Sheehan's Syndrome?

[bellemama]

Has anyone here been diagnosed with Sheehan's syndrome because of HELLP? If yes, what were your symptoms? How were you diagnosed? Thanks.

[ambersjourney]

What is Sheehan's syndrome?

[kara]

Val,
I think Sheehan's syndrome is extremely rare. Have you been diagnosed, or are you experiencing some of the symptoms? A lot of the symptoms of Sheehan's can also be explained by other metabolic disorders.

[bellemama]

Kara, they still don't know exactly what is wrong with me. My T4 & T3 are very low, but so is my TSH, so it could be a hypopituitary issue. My growth hormone is also low, although my prolactin is fine and my FSH is sky high. I know it's rare, but having severe HELLP (as I did) that requires transfusions can be one of the precipitating factors; but as it isn't a tumor, it doesn't necessarily show on an MRI.

I'm just wondering if anyone here has it as a result of HELLP and how the drs. found it.

[alviarin]

Val,
I'm sorry you are still not feeling well.

I don't know a lot about Sheehan's, but it sounds like they did check your pituitary function by testing your pituitary hormone levels (PRL, GH, FSH, etc.). What do the docs think about the conflicting results and what the next step should be?

I don't know anyone personally who has Sheehan's but a search turned up an older thread on this topic. It's been a while but you could try emailing the original posters for info:

http://www.preeclampsia.org/forum/viewtopic.php?t=17019&SearchTerms=,sheehan%27s

How low are your T3 and T4 levels (below range, 10% of range...)? Are they checking your free T3 levels (as opposed to total)?

Have they checked you for autoimmune thyroid disease by checking for anti-thyroid antibodies? (including Anti-TPO and anti-Tg and TSH receptor antibodies)

Are you taking any drugs regularly that could inhibit thyroid function?

Another test they could run is called reverse T3. High reverse T3 levels can cause low T3 levels, however rT3 is unlikely to be high unless someone is very sick.

Something your docs might consider is a TRH test to check your pituitary function. TRH stimulates the pituitary gland to produce TSH.

Sorry you are dealing with this, I hope this helps, or at least gives you some ideas to discuss with your doctors.

[bellemama]

Thanks for the ideas, Alanna. They've tested quite a few things:

TSH .6 (ref.47-4.68)
Free T4 .7 (ref .6-2.0)
Free T3 3.35 (ref 3.5-5.90)
Thyroperoxidase 5.0 (expected <9.0)
Thyroglobulin <1.8 (expected value <4.0)
Estradiol 194
GROWTH HORMONE 0.19 (0.01 - 3.61)
PROLACTIN 5.1 (3.0 - 18.6)
FSH 12.8 (2.0 - 23.4)

They haven't tested my reverse T3 or my TRH. I have multiple nodules on my thyroid, all benign, but they didn't do an uptake test. I have hypo symptoms, except that I'm also losing weight and hair and I'm more heat intolerant than cold intolerant and I have major tachycardia and labile bp (that's gotten better with atenolol). I also have some fairly serious upper abdominal pain, but my liver and kidney function is fine. They even tested my catecholemines, which were in normal ranges.

So they are stumped, essentially. Very frustrating, as I am so tired all the time I can barely function....

[alviarin]

Are you on thyroid meds now? MY endo would probably treat at those levels, since she relies more on free T3 and free T4 than TSH.

In your shoes I would ask about getting your morning cortisol and ACTH levels tested to rule out an adrenal problem. Adrenal insufficiency or Addison's disease can cause heat intolerance & weight loss, and is something that should be ruled out before starting thyroid meds. I might also ask about rT3 also, since you have some bad abdominal pain that is still under investigation.

Although most people who are hypothyroid gain weight, some lose weight since they feel weak and have no appetite.

The atenolol might be affecting your T3 levels somewhat since beta blockers inhibit conversion of T4 to T3 (T3 being the more active form of the thyroid hormone). Beta-blockers can even be used to treat hyperthyroidism. Most people with a normal gland have no trouble adjusting to meds that inhibit thyroid function, but for someone whose thyroid gland is struggling or not functioning correctly it could have an impact.

Is there any way you could get a second opinion from another endocrinologist? Maybe one with more experience with Sheehan's? (since it sound like your docs are currently stumped).

[alviarin]

quote:

---

Originally posted by AmbersJourney

What is Sheehan's syndrome?

---

"Sheehan syndrome is a condition that may occur in a woman who has a severe uterine hemorrhage during childbirth. The resulting severe blood loss causes tissue death in her pituitary gland and leads to hypopituitarism following the birth.
...
"The pituitary gland, which is located at the base of the brain, produces hormones that help regulate growth, reproduction, and metabolism."

http://www.nlm.nih.gov/medlineplus/ency/article/001175.htm

[bellemama]

Thanks for the thoughts, Alanna.

That's what I did -- I met with a dr. with a more natural approach. We're waiting for the cortisol/adrenal tests right now, but she feels that I am both hypothyroid and hypopituitary (not full-blown Sheehan's, but it is clear that my pituitary was damaged at some point, probably from my HELLP pg). I started a bunch of supplements and am going on Armour, just to see if it will kick start my pituitary/thyroid into functioning again. It's nice to have found a dr. that takes me seriously and is willing to actually treat the symptoms.

[alviarin]

Thanks for the update. I'm glad you found a doctor you are happy with.

One other thing I forgot to mention earlier- with all that blood loss you probably depleted your iron levels. You might want to get your iron stores or ferritin levels checked. Anemia can also cause tachycardia and hair loss.

After I had my son I had low hemoglobin, but not quite low enough to require a transfusion. It took me three months of prescription iron supplements to get my levels up and to feel human again.

Keep us posted on your progress, and I hope you feel better soon!