Patient: Professor Yan: Hello! The patient is a female, 52 years old (2.5 years of menopause), who underwent total excision of the right side of the thyroid gland and subtotal excision of the left side at the Affiliated Hospital of Qingdao Medical College in 1998, taking 2 tablets of Eugenol daily. Her latest thyroid function tests were: thyrotropin 9.60, free thyroxine 28.12, free triiodothyronine 5.68, anti-thyroglobulin antibody 204.90, anti-thyroid microsomal enzyme antibody 363.90. luteinizing hormone 56.23 (7.7-58.5), prolactin 145.4 (102-496), estradiol 26.07 (<201), adrenocorticotropic hormone 8am 23.49 (7.2-63.6), and serum cortisol 232.60 ( 171-536) (numbers in parentheses are reference values for menopause). Six months ago, the upper eyelid weakness (is around evening) and joint pain (mainly at night), Eugenol was changed to 2.5 tablets daily and Calcitriol 1 capsule daily, and after one month, when the symptoms improved, Eugenol was changed again to 2.25 tablets daily. In the past two months, the upper eyelid weakness was more severe than six months ago (all day long, irregularly), sometimes accompanied by dizziness, head swelling and soreness and pain in the back of the neck and shoulders. In recent days Eugenol has been changed to 1.5 tablets and 2 tablets alternately every other day. A pituitary microadenoma was diagnosed on May 11, 2012 by dynamic enhancement of the pituitary MR. The pituitary tumor has not yet started treatment Please ask the experts: 1. What medication is available to treat pituitary microadenoma? What are the side effects of this medication on the body? 2. What will be the development trend of pituitary microadenoma after the treatment? 3.What should I pay attention to in my daily life and diet? 4.Will long-term use of Eugenol affect the pituitary gland? 5.How much Eugenol should I take? Thank you very much! Neurosurgery Department, Beijing Tiantan Hospital: Please send the MRI of pituitary gland dynamic enhancement by mail. What was the reason for the thyroid surgery in 1998? What is the reason for the MRI of the pituitary gland this time? Patient: Professor Yan: Hello! I’ll be in Beijing next Tuesday and would like to send you the MR film on Wednesday for an interview. Thank you very much! Three years before the surgery in 1998, I had a checkup for shortness of breath and a thyroid nodule was detected without any treatment. 1998, when the nodule was found to be bigger and harder and the above condition became worse, I had surgery and the pathological diagnosis was nodular goiter. This time, the pituitary MR was done mainly because the thyrotropic hormone was persistently high (there is a lab report of thyroid function for the past four years) and the free thyroxine was also high (this phenomenon only appeared recently), accompanied by dizziness, head swelling, upper eyelid weakness, and pain in the body, which has worsened in the past six months. Beijing Tiantan Hospital Neurosurgery Department: I know the reason why you had thyroid surgery and pituitary examination. How was the thyroid function at the time of the goiter? You now eat thyroxine in the case of high FT3, TSH high, indicating two problems: one is that you have low thyroid function, feedback regulation resulting in TSH increased, so that the body thyroxine close to normal, is a normal regulatory mechanism of the body, long-term feedback regulation resulting in the pituitary gland reward hyperplasia increased, looks like a pituitary adenoma, medical called hypothyroidism pituitary hyperplasia (hypothyroidism pituitary enlargement ). The second is that you have a pituitary adenoma, which secretes TSH, resulting in an increase in TSH in your blood. However, if TSH is increased, FT3 and other thyroid hormones are high, so there is no need for in vitro supplementation, and the patient has hyperthyroidism. Your current weakness is a manifestation of low thyroid. So you are very likely to have the former and less likely to have the latter. Pituitary micro-adenoma is probably not established and there is no talk of treating micro-adenoma. For reference.