Got my MRI back.. I have something called" empty sella syndrome"

[Arcane]

Anyone know anything about this?
I got an MRI last week, findings showed that I have a prominently flattened Pituitary gland and possible empty sella syndrome. What does this mean? Doctor didnt give any suggestions, just said it isn't anything serious

 

[BigTex]

Anyone know anything about this?
I got an MRI last week, findings showed that I have a prominently flattened Pituitary gland and possible empty sella syndrome. What does this mean? Doctor didnt give any suggestions, just said it isn't anything serious

Here you go....


Empty sella syndrome (ESS) is a medical condition characterized by the partial or complete emptying of the sella turcica, a bony structure in the skull that houses the pituitary gland. The pituitary gland is a small, pea-sized gland located at the base of the brain, often referred to as the "master gland" because it produces hormones that regulate various bodily functions.

In individuals with empty sella syndrome, the sella turcica appears enlarged on imaging scans, and the pituitary gland may be flattened or compressed against the walls of the sella. This occurs due to the expansion of the subarachnoid space, the area surrounding the brain and spinal cord, into the sella turcica. As a result, the pituitary gland may become flattened or displaced, leading to various hormonal imbalances and symptoms.

There are two main types of empty sella syndrome:

1. Primary empty sella syndrome: This occurs when the sella turcica becomes empty spontaneously or due to an unknown cause. It is often discovered incidentally during imaging tests conducted for unrelated reasons.
2. Secondary empty sella syndrome: This type of ESS develops as a result of an underlying condition or previous medical intervention, such as surgery, radiation therapy, or a tumor affecting the pituitary gland. These factors can lead to the partial or complete collapse of the sella turcica, causing the pituitary gland to be flattened or displaced.

Symptoms of empty sella syndrome can vary widely and may include:

1. Hormonal imbalances: Due to the disruption of the pituitary gland's function, individuals with ESS may experience hormonal deficiencies or excesses, leading to symptoms such as fatigue, weight changes, irregular menstruation, infertility, and decreased libido.
2. Headaches: Some individuals with ESS may experience headaches, which can range from mild to severe and may be chronic.
3. Vision changes: Compression of the optic nerves, which pass through the area near the pituitary gland, can occur in ESS, leading to vision changes or even visual disturbances such as double vision or loss of peripheral vision.
4. Other symptoms: Additional symptoms may include mood changes, difficulty concentrating, and symptoms related to hormonal imbalances.

Treatment for empty sella syndrome depends on the underlying cause and the severity of symptoms. In cases where hormonal imbalances are present, hormone replacement therapy may be prescribed to manage symptoms. Additionally, treatment may be directed towards managing specific symptoms such as headaches or vision changes. It's essential for individuals with ESS to undergo regular medical monitoring to assess hormone levels and overall health.

 

[Arcane]

Here you go....


Empty sella syndrome (ESS) is a medical condition characterized by the partial or complete emptying of the sella turcica, a bony structure in the skull that houses the pituitary gland. The pituitary gland is a small, pea-sized gland located at the base of the brain, often referred to as the "master gland" because it produces hormones that regulate various bodily functions.

View attachment 42894

In individuals with empty sella syndrome, the sella turcica appears enlarged on imaging scans, and the pituitary gland may be flattened or compressed against the walls of the sella. This occurs due to the expansion of the subarachnoid space, the area surrounding the brain and spinal cord, into the sella turcica. As a result, the pituitary gland may become flattened or displaced, leading to various hormonal imbalances and symptoms.

There are two main types of empty sella syndrome:

1. Primary empty sella syndrome: This occurs when the sella turcica becomes empty spontaneously or due to an unknown cause. It is often discovered incidentally during imaging tests conducted for unrelated reasons.
2. Secondary empty sella syndrome: This type of ESS develops as a result of an underlying condition or previous medical intervention, such as surgery, radiation therapy, or a tumor affecting the pituitary gland. These factors can lead to the partial or complete collapse of the sella turcica, causing the pituitary gland to be flattened or displaced.

Symptoms of empty sella syndrome can vary widely and may include:

1. Hormonal imbalances: Due to the disruption of the pituitary gland's function, individuals with ESS may experience hormonal deficiencies or excesses, leading to symptoms such as fatigue, weight changes, irregular menstruation, infertility, and decreased libido.
2. Headaches: Some individuals with ESS may experience headaches, which can range from mild to severe and may be chronic.
3. Vision changes: Compression of the optic nerves, which pass through the area near the pituitary gland, can occur in ESS, leading to vision changes or even visual disturbances such as double vision or loss of peripheral vision.
4. Other symptoms: Additional symptoms may include mood changes, difficulty concentrating, and symptoms related to hormonal imbalances.

Treatment for empty sella syndrome depends on the underlying cause and the severity of symptoms. In cases where hormonal imbalances are present, hormone replacement therapy may be prescribed to manage symptoms. Additionally, treatment may be directed towards managing specific symptoms such as headaches or vision changes. It's essential for individuals with ESS to undergo regular medical monitoring to assess hormone levels and overall health.

Interesting, so Im a candidate for HRT. I was mainly wondering about if it effects prolactin. I hear people with pituitary issues have high prolactin

 

[BigTex]

Seems like you would be. I am sure your doctor will get blood work done to see what hormones values need to be enhanced.

 

[StephCurryFtw]

Could adenomas cause this condition?

Woops, nvm. I didn’t see the part that already talks about this above.

 

[Stpfan]

Anyone know anything about this?
I got an MRI last week, findings showed that I have a prominently flattened Pituitary gland and possible empty sella syndrome. What does this mean? Doctor didnt give any suggestions, just said it isn't anything serious

Quite interesting. I was just diagnosed with this around Feb 2024. It took me 5 years to convince any Endocrinologist to run an MRI on the Pituitary... I finally found a woman doctor who would authorize the MRI. She told me... I didn't even order this searching for "Partially Empty Sella"... this was considered an "incidental finding". After confirming "Partially Empty Sella" my report indicated Pituitary Gland small in size and having decreased volume. No other indications or findings in the report. No lesions found. Basically she told me this is considered idiopathic. She said your Testosterone levels were low and you replaced them... your thyroid, cortisol, is normal. She said... I can't conclusively say "Partially Empty Sella" caused low testosterone. If I had to guess... (she said) I would say no. Then she indicated good luck on everything... I can't treat you. Please find someone else. lol Ever since this new information surfaced.... every single Endocrinologist wants me OFF OF TESTOSTERONE. The only doctor that wants me ON TESTOSTERONE is my Urologist. My Urologist told me... have your other doctors gone nuts? He said please show me why YOU DON'T NEED IT? That's all I request. Show me why you don't need it? I haven't seen 1 document in 5 years that indicates you don't need it. Gotta love the medical field right?

 

[Stpfan]

All I can say additionally on this matter... I do meet with my Urologist for my yearly check up April 16th. I will ask him what he thinks of the new "Partially Empty Sella" finding. I don't believe he will add anything to my protocol. I will say this... I have tried 80mg of Test Cyp a week.... 100mg.... 120mg.... 140mg and higher. If I don't take in at least 140mg a week... mentally I simply can't function. I'm zombie dead. Forget about sex... I'm just talking mentally to function. I've tried everything. But when you take 140mg+ a week it's hard to keep RBC low. I'm donating blood every 56 days on the nose. It's taking it's toll on my body. Hard to recover... hard to pump yourself up to donate every 8 weeks.

I really don't know what else to do? I thought about taking Oxandrolone at 5-10mg per day a long with a low dose of Test Cyp at 80mg a week. But when you take an oral steroid... your Cholesterol Ratio will get out of whack real quick. You can't do this long term. I do remember Oxandrolone giving me a higher level of alertness and energy. Simply put... automatic energy.

I'm really frustrated feeling unproductive. I feel like life is just passing me by.

 

[Arcane]

All I can say additionally on this matter... I do meet with my Urologist for my yearly check up April 16th. I will ask him what he thinks of the new "Partially Empty Sella" finding. I don't believe he will add anything to my protocol. I will say this... I have tried 80mg of Test Cyp a week.... 100mg.... 120mg.... 140mg and higher. If I don't take in at least 140mg a week... mentally I simply can't function. I'm zombie dead. Forget about sex... I'm just talking mentally to function. I've tried everything. But when you take 140mg+ a week it's hard to keep RBC low. I'm donating blood every 56 days on the nose. It's taking it's toll on my body. Hard to recover... hard to pump yourself up to donate every 8 weeks.

I really don't know what else to do? I thought about taking Oxandrolone at 5-10mg per day a long with a low dose of Test Cyp at 80mg a week. But when you take an oral steroid... your Cholesterol Ratio will get out of whack real quick. You can't do this long term. I do remember Oxandrolone giving me a higher level of alertness and energy. Simply put... automatic energy.

I'm really frustrated feeling unproductive. I feel like life is just passing me by.

do you have any nerve or body pain?

 

[Stpfan]

do you have any nerve or body pain?

Overall, nothing out of the ordinary in my opinion. But past 3 months I've had unusual neck pains. My PCP wanted me to get x-rays done. Those were done last month. Indicates arthritis forming... which was a surprise to me being almost 47 years old. I'm also getting an MRI done on the neck April 16 (same building)... I fear a disc has partially slipped.

I still go to the gym and blood pressure is always around 118/74 or so. I believe being on Test Cyp corrected my blood pressure... while I had low T... blood pressure was around 140+ at times.

I don't feel the neck issue has altered any lifting power in my arms or shoulders. Not yet anyways.

But back to the "Partially Empty Sella"... it's funny how doctors say... you're fine... you can live with it. Well of course we can. It doesn't mean it's the correct way in handling it. Honestly... these doctors just don't care. Hard to find anyone who does. I've had doctors review the report and they told me... it's "genetics". Or this was simply inevitable. Bad luck? lol The ignorance in some of these doctors. How about saying... we need to find someone to correct this for you? Or.. I will get right on this! Nope. Doesn't work that way. One doctor believes that "Partially Empty Sella" is caused by brain tissue pressing hard on the pituitary and flattening it. Another doctor believes that if anyone was involved with oral steroids earlier in their life... this is also a cause of "Partially Empty Sella".

If I receive any "factual" information... I will make sure I update this thread and let you know.