Do you feel always tired?

I've been dealing with an underperforming pituitary gland most of my life-possibly from a seemingly minor head injury when a drunk driver hit my parent's car during my eleventh month.

However it happened, the deal is this: When the pituitary ain't happy, ain't nothing happy. The endocrine system, of which the pituitary is king, is the wheel in the middle of the wheel that makes everything go 'round-or not.

Doctors claim panhypopituitarism (Let that trip off your tongue!) is rare. But before we discuss their claim, lets look at what we're talking about. The pituitary is made up of parts; "pan" means every part is a mess. "Hypo" means underperforming. "Pituitarism" means it involves the pituitary.

So, back to the claim of rarity. Who knows? The fact is, doctors don't check for it. It's amazing what you don't find when you're not looking.

And, yes, I'm peeved about it. I've spent most of my life dealing with a significant health issue while the medical community denied I had a problem-although it was diagnosed by an internationally known diagnostician who received calls for his skills from all around the world. Plus, I have the symptoms that prove the problem.

Sadly, if you have a pituitary problem, doctors go into denial. Funny thing that: You have the problem, but they're the ones in denial.

So let's go the lawyers and see what the word is there. Timothy Smith, writing for, quotes studies of injury to the pituitary that caused endocrine dysfunction. One study of 70 people ages 18 to 58 years old who had suffered a head injury found that 68.5% of the group had resulting pituitary damage.

And the injury doesn't have to be severe. A concussion could be enough. Retired boxers are known for significant pituitary problems. Probably football players and combat veterans, too, although I haven't seen studies.

Since the pituitary produces our growth hormone, low GH levels are a pretty good indicator of a pituitary problem.

But if you can't get anybody to check you out, how do you figure out whether or not you may have an endocrine problem? While endocrine problems provide an encyclopedia of symptoms, three are ever-present red flags.

The first symptom is constant fatigue. Sleep doesn't fix it, although getting through the day may require a nap. Caffeine doesn't make a dent in it. You're tired (if your problem is severe, you're barely making it) and nothing helps.

The second symptom is "brain fog." Ideas slip away before you can jot them down. You forget what you're talking about-even in the middle of a prepared speech. Words you know are tantalizingly out of reach.

My mother, who's head crashed into the windshield, thanks to the drunk, used to say she felt as if her brain was full of oatmeal. A homey description of a devastating reality.

The third symptom is thinning hair-on the scalp and elsewhere. If your adrenal glands get sucked into the abyss, your hair may change colors, and curly hair could go straight. The hair on your lower legs thins out, too. If your thyroid gland joins in, you'll probably lose the outside third of your eyebrows. Pituitary problems thin out body hair. Weirdly, if I let myself slip, my eyebrows get bald spots.

Doctors who sympathetically and knowledgeably treat endocrine problems are rare, often because of HMO, military and State Medical Board restrictions, but they're worth the hunt if you can find one. Otherwise, mine the internet for all the gold there. Get on good forums and learn.

Just don't give up. Keep on keeping on. You owe it to yourself.

Always Tired