urgent blood tests following MRI - scared

[pelagra]

DH had a brain MRI on Friday. This morning the GPs phoned to book a blood test for tomorrow morning, with an appointment three days later to discuss the results. It's not going to be good news is it? We are both looking and sounding calm, but I'm seriously worried underneath.

He already had many bloods, and a chest X-ray done in the last week, but they all came back normal.

He has had abnormal fatigue, been pale (particularly when tired), painful legs, very cold hands and feet, then persistent frontal headaches, and finally severe knee pain.
The GP has taken it seriously, but we have spent several months going down a referral to Chronic Fatigue, who saw him once, said he didn't fit their criteria and sent him back to the GP with a long list of suggested investigations.

I was expecting something circulatory, maybe PAD, but this rapid follow up from the MRI looks much scarier. What would a blood test be needed for? So far I've wondered about an abnormality in one of the glands in the brain and of course a tumour. It doesn't help that I've lost two good friends to brain tumours.

I'm sorry I can't help with ideas as to what might be going on but it does sound like it's being taken seriously and I wish you both all the best in the coming days whilst you wait for his appointment.

Thank you. I'm one of those people who functions best with lots of detail about a situation. I wish I knew what was happening.

I am sure it’s a worry, but you know there are far more likely benign or manageable causes than anything sinister.

I can relate to wanting to know all the detail, I’m exactly the same.

I wish DH had thought to ask the surgery which blood test they were scheduling. I suggested he could ask the nurse, but I'm not going to push that, as he may prefer not to know.

I am totally like you, needing the detail. If your DH wants to know, the surgery secretaries could tell him what bloods have been ordered.

Do you know the two are definitely connected, not just a co-incidence that they’ve co-occurred if lots of investigations are being done?

Hoping all is ok.

I would find it reassuring that his previous results came back OK. It could be that they just want a fresh set of standard bloods before the appointment so that they have a full picture.

He could look on the NHS app if he has access to his heath records but I understand he may be apprehensive to push for information until his appointment.

He said the receptionist told him it needed following the MRI. Since that only happened on Friday, it does seem alarmingly quick. They told him the results would take three weeks, but this is one working day.

Would the NHS app show what test was booked? It shows all the results from the previous weeks tests, but they are all sitting well in the middle of normal range

Could be a pituitary tumour. They are quite common, can cause a range of odd symptoms, and blood tests would be needed to assess whether the tumor is producing any hormones or not (as this impacts treatment). They're usually benign and quite treatable. Can you find out which bloods have been ordered as this might assist in working it out?

The technician taking the image may have spotted something that needs investigation, I had ultra sounds done last week and I’d actually asked the sonographer to check my ovaries as I had a large cyst there 19 years ago, bingo, I have another one! So that would mean they’ve seen something that needs checking. It must be scary but at least they’re on their toes and doing things rapidly, however, they’ve not brought him into the hospital today, my first cyst they mentioned is need an operation, I was really worried, asked how long it would take til I would have the operation and the consultant said ‘when did you last eat’ 😵 … it was out first thing then next morning …. So be pleased they’re moving fast - good luck and don’t always consider the worst case scenario

Something neurological like MS could also be possibility. The blood test might be to look for inflammation or autoimmune markers. If they suspect a diagnosis based on the scan then they will probably order more specific tests going down that route.

Another common incidental finding on brain MRIs are aneurysms (1 in 20 people). If they see one they might order tests related to blood clotting or genetic clotting disorders.

MRIs often pick up small signal changes in the pituitary gland which are usually nothing but pituitary function blood tests are recommended (thyroid function etc). It is not likely to be ms or a tumour as there are no useful blood tests for these. Try not to panic, may well be nothing serious at all

Sorry just saw someone above already said this.

I thought a CA125 picked up signs of cancer? I had one a few months ago.

II thought MS was genetically linked. DH has a huge family , and no-one ever had MS

I do think something related to the pituitary sounds more likely, though a quick google doesn't offer up the cold hands and feet that are his most noticeable physical symptom.

I hate not knowing. I'm theorising to avoid panic. A bit of my brain is also listing the things around the house that are his responsibility that I need to understand better - like our odd drainage system which requires weekly intervention.

Could the MRI be suggestive of an autoimmune condition - that requires specific antibody blood tests? Only guessing as unsure of which area they have scanned. Try not to worry which is definitely easier said than done.

The nurse said they were all hormone tests.

I'm slightly reassured by reading that most pituitary tumours are not cancerous. We are indulging in some very black humour, as we have always enjoyed programmes on surgery and claimed they were Teach Yourself instructional videos.

If they're hormone tests, it's probably pituitary. A tumour on the pituitary can cause excess hormone production or it can do the opposite and result in low hormone production. Cold hands and feet, pallor and fatigue could be due to low thyroid hormone; the pituitary produces Thyroid Stimulating Hormone (TSH) so a tumour that disrupts production of this hormone can then lead to low thyroid. So it's very possible the symptoms could be caused by a pituitary tumour. Sounds scary but like I say they are usually non cancerous and treatable and surprisingly common!

Thankyou @Octonaut4Life You sound knowledgeable about all this. We have now seen the MR Ireport,and as well as the expected enlarged pituitary gland it mentions "gliotic lesions" and "T2 FLAIR hyperintense lesions in the deep white matter"
Jst the word ABNORMAL in the heading was chilling, but seeing the lesions as well is quite alarming.

Echoing @Octonaut4Life - if the pituitary is enlarged, that’s what the blood tests will be investigating.

I’m not massively knowledgeable about this, but my understanding of gliotic lesions is that they are effectively akin to scar tissue, where the brain tissue has healed from something in the past. They’re non-specific and can be caused by everything from infection and migraines, to more serious things like MS.

Similar thing with the active lesions, they could be caused by a whole host of things and not necessarily something sinister. And may just be an incidental finding not related to the enlarged pituitary.

it all sounds super stressful for you both, I hope you can get some answers soon ❤️

thanks @ResearchFairy

Almost everyone has some white matter lesions - normal part of aging