User :   after stopping T3 and T4 came normal but TSH was still low
Doctor :  
so by comparing and combining all reports, final diagnosis can be reached
User :   due to which RAIU was done
Doctor :  
in thyroiditis TSH will be low, normal or high also depending on the cause for the thyroididtis
Doctor :  
your case follicular hyperplasia, so the TSH is low
User :   also optho will do test on 20th Dec
User :   but when RAIU report came then also TSH was low
Doctor :  
ok
User :   all this is creating more and more confusion to me
User :   will they do FNAC again?
Doctor :  
yes it wil be low, as the follicular hyperplasia which is the cause for thyroiditis in your case did not happen overnight, it took some time to develop. the thyroid scan using RAIU was done to look for the cause and confirmation of the FNAC report
Doctor :  
repeat FNAC is not necessary
Doctor :  
kindly wait for the blood test results to come
User :   ok
Doctor :  
you are getting too much confused wit reading and thinking over your test results
Doctor :  
relax yourself first
User :   ok
Doctor :  
then slowly you will be able to find a link between all the things
User :   ok
Doctor :  
what you can do the best will be to wait for all the results
User :   fine
Doctor :  
and take them together to a counsellor who wil sit with you
Doctor :  
to explain the results and link betwenn each
Doctor :  
as why and what probably lead to what
Doctor :  
such that you can figure out what is happened from begining
Doctor :  
based on your symptoms, investigations result and the probable cause
User :   I got FNAC done when my there was swealing and pain
Doctor :  
ok
User :   and RAIU at it was normal
User :   so that may be the reason for two different report
Doctor :  
i have told you earlier that they are two different tests which will give you different results, that wil be interpreted along with the symptoms that you have
User :   ok
Doctor :  
also the medications use or stoppage will be taken into consideration when evaluating the reports
User :   yesterday optho said to me that pituary gland has made some effect on my optic nerve
User :   ok
Doctor :  
the optic nerve crosses over at the same point where the cyst is suspected
User :   what kind of test they will perform, can u shed light on this
Doctor :  
and you had some visual symptoms earlier
Doctor :  
which would have lead to suspicion
User :   no but due to age near vision is effected.
User :   its only +0.25
Doctor :  
and hence the need for the ophthalmic examination
Doctor :  
opk
Doctor :  
*ok
User :   if cyst is diagonised will there be a surgery
User :   is that is the root cause of my thyroid disorder
Doctor :  
surgery will be waranted if there are pressure symptoms or signs noted
Doctor :  
if it is affecting th eoptic nerve
User :   ok
Doctor :  
then may be it might be needed to releive the pressure
User :   ok
Doctor :  
if the opthalmic examination goes on normal, it wil not be needed
User :   fine
Doctor :  
Is there any thing else I can help you with?
User :   maybe tomarrow i will get the blood report so i will contact
User :   thanks for the support
Doctor :   sure you can get back to us with the reports
Doctor :  
Please fill the feedback form say done when done.
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please chat with our doctors 24/7 for medical queries.
User :   bye
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