https://maternalpituitarysupport.org/news-blog daily 0.75 2026-02-24 https://maternalpituitarysupport.org/news-blog/maternal-pituitary-menopause monthly 0.5 2026-02-24 https://maternalpituitarysupport.org/news-blog/inge-shares-her-experience-of-critical-illness-sepsis-and-diagnosis-of-sheehans-syndrome monthly 0.5 2026-02-24 https://maternalpituitarysupport.org/news-blog/lorna-shares-her-journey-to-diagnosis monthly 0.5 2026-02-24 https://maternalpituitarysupport.org/news-blog/sowmi-recounts-her-journey-to-diagnosis monthly 0.5 2025-10-19 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1e1df318-bcb3-49e7-980a-fa86743dbdc5/Sowmi.png News & blog - Sowmi recounts her journey to diagnosis, three years after giving birth https://maternalpituitarysupport.org/news-blog/q-and-a-with-the-kings-college-hospital-endocrine-nurses monthly 0.5 2025-10-19 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/e9fcad4f-f865-435a-aaae-daffb41461c8/Endocrine+nurses.png News & blog - Q&A with The King’s College Hospital Endocrine Nurses https://maternalpituitarysupport.org/news-blog/heather-in-conversation-with-her-obstetrician monthly 0.5 2025-10-19 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/02a665b6-14c5-4b5f-a9c9-446fa90d8fb5/Heather+in+convo.png News & blog - Heather in conversation with her Obstetrician Dr Chad Thomas: When Awareness Becomes Lifesaving A Conversation on Sheehan’s Syndrome With Heather Thiessen and Dr Chad Thomas Introduction: When Awareness Becomes Lifesaving Heather: Hi everyone, and thank you so much for joining this important conversation today. I’m Heather Thiessen, and my journey into pituitary health began unexpectedly after the birth of my son. Following multiple hospital visits and countless tests, we learned that the symptoms I was experiencing were caused by a rare condition called Sheehan’s Syndrome—damage to the pituitary gland that can occur after childbirth. Because it’s so rare, diagnosis often takes years. What my medical team identified in about nine days can take other women up to nine years to uncover. I’m deeply grateful for the care I received and honoured to sit down with my obstetrician, Dr. Chad Thomas, to talk about recognizing early signs and ensuring women get the care they need sooner. Our goal today is to raise awareness for both patients and providers—because when something feels off, it deserves to be investigated with urgency. Awareness doesn’t just change outcomes; it can save lives. A Rare Case and a Shared First Heather: Dr. Thomas, thank you so much for being here. We’ve been through quite a journey together, and looking back, I realize how critical awareness is—for mothers and for the medical community. Is it fair to say we experienced a big first together? Dr. Thomas: Absolutely. Sheehan’s Syndrome is incredibly rare. In my 15 years as an OBGYN, you’re the only patient I’ve seen with it. In the U.S., it occurs in roughly one in 100,000 births. Globally, it’s more common due to different healthcare circumstances, but still unusual. So yes—you’re one of those cases I’ll always remember. Understanding Sheehan’s Syndrome Heather: Before we go too far, can you help set the stage a bit? What’s actually happening physiologically when Sheehan’s develops? Dr. Thomas: Most often, Sheehan’s Syndrome occurs after a massive postpartum haemorrhage—when a mother loses a large portion of her blood volume and her blood pressure drops dramatically. The pituitary gland, which sits at the base of the brain, enlarges during pregnancy to support hormone production. When blood flow suddenly decreases, the gland can suffer damage or even infarction (tissue death) from the lack of oxygen. Because the pituitary controls so many hormones—thyroid, adrenal, reproductive, and more—its failure can affect almost every system in the body. Early Signs: What to Watch For Heather: My symptoms came on fast because my case was severe, but for women who might have a more gradual onset, what early signs should they look for? Dr. Thomas: That’s a great question. Sheehan’s can vary widely. The two signs I most often associate with it are: Difficulty with milk production. If a mother’s milk doesn’t come in, that can be a red flag. Of course, there are many other reasons for low milk supply, so we have to be careful not to jump to conclusions. Lack of menstrual return. If menstruation doesn’t resume several months after delivery and after stopping breastfeeding, that’s another clue worth investigating. Because these symptoms can take time to become apparent, many women don’t realize something is wrong until they’re months or even a year postpartum. Heather’s Story: From Home Birth to Hospital Crisis Heather: Everything looked healthy leading into my birth, so I chose a home birth. The delivery itself was beautiful—our son was healthy and everything seemed perfect. But when it came time to deliver the placenta, everything changed. I developed a rare complication called an inverted uterus, which led to severe haemorrhaging. I remember the pain and the chaos, but everything happened so fast. I was rushed to the ER by ambulance. The next day, I had a splitting headache—worse than anything I’d ever experienced. My care team tried everything, and I underwent several rounds of blood transfusions. Eventually, an MRI was done to help piece together what was happening. Dr. Thomas: By the time we saw you, you’d lost roughly half your blood volume. That’s an enormous loss. Initially, we were focused on stabilizing you and making sure your vital signs and lab results improved. It seemed like things were headed in the right direction—until your symptoms started to shift. When you mentioned your milk wasn’t coming in, it triggered a memory for me from medical school—Sheehan’s Syndrome. It’s one of those “zebra” diagnoses we read about but rarely see. That prompted us to order the MRI and additional hormone testing, including prolactin and cortisol levels. Connecting the Dots Heather: So it was really the combination of the haemorrhage and my milk not coming in that prompted the Sheehan’s diagnosis? Dr. Thomas: Exactly. Your prolactin levels were low and didn’t rise after breastfeeding attempts, which told us your pituitary wasn’t responding normally. We also found abnormalities in your cortisol levels—another sign that multiple parts of your pituitary were affected. That’s when we brought endocrinology on board and confirmed the diagnosis. How Sheehan’s Can Vary Heather: For others who might be wondering, can Sheehan’s affect just part of the pituitary, or does it always involve the whole gland? Dr. Thomas: You can have Sheehan’s even if only part of the pituitary is affected. Usually, the posterior pituitary is more vulnerable, which can lead to issues like failure to lactate. But with more severe events, the anterior pituitary can also be damaged—impacting menstruation, blood pressure regulation, growth hormones, and more. The extent of the damage determines how widespread the hormone deficiencies are. Testing and Diagnosis Heather: If someone suspects Sheehan’s—either a patient advocating for herself or a doctor evaluating a postpartum patient—what tests are most useful? Dr. Thomas: A good starting point is a prolactin level test, ideally measured after breastfeeding or pumping. Normally, prolactin spikes in response to feeding. If that level stays low or undetectable, that’s a red flag. From there, depending on the symptoms, we might check cortisol and thyroid hormone levels, since those can also be impacted by pituitary injury. It’s always a balance—we don’t want to over-test, but we also don’t want to miss something serious. Lessons Learned Heather: It’s incredible how many factors were at play—and how much depends on awareness and timing. I’m endlessly grateful that our paths crossed when they did and that you connected the dots so quickly. Dr. Thomas: Thank you, Heather. My takeaway from your case is a reminder to stay curious. Most of the time, we’re treating the “horses,” the common conditions. But occasionally, we encounter a “zebra”—the rare diagnosis that changes everything. When things don’t quite add up, that’s our cue to look deeper. Closing Reflections Heather: I love that. My hope in sharing this story is that it helps shorten the path to diagnosis for other women. Recovery after childbirth looks different for everyone, and listening to your intuition, asking questions, and advocating for follow-up care can make all the difference. Dr. Thomas, thank you for your compassion, for your curiosity, and for helping to bring more visibility to maternal pituitary health. The more we talk about these rare conditions, the more women we can reach—and the more lives we can change. Dr. Thomas: You’re welcome. I’m glad to be a part of it. https://maternalpituitarysupport.org/news-blog/when-the-dream-turns-into-a-nightmare monthly 0.5 2025-10-19 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/6e16d16f-c954-4073-8f4e-f890c2b40a8f/Aine.jpg News & blog - When the Dream Turns into a Nightmare: My Postpartum Pituitary Story https://maternalpituitarysupport.org/news-blog/lisa-tells-her-story-for-rare-disease-day monthly 0.5 2025-10-18 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/36722618-8171-4808-93ca-73597677c317/mother+and+daughter.png News & blog - Lisa tells us how a diagnosis of two rare diseases has impacted her life https://maternalpituitarysupport.org/news-blog/jenns-blog-what-is-adrenal-insufficiency monthly 0.5 2025-02-27 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/efc88308-37dd-4d72-9795-8e41fd2d3901/Jenn+bio+pic.jpg News & blog - Jenn’s Blog: What is Adrenal Insufficiency? https://maternalpituitarysupport.org/news-blog/heather-tells-us-whats-helped-her-and-her-partner-to-manage-steriod-replacement-therapy monthly 0.5 2025-02-27 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/e77ebb79-9088-4969-ba8b-f25c8210a4e4/Heather%27s+piece.png News & blog - Heather tells us what’s helped her and her partner to manage steroid replacement therapy https://maternalpituitarysupport.org/news-blog/talking-to-your-child-about-your-pituitary-condition monthly 0.5 2024-10-17 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/d2f32a8f-e165-4592-91b0-a74847cd3a1b/Talking+to+child.png News & blog - Talking to your child about your pituitary condition https://maternalpituitarysupport.org/news-blog/our-response-to-the-publication-of-the-birth-trauma-inquiry-report monthly 0.5 2024-10-14 https://maternalpituitarysupport.org/news-blog/my-gp-hadnt-even-heard-of-sheehans monthly 0.5 2024-10-14 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/64f9c4d1-ad74-4d6f-9a00-6d059208d178/Caroline+2.jpg News & blog - My GP hadn’t even heard of Sheehan’s https://maternalpituitarysupport.org/news-blog/one-mothers-quest-for-answers monthly 0.5 2024-05-08 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/aaefaa42-e78c-4201-9075-7047437f6f8f/Rachel.jpg News & blog - One Mother’s Quest for Answers https://maternalpituitarysupport.org/news-blog/my-take-on-rediscovering-you monthly 0.5 2024-04-29 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/a295484f-5158-45d9-87e9-55d500e91d04/Jenn+photo+2024.jpg News & blog - My take on rediscovering you https://maternalpituitarysupport.org/news-blog/i-want-to-help-spread-the-word-about-sheehans monthly 0.5 2024-05-02 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/008a3cf4-f047-4ca7-95fd-48a0d0024d80/Barbara.jpg News & blog - I want to help spread the word about Sheehan’s https://maternalpituitarysupport.org/news-blog/how-do-we-actually-advocate-for-ourselves-in-pregnancy-and-during-birth monthly 0.5 2024-04-28 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/72dd8b5e-5b4d-415f-bb98-9315adc6c19e/Dr+Rebecca+Moore+.jpg News & blog - How do we actually advocate for ourselves in pregnancy and during birth? 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The Symptoms not to ignore. https://maternalpituitarysupport.org/news-blog/an-irish-expat-in-the-netherlands monthly 0.5 2022-10-07 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/8d39d810-5117-47ac-8f0b-22de9bc79130/Abigail+3.jpg News & blog - My Story - Abigail, An Irish Expat in The Netherlands https://maternalpituitarysupport.org/news-blog/feeding-my-girls monthly 0.5 2022-09-23 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/aebf9c75-61ce-417f-96dd-ba487bc5cc30/Kirsty+%26+Ivy.jpg News & blog - Feeding my girls https://maternalpituitarysupport.org/news-blog/i-fed-my-baby-on-donated-breast-milk monthly 0.5 2022-08-23 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1656589560652-DVBJL5KQAF3DDANB87EM/Krystal.jpeg News & blog - I fed my baby on donated breast milk & formula https://maternalpituitarysupport.org/news-blog/overactive-let-down monthly 0.5 2022-08-18 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/33dbc980-d28c-4499-91f8-2088c55a1bfb/Ruth.jpg News & blog - My experience of overactive let down https://maternalpituitarysupport.org/news-blog/why-cant-you-breastfeed-your-baby monthly 0.5 2022-08-18 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/f570992d-2219-4b76-8b97-fc0820d784c5/Victoria.jpg News & blog - Why can’t you breastfeed your baby? https://maternalpituitarysupport.org/news-blog/we-bottle-fed-our-son-to-keep-him-safe monthly 0.5 2022-08-18 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1660292245262-REL3OQY66F78JVPK5C5F/3E76C803-3AA3-435C-A70E-738D15E04E69.jpeg News & blog - We bottle fed our son to keep him safe https://maternalpituitarysupport.org/news-blog/and-then-we-were-four monthly 0.5 2022-07-22 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/c74c9f84-2324-4c71-9cd2-f1c61a6b2980/Andrea%27s+pic.jpg News & blog - And then we were four https://maternalpituitarysupport.org/news-blog/my-name-is-pippa monthly 0.5 2022-07-22 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/dba93042-81e1-4eb6-a503-d0e6a9b88854/Pippa+%26+family.png News & blog - My name is Pippa and this is my story… https://maternalpituitarysupport.org/news-blog/what-to-wear-to-feel-great monthly 0.5 2022-06-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/6e236db8-e4c6-4566-aa30-8608bbe1b5c9/Georgina+Davies+pic.jpeg News & blog - What to wear to feel great - top 5 tips https://maternalpituitarysupport.org/news-blog/lymphocytic-hypophysitis monthly 0.5 2022-06-30 https://maternalpituitarysupport.org/news-blog/physical-recovery-and-mental-health monthly 0.5 2022-06-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/be5e6891-55b7-43de-9581-8b75d6a80c15/Lyanne+Nicholl+picture.jpg News & blog - Physical recovery & mental health https://maternalpituitarysupport.org/news-blog/im-that-someone-else-in-everyone-elses-plan monthly 0.5 2022-06-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/42d3fd5a-13e3-4c85-ae42-11423ee246fd/Emily+%26+family.JPG News & blog - I'm that someone else in nearly everyone else's plan https://maternalpituitarysupport.org/news-blog/my-bottle-feeding-journey monthly 0.5 2022-08-18 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/bed7dfb7-98d3-4ad9-8fd2-83d0142f077c/Claire+%26+Saskia.jpg News & blog - My bottle feeding journey https://maternalpituitarysupport.org/news-blog/feeding-my-son monthly 0.5 2022-06-21 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/01258d8f-b979-4ac5-84c0-505e8f8c6453/IMG_20140516_154825.jpg News & blog - Feeding my son https://maternalpituitarysupport.org/home daily 1.0 2025-09-13 https://images.squarespace-cdn.com/content/v1/5ec321c2af33de48734cc929/1618497259178-6XJGK9GR6YAVBQL5L519/20140301_Trade-151_012-2.jpg Home https://images.squarespace-cdn.com/content/v1/5ec321c2af33de48734cc929/1607694583486-2PQT0LQ193RL7MCB6DX4/20140228_Trade+151_0046.jpg Home https://images.squarespace-cdn.com/content/v1/5ec321c2af33de48734cc929/1607694644871-IC85FNH781UNZSZEGHDR/Aro+Ha_0428.jpg Home https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1646495948245-BW7UCWL09RMVLWTE4J8Q/unsplash-image-9e4n5-xvvbg.jpg Home - Here to help you Supporting your postpartum journey If you have been diagnosed with Sheehan’s Syndrome or Lymphocytic Hypophysitis following childbirth, here you’ll find a community with shared experience and support for you and your family. Our website is packed with information to guide you through seeking diagnosis and beyond. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1656316927404-LP5P7W7L2OOJB88D37WL/GettyImages-1139791140.jpg Home - Join our community Our community is a supportive place where you can connect to women who have had a similar experience to you, share your stories and learn from one another. You will be able to access past and future events on relevant topics for you, including nutrition, exercise, mental health, managing your hormones and living with a pituitary condition. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1633764291182-N2XM80P9679KDCKTFRVQ/unsplash-image-W6MGOy0QRjs.jpg Home - Calling healthcare professionals Are you a midwife, obstetrician, gynaecologist, GP, lactation consultant, health visitor, doula, endocrinologist or do you support women postnatally? Visit our page here. Please read and share our awareness campaign: https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1633778364227-BH0DMNSDCJ7MMW9A3EYK/unsplash-image-0aMMMUjiiEQ.jpg Home - Join the conversation Our news & blog covers all aspects of the lives of women with postpartum hypopituitarism, from birth stories to living with a long-term condition. Please read with care. https://maternalpituitarysupport.org/sheehans-syndrome-explained daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/f812ffe0-2914-4a8d-975b-771291a955ba/unsplash-image-iXhYIz4H0Ps.jpg Sheehan's Syndrome explained - What is Sheehan’s Syndrome? In 1937, Dr Sheehan described damage to the pituitary caused by haemorrhage (blood loss) or hypovolemia (very low blood pressure) during and after childbirth. This is where the condition “Sheehan’s Syndrome” comes from. It occurs because the pituitary gland does not receive enough oxygenated blood to keep the cells within it alive. Dr Sheehan called this pituitary necrosis. In more recent years, there have been calls for further research into this condition and whether there are other factors causing the damage. Scientists believe there may also be a link to autoimmunity or having a small sized sella (the bony hollow that houses the pituitary) . [1] [2] https://maternalpituitarysupport.org/community daily 0.75 2026-02-14 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/0e68d50b-67b0-49d1-b5a3-57868c3cb5cd/unsplash-image-DNkoNXQti3c.jpg Community - Join our Community If you have a pituitary condition arising in pregnancy or postpartum, this is for you. Created for you to connect to a community of women who understand and experience the same as you. This community is your voice. We work to raise awareness of maternal pituitary conditions, to ensure people do not suffer alone, campaign for swifter diagnosis and better care. We also welcome mothers with other pituitary conditions who would like to join our community. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/5d65d700-a359-43ef-a930-d4e8ff3988c3/Membership+push.png Community - Our Community What’s Included? An online community of people with a shared experience - bringing you together with women from all over the world who are living with pituitary conditions like yours. We have a private WhatsApp chat (new for 2026) and a private Facebook group. “Thank you for this community.” “It’s been really isolating. It’s great to finally meet and connect with others.” Access to our past and future Pitstop Talks (live & online) including leading endocrinologists, birth trauma resolution specialists, nutritionists and wellbeing practitioners.* Online socials and events so you can meet and get to know one another (these will initially be online, but we’d love to bring everyone together in person one day soon!). “Thank you so much for the social. It was lovely to see everyone’s faces.” “It was wonderful to put voices & faces to names. This was a great idea!” *Please note, we are unable to give individual medical advice. Please ensure you speak to your doctor before participating. All members use the community at their own risk* https://maternalpituitarysupport.org/recently-diagnosed daily 0.75 2023-07-30 https://maternalpituitarysupport.org/campaign daily 0.75 2023-08-04 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1633899680661-JMG9356G2VNSROKGOGTY/unsplash-image-y1j60Ifj5-M.jpg No Milk? Think Sheehan's! - No Milk? Think Sheehan’s! Whether acute or chronic Sheehan’s Syndrome, the most frequently documented symptom in the postnatal period is failure to lactate or difficulty lactating. This is because the hormone whose function it is to produce milk (and whose name comes from its role) - the hormone Prolactin - is very often one of the hormones damaged in the pituitary gland. https://maternalpituitarysupport.org/team daily 0.75 2025-09-13 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1646340139097-P4K31AVA5IU2JSLII0XH/MPS.jpg Team https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1646390134904-PBMIWUUJ3LKJ7NT7H33M/Jenn%252Bbio%252Bpic.jpg Team https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/7661a0fa-8148-41ad-9021-e5bdc5ec59db/Logo+2022.JPG Team - Why are we called Maternal Pituitary Support? Our organisation provides support for women, and their families, with pituitary conditions that arise during pregnancy, childbirth, or the early postnatal period. This includes those who may have sadly experienced miscarriage, stillbirth, or loss of their baby. We use the term maternal to welcome anyone with a pituitary condition arising during this unique time of life. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/05cb305e-012a-48d0-b869-d914c845c381/Smaller+WAPO+logo+2023.jpg Team https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/f6986aa2-21fe-4587-9093-9f9dd3d5e6b3/Smaller+size+The+Pituitary+Foundation+-+logo%2Bstrapline-navy-orange.jpg Team - Make it stand out Whatever it is, the way you tell your story online can make all the difference. https://maternalpituitarysupport.org/healthcare-professionals daily 0.75 2022-06-18 https://maternalpituitarysupport.org/endocrinologist-explained daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1644504374388-LTGDK35PSAX4FKTI3QSZ/unsplash-image-oi6jf34bQrU.jpg Endocrinologist explained What happens in an Endocrinology appointment? Your endocrine doctor will usually see you in an outpatient setting. A nurse or healthcare professional may ask to measure your height and weight, take your blood pressure and heart rate (observations) before your appointment. This is so that your endocrinologist has a good idea of your health when they see you. Most hormone levels are assessed and monitored through blood tests, so you may be asked to visit the phlebotomy (blood test) department during your visit as well. Some hospitals send out forms ahead of the appointment so you can have blood tests before the day. This is helpful because the results are then ready for you to discuss with your endocrinologist in your appointment. Your endocrinologist will ask questions about you, your health and about the history of your condition. This might involve talking about your general health before you were pregnant, during pregnancy and after. You will also be able to describe your symptoms now and your quality of life. Some endocrinologists use a quality-of-life score to measure how you are feeling through a short questionnaire. If you have adrenal insufficiency (lack of cortisol requiring steroid replacement) your endocrinologist should make sure you are given an emergency injection kit. Many hospitals provide training for how and when to use this. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1644504817383-DRYOX75O594Q95NCH7GD/unsplash-image-pA0uoltkwao.jpg Endocrinologist explained https://maternalpituitarysupport.org/references daily 0.75 2022-05-11 https://maternalpituitarysupport.org/pituitary-gland-explained daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/fbc87edc-df2a-4de6-95cf-fcd5cb20cb29/AdobeStock_158571739.jpeg Pituitary gland explained - What is the pituitary gland? The pituitary is a pea-sized gland found inside a bony hollow in the base of your skull. It sits underneath your brain, level with the bridge of your nose. It is also known as the adenohypophysis. The pituitary is known as the "master gland" due to its important job. It controls every cell in the body, such as growth, fertility, stress response and water balance. The pituitary controls hormones essential for keeping you alive and important bodily functions. The pituitary is split into two parts: the front part known as the anterior and the back part is known as the posterior. Like the other parts of your body, it relies on blood to carry oxygen to keep it alive. The anterior part of the pituitary does not have a direct blood supply of its own, so it relies on blood coming down a very narrow stalk from the hypothalamus, at the base of the brain, then through the posterior part. [1] https://maternalpituitarysupport.org/lymphocytic-hypophysitis-explained daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1647000779599-1IOQYAF7R5JFDPEA9LWO/unsplash-image-xTedodxYTuQ.jpg Lymphocytic Hypophysitis explained - What is Lymphocytic Hypophysitis? Lymphocytic Hypophysitis was first described by Dr Goudie and Dr Pinkerton in 1962. In pregnancy, the pituitary gland is already enlarged to provide the hormones needed to grow your baby. Lymphocytic Hypophysitis is an autoimmune condition, where the body’s immune system mistakes the cells of the pituitary gland for a pathogen or “invader”. Immune system cells such as lymphocytes are sent to the pituitary, where they cause damage by attacking the cells. This causes the pituitary gland to become inflamed and significantly enlarged. [1] [2] Terminology explained Lymphocytic - means related to immune system cells Hypophysis - anatomical name for the pituitary gland itis - means inflammation Lymphocytic Hypophysitis - “Inflammation of the hypophysis by immune system lymphocytes”. https://maternalpituitarysupport.org/difficulty-breastfeeding daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1647001554483-9JHYUXBPMI3H01D0963C/unsplash-image-V5lwTgW4wOk.jpg Difficulty breastfeeding - What if I can’t breastfeed? We want you to know, you are not alone. When the pituitary gland is damaged, the hormone Prolactin is no longer released, meaning that the body does not produce breast milk. For many women, being unable to produce breast milk is a very sad and challenging experience. It is important to remember that it’s not your fault. Some good news is that during pregnancy your body was busy producing and storing colostrum in the milk ducts in your breasts, which your baby took in the first days before milk would usually come in. This contains help for your baby’s immune system and lots of energy and goodness. Don’t worry if you were very unwell and unable to do this, your baby should still be just fine. If you’re worried about this, you can speak with your midwife or health visitor. https://maternalpituitarysupport.org/cortisol-acth daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/e91ae950-dc90-4085-b99b-24ecf8bcb76c/HPA+Axis+for+Adrenal+Insufficiency+page.jpeg Cortisol (ACTH) - Adrenocorticotrophic hormone (ACTH) ACTH is released by the pituitary, a part of the Hypothalamic-Pituitary-Adrenal Axis (HPA Axis) ACTH stimulates the adrenal glands (situated on top of the kidneys) to release the hormone cortisol. Cortisol is a steroid stress hormone and is used in every cell of the body. It is essential for life. When the pituitary is damaged, the feedback loop of the HPA axis can be damaged too, meaning the adrenal glands are not stimulated to release enough, or any cortisol. ACTH deficiency is more commonly known as secondary adrenal insufficiency - the adrenal insufficiency is secondary to a problem in the pituitary. You may also hear it described as secondary Addison’s, hypoadrenalism or hypocorticolism. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1650087009202-5T5TCNV2OI0NH6QCF4HI/unsplash-image-4hWvAJP8ofM.jpg Cortisol (ACTH) - Be safe If you have been diagnosed with ACTH deficiency it is important you learn how to keep yourself safe and avoid a life-threatening lack of cortisol known as adrenal crisis. https://maternalpituitarysupport.org/your-mri-scan daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/76492fe5-74f7-4d5b-8436-8b812de8851e/unsplash-image-bWllW3gy35w.jpg Your MRI scan - Why do I need an MRI scan of my pituitary gland? An MRI scan (Magnetic Resonance Imaging scan) enables doctors to see in detail the structure of your pituitary gland and surrounding brain. This is an important step in understanding more about your pituitary gland and any changes in hormones you might be experiencing. https://maternalpituitarysupport.org/recovering-from-acute-illness daily 0.75 2024-03-05 https://maternalpituitarysupport.org/getting-help-from-your-gp daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1647532655354-FBF06U8CZ7HEW0WYFRZU/unsplash-image-m1Hq4ibP9rc.jpg Getting help from your GP - Free Prescriptions (UK) In the UK, a diagnosis of hypopituitarism means you are eligible for free prescriptions with a medical exemption certificate. You can usually collect a form for this from your pharmacy and your GP will need to sign this. You will need to provide an addressed envelope with a stamp so your GP can send the form off. Having a medical exemption certificate will save you a lot of money on prescription fees. You can ask the pharmacy for a special receipt in the meantime, so that you can claim back the costs whilst you wait for your certificate in the post. https://maternalpituitarysupport.org/seeking-diagnosis daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/a44d6b48-3bcb-4cac-97dc-a9ab512820d8/unsplash-image-i-ePv9Dxg7U.jpg Seeking diagnosis? - A guide for those seeking diagnosis Maternal pituitary conditions tend to fall into these categories: Acute presentation, where there is a sudden or early onset of symptoms, perhaps combined with being very unwell. This might be for example if you had an adrenal crisis, or the intense headaches and visual disturbance that can come with Lymphocytic Hypophysitis. Chronic presentation, where it takes a while to find a diagnosis and explanation for symptoms. This can be a long and frustrating journey for many women. https://maternalpituitarysupport.org/keeping-yourself-safe-adrenal-insufficiency daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/8036a5f9-4809-4d2f-85f5-f44bb8e3e530/Jenn+medic+alert+3.jpg Keeping safe - adrenal insufficiency https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/5fd76a55-84c0-4305-bc87-e4ea1075e42c/Jenn+medic+alert+2.jpg Keeping safe - adrenal insufficiency https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1648291061532-0FOORNBGH2NELVYPCYV4/Jenn%2Bmedic%2Balert%2B1.jpg Keeping safe - adrenal insufficiency https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/f717886f-1779-4b46-96bc-6a75b1a58693/IM+injection+.jpeg Keeping safe - adrenal insufficiency - Emergency Injection Kits Your GP or Endocrine consultant will be able to provide you with what you need for an emergency injection. This is usually a vial of Solu-Cortef (powder form of Hydrocortisone) which is mixed with water for injections, or hydrocortisone sodium phosphate (which is a liquid form that does not require pre-mixing). There will then also be a needle and syringe. There are some examples of injection kits available for the UK and ROI here. These include a small plastic box, needles and syringes. You might like to have more than one injection kit, for example, one in the car and one in your bag. Make sure you know when your medication expires, so that you can replace it in advance. Hydrocortisone sodium phosphate tends to have a shorter life than Solu-Cortef. Many Endocrine departments provide training sessions on how to give a hydrocortisone injection in an emergency. You can also find out more information from Addison’s Disease Self Help Group here. Watch a video on how to give an emergency injection here. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/b175044a-41fd-4255-87ce-3a6f563767b1/nhs-steroid-card-front.jpg Keeping safe - adrenal insufficiency - NHS Steroid Card When you start on steroid (glucocorticoid replacement) you should be given a card by your doctor to say that you are dependent on steroids. In the UK it looks like this. https://maternalpituitarysupport.org/medmin-medical-admin daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/f2a20b74-573f-4c26-8ffe-6473fcb50019/Claire+meds+calender.jpg Medmin - medical admin Medmin calendar kept next to bed. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/031ba687-5831-4162-aa9c-a9571fc32864/new+jenn+med+box+4.jpg Medmin - medical admin Clearly labelled key is kept in box out of reach and a spare on kitchen notice board. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/4aebfb45-af77-4a95-99c2-e118dfe9109b/New+Jenn+med+box+2.jpg Medmin - medical admin Post-it notes with expiry dates on lid of trunk. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/4aab0bde-1c17-4faa-8adb-51cfa585f937/new+jenn+med+box+3.jpg Medmin - medical admin Medicines easy to see. Blood pressure and blood sugar monitors also kept in trunk. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1648331685775-P0ZA944K8UEIZPOYF0OB/unsplash-image-e5wjYI5c1Rw.jpg Medmin - medical admin - Prescription Hacks Ordering repeats Ask your GP if you can have a regular medication (one that isn’t likely to change) prescribed in a 6 monthly amount. Find out if there is an app you can use to order repeat prescriptions. In the UK, many GP practices use the NHS app. This will save you needing to make a phone call or go into the GP practice. Collecting from the Pharmacy You can ask your pharmacy to order your repeat prescriptions at the same time (in the UK, the pharmacy will call this “in line”). This means your prescriptions should be ready at the same time, so you only need to collect once until your next repeat is due. There are some pharmacies that deliver free of charge, or you can find out if there are any pharmacies that deliver through the post in your country. You can return out-of-date medicines to the pharmacy for safe disposal. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/dace9e09-6c96-4994-b35f-c837c441d360/New+med+box+1.jpg Medmin - medical admin - Safely storing your medications It’s vital your medicines are safely stored away from your child. There have been cases of children finding and consuming medicines in bathroom cabinets and kitchen cupboards. Children have died or been seriously injured through consuming medication for someone else. Co-founder Jenn uses a Tuck Box trunk to store her medicines. This is lockable and has some fiddly clasps that small hands can’t work. The key is hidden nearby in a jewellery box (and out of reach) and there’s also a spare key hanging on the kitchen notice board, just in case. It’s also worth making sure your child knows that mummy’s medicines are only for mummy, and they must stay away from them or get very poorly. If your child shows an interest in your medicines (e.g. sees you taking them) it’s never too early to start reinforcing this. The key to this trunk has a medic alert keyring so that it can be easily identified by an adult family member if needed. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/96726c2a-41c5-49f2-b017-01d3722b4858/Claire+meds+calender.jpg Medmin - medical admin https://maternalpituitarysupport.org/your-mental-health daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/5ec321c2af33de48734cc929/1618497259178-6XJGK9GR6YAVBQL5L519/20140301_Trade-151_012-2.jpg Mental Health Charities List https://images.squarespace-cdn.com/content/v1/5ec321c2af33de48734cc929/1607694583486-2PQT0LQ193RL7MCB6DX4/20140228_Trade+151_0046.jpg Mental Health Charities List https://images.squarespace-cdn.com/content/v1/5ec321c2af33de48734cc929/1607694644871-IC85FNH781UNZSZEGHDR/Aro+Ha_0428.jpg Mental Health Charities List https://maternalpituitarysupport.org/thyroid-tsh daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/86a2f079-41b2-416b-ae94-a1368820f651/TSH+Thyroid+Hypothalamic+axis.jpeg Thyroid (TSH) - Thyroid Stimulating Hormone (TSH) TSH stimulates the thyroid gland (found in the front of the neck) to release the hormones thyroxine and triiodothyronine. When the pituitary gland is damaged, it does not release enough TSH to stimulate the Thyroid gland to release thyroxine and triiodothyronine. Thyroxine is converted into triiodothyronine and most of this occurs in the cells of the body. Thyroxine and triiodothyronine are essential for metabolism, digestive function, heart function, development of the brain, muscle control and bone maintenance. Further reading at You & Your Hormones here. https://maternalpituitarysupport.org/oestrogen-progesterone daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/064133fa-dbca-468b-8638-28a5f7eb418c/FSH+LH+Oestrogen+Progesterone.jpeg Oestrogen, Progesterone & Testosterone (FSH & LH) - Follicle Stimulating Hormone (FSH) & Luteinising Hormone (LH) FSH is known as a gonadotropic hormone. It stimulates the follicles in your ovaries to grow and prepare for ovulation. As the follicle in the ovary grows it releases the hormone oestrogen. High oestrogen levels stimulate the release of LH from the pituitary. This is another gonadotropic hormone. LH brings about ovulation (release of an egg from the ovary). After ovulation the follicle forms a corpus luteum which releases the hormone progesterone. Progesterone inhibits (stops) the release of FSH from the pituitary. This usually occurs in a cycle – the menstrual cycle. When your pituitary gland is damaged the feedback loop between hypothalamus, pituitary and ovaries can be partially or fully affected. This is why your periods (menstruation) may not have returned (amenorrhoea) or be less frequent (oligomenorrhoea). It can also cause secondary ovarian failure. This means your ovaries can still work, however your pituitary is not releasing the hormones needed to stimulate them to release an egg. This means if you would like to conceive, your ovaries can be stimulated to produce and release an egg with assisted conception. You can find support and understanding in our community. We will also be hearing from women in our blog and their story around fertility and early menopause. Further reading at You & Your Hormones here. https://maternalpituitarysupport.org/growth-hormone daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/c39cde1f-fc7f-48b3-9c72-d15dd38c14c0/GH+axis.jpeg Growth Hormone (GH) - Growth Hormone Growth hormone is released by the pituitary and has a direct effect on cells in the body. It also stimulates cells in the liver to release insulin-like-growth factors (IGF). The most common is IGF-1. Growth hormone in adults plays a really important role around the body. It helps to maintain muscle strength, bone density, cardiac (heart) function, distribution of fat, energy levels, mood and feeling of wellbeing. It also plays an important role in regulating blood glucose levels. Some people with growth hormone deficiency experience extreme tiredness or fatigue. Growth hormone is normally released during sleep and in times of stress. https://maternalpituitarysupport.org/your-hormones-1 daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/2e41d359-e0e6-49e4-a74f-b18021fdc0e7/AdobeStock_92821780.jpeg Your hormones - Your hormones The pituitary gland is involved in many hormonal feedback loops, each known as an ‘axis’. When the pituitary cells involved in each axis are damaged, the whole feedback loop is affected. What this means is that when your pituitary gland is damaged then some of your hormones become deficient, because the signals are not getting through to them to tell them to work properly. The number of hormones that are deficient, depends on the extent of the damage. https://maternalpituitarysupport.org/symptoms-1 daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/5d550d42-f864-4b7e-a910-8d7d650c6b42/unsplash-image-RdvZ9x0xgfI.jpg Symptoms - Listen to your body Symptoms of hormone deficiencies and excesses are wide ranging and can overlap with each other (and side effects from medication). This can be frustrating and confusing, especially when you are newly diagnosed or seeking a diagnosis. It is important that you listen to your body and start to recognise patterns of symptoms. It will help you to better communicate with your health professionals and learn to manage your condition. This is an important part of becoming an expert patient, along with learning more about your hormones and your body. Keeping a diary of your symptoms is an ideal way to monitor how you are feeling, particularly once you progress onto hormone replacement medications. We have listed common symptoms on this page and in each hormone section. This isn’t a definitive guide, so if you have any queries please speak with your doctor https://maternalpituitarysupport.org/prolactin daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/f4d0813b-50c0-4e2d-b9e6-27cc89a128bd/unsplash-image-Ui0uW21uTxY.jpg Prolactin - Prolactin Prolactin is the hormone released from the anterior pituitary and stimulates the production of breast milk. It has also been found to have many functions around the body, including metabolism, reproduction, regulation of fluids and the immune system. The release of prolactin is affected by other hormones including dopamine, oestrogen, thyrotropin releasing hormone (see thyroid), oxytocin and anti-diuretic hormone (see posterior pituitary hormones). Some women with Lymphocytic Hypophysitis release too much prolactin due to inflammation and significant enlargement of their pituitary. This is known as hyperprolactinaemia. This can result in unwanted breast milk production and disturbance to the menstrual cycle. A deficiency in prolactin is known as hypoprolactinaemia and is caused by damage to the pituitary gland. This results in a lack of breast milk production following pregnancy. Lack of breast milk production is a key early sign of pituitary damage in the postpartum period. Further reading at You & Your Hormones here. https://maternalpituitarysupport.org/melanocyte daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/ec55cb48-00d0-4a91-9d2a-36b7fb70e166/unsplash-image-3YrtBEpMh60.jpg Melanocyte Stimulating Hormone (MSH) - Melanocyte Stimulating Hormone (MSH) MSH is produced by the pituitary, hypothalamus and skin cells. The pituitary releases MSH in response to increased UV (sun) exposure in the skin. MSH regulates melanin levels in the skin, hair and eyes (pigments and skin tone). It also regulates protection in the skin against UV rays. MSH is produced from the same starting molecule as ACTH (see adrenal insufficiency). MSH has anti-inflammatory properties and can affect the hormone aldosterone (which regulates salt and fluid balance). Further reading at You & Your Hormones here. https://maternalpituitarysupport.org/oxytocin-1 daily 0.75 2022-05-13 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1652263782803-M7JOEXH8CXASYBJBWZGQ/unsplash-image-odIhQypCuUk.jpg Oxytocin - Oxytocin Oxytocin is produced in the hypothalamus and released into the blood by the posterior pituitary. In pregnancy and childbirth, it plays an important role in starting and regulating contractions and the delivery of the placenta. It also affects let down of breastmilk and release through the nipples. Oxytocin acts in the brain and affects behaviour, such as sexual arousal, feelings of trust, attachment, and bonding. Research is being carried out to investigate the role of oxytocin in depression, anxiety and post-traumatic stress. You may have heard oxytocin referred to as the “cuddle hormone”. Further reading at You & Your Hormones here. https://maternalpituitarysupport.org/adh-1 daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1652264819942-ZDJC0U0JSU3J61I3MJE8/unsplash-image--xcouO3bxr8.jpg Anti-Diuretic Hormone (ADH) - Anti-Diuretic Hormone (ADH) ADH is produced in the hypothalamus and released into the blood by the posterior pituitary. It helps to control blood pressure by communicating with the kidneys and blood vessels around the body. ADH controls the amount of water able to leave your body in urine by communicating with your kidneys. Further reading at You & Your Hormones here. https://maternalpituitarysupport.org/understanding-mental-health daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1652266890838-2XMHG8D6L8CDRAIEJ8PC/unsplash-image-hluOJZjLVXc.jpg Your mental health - Your Mental Health Having a pituitary condition can impact your mental health and wellbeing. You may have feelings of anger, frustration and confusion around your diagnosis and what the future may hold. Diagnosis with a rare condition can be a lonely and isolating experience. You may have been through a traumatic experience, or be grieving, which can affect your mental health. Becoming a parent is also a huge life change and sleep deprivation can really affect us. Changes in hormones can also affect your mental health. We currently have funded mental health sessions for women in the UK. These are funded by The National Lottery and in partnership with The Self Space. You can apply here. https://maternalpituitarysupport.org/supporters daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/e0e18fec-cd8a-42af-a854-fa9d849f09dc/unsplash-image-1HtzdbptBr4.jpg Supporters - Supporters We are incredibly grateful to you all for your support. Your donations are vital to continuing our work. Thank you! Thank you to The National Lottery Community Fund’s Awards for All for funding our Sheehan’s Mothers Mental Health Project. https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1655583970010-OYT5POHE7UOYY1CRKVFT/unsplash-image-baLUAKBNsG4.jpg Supporters - Acknowledgements We’d like to say a big “thank you very much!” to the following people for their time and support in enabling us to launch Maternal Pituitary Support. Dr Philip Kelly (Consultant Endocrinologist and General Physician at Kings College Hospital, London) who has fact checked our information pages on the website. Dr Kathryn Gutteridge (Independent Consultant Midwife and former President of the Royal College of Midwives) for her encouragement and putting our case study forward for publication. Our family and friends for giving their time to support us with technical IT and comms, proof-reading our website and providing childcare, plus extensive emotional support and encouragement. We couldn’t do it without you! https://maternalpituitarysupport.org/donate-1 daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1654870174318-OC6AFPISXOSXNOO0NS8F/unsplash-image-BxXgTQEw1M4.jpg Donate Make a difference Will you help by making a donation to support our work? We’re a not-for-profit organisation and we rely on generous donations to continue our work. Your money will go towards achieving our mission: to raise awareness of Sheehan’s Syndrome and postpartum Lymphocytic Hypophysitis, to educate healthcare professionals in early identification of these life threatening and life changing conditions, to ensure those affected get the help and support they need as early as possible. Maternal pituitary conditions are affecting families around the world, right now. Mothers are struggling with debilitating and life threatening symptoms. We believe each mother deserves early support to manage her health and to flourish. Please consider making a donation today and making a difference to a mother and her family. Thank you. https://maternalpituitarysupport.org/thank-you-for-your-donation daily 0.75 2022-07-19 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1654867871424-SS322LDXPWJ23U93ZQE3/unsplash-image-hRdVSYpffas.jpg Thank you for your donation Thank you so much for your donation! Your generosity enables us to make a difference to the lives of those with maternal pituitary conditions around the world. We’re so grateful. Kindest wishes, Claire & Jenn (Co-Founders of Maternal Pituitary Support) https://maternalpituitarysupport.org/membership-confirmation-page daily 0.75 2022-07-19 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1654867871424-SS322LDXPWJ23U93ZQE3/unsplash-image-hRdVSYpffas.jpg Membership confirmation page Thank you for joining our community! We can’t wait to start getting to know you in our members area. We’ll be in touch shortly with access details to our community in Guild. Kindest wishes, Claire & Jenn (Co-Founders of Maternal Pituitary Support) https://maternalpituitarysupport.org/sign-up-newsletter daily 0.75 2024-06-17 https://maternalpituitarysupport.org/your-mental-health-project-funded-by-the-national-lottery daily 0.75 2023-07-30 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/ad07cdc1-8207-4786-8796-45d507a1b865/National+Lottery+thank+you.png https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/d4ee5858-0379-4476-a69e-f86ae519555f/Self+Space.png https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1666084634923-8UH9WDX8FYW3O308BOYF/Magdalena%2BWatling.jpg https://maternalpituitarysupport.org/pituitarytests daily 0.75 2024-03-05 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/2e41d359-e0e6-49e4-a74f-b18021fdc0e7/AdobeStock_92821780.jpeg Pituitary Tests - Pituitary Tests Here’s a quick summary of tests your doctor may request to test your pituitary function. Some are simple tests that can be requested by your General Practitioner and some are more complex and carried out by an Endocrinologist. Testing for Adrenocorticotropic Hormone (ACTH) Deficiency Insulin Tolerance Test (ITT) also called Insulin Stress Test is the “gold standard” test. The test involves lowering blood glucose with the hormone insulin and measuring through blood samples how much cortisol is produced from the adrenal glands in response to that stress on the body. The hypoglycaemia is sensed at the hypothalamus so this tests the integrity of the whole axis. There are some contraindications to this and so you may be offered a different test if required. Metyrapone test –an alternative where an Insulin Tolerance Test (ITT) is contraindicated. For this test you spend the night in hospital. At midnight you’re given a tablet containing Metryrapone along with a snack. In the morning, you will have a blood test between 8 am and 9 am to test the response of your HPA axis. Glucagon stress test – an alternative where an Insulin Tolerance Test (ITT) is contraindicated. For this test you’re in the unit for the day from 9 am. You’ll have a cannula (a small needle) inserted into a vein in your arm. You’ll have blood tests before and at intervals after being given an injection of glucagon. The blood tests measure the response of your HPA axis and also your Growth Hormone. Testing Adrenal gland function Short Synacthen test - You may be offered this test to see if your Adrenal glands can release the hormone Cortisol when stimulated. In many patients it can give information that is almost as reliable as an insulin or glucagon stress test. It is safer, quicker, more available and reproducible. A synthetic form of ACTH is given to you via an injection. The response of your adrenal glands is then measured via a blood test. It therefore does not test the whole axis, but this does not matter in most cases, the information can still be useful. Monitoring cortisol levels Blood test: your doctor may request serum cortisol tests to monitor your cortisol levels. Sometimes several of these tests are taken throughout a day, known as a cortisol day curve. This is to give a picture of your cortisol levels through the day. This is usually to monitor glucocorticoid replacement, for example hydrocortisone tablets. Testing for Thyroid Stimulating Hormone (TSH) deficiency Blood test: Your TSH levels and free thyroxine can be measured in a routine blood test, usually carried out in your hospital phlebotomy department, your GP practice or in a community blood test unit. Some thyroid function tests only measure TSH routinely. If there is secondary thyroid insufficiency (from hypopituitarism) then measuring TSH alone will not necessarily help. Free thyroxine (T4) must be measured alongside the TSH. This is sometimes supported by a free triiodothyronine test (T3). This test can be difficult to interpret because the conversion of thyroxine (T4) into triiodythyronine (T3) occurs mostly in the cells of the body. Testing for Follicle Stimulating Hormone (FSH) & Luteinising Hormone (LH) deficiency This involves a routine blood test to check the levels in your blood. Your hospital laboratory will have reference intervals for each part of the menstrual cycle. Testing for Growth Hormone Deficiency An Insulin Tolerance Test (ITT) is the “gold standard” test for growth hormone deficiency. This involves lowering blood glucose levels with insulin and taking blood tests to measure the response to this stress. There are contraindications for this test and so you may be offered a different test. A GHRH-Arginine Test is another way to measure growth hormone. GHRH is the hormone from the hypothalamus that usually stimulates the pituitary to release growth hormone. In this test a synthetic version of GHRH is given to you via injection. The response from your pituitary gland is then measured in blood tests. This test has less contraindications compared to the ITT; however, it can also be less reliable. Glucagon stress test – an alternative where an Insulin Tolerance Test (ITT) is contraindicated. It can be difficult to accurately measure your Growth Hormone levels in a routine blood test, so IGF-1 is measured instead. This is how your Growth Hormone levels will be monitored if you start on replacement medication. A newer test, known as the Macrilen or Macimorelin test has also recently been approved in the USA. Testing for prolactin Your doctor may request a blood test to measure your prolactin. Testing for Melanocyte Stimulating Hormone (MSH) MSH levels in the blood can be measured in a blood test, however it is not commonly tested for. Oxytocin deficiency or excess Currently there are no routine tests for this. Testing for Anti-Diuretic Hormone (ADH) deficiency Serum osmolality and urine osmolality test measures levels of fluid in the blood compared to fluid levels in the urine. A water deprivation test may be carried out in hospital to confirm a diagnosis of AVPD. This starts in the early morning and continues through the day. You are not able to drink or have any fluids throughout the test. Blood and urine samples are taken each hour to compare their concentration / osmolality. Blood pressure, body weight and urine volume passed are also measured. AVDP is confirmed if the blood osmolality increases beyond a certain level but the urine fails to concentrate. If the urine concentration defect then corrects with the addition of ADH (given by injection as part of the test) cranial AVDP is confirmed. This test is difficult and generally only done by doctors, and in centres, with some experience of arranging and interpreting it. Other tests Your doctor may sometimes also request these tests to get an overall picture of your health: Cholesterol Diabetes Mellitus Vitamin D Serum Sodium Full Blood Count Bone Profile Liver Function This summary is intended for general information only. Please refer to your doctor for information and advice specific to you as a patient. If you would like to learn more and you are a patient, why not consider joining our community? You will be able to access recordings of our Ask The Expert events, where leading Endocrinologists answer our questions. You’ll have access to our future online events too, along with online socials, where you can chat with people who get what you’re going through. It’s a really kind and supportive community! https://maternalpituitarysupport.org/community-rules daily 0.75 2024-05-22 https://images.squarespace-cdn.com/content/v1/615ec1175334524d9e899450/1654867871424-SS322LDXPWJ23U93ZQE3/unsplash-image-hRdVSYpffas.jpg Community Rules Thank you for joining our community! We can’t wait to start getting to know you. Before you access the community, please familiarise yourself with our community rules, which you can read below. By joining our community on Guild you confirm that you agree to these rules. All members access the community at their own risk and any information within is not a substitute for medical advice given by your qualified health professional.