Hypopituitarism

Specialty of Endocrinology, diabetes & metabolism

What is hypopituitarism?

Hypopituitarism is a condition in which the pituitary gland is not producing normal quantities of certain hormones. The pituitary gland is located below the brain and is connected to the hypothalamus. It is responsible for producing different types of hormone, including thyroid-stimulating hormone (TSH) and growth hormone (GH).

Prognosis:

This disease requires continuous treatment. Nevertheless, patients can lead a normal life, provided they are managing their condition correctly.

Symptoms of hypopituitarism

In most cases, the symptoms develop gradually, hence they may not be noticed for a while. Moreover, the symptoms depend on which hormones are lacking. The most common symptoms include:

  • Fatigue, loss of energy, muscle weakness
  • Low blood pressure
  • Dry skin
  • Reduction in appetite with weight loss
  • Nausea and vomiting
  • Loss or reduction in libido

How is hypopituitarism diagnosed?

Testing for hypopituitarism consists of a physical examination of the thyroid gland, sex organs and eyes to detect signs of hormone deficiency and symptoms associated with the disease. Blood tests may also be required to determine the level of hormones in the blood. In some cases, a stimulation test may be done to determine whether certain hormones are deficient, principally cortisol or growth hormone. In addition, urine testing may be done, as it may indicate a deficiency in antidiuretic hormone.

What are the causes of hypopituitarism?

Some of the possible causes are as follows:

  • Brain surgery or a brain tumour, in the pituitary gland or hypothalamus.
  • Cranial injury
  • Infection or inflammation of the brain
  • Radiotherapy to the brain
  • Haemorrhage caused by an aneurysm

Can it be prevented?

This disease cannot be prevented. However, early diagnosis may help in managing it correctly and reducing the number of symptoms experienced.

Treatments for hypopituitarism

There are different types of treatment, including:

  • Treatment of the cause : if the cause is a tumour, the treatment will consist of removing the tumour surgically, if this is possible. Removal may reduce certain symptoms.
  • Hormonal treatment consists of replenishing the deficient hormones.

Medications for hypopituitarism

In case of a hormone deficiency, the possible medications are:

  • Levothyroxine, if there is a TSH deficit
  • Hydrocortisone / cortisone, if there is an adrenocortical deficit (ACTH)
  • Testosterone / Oestradiol+progesterone (if no desire for fertility), together with injections of GnRH (if fertility desired)
  • GH, if it is shown to be deficient

Which specialist treats it?

Hypopituitarism is treated by endocrinologists.

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