T Nation

Low Pituitary Function/Empty Sella Syndrome


i've been fighting(and losing)the battle of the bulge for about 7-8 years.
i was a competitive kickboxer that would put on weight(fat)while training for fights.no matter how much i worked out or dieted i kept gaining weight.i was also dealing with what i was sure was low test.

I went to some doctors and everyone told me i was just getting older.i got one doctor to listen and she agreed with me about my test levels.

finally got to an endo(a good one)and he at first thinks that i don't have a low test problem but an estrogen conv. problem.does bloodwork and finds out that my fsh and lh levels are both low,and that he feels something is wrong with my pituitary gland.i'm now going for an mri.he thinks it's either a tumor(runs in my family)or something called empty sella syndrome.

has anyone else had this or at least heard of this?

The endo put me on injectable test.shot it 3 days ago but nothing seems different.


I recently read an article that a blow to the head could mess up your hormonal balance. The trauma could have damaged your pituitary gland or the connection with the hypothalamus.

One of the first results of this damage would be reduced production of growth hormone and this would lead to loss of lean mass and increased intra-abdominal fat.

The article is in Dutch, so it won't be much use to you.


I am having the exact same problem and had my MRI last Thursday. Waiting for the results. Did my first 200mg shot of cypionate on February 1 and I had bloodwork drawn this morning. A complete metabolic panel, estrogen, estrodial, free and total test. My next endocrinologist appointment is next Thursday. I'll let you know what she is going to do for me.

Mike Sullivan


thanks sully.this kinda has me worried,and kinda not.

i have history on both sides of my family with head tumors.my cousin had a tumor pushing on his pituitary gland causing it to release to much growth hormone which caused his hands and feet to grow.however,i'm sure it's probably from my years of fighting and sparring that has caused this.i'm worried what else the mri might show.

have you noticed anything from the injections yet?


I have not noticed anything yet as I had been on Testim gel, 5g per day for 5 months and 10g a day for 1 month and on Feb 1 switched to the cypionate shots. My wife could not stand the smell of the Testim and the patches were very irritating. I have no history of repeated head trauma to help explain my situation. Apparently just a freak of nature.


I have low pituitary hormones myself (lf and fsh) but no tumor, prior roid use, or accident. So it is "idiopathic". Get on Androgel, 5 to 10 g per day. Injections are SHIT! My test levels are consistently 800 to 1000 with 7.5 g of Androgel and I tested at 240 ng/dL when I was first diagnosed.



Went to the endo today to review my progress on HRT and to review my low pituitary functions. LH and FSH still way below normal, MRI scan showed no tumors or abnormalities. She stated that I have an idiopathic pituitary function meaning that she does not know the cause of it's malfunction.

I asked what we can do about it and she stated that there are medications but they are very expensive and are only used for fertlity issues. She is only going to continue to monitor my T levels, she wants me to go to her office to receive my shots.

She was not happy that I gave myself the first shot. I may just go on my own for HRT and get my cypionate myself. There is an over the counter product out there for GH boosting. Go to www.agelessoptions.com for more info. It may merit some investigation.

Mike Sullivan


thanks sully,and good luck in your quest.i know how you feel.i will check out the gh boosting agent.i started wondering what else may have been effected.

my endo was cool with me getting my shots at home even before he found out my wife was an rn.they were going to show me how to give the shots.

i have noticed the test.morning wood is back but things still aren't the same.

i go for the mri tomorrow.hopefully more answers soon.



How's everything going?



Why is it that so many endos put patients immediately on testosterone without thinking of other means?

Case in point: the topic here is low LH. How do you treat low LH? Well, you typically treat that with Clomid or Nolvadex.

BUT, before that, there really should be a check of the testes. A shot of HCG and subsequent bloodwork will determine if that portion of T-production is bad.

If it's good, and if LH is low, and IF there is no pituitary tumor, then treatment with Clomid should be tried. In my opinion, all this should be exhausted before going on good ol Testosterone.


From a pragmatic point of view, TRT may be the cheapest and most practical therapy, certainly for injectables. You do not need LH and FSH to feel well etc. But HCG does have some value and is also quite inexpensive... but the recombinant type is more costly.

If T is low and E is not abnormally high, then I don't expect that suppressing E or its effect on receptors would raise T to high-normal levels that are the objective for many progressive doctors.

As for real problems and getting therapy covered by insurance, TRT is gaining acceptance and other alternatives might not be covered for reason of cost or ignorance.

But if there are other concerns... I am always wanting to learn more.


Personally, I don't think the decision to potentially bypass the body's natural production system by adding the end ingredient is a very good way to go. This is a LIFE-long decision. You start, you basically stay on for the duration.

With respect to low T and average E; clomid will act like a less estrogenic compound than typical circulating estrodiol. Therefore, the brain will sense a low level of T and E and will pump out more LH to try and stimulate the testes. That's the theory. I have many friends, acquantances, and enemies who have gone the proper route as I have mentioned and have checked the testes first via HCG, then went on clomid therapy and have great testosterone numbers.

I understand that some might have to make a financial decision, and that going the straight T-injection or T-gel route is more cost effective. However, if one can afford it, I believe the PCT used by many steroid users over the decades can have tremendous benefits for the aging or low T crowd.

If your testes are fine that is! If not, then straight T is the way to go.


Thanks for sharing those real world experiences, that puts things in a whole new light for me.

The clomid therapy would also have a more favourable outcome as far as T:E ratios go, and perhaps one might get a higher free testosterone level in some cases than with TRT or TRT+HCG.

As far as TRT/HRT for guys going into their 60's, I wonder if the testes are simply getting old and a clomid kick to increase LH might not do the job. I spoke to a big time age management specialist about HCG issues and he explained that many men are non responders to HCG as they get to their 70's. All of these age things are of course subject to one's genetics, and life history of injury/illness, drinking, smoking, weight gain and diet (state of aging).

(Back to costs, test cyp can cost as low as $42 for 1ml @ 200mg/ml at some pharmacies. Gels and patches cannot compare.)


Yes, it is quite unfortunate isn't it that as we get significantly older, the boys (testes) are just not the same!

At that time, as you mentioned, something like clomid just won't matter. The LH increase will just be trying to stimulate something that just doesn't feel like getting off the couch.

THAT's when exogenous T is most necessary!