End Fatigue

Pituitary Adenomas

Background

Pituitary adenomas are small benign growths in the pituitary. They do not become cancer, and the key concerns are if they become large enough to:

	1.	Push on the optic nerve, causing a loss of peripheral vision. This is uncommon, but the Hopkins doctor will do simple visual field screening tests to monitor for this.
	2.	Cause problems with pituitary function. This is where the problems I discuss with lab testing occur. Put simply, the normal range will say you have no problem unless you drop below the lowest 2% of the population. To use a simple analogy, the average household income in the U.S. is ~ $50,000 a year but you have to drop under $8,000 a year to be in the lowest 2 % (under $16,000 a year is poverty level). So if you dropped your income from $50,000 to $9,000 a year, the way that out-of-date medicine uses the tests would define you as having no problem! So they may say your tests are fine and no problem — even though the adenoma is contributing to major hormone deficiencies — and can even cause fatigue, CFS and Fibromyalgia.
	3.	It may cause an elevation of the hormone called "prolactin" which can then cause a host of problems including low dopamine, infertility, mood issues, and others. They may want to give a medication called "bromocriptine" for this (OK to use) but simply taking vitamin B6 at 250 mg a day will often lower the prolactin after 6 weeks (eliminating the problems caused by the high prolactin), without the side effects. We find treating with our SHINE protocol also usually lowers the prolactin level in those who have CFS/FMS.

Treatment

If you feel well, the adenoma simply needs to be monitored (usually by your eye doctor) to be sure it is not causing peripheral vision loss.

If the prolactin level is elevated and infertility becomes an issue, add vitamin B6 250 mg a day and consider the medication bromocriptine (which will lower the prolactin and lower the risk of birth defects when you get pregnant).

If you have fatigue, insomnia or achiness (CFS/fibromyalgia from the adenoma), removing the adenoma will not help the symptoms and is not needed (unless it is endangering vision — if the adenoma expert recommends surgery, get a second opinion if you feel it is needed, and then do it). Simply optimize hormone function based on symptoms (using the labs to check that they are in the normal range for safety after you find the optimal hormone levels as discussed in my book) and treat with the rest of the SHINE protocol.

Specialists will do a good job of evaluating your adenoma (they are very good at this) but may be clueless about CFS/fibromyalgia if you have fatigue, insomnia and achiness as well. So tell them thank you when they say the adenoma is OK and has nothing to do with your other symptoms, follow their instructions for monitoring the adenoma, and then go to a CFS/FMS expert (visit the Fibromyalgia and Fatigue Centers to find one) to get well. It is OK to do our treatment approach as in my book or the online program now while going through the adenoma evaluation, except I would hold off on thyroid or adrenal treatments (including DHEA) until they finish their initial evaluation. Once they say the hormone tests are OK you can have your FMS expert start the hormones.