HYPOTHYROIDISM, POLYCYSTIC OVARIES with no TUMOUR in MRI.

Resolved Question:

I have hypothyroidism and polycystic ovaries .
by august 2012 until now I've taken 25kgs and keep taking .
i use t4 150mg , glucophage 850mg and yasmin.
i am diagnosed with pituitary cushing's disease acth dependant .
there is no tumor shown in the mri.
i eat very healthy and exercise every day.
for 4 years old patientnow i can't find a solution to my problem.
i have gone to endocrinologists and neurologists.
i also have acne, if i don't take birth control pills i don't have period, i am very tired all day every day, it's difficult to move, i have anxiety.
doctors suggested to take metyropone until the tumor is shown and also remove both the adrenal glands.
what do you suggest?


Category: Endocrinologist

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Category: Diabetologist
Dr. J Muthukrishnan is online now

Expert:  Dr. J Muthukrishnan replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I have gone through your query and I understand your concern.
You do have Cushings Disease with no obvious pituitary source of ACTH.
There doesn't seem to be any ectopic source of ACTH which needs further ruling out with a CECT Scan chest and Abdomen. Can you get that done and follow up?
Pasireotide is a new drug which can be used to treat cases like yours. Do consult an endocrinologist for the same.
Feel free to discuss further.


Patient replied :

pasireotide causes diabetes so i don't want to take this. do you think that removing the adrenal glands will rull out Csuhing's disease?


Expert:  Dr. J Muthukrishnan replied 3 Days.

Yes, removing adrenals will definitely help curing Cushing disease.


Patient replied :

I have cushing's disease for 4 years old patientnow . When do you believe that the pituitary tumor will show in the mri?


Expert:  Dr. J Muthukrishnan replied 2 Days.

There is no such prediction that can be done. Such tumors are very small and may grow very gradually or remain undetected.


Dr. J Muthukrishnan
Category: Diabetologist
Experience: 
Fellowships/Training: 
1. 10th Asia-Pacific Pediatric Endocrine Society  Fellows meeting, Seoul, Korea, Oct 2008
2. Eighth ICMR Course on Genetics and Genetic Counseling – Jul 2008 – SGPGI, Lucknow
3. Annual Certificate Course on Endocrinological Laboratory Techniques at National Institute of Nutrition (ICMR) Hyderabad,India, ( Aug-Sep 2006) 
Fellowship: Endocrinology, Diplomate of National Board, National Academy of Medical Sciences, New Delhi, 2008, Medwin Hospital, Hyderabad
Senior Residency: Diplomate of National Board (General Medicine), National Academy of Medical Sciences, New Delhi, 2002
Residency: MD, General Medicine, 1997-2000, Armed Forces Medical College, 2nd position in University
Medical School: MBBS, Armed Forces Medical College, 1992
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