I made it up to the Swedish Neuroscience place in Seattle yesterday and had a bizillion lab tests done, as well as meeting with the endocrinologist and his nurse practitioner. Mostly the NP–the doc just joined us at the end, after SHE had done all the work.
They said that my adenoma, at one cm, is below the size that would indicate immediate surgery (1.5 cm), since it isn’t impinging on any adjacent areas or causing a mass effect. However, it’s large enough to be potentially causing some of the pituitary hormones to be either too hi or too low, which is what the lab studies will tell us.
It isn’t growing, as evidenced by the lack of change over the past 2 years. Apparently I’ve had it for decades–he said at least 10 years and likely much longer.
If it’s causing headaches or my other ongoing symptoms, it would be due to hormonal abnormalities. The most sensitive and most likely hormone to be affected by a pituitary tumor is growth hormone (HGH). The lab studies will show if this is the case with me, as well as all the other pituitary/hypothalamus/adrenal pathway problems that are affected by a malfunction of the master gland. Another one that can be outa whack is cortisol (steroid), which depends on the communication between the pituitary gland and the adrenal glands.
In terms of treatment, if there are hormonal deficiencies or excesses, he will then recommend replacing the deficient hormone(s), or meds to suppress whatever is in excess. He said many people with my medical profile end up needing a little of a lot of things (oh goody) so not to be surprised by a lot of prescriptions initially.
This neuro group does not use bioidentical hormones, unfortunately. So I realize I will have to bend away from my desire to resume those, and–at least temporarily–agree to try the pharmaceutical versions if I am to proceed with treatment, as much as I hate to do that. I guess I am prepared to go that route if that’s his recommendation, to see if it can possibly make a significant difference, given that I haven’t made huge leaps going the natural route… at least for now. I believe the negative biochemistry driving my weight gain, crappy lipid profile, and my decreasing bone density, etc., is probably doing as much harm to my life expectancy as hormone replacement would–so it’s a tradeoff.
That about sums it up.
Now I wait for lab results, which should be back in a couple of days, and I’ll proceed from there.