Except for a complete inability to lose weight no matter what I do, I mostly feel good physically. I am working out 5 times a week for an hour each time and am sore in one place or another all the time. Well, except also for the afternoon fatigue. It used to be that I’d take an occasional 12 minute power nap a couple of times a week. Then, I started napping for a half an hour. Then, an hour. Then, I’d wake up after an hour and if G was still asleep, I’d go back to sleep, too, sometimes for another 30 mins. And then there is the forgetfulness. Not the kind that comes with age where you walk in a room and forget why. Or even the kind that has me hunting for my keys. This is literally not remembering what I’m talking about mid-sentence. This is asking myself a dozen times a day, “what did I just say?” or “what was I just going to do?” or “what’s the word that means…?”.
It was a combination of the above but mostly the frustrating inability to lose weight that had me reach out to my endocrinologist (who has been treating me off/on for the last 25 yrs) to inquire about running some tests. I wanted to check my cortisol. That required a 24 hr urine capture test, where I had to collect my urine for 24 hrs, refrigerate it, and take it to the lab. The results came back that my cortisol was indeed, low. She then ordered a blood test to test both my cortisol and adrenocorticotropic hormone (acth). Cortisol is released by the adrenal glands and acth is produced by the pituitary gland and signals the adrenals to produce more cortisol when it is low. Both levels were low, which is odd, as acth should have been high. As a result, she ordered a stimulation test, which meant an IV was placed, synthetic cortisol was injected, and my blood was drawn in specific intervals to check both cortisol and acth. There is a normal starting point for cortisol and a normal rise over the length of the test. Not only was my starting cortisol half of what it should be, the rise, which should have been 12, was less than half that, too. Acth was on the low end of normal.
Cue orders for a pituitary MRI. The pituitary, a pea sized gland, is part of the endocrine system and considered a master gland as it secretes hormones that balance almost all of the body’s systems, is located behind the eyes:
I had the MRI today. I’ve had two MRIs before so knew what to expect. I also had the chance to meet with my endocrinologist face to face for an hour, something I haven’t done since 2010. We reviewed my symptoms, test results, and possible outcomes of the MRI. Unfortunately, the most straightforward treatment will be if there is a tumor. If not, there is going to be some trial and error to figure out the underlying cause of my pituitary problem. I made the request of the tech that the images be expedited to the radiologist so that my doctor could call me by Friday. I want to go into the weekend knowing what there is to know and, hopefully, be able to celebrate my birthday.
My doctor reiterated that nothing is straightforward with me, something I have heard all my life and recounted on this blog more than once. She did validate that I know my body better than most and that when I say something is wrong, something is. It’s a matter of what that something is, in this case. Oh, and I’m at my highest post-pregnancy weight as of today (I could not, for the life of me remember that the word is “highest” and continued to spell it ‘heighest’ and couldn’t figure why it was underlined in red. That kind of memory problem).