Ask an expert about pituitary disorders (UCLH web chat) 

Dr Stephanie Baldeweg

For our March web chat, we had Dr Stephanie Baldeweg, a consultant physician in diabetes and endocrinology disorders at University College Hospital taking your questions about pituitary disorders. The pituitary is an important gland in the body and it is often referred to as the 'master gland', because it controls several of the other hormone glands (e.g. adrenals, thyroid). Dr Baldeweg is interested in all aspects of diabetes and endocrinology and has a special clinical and research interest in pituitary disease. She regularly gives talks at national and international meetings as well as patient days for support groups such as Diabetes UK and the Pituitary Foundation.  You can view a replay of the web chat below.

Here is a transcript of the webchat below:


12:50 Dr Stephanie Baldeweg: 
Our web chat is due to start in 40 minutes - please start sending in your questions to Dr Stephanie Baldeweg.

1:21 Dr Stephanie Baldeweg: 
Hello, we are ready for the webchat, lots of questions are coming in, we'll start in 10 minutes.
 
1:29 [Comment From SueSue: ] 
Dear Dr Baldeweg Thank you for giving us your time yet again. At the London Pituitary Group Conference you mention pituitary patients have several comorbidities. Could you go through that list again...I remember one was colonic polyps and maybe bone problems - please explain why we are prone to these and if these affect one type of patient more than another. Also, what we can do to try to prevent them. Thanks
 
1:30 Dr Stephanie Baldeweg: 
Sue, thank you for your question.
I enjoyed being part of the London Pituitary Conference. The comorbidities with pituitary disease vary depending on the original diagnosis. Common problems are diabetes, hypertension, hi-cholesterol, and osteoporosis. Osteoporosis can be due to lack of certain pituitary hormones and can be improved by replacing those.
Thanks
 
1:30 [Comment From EvaEva: ] 
I've heard that patients with panhypopituitarism are likely to have a reduced life expectancy. Can you explain why? At a Lapps meeting I heard we are at increased risk of cardiovascular disease too - what makes this so likely please?
 
1:32 Dr Stephanie Baldeweg: 
Eva, thank you for your question,
Cardiovascular disease is indeed a complication of pituitary disease. This happens because of negative effects of panhypopituitarism on the whole body. The risk can be reduced by reducing the usual risk factors. We would aim to optimise blood pressure, blood glucose and cholesterol levels. A health living approach and avoiding smoking would be essential.
 
1:32 [Comment From MartinMartin: ] 
I have just been told I have a tumour; does this mean I have cancer?
 
1:34 Dr Stephanie Baldeweg:
Martin, thank you for your question,
I am sorry to hear about your new diagnosis. Pituitary tumours are usually benign and not cancerous. A good source of information is the Pituitary Foundation – www.pituitary.org.uk
I hope this helps.
 
1:34 [Comment From GrahamGraham: ] 
Hello and thanks for answering so many of our burning questions. Why isn't there a ready made steroid kit - like the epipen - that we could use in emergencies. The prospect of dissolving powder and liquid, changing needles and giving myself an injection when I may be ill sounds quite challenging. Also, what symptoms might I or the family notice that I'm in need of emergency steroids please.
 
1:38 Dr Stephanie Baldeweg: 
Graham, thank you for your question,
I absolutely agree that there should be a ready-made steroid pen. We, with the Pituitary Foundation, have petitioned Parliament for this and will continue to do so. Because pituitary disease is relatively rare, it seems to be less attractive to companies to produce a pen like the epi-pen for this situation.
On your second question regarding when to use emergency steroids, the answer can be found on the Pituitary Foundation website in their Hydrocortisone advice leaflet. www.pituitary.org.uk It will be useful if you and your family read this and have it at hand in case you ever need it.
Many patients also wear a steroid bracelet and carry a steroid card for emergencies, and I would strongly recommend this.
Thanks again for this question.
 
1:38 [Comment From JanetJanet: ] 
I have borderline growth hormone, what exactly does this mean and will I end up on medication?
 
1:40 Dr Stephanie Baldeweg: 
Janet, thank you for your question,
It is recognised that adult growth hormone deficiency is a continuum. However, the National Institute for Clinical Excellence (NICE) approved growth hormone treatment in adults in 2003. For this you have to have severe growth hormone deficiency and a severely affected quality of life. You should also be receiving replacement for any other pituitary hormone deficiencies and these should be optimal before growth hormone is started.
The Pituitary Foundation (www.pituitary.org.uk) has a growth hormone factsheet giving details of criteria for growth hormone replacement, monitoring and injecting devices.
 
1:40 [Comment From GrahamGraham: ] 
Hi again, can you also advise what I should do if I accidentally miss one of my steroid tablets. Do I double up later or just take my normal dose>
 
1:42 Dr Stephanie Baldeweg: 
Hi Graham, welcome back,
If you miss a steroid tablet and you notice within a couple of hours I would advise to take this at a normal dose. If you only remember when your next dose is due I would double that one.
Thanks
 
1:42 [Comment From GuestGuest: ] 
Dr Baldeweg, Could you please tell us what signs and symptoms we might be experiencing if our dose of thyroxine or steroids may be too much or too little> I've been told by one person the free T$ blood test result is more important - why?
 
1:46 Dr Stephanie Baldeweg: 
Hi, thank you for your question,
The judgement on the correct dose of steroid replacement is made on both, the blood tests and the clinical picture. Fatigue and weight changes might influence the dose.
Typical signs of too much thyroxin are palpitations, weight loss, anxiety and diarrhoea. Typical signs of too much steroids would be weight gain and adverse effect on blood sugar and bone health.
Your endocrinologist will be able to talk you through your blood tests.
Thanks
 
1:46 [Comment From TottyTotty: ] 
If you've been diagnosed with hormone deficiencies like cortisol for example is it worth getting a mri scan to check, measure the size of the pituitary gland? Is there a special mri scan that you need to have?
 
1:50 Dr Stephanie Baldeweg: 
Hi Totty, thank you for your question,
Hormone deficiencies can be due to the pituitary gland or other glands. For example, the adrenal glands. If the course is pituitary in nature an MRI will be indicated to look at the size and appearance of the pituitary gland. Often a contrasted scan will be helpful to give more detailed information.
Thanks
 
1:52 [Comment From SylviaSylvia: ] 
Steroids have in part increased my weight...and appetite too! My cholesterol has gone up yet one of the side effects of statins is an increase in my liver enzymes. I've tried several statins but all have some side effects. Statins keep having a mixed press as to what else they cause, could you comment on whether it's better to keep on the statins despite their affects, or accept a raise cholesterol and try to minimise it just with diet. Furthermore, do you have any advice regarding reducing my appetite as some times, I feel I could eat and eat.( Yes, I do try to eat healthier choices but they aren't necessarily very filling. )
 
1:53 Dr Stephanie Baldeweg: 
Hi Sylvia, thanks for your question,
This is a very tricky and common problem. The same question gets asked by people who don’t have pituitary disease. However pituitary disease can exacerbate it. It is complex to answer. There are alternatives to statins which you should discuss with your doctor and weight loss programmes you may be able to join.
 
1:54 [Comment From VickyVicky: ] 
Dear Dr Baldeweg. Just wondering what you think might happen with regard to advances in our care/treatment 10 years?
 
1:56 Dr Stephanie Baldeweg: 
Hi Vicky, thanks for your questions,
Your first question was on annual review, but it seems to have disappeared from our screen!
The annual pituitary review should include general information on your wellbeing, health related events in the last year and any future plans, such as operations or fertility plans. We would like to know in between if you feel a significant change in your health, weight and, for women, your menstrual period pattern.
The second question regarding advances in care in the next ten years has not got an easy answer. I would envisage many advances in genetics and the understanding of which tumours might respond to which treatment. I would also hope that more hormones might be replaced such as oxytocin.
Thanks
1:58 Dr Stephanie Baldeweg: 
Paul :] Hi I have sent about 5 questions are you receiving them , sorry I am new to this , thank you very much for your time
 
1:59 Dr Stephanie Baldeweg: 
Thanks Paul, sorry to keep you waiting. We are having so many questions, but are working through them! Yours will be next.
 
2:00 [Comment From Paul JenkinsonPaul Jenkinson: ] 
I have diabetes insipitus can then turn into type 1 or type 2 diabetes thanks
 
2:03 Dr Stephanie Baldeweg: 
Hi Paul, thanks for this first question,
Diabetes insipidus is due to lack of anti-diuretic hormone made in the posterior lobe of the pituitary. Type 1 and Type 2 diabetes are due to problems with insulin and blood sugar levels (diabetes mellitus). Diabetes insipidus has this name because the urine is very clear. Diabetes mellitus has its name because the urine is sugary. They are very different conditions.
Thanks
 
2:04 [Comment From Richard SRichard S: ] 
I understand that the liver can regenerate. What is known at present in this respect about the pituitary?
 
2:05 Dr Stephanie Baldeweg: 
Thanks for your question Richard,
Unfortunately the pituitary gland cannot regenerate like the liver. Hopefully in the future we may be able to produce pituitary cells and use them for treatment.
Thanks
 
2:05 [Comment From DavidDavid: ] 
Pelasi, if I travel abroad for 8 days, do I have to TaKe my GrowHow hormone injections with me ?
 
2:08 Dr Stephanie Baldeweg: 
Hi David, thanks for your question,
It depends whether you feel bad without your growth hormone. Most people would tolerate a short time without it. For travelling there is a disposable pen which does not need to be kept in a fridge (MiniQuick) that might be suitable for your travels. Please make sure you have a travel letter about carrying syringe and needle in your hand luggage if you are flying. This letter should be provided by your endocrinologist.
Thanks
 
2:08 [Comment From GrahamGraham: ] 
Dr Baldeweg: on the subject of a readymade steroid pen, would it help for the Pituitary Foundation to set up a petition for these to become available? Is there anything else we could do as it would help so many and that includes people with other diseases too eg adrenal insufficiency. Wouldn't there also be use for them on ambulances and in hospitals that the costs of production could be offset by the ease of use?
 
2:10 Dr Stephanie Baldeweg: 
Dear Graham,
Your offer is much appreciated. Please would you contact the Pituitary Foundation directly and I’m sure they will be very grateful for any such support.
Thanks
 
2:10 [Comment From Harriet TattersdillHarriet Tattersdill: ] 
My enquiry is about Vitamin D please. Is it OK to take it on it's own when you have a low level? The combined Vit D and calcium tablets seem to be affecting my teeth or do we need the calcium too. I've been told not to take it with my thyroxine first thing Can you offer any other advice
 
2:12 Dr Stephanie Baldeweg: 
Dear Harriet, thank you for your question,
Vitamin D is very topical, so your question is very welcome. It is safe to take vitamin D without calcium tablets. You could get your calcium from a healthy diet. It is best to take thyroxine on an empty stomach half-an-hour before breakfast.
Thanks
 
2:13 [Comment From KarenKaren: ] 
Hi again.Should my hydrocortisone dose be increased in times of severe emotional stress (eg bereavement?)as well as physical illness stress? Thank you.
 
2:16 Dr Stephanie Baldeweg: 
Dear Karen, thank you for your question regarding when to use emergency steroids. The answer can be found on the Pituitary Foundation website in their Hydrocortisone advice leaflet. www.pituitary.org.uk It will be useful if you and your family read this and have it at hand in case you ever need it.
Many patients also wear a steroid bracelet and carry a steroid card for emergencies, and I would strongly recommend this.
Regarding severe emotional stress and steroids, the answer is not clear. At a time of bereavement, if in doubt, I would double the dose for a couple of days. And that would be safe.
Thanks
 
2:16 [Comment From KarenKaren: ] 
Hi again. What are indicators that we are scanned for MEN1? I have had a tumour removed but there is infertility in my immediate family, café au lait spots and gastric problems. Should I mention this to my endocrinologist? Thank you.
 
2:19 Dr Stephanie Baldeweg: 
Hi again Karen,
Some patients with pituitary disease can have a genetic condition leading to other endocrine problems as part of a multiple endocrine neoplasia syndrome (MEN). I would suggest you discuss your concerns with your endocrinologist.
Thanks
 
2:19 [Comment From georgegeorge: ] 
HI Dr Baldeweg, I am a 16 year old panhypopituitarism patient. Recently, my testosterone levels have been a little on the low side. My endocrinologist has changed me from 3 weekly testosterone enentate to nebido. After reading the side effects, I am quite concerned about having it. Are their any side effects that occur commonly in patients?
 
2:22 Dr Stephanie Baldeweg: 
Hi George, thanks for your question,
Testosterone replacement therapy is usually safe if appropriately prescribed and administered. A possible side effect to watch out for is thickening of the blood. To check this you will need a blood test for full blood count every six months. Most people tolerate nebido very well.
Thanks
 
2:22 [Comment From fortfort: ] 
Endocrinologists in the USA often recommend dexamethasone instead of hydrocortisone, especially if the patient is on growth hormone replacement. This is, as far as I know, unheard of in the UK/Europe. Is there something doctors in the UK know, that US doctors don't, or vice versa? Thank you.
 
2:24 Dr Stephanie Baldeweg: 
Hi Fort, thanks for your question,
The difference in practice here seems to be to do with tradition rather than real science as far as I know. Some people in the UK use prednisolone instead of hydrocortisone. It is cheaper and longer acting, but perhaps less flexible.
Thanks
 
2:25 [Comment From KarenKaren: ] 
Hi, Thank you for your time. I had a large macro adenoma removed at LGI on 23/01/2015 and am still drinking large amounts ( altho the overall fluid in and output balances).On average how long does this take to settle down?
 
2:26 Dr Stephanie Baldeweg: 
Dear Karen, thanks for your question,
I would suggest you discuss this with you endocrinologist as you may be suffering from diabetes insipidus, which can be easily treated.
Thanks
 
2:26 [Comment From HelenHelen: ] 
Does the need for growth hormone replacement decline with age, as we grow older do we need less?
 
2:27 Dr Stephanie Baldeweg: 
Hi Helen,
Growth hormone requirements decrease with age. IGF-1 is used to assess growth hormone replacement levels. The normal ranges are automatically age adjusted.
Thanks
 
2:28 [Comment From MariaMaria: ] 
How frequently should a pituitary patient (tumour removed ) on all the replacement medication have their bloods reviewed?
 
2:28 Dr Stephanie Baldeweg: 
Hi Maria,
Thank you for your question. I recommend a six-monthly review.
Thanks
 
2:29
Hello, I believe Oxytocin is one of the hormones not substitued for panhypo pituitary patients. It seems that this is an important hormone. Is there any work going on to eventually substitute this hormone?
 
2:32 Dr Stephanie Baldeweg: 
We are due to finish now but we are going to keep going for a little bit longer as we have so many interesting questions. Thank you.
 
2:33 Dr Stephanie Baldeweg: 
Hi,
Thanks for asking my favourite question. Oxytocin is a very trendy hormone and much discussed in medical and lay papers. A lot of work is done looking at a possible replacement. It is implicated in many emotional processes. I would hope that we would use it routinely in the future
 
2:33 [Comment From TottyTotty: ] 
Thanks Dr Baldaweg that's great information. I am worried about my chest problems and breatlessness, do you think this could be linked to the hypopituritism or maybe heart problems?
 
2:35 Dr Stephanie Baldeweg: 
Thanks Totty, glad you found it useful. For everybody, the advice is to seek urgent medical help with breathlessness or chest pain.
 
2:35 [Comment From Helen GrantHelen Grant: ] 
Thank you for your time, much appreciated
 
2:35 [Comment From HelenHelen: ] 
Is the response to desmopressin affected by stress? I find it very variable.
 
2:38 Dr Stephanie Baldeweg: 
Thanks Helen, the effect of desmopressin can indeed be variable and can be affected by changes in weather, climate, fluid intake.
 
2:38 [Comment From DavidDavid: ] 
Yeh, cheers doctor, take care David x
 
2:38 Dr Stephanie Baldeweg: 
Thanks David, my pleasure!
 
2:39 [Comment From Helen GrantHelen Grant: ] 
I do not have a pituitary gland. I find it difficult to cope sometimes with the pressures and stresses of a difficult job, and I take occasionally take extra hydrocortisone (5mg) on top of my usual daily 25 mg. Is this Ok in your opinion?
 
2:42
Dr Stephanie Baldeweg: 

Hi Helen, as I mentioned earlier, regarding when to use emergency steroids, the answer can be found on the Pituitary Foundation website in their Hydrocortisone advice leaflet. www.pituitary.org.uk It will be useful if you and your family read this and have it at hand in case you ever need it.
Many patients also wear a steroid bracelet and carry a steroid card for emergencies, and I would strongly recommend this. I tell my patients that it’s OK to take the occasional extra small dose of Hydrocortisone. The drawbacks are the negative effects on weight, blood glucose and bone health if you do this too much.

 
2:42 [Comment From LauralooLauraloo: ] 
How can an ACTH high adenoma NOT be Cushing's?
 
2:45 Dr Stephanie Baldeweg: 
Thank you Lauraloo.
Cushing’s Syndrome (named after Harvey Cushing, a neurosurgeon) can be due to many causes of cortisol over-production. An ACTH producing pituitary adenoma would lead to Cushing’s Disease. High ACTH levels can also be due to ectopic sources for example in the lung.
 
2:45 [Comment From CarlCarl: ] 
I have Hypopituitarism and take 10mg-5mg-5mg of Hydrocortisone daily. When I am much more physically active than normal, I suffer Cortisol 'lows' (my day job is a desk job, much more sedentary). How much, if at all, can I vary my Hydrocortisone intake?
 
2:46 Dr Stephanie Baldeweg: 
HI Carl thank you for your question, as I mentioned earlier, regarding when to use emergency steroids, the answer can be found on the Pituitary Foundation website in their Hydrocortisone advice leaflet. www.pituitary.org.uk It will be useful if you and your family read this and have it at hand in case you ever need it.
Many patients also wear a steroid bracelet and carry a steroid card for emergencies, and I would strongly recommend this. I tell my patients that it’s OK to take the occasional extra small dose of Hydrocortisone. The drawbacks are the negative effects on weight, blood glucose and bone health if you do this too much
 
2:47 [Comment From AlimurrAlimurr: ] 
Are night sweats normal for someone with diabetes insipidus?
 
2:50 Dr Stephanie Baldeweg: 
Hello Alimurr thank you for your question. I would suggest to discuss this with your doctor if you have other hormone deficiencies. For example low oestrogen or testosterone can cause night sweats. Sometimes other illnesses can also contribute and should be exlcuded, for example infections.
 
2:50 [Comment From Dick SmithDick Smith: ] 
Good afternoon. I'm looking forward to your advice please. I've been diagnosed with panhypopituitarism due to Empty Sella Syndrome and have been told the pituitary gland has been replaced with what's likely to be a cyst about the size of a golf ball. I'm on medication: steroids, thyroxine to treat the lack of hormones. What might have caused the cyst and is just monitoring the blood tests once a year enough. I had a second MRI scan a few months after my diagnosis 7 years ago and so far my local hospital seems happy to see my for a quick review ever 12 months or so.
 
2:52 Dr Stephanie Baldeweg: 
Dear Dick, I would agree that keeping an eye on your hormones is the most important strategy. Depending on the actual appearance of the cyst, a repeat scan at some point may also be useful. We do not really understand why cysts form but may learn more in the future.
 
2:52 [Comment From LauralooLauraloo: ] 
I had a 3 cm silent corticotroph adenoma, "ACTH high, but not Cushing's" removed January 2014 at Kings. I am not on hydrcortisone as IST showed I made enough of my own. I am on 125mcg thyroxine and .5 daily growth hormone injections. I am mostly house and bed bound and suffer with extreme "energy" drains most days. Do you have a reason why this might happen? What am I lacking? Many thanks.
 
2:55 Dr Stephanie Baldeweg: 
Hi Laurloo, thank you for coming back. I am sorry to hear you are suffering with extreme fatigue. Fatigue in pituitary disease is very troublesome and distressing for a proportion of patients. Optimising the hormone replacement is the first step. Unfortunately it doesn’t resolve this in everybody. Other strategies include psychological support, graded exercise and plenty of sleep and rest. We do not fully understand why this occurs, and hope that we will understand more as time goes by. I wish you well.
 
2:56 [Comment From Paul JenkinsonPaul Jenkinson: ] 
Hi, I was a patient of Mr Micheal Powell, but have now moved to have my care at Walton Hospital as unfortunatly there is nothing more can be done than what is allready being done , IE) meds to replace my Pituitary function . My question is pease although my blood results are fine , I am constantly tired , I am probably only awake 7 hours a day , waking about 10am , back in bed 3pm ish for 3-4 hours then bed again 1am ish , when I am awake I can only potter around as no intrest in doing anything. thanks
 
2:56 Dr Stephanie Baldeweg: 
Dear Paul, please see our answer to Lauraloo’s question. I hope this is helpful to you too.
 
2:57 [Comment From Paul JenkinsonPaul Jenkinson: ] 
Can diabetes insipitus be passed onto my daughter , or any other endrocrinology conditions I have , I only have 1 child aged 4 . I have to come of some of my meds and have daily fertility injections to be able to get my wife to conceive thanks
 
2:59 Dr Stephanie Baldeweg: 
Dear Paul, welcome back. It would be extremely unlikely to have a genetic cause of diabetes insipidus. Regarding the fertility treatment, in hypopituitarism, often patients are asked to stop their testosterone and start injection treatment. I hope this works for you and your wife. Good luck.
 
3:00 [Comment From TottyTotty: ] 
I've got hypopituritism and been suffering with chest pain and breathlessness lately. My ECG has come back abnormal with left atrial enlargement & anterior infarct. Is there a possibility I could have heart disease or damage?
 
3:02 Dr Stephanie Baldeweg: 
Dear Totty, it sounds like you have already been investigated for this, discuss this with your treating doctor. Remember if you are on hydrocortisone and any medical procedures are planned to follow the emergency steroid guidance. Regarding when to use emergency steroids, the answer can be found on the Pituitary Foundation website in their Hydrocortisone advice leaflet. www.pituitary.org.uk
 
3:02 [Comment From SookiSooki: ] 
I have gained 2 stone in the last year, in my early 50s, could this be thyroid related? I've a relatively healthy lifestyle
 
3:04 Dr Stephanie Baldeweg: 
Hello Sooki, thank you for your question. Weight gain can be a sign of hormonal disturbances, I would suggest you see your GP and discuss this with her/him. Menopause and thyroid disorders could contribute especially in your 50s.
 
3:04 [Comment From DonnaDonna: ] 
I have secondary adrenal insufficiency I'm severely vitamin d deficient and my on 20,000iu a day for 12 months my level is now only 14. When first diagnosed it was 8 Gp doesn't seem too concerned but is offering injection but can this be an issue with pituitary problems?
 
3:05 Dr Stephanie Baldeweg: 
Dear Donna, thank you for your question. There’s no direct correlation between vitamin D deficiency and pituitary disease. However as pituitary disease can often affect bone health, vitamin D replacement is especially important.
 
3:06 [Comment From Paul JenkinsonPaul Jenkinson: ] 
Hi about to get travel insurance and never know what conditions to put down so always list them indiviually and it very costly , I would like to know is there one umbrella heading for my condition , I have no pituatiry function and so have underactive thyroid , underactive pituatiry as said, growth hormone deficiancy , diabeties insipitus , they all because of non working pitutary ..on top of that which I can list are registared blind due to pitutary space stretching my optic nerves and then I went and had a brain haemorrhage ....thanks
 
3:08 Dr Stephanie Baldeweg: 
Paul, I’m glad you are planning another holiday! Hypopituitarism should cover all of your hormone deficiencies including diabetes insipidus on the insurance form. I think the visual problem and brain haemorrhage should be declared separately. Hope you have a nice time!
 
3:09 [Comment From Richard SRichard S: ] 
Thanks Dr Baldeweg. What changes over time if any have been observed in the pituitaries of post-op pituitary patients?
 
3:11 Dr Stephanie Baldeweg: 

Hi Richard, welcome back. We usually assess pituitary function after surgery with dynamic tests. Generally it remains stable. However in patients who also underwent radiotherapy, pituitary function often declines over time and needs to be watched much more closely.

3:11 [Comment From JeanJean: ] 
Hi I have Acromegaly, is there check list that guides us to what should be getting checked on a regualar basis and how often
 
3:12 Dr Stephanie Baldeweg: 

Hi Jean, regarding Acromegaly, a useful source of information is the booklet provided by the pituitary foundation – this should answer all your questions.
 
3:12 [Comment From KarenKaren: ] 
Hi again . I am usually a very optimistic and "sunny" person but recently I have been down in mood after my surgery. Although the effects of major surgery are probably playing a part, could this be my hormones readjusting? Should I mention this to my endocrinologist? Thank you
 
3:14 Dr Stephanie Baldeweg: 
Dear Karen, I’m sorry to hear that. Mood can be affected by many things and major surgery would contribute. However, I agree you should discuss this with your endocrinologist to exclude hormonal causes for this. Hope you feel sunny again soon.
 
3:14 [Comment From jodie.jodie.: ] 
My daughter was born early with iugr. She never really caught up. They would like her to see an endocrinologist. There was talk about delaying puberty and giving growth hormones. Are they as bad as I've heard? Is it truly necessary? She will make 5" if she carries on her growth pattern.
 
3:15 Dr Stephanie Baldeweg: 
Dear Jodie, I’m sorry to hear that you are worried. I would discuss with your GP a possible referral to a paediatric endocrinologist. With best wishes.
 
3:15 [Comment From GuestGuest: ] 
I get bladder infections all the time - is this a sign of something going on with my hormones?
 
3:17 Dr Stephanie Baldeweg: 
Hi guest, we find that changes in sex hormones such as testosterone and oestrogen can contribute to the development of bladder infections. It is also important to exclude diabetes mellitus as a cause.
 
 
3:17 
How long does it take to get results from a ACTH text Please? If ACTH test comes back negative does that mean you do not have any form of Addisions?
 
3:19 Dr Stephanie Baldeweg: 
Hello, interpretation of hormone levels is quite complex. An isolated ACTH level is impossible to use for the diagnosis of Addison’s Disease. The usual test would be a short synachten test looking at cortisol response in relation to an ACTH injection.
 
3:20 [Comment From KarenKaren: ] 
Dear Moderator, Please thank the Doctor on my behalf.
 
3:20 Dr Stephanie Baldeweg: 
Actually Karen, I'm still and thank you for your feedback, glad you found it helpful.
 
3:21 [Comment From GrahamGraham: ] 
Thanks again for your time. The hour has gone far too quickly and I'm sure not enough pituitary patients will have learnt about your webchat...maybe the Pituitary Foundation can publicise it so others can see your answers. I hope it's something you may do again as we all have so many burning questions. Most of all a HUGE thank you as we know your time is invaluable but then so is help in this form too. Sadly, I've learnt all I know about pituitary problems from the internet and the Foundation, not through my local endocrinologist.
 
3:22 Dr Stephanie Baldeweg: 
Thank you Graham, we had a similar experience at the national pituitary conference. I will ask the team at the Foundation to put a link to this web chat on their website. You can also replay this chat at any time, I'm glad you found this useful. As you know, I am very passionate about giving information to patients.
 
3:23 [Comment From Jaina CiprianoJaina Cipriano: ] 
I have seen 2 neurosurgeons about a rathkes cleft cyst in my pituitary gland. All three of them, when asked "what harm could this cause me" told me only 2 things, going blind slowly and fake pregnancy. Are these doctors competent? Shouldn't they have known more than this? I am struggling to find a good doctor.
 
3:24 Dr Stephanie Baldeweg: 
Dear Jaina, I am sorry to hear this. Often there isn’t a clear cut answer. The Pituitary Foundation has a list of pituitary centres on their website. Your GP can refer you for further opinion and hopefully you will be able to have a detailed discussion.
 
3:25 [Comment From LauralooLauraloo: ] 
Thank you.
 
3:25 Dr Stephanie Baldeweg: 
You're welcome Lauraloo
 
3:25 [Comment From SusanSusan: ] 
This has been really interesting and helpful and just shows how many questions we have that never get round to being answered in our short hospital visits. I hope a list of Q&A will be published (maybe Pit Foundation??please) but your time in answering these has really been appreciated. Thanks so very much.
 
3:26 Dr Stephanie Baldeweg: 
Thank you Susan, we had a similar experience at the national pituitary conference. I will ask the team at the Foundation to put a link to this web chat on their website. You can also replay this chat at any time, I'm glad you found this useful. As you know, I am very passionate about giving information to patients.
 
3:26 [Comment From FionaFiona: ] 
Will this page/web hat stay open after the conversation has ended so the answers and questions can be viewed after you leave?
 
3:27 Dr Stephanie Baldeweg: 
Yes - you can replay this chat at any time, I'm glad you found this useful.
 
3:28 [Comment From FionaFiona: ] 
Thank Dr Baldeweg - I look forward to asking some more questions in April. Also is there another conference due to take place this year? They are very informative!
 
3:29 Dr Stephanie Baldeweg: 
Dear Fiona, thank you. I'm glad you found this useful. The Pituitary Foundation is planning another national conference in 2016. There are many local support groups who meet regularly and may be worthwhile joining.
 
3:29 [Comment From DonnaDonna: ] 
Thank you for your time I have an appointment with you in April and look forward to meeting you and hopefully get better treatment thank you again for answering these questions
 
3:30 Dr Stephanie Baldeweg: 
Look forward to seeing you in April Donna.
 
3:30 [Comment From TottyTotty: ] 
This open forum is a great idea will you be doing it again? I hope so :)
 
3:34 Dr Stephanie Baldeweg: 
We are now closing the web chat as we have run it for two hours instead of the usual hour. We have not been able to answer all your questions and will plan another chat in the future. We are aware of the complex nature of pituitary disease. Please remember that a useful source of information and support is available at www.pituitary.org.uk or www.nhs.uk. Always try to discuss your concerns with the team looking after you. I am grateful for all your interesting questions and look forward to the next web chat.

 Useful links