Today, I saw the man I diagnosed with pituitary hypothyroidism 6 months ago. He had secondary hypothyroidism. That means his hypothyroidism was due to the failure of the pituitary to send enough TSH to sustain normal thyroid function. An MR of the head revealed a large tumor that was interfering the normal gland function. He had low testosterone for several years. A 3-4 cm mass was seen on the MR. The surgery was long and difficult. However he returned to see me after the surgery, with normal pituitary function. The clue to his diagnosis was a low Free T4, and a normal TSH. This was not the usual numbers for primary thyroid failure and suggested a central cause for his failure. His testosterone normalized, and he was markedly improved. He does not need replacement or stress steroids!
Great case,
Good result.
Until next time,
Dr.G.
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