Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

190 Doctors Online
Doctor Image
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

What causes tiredness, fatigue and slow heart beat?

Answered by
Dr.
Dr. Shehzad Topiwala

Endocrinologist

Practicing since :2001

Answered : 1663 Questions

default
Posted on Tue, 12 Aug 2014 in Brain and Spine
Question: I have a slow heart beat which began in 2013 also have sleep apnea and HBP. I was examined by a cardiologist
who ordered every test in the book He said some ppl just have a slow heart beat. I'm a 69 y/o XXXXXXX XXXXXXX male. I have a tumor on my pituitary gland, elevated prolactin and reflux in my left ankle, diabetes type II last 3 A1c=4.1. I have no energy and am fatigued most of the time.
doctor
Answered by Dr. Shehzad Topiwala 10 hours later
Brief Answer:
Pituitary

Detailed Answer:
Sorry to learn about your symptoms.

Your complaints are of significant concern to me.

Kindly do not ignore these and see an Endocrinologist in person at the soonest opportunity.

I dont mean to cause panic, but you should seek immediate care to make sure you do not have life threatening endocrine problems, such as adrenal insufficiency.

This can occur with pituitary tumors.

When I see someone who comes to me with such complaints, i immediately refer them to the ER. There the ER physician stabilizes their vital signs while I give my inputs on the work up. Some examples of tests that I order are :

CBC
CMP
TSH
Free T4
Prolactin
8 am cortisol
ACTH
IGF1
Salivary cortisol
Lipids
Total testosterone
SHBG
Free testosterone
FSH
LH

Many of your symptoms can be potentially explained by pituitary conditions. For example a slow pulse can be caused by 'Secondary hypothyroidism' meaning an under active thyroid due to lack of pituitary signal to the thyroid gland. This can cause fatigue and many other symptoms too. Further, extreme lack of energy can very be a classic manifestation of low adrenal hormones. this can also occur when the pituitary signal to the adrenal glands is reduced.

Please seek specialized endocrine care promptly
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
premium_optimized

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,  
Medical Topics ,   ,   ,  

Recent questions on  Pituitary tumors

doctor1 MD

I am a man in my 50s when I was 44 I dated a woman 21 lots of sex porn masturbation for 6 years. And now I am having erectile dysfunction could this be sex exhaustion. the last 7 months I been resting up it felt like it was getting better but the...

doctor1 MD

Hi I'm a 26 year old male who suffered from tubular gynecomasty since I was 15-16 years old. Recently I moved to a larger city where I had health care and better professionals. I went to see a surgeon who sent me to various other doctors to do a lot of test. I reached the local endocrinologist who sent me to do a blood test, when they came back it was determine that I have high prolactin 720 out of 450 in the first measurement, after 15 minutes of waiting they took another prolactine test and it was 712 out of 450.
The endocrinologist doubts that I have a pituitary tumor and prescribed Dostimex pills and an MRI. Unfortunately in my country you wait long to get an MRI so my term is in September 2014. Private MRI's are expensive 350 $ or more.
Do you think that my gynecomastia is tied to high prolactine? If so how come that I had gynecomastia for 11-12 years?
Do you think that I could try some diet changes instead of taking drugs, perhaps some prolactine inhibitors (maca, ginseng, ...)?
Thank you very much

doctor1 MD

Is it possible to lactate while not or ever being pregnant?

doctor1 MD

Hi, I'm male, 29, average height/weight (slight paunch). I've had a vitamin D deficiency for many months, I tend to over-perspirate a fair bit, I am red-green color blind, and recently the hair on my head has started to grow back. Approx 4 months ago, my libido dropped (after breaking up suddenly with my partner), so I saw my GP who ran teats. He found my testosterone level low due to low LH and FSH. I've had many tests done and no one appears to know what has lead to this. One specialist believed I must have a pituitary tumor but an MRI didn't pick up on any. I'd like to know whether you know of anything that may have caused this, also whether it is reversible, and whether there is anything I can do to assist in normalizing my hormone levels. It was a huge shock but now it's frustrating as no one appears to know what's going on. Ur assistance is much appreciated. Thanking u in advance.

doctor1 MD

Dear Doctor, I recently had an MRI Brain and Pituitory to investigate high prolactin (I think around 800)/infertility. The MRI report read as follows: “There is a 6 x 4mm lesion posteriorly in the anterior pituitary just anterior the posterior pituitary bright spot. This lesion is hyperintense on the T2 weighted sequences and hypointense on the T2/FLAIR and SWI sequences consistent with subacute haemorrhage. It does not demonstrate any enhancement. The findings are most consistent with an adenoma with associated intralesional haemorrhage. Findings are not typical for Rathke’s cleft cyst The remainder of the pituitary has a normal appearance with normal enhancement of the pituitary stork and remaining pituitary tissue. The posterior pituitary bright spot is preserved. There is no gross expansion of the sella and no soft tissue extends above the sella into the suprasellar cistern. The optic chiasm has a normal appearance with no evidence of compression and there is no displacement of the pituitary stalk. The adjacent carotid arteries and cavernous sinus have a normal appearance. No other intracranial mass is demonstrated. The ventricles, sulci and cisternal spaces are normal for age and there is normal grey-white matter differentiation. There are several foci of subcortical white matter FLAIR hyperentensity particularly in the frontal lobes which are slightly more numerous than expected for age. These may be an incidental finding but may also be seen in vasculopathies including migrainous vasculopathy. The differential includes chronic microvessal ischaemic change greater than excpected for age. The findings are not typical for demyelination. The posterior fossa structures and craniocervical junction are unremarkable. There is minor mucosal thickening of the anterior ethmoid air cells but the remainder fo the paranasal sinuses are normally pneumatised. My GP has referred me to a neurologist, but the neurologist is currently away and unable to see me for 2 weeks. The neurologist’s receptionist called me and told me not to worry in the meantime, but to go to the hospital if I experience headaches. Meanwhile, I am anxious about the reference to haemorrhage in the MRI report and whether it could be continuing and whether it could possibly be pituitary apoplexy. I don’t have a headache but I do have a feeling of pressure. I would be very grateful if you could take a look at the report (I also have the scans on disk if you need to see those) and tell me: 1.     Whether I might have pituitary apoplexy 2.     Whether it is ok to wait 2 weeks to see the neurologist 3.     What other kinds of tests might help with diagnosis. I have not at this point been prescribed with any medication. Sincerely, Jodie

doctor1 MD

i was diagnosed with a prolactinoma 4 years ago. it seems to be back, my symptoms are quite severe. my first blood tests revealed normal prolactin levels. i have since had them repeated along with a full hormone panel. i am waitin for those results. the doctor has recommended i start treatment 5 mg bromocriptine twice a day in the mean time. how dangerous is it and what will happen if the hormones are still normal. what are the other possibilities?

doctor1 MD

Can a pituitary tumor re grow