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cretinism and pituitary insufficiency

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Replied by JaGill on topic cretinism and pituitary insufficiency

Thank You Tammy for taking the time to answer me. pituitary.org/media/kunena/topicicons/default/user/question.png
I see you confirmed that cretinism can be caused by low TSH as well as poor thyroid gland function. Thank you for that.
I realise that it would be very difficult for you to give advice from just a small piece of information, which is all I could give of course, so I appreciate your limitations.
Even missing a tablet a week for a few weeks has a serious effect on me which takes a year or more to recover from, so missing all my tablets for a month would be worse than devastating for my health. I didn't take my tables for a weekend once as a teenager, and by the end of that time I couldn't even talk properly, and very simple sums became hugely difficult, so I've certainly avoided doing that again.
I have been totally (or nearly totally) dependant on thyroid medication for nearly 55 years.
Is there any other way to find out if the Pituitary is working properly?
6 years 8 months ago #10133

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Replied by PNA-Tammy on topic cretinism and pituitary insufficiency

Hello JaGill,

I am not a medical professional so I sent your question to one of our advisers. Here is his response.

Cretinism is caused by low levels of thyroid hormones, or that the developing brain is not getting enough thyroid hormones. Given that TSH controls thyroid hormone production from the thyroid gland, then low TSH from whatever cause from birth will result in low thyroid hormone levels and potentially cause cretinism. To prove this would require a blood draw at birth to check for TSH and free T4 levels. To ascertain if you truly have low TSH, you will need to stop Levothyroxine treatment for 4 wks or so, and measure TSH and free T4. If your TSH is low or low normal, and free T4 is also low, then this confirms that your pituitary is not producing enough TSH to stimulate your thyroid gland to produce thyroid hormones. Having said this, stopping Levothyroxine for that length of time can be uncomfortable for some.

I hope this helps.

Take care,
6 years 8 months ago #10131

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cretinism and pituitary insufficiency was created by JaGill

Can cretinism be caused (partly or fully) by low pituitary output of TSH? If so, how could this be proven?
(NB: I've been on thyroid treatment since I was 17 months old, which will be coming up to 55 years of treatment this year)
I have had very low TSH since this test became used (1985 here). It was actually near zero for about a decade. Doctors always blame my 'high' thyroxine. Even when my TSH climbs a bit, though, it scarcely if ever has climbed as high as the minimum in the range.
Yes, my T4 results are usually high-ish, but I have tried managing on less thyroxine, (presently just over 150mcg/day; was 200mcg/day for about three decades) and my health suffers, so I refuse to live according to blood test results.
I started wondering about a decade ago if the reason for my consistently low TSH is at least partly due to my pituitary simply not producing much of it, but this is difficult to prove, and few medical people I've ever spoken to have been sure about how to respond.
I realise one of the signs of hypopituitarism is also low T4, but I presume that is in patients who are not already on thyroid medication.
I look after my health as well as I can, and am actually in reasonably good health.
6 years 8 months ago #10130

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