Empty Sella: what does endocrinologist test?

Posted by marcia101 @marcia101, Jul 19, 2021

I was diagnosed with partially empty sella after an MRI for migraines and headaches. I was sent to an endocrinologist to test my thyroid and I thought the pituitary. My body temperature is all over the map and I suddenly have what feel like hot flashes 20 years post-menopause along with weight gain. I told him all of the symptoms I have not knowing if they were tied to partially empty sella or something else. He said none of it was partially empty sella and said menopausal symptoms I have are normal. I do not believe this is true.

He did a sonogram of the thyroid, lab tests but did not include hormone tests. I thought that would be one of the tests to see if that was part of my problem. Were those expectations wrong?

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@marcia101 – Welcome to Mayo Clinic Connect!
Since you have menopausal symptoms 20 years after menopause one would expect some hormonal testing to be done.
Were the headaches caused by the empty sella syndrome? According to literature headaches are often what brings you to the doctor.
There are endocrinologists that have special interest in pituitary function.
If you are able to go to a university hospital where there are many specialists, doctors are often listed with the special interest they have.
I always recommend a second opinion if you are not satisfied with the first one.
Please let me know what you decide to do!

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@astaingegerdm

@marcia101 – Welcome to Mayo Clinic Connect!
Since you have menopausal symptoms 20 years after menopause one would expect some hormonal testing to be done.
Were the headaches caused by the empty sella syndrome? According to literature headaches are often what brings you to the doctor.
There are endocrinologists that have special interest in pituitary function.
If you are able to go to a university hospital where there are many specialists, doctors are often listed with the special interest they have.
I always recommend a second opinion if you are not satisfied with the first one.
Please let me know what you decide to do!

Jump to this post

Thank you. The best university hospital nearby is an hour away. I'm not sure what kind of doctor to go to for these symptoms. I have a neurologist but she doesn't handle thyroid testing so I went to the endocrinologist.

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@marcia101– I would get a second opinion from an Endocrinologist.

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Hello, @marcia101 I heartily agree with @astaingegerdm about going to a university medical center for a second opinion. I drive about an hour to see an endocrinologist at a university center and it is worth the drive. University medical schools have great research programs ongoing and doctors who communicate with each other. These factors make this type of medical facility the very best.

As @astaingegerdm said, please post again when you make a decision regarding getting a second opinion.

REPLY
@astaingegerdm

@marcia101 – Welcome to Mayo Clinic Connect!
Since you have menopausal symptoms 20 years after menopause one would expect some hormonal testing to be done.
Were the headaches caused by the empty sella syndrome? According to literature headaches are often what brings you to the doctor.
There are endocrinologists that have special interest in pituitary function.
If you are able to go to a university hospital where there are many specialists, doctors are often listed with the special interest they have.
I always recommend a second opinion if you are not satisfied with the first one.
Please let me know what you decide to do!

Jump to this post

I go to the neurologist for headaches and migraines and they discovered the partially empty sella, believe it to be the cause of the headaches. I'm not sure if pressing on the pituitary has created some disruption of my hormones leading to the other symptoms: the hot flashes and wildly vacillating body temperatures.

REPLY
@hopeful33250

Hello, @marcia101 I heartily agree with @astaingegerdm about going to a university medical center for a second opinion. I drive about an hour to see an endocrinologist at a university center and it is worth the drive. University medical schools have great research programs ongoing and doctors who communicate with each other. These factors make this type of medical facility the very best.

As @astaingegerdm said, please post again when you make a decision regarding getting a second opinion.

Jump to this post

Thanks. Here's a question: how do you know what their special interest is? They are vague on websites and when you call for an appointment, of course all of their doctors do everything, are experts in all conditions. Don't know if I should laugh or cry about that.

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@marcia101

Thanks. Here's a question: how do you know what their special interest is? They are vague on websites and when you call for an appointment, of course all of their doctors do everything, are experts in all conditions. Don't know if I should laugh or cry about that.

Jump to this post

@marcia101,

If it were me, I would call for an appointment with an internist (primary care doctor) and have that doctor sort out which specialists to refer. If you go to a Mayo Clinic facility the scheduler would help you sort that out when you call. Here is a link to Mayo appointment information http://mayocl.in/1mtmR63.

Will you post again about this decision?

REPLY
@marcia101

I go to the neurologist for headaches and migraines and they discovered the partially empty sella, believe it to be the cause of the headaches. I'm not sure if pressing on the pituitary has created some disruption of my hormones leading to the other symptoms: the hot flashes and wildly vacillating body temperatures.

Jump to this post

@marcia101 – in literature they describe the sella as appearing empty, mostly filled with cerebrospinal fluid and the pituitary flattened out against the bone. This is why there could be some hormonal deficiencies and these could usually be treated.

REPLY
@astaingegerdm

@marcia101 – in literature they describe the sella as appearing empty, mostly filled with cerebrospinal fluid and the pituitary flattened out against the bone. This is why there could be some hormonal deficiencies and these could usually be treated.

Jump to this post

Thanks. That's what I had read, what I thought and expected from the doctor I saw. I'm getting another opinion.

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@hopeful33250

@marcia101,

If it were me, I would call for an appointment with an internist (primary care doctor) and have that doctor sort out which specialists to refer. If you go to a Mayo Clinic facility the scheduler would help you sort that out when you call. Here is a link to Mayo appointment information http://mayocl.in/1mtmR63.

Will you post again about this decision?

Jump to this post

Thanks. I'm near the DC area and traveling to the Midwest is not appealing. I'm going to go to a new primary care physician next month and the neurologist next week and hope for more guidance from both of them. Trying to do this on my own is challenging. Meanwhile, I got the name of an endocrinologist at a university hospital as a possible person to call. Once we figure out a plan, I'll post.

REPLY
@marcia101

Thanks. I'm near the DC area and traveling to the Midwest is not appealing. I'm going to go to a new primary care physician next month and the neurologist next week and hope for more guidance from both of them. Trying to do this on my own is challenging. Meanwhile, I got the name of an endocrinologist at a university hospital as a possible person to call. Once we figure out a plan, I'll post.

Jump to this post

Great to hear! I hope you find just the right doctor.

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@marcia101

Thanks. I'm near the DC area and traveling to the Midwest is not appealing. I'm going to go to a new primary care physician next month and the neurologist next week and hope for more guidance from both of them. Trying to do this on my own is challenging. Meanwhile, I got the name of an endocrinologist at a university hospital as a possible person to call. Once we figure out a plan, I'll post.

Jump to this post

I agree it’s challenging. I find it takes unnecessary energy just to get the right answers. Good luck!

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