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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?
Asked On : Wed, 20 Feb 2013
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Endocrinologist 's  Response

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.
Answered: Tue, 19 Mar 2013
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