OpenHealth Q&A

Struggling with Persistent Nausea While Awaiting MRI for Pituitary Tumor Diagnosis

Several weeks ago, my prolactin levels were tested and revealed a concerning upward trend, with results showing 74 ug/L in the first test and 101.7 ug/L in the second, conducted just a week later (monomeric prolactin at 77 ug/L). Following these tests, I consulted with an endocrinologist, who placed me on a waiting list for an MRI. Unfortunately, she informed me that the wait could extend beyond three months. Although she suggested cabergoline to potentially reduce the size of any tumor, I chose to forego that option. My past experiences with hormonal imbalances—often misdiagnosed as PCOS—prompt me to seek clarification on my condition instead of masking it. For context, I used to have regular menstrual cycles until recently when they ceased entirely. While my follicle development has been fine, I've experienced hair thinning on my scalp alongside chin hair growth and some insulin resistance, which has now escalated to prediabetes. I suspect these symptoms align more with a prolactinoma rather than PCOS, given their similarities. Nausea has become a constant companion; I wake each morning with a gagging reflex, experiencing waves of nausea that leave me on the verge of vomiting throughout the day. Despite taking the maximum dose of Gravol, relief feels elusive, and ginger chews barely help. My appetite is nearly nonexistent, and I find myself vomiting at least once daily. Exhaustion plagues me, compounded by daily headaches and frequent migraines. My vision appears to have deteriorated, necessitating two new glasses prescriptions within a single year—a stark contrast to my previous experience of only needing new lenses every two years. As I anticipate starting my practicum as an intern therapist in a week, I feel overwhelmed by the thought of juggling my schooling, thesis work, and internship while battling these debilitating symptoms. I worry about how I will manage when getting out of bed is a struggle. My MRI appointment seems a long way off, and I’m at a loss regarding how to accelerate that process. This constant state of unwellness is taking a serious toll on me—I am mentally and physically drained. My interactions with family and friends suffer, and I feel like my academic and professional efforts are slipping through my fingers. At 24 years old, I may have a prolactinoma or a similar pituitary adenoma, unofficially diagnosed with PCOS by my endocrinologist. Additionally, my primary care physician suspects Hidradentitis Suppurativa, and I am on the waiting list to see a dermatologist. Currently, I manage my health with metformin (1000mg), Movisse progestin-only pills, Tylenol, Advil, and Gravol as needed (basically at maximum dosages daily), plus topical treatments including Arazlo and azelaic acid for back acne. Key symptoms affecting me include: - Daily bouts of nausea and vomiting - Near-daily headaches and migraines - Persistent fatigue - Mood fluctuations, particularly feelings of sadness and anxiety - Recent painful vaginal boils, potentially linked to HS, appearing over the last two months - Six months without a menstrual period - Four months of lactation - A dramatic decline in sexual desire for over six months - Vaginal dryness persisting for the equivalent duration - Noticeable vision changes with a 0.5 diopter shift between December and June - Tenderness and swelling in the breasts - Severe acne on my back - Occasional phantom smells, reminiscent of gasoline. I reside in London, Ontario, Canada, and would greatly appreciate any guidance on how to manage my situation more effectively or expedite my MRI scheduling.

Answers (1)

8/30/2025, 3:04:16 PM

OpenHealth AI

It’s understandable that you’re feeling overwhelmed given the combination of your symptoms, the uncertainty regarding your condition, and the challenges you’re facing as you prepare for your internship. Let's break this down and focus on actionable steps to help manage your symptoms while you await further diagnostic information.

Main Points:

1. Persistent nausea and vomiting are concerning and can significantly impact your quality of life.
2. It's important to focus on a manageable routine and symptom relief strategies.
3. Consider ways to potentially expedite your MRI and coordination with healthcare professionals.

Explanation:

Your elevated prolactin levels and associated symptoms suggest a possible prolactinoma or another pituitary issue, as you've noted. The nausea, headaches, fatigue, and changes in vision could be interrelated to hormonal imbalances caused by this potential condition. Coping with nausea while managing academic responsibilities can be particularly challenging, and it’s crucial to prioritize both symptom relief and self-care.

Next Steps:

1. Nausea Management:

   • Since Gravol hasn’t been effective, consider other over-the-counter options like meclizine or ondansetron (with a physician's advice). It’s important to discuss with a healthcare professional before starting new medications.
   • Keep track of your food intake to identify any specific triggers for your nausea and avoid them. Plain foods or easily digestible options (like crackers or toast) may help.

2. Hydration and Nutrition:

   • Stay hydrated, especially if you are vomiting frequently. Sipping clear fluids like ginger tea or electrolyte solutions can help maintain hydration.
   • Small, frequent meals might be more tolerable than larger meals.

3. Fatigue Management:

   • Prioritize rest whenever possible. Short naps or breaks in your daily routine can be beneficial.
   • If you experience fatigue particularly during the day, try gentle stretching or light physical activity, which can sometimes help increase your energy levels.

4. Symptom Tracking:

   • Keep a detailed log of your symptoms, including nausea episodes, headaches, changes in vision, and mood fluctuations. This information will be valuable for your healthcare providers and may help in adjusting your treatment more effectively.

5. Expediting Your MRI:

   • Communicate regularly with your endocrinologist's office. Express your ongoing symptoms clearly and ensure they understand the urgency due to worsening nausea, headaches, and your impending internship.
   • If possible, ask if they can place you on a cancellation list to receive an earlier appointment.

6. Emotional Support:

   • Seek support from friends, family, or a counselor. Addressing your emotional health is just as vital as managing physical symptoms. Consider mindfulness techniques, breathing exercises, or short meditation sessions to help manage feelings of anxiety and sadness.

7. Support for Your Academic Responsibilities:

   • Speak with your academic advisors about your situation. Many educational institutions have resources to support students with health challenges, which could include extensions or accommodations for your coursework and internship.

Your well-being is essential both professionally and personally, so these steps are focused on making daily life more manageable while actively pursuing further diagnosis and treatment. Remember, you are not alone in this journey, and seeking help is a strong step towards feeling better. Please keep the lines of communication open with your healthcare team and don't hesitate to reach out if symptoms worsen or new ones arise.