I thought thia was an interesting article I saw on FB today...It's from:
http://www.chiariconnectioninternational.com/doctor3.php#3
The issue of thyroid/adrenal and basic pituitary function has come up on the list. What specific tests we should/could be doing in this regard. Also, could someone have flattening of the pituitary gland if they had a systemic disease? Would it appear the same? And could someone have 2 problems causing the flattening?
September 2009
Dr. Michael Rosner:
"Large number of Chiari patients have endocrine dysfunction, though systematically collected data does not exist. Hypothyroidism of many different causes, diabetes, dysmenorrhea, endometriosis, fertility problems, multiple miscarriages, and a large percentage of children with Chiari who are pan hypopituitary all suggest dysfunction of the hypothalamic-pituitary axis. Many patients are orthostatic intolerant, have Positional Orthostatic Tachycardia Syndrome (POTS) or Neurally Mediated Hypotension (NMH) and Raynaud's phenomena which in most tend to improve after decompression. Often menstrual abnormalities improve. We have seen a number of younger women develop larger breasts, acne and improved libido. Diabetes and reactive hypoglycemia may become more easily managed.
The empty sella is often missed in the evaluation of Chiari, has traditionally been dismissed as being of little to no consequence, but is indicative of high intracranial pressure--which is typical of Chiari. I find the empty sella or partially empty sella association too coincidental and feel that it is a direct link with at least some of the endocrinological dysfunction seen in this group. Additionally, a part of the problem may lie in the direct input from the brainstem (potentially impaired) to the hypothalamus which then controls the pituitary rather directly. Still, most of this is conjecture."