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PubMed This is a summary of 41 peer-reviewed journal articles Updated
Endocrinology · Empty Sella Syndrome

Empty Sella Syndrome: Your Complete Guide

At a Glance

Empty Sella Syndrome happens when the pituitary gland is flattened, making its bony resting place look empty on scans. While often a harmless anatomical variation, it can cause hormone deficiencies, headaches, and vision changes requiring hormone replacement.

Welcome to the comprehensive guide on Pituitary Deficiency due to Empty Sella Syndrome. Discovering the term “empty sella” on an MRI report can be alarming, but this guide is designed to empower you with evidence-based information, helping you understand your anatomy, symptoms, and treatment options.

An “empty sella” refers to the appearance of the space where your pituitary gland sits, which looks empty on a scan because the gland is flattened. While for many this is just an anatomical variation, for some, the compressed gland may struggle to produce essential hormones, leading to Empty Sella Syndrome (ESS).

In this guide, we break down everything you need to know to navigate your care effectively. We encourage you to read through the sections below:

01

Understanding Empty Sella: The Basics

Learn what an empty sella finding on your MRI means. Understand the difference between an incidental finding and Empty Sella Syndrome, and next steps for care.

02

Primary vs. Secondary Empty Sella: Causes and Subtypes

Understand the difference between primary and secondary empty sella. Learn about the causes, risk factors, and when to test for pituitary hormone deficiencies.

03

Symptoms and the Hormonal Cascade

Learn about Empty Sella Syndrome symptoms, including hormone deficiencies, headaches, and vision changes. Discover why hormone blood tests matter most.

04

Getting the Right Diagnosis: MRI and Hormone Testing

Learn how Empty Sella Syndrome is diagnosed. Understand why an MRI isn't enough, which baseline hormone blood tests you need, and how brain pressure is checked.

05

Treatment Strategies and Long-Term Management

Learn about treatment for Empty Sella Syndrome (ESS). Understand hormone replacement therapy, sick day rules for adrenal support, and when surgery is needed.

Remember, you are not alone in this journey. Armed with the right information, you can partner with your healthcare team to ensure you receive the precise care and monitoring you need.

Common questions in this guide

What does it mean to have an empty sella on my MRI?
An empty sella means that on an MRI, the bony structure housing your pituitary gland looks empty because the gland is flattened or compressed. For many people, it is just an anatomical variation, but it can sometimes cause hormone issues.
What is the difference between primary and secondary Empty Sella Syndrome?
Primary empty sella happens spontaneously, often when spinal fluid presses on the pituitary gland. Secondary empty sella occurs after a specific event that alters or damages the gland, such as brain surgery, head trauma, or a complicated childbirth.
How is Empty Sella Syndrome diagnosed?
While an MRI shows the physical shape of the pituitary gland, a diagnosis of the syndrome requires blood tests to check your hormone levels. These blood tests confirm whether the flattened gland is actually struggling to produce essential hormones.
What are the most common symptoms of Empty Sella Syndrome?
Many people have an empty sella with no symptoms at all. Those who develop the syndrome may experience chronic headaches, vision changes, or signs of hormone deficiency, which can include profound fatigue or adrenal issues.
Should I see an endocrinologist for Empty Sella Syndrome?
Yes, it is highly recommended to see an endocrinologist. They specialize in pituitary function and hormone disorders, allowing them to determine exactly which baseline tests you need and manage any necessary hormone replacement therapy.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Can you explain whether my empty sella is a primary finding or secondary to another condition?
  2. 2.Which specific hormone deficiencies am I at risk for based on my medical history?
  3. 3.Do you recommend I see an endocrinologist for specialized care?

Questions For You

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This guide is for informational purposes only and does not replace professional medical advice. Always consult your endocrinologist or primary care physician regarding your specific imaging results, symptoms, and treatment options.

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