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Category Archives: Hypopituitarism
Hypopituitary Hypopituitary Overview
Hypopituitarism is a condition in which the pituitary gland (a small gland at the base of the brain) does not produce one or more of its hormones or not enough of them. This condition may occur because of disease in the pituitary or hypothalamus (a part of the brain that contains hormones that control the pituitary gland). When there is low or no production of all the pituitary hormones, the condition is called panhypopituitarism. This condition may affect either children or adults.
The pituitary gland sends signals to other glands (eg, thyroid gland) to produce hormones (eg, thyroid hormone). The hormones produced by the pituitary gland and other glands have a significant impact on the bodys functions, such as growth, reproduction, blood pressure, and metabolism (the physical and chemical processes of the body). When one or more of these hormones is not produced properly, the bodys normal functions can be affected. Some of the hormones like cortisol and thyroid hormone may require prompt treatment, whereas others may not be life threatening.
The pituitary gland produces several hormones. Some of the important hormones are as follows:
In hypopituitarism, one or more of these pituitary hormones is missing. The lack of hormone results in a loss of function of the gland or organ that it controls.
Medically Reviewed by a Doctor on 7/30/2014
James R Mulinda, MD, FACP, FACE
Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS
Hypopituitarism is a general term that refers to any under-performance of the pituitary gland. This is a clinical definition used by endocrinologists and is interpreted to mean that one or more functions of the pituitary are deficient. The term may refer to both anterior and posterior pituitary gland failure. Below is a list of the hormones secreted by the pituitary and their functions:
In cases of hypopituitarism, single or multiple hormone deficiencies are present. The deficiencies affect the target organ activity or secretion (the thyroid; the adrenals; or the gonads, which includes both female and male sexual development and function). Causes of hypopituitarism are tumors or lesions of various origins, congenital defects, trauma, radiation, surgery, encephalitis, hemochromatosis, and stroke. In children, the condition results in slowed growth and development and is known as dwarfism. The cause may also be unknown.
Deficient pituitary gland function can result from damage to either the pituitary or the area just above the pituitary, namely the hypothalamus. The hypothalamus contains releasing and inhibitory hormones that control the pituitary. Since these hormones are necessary for normal pituitary function, damage to the hypothalamus can also result in deficient pituitary gland function. Injury to the pituitary can occur from a variety of insults, including damage from an enlarging pituitary tumor, irradiation of the pituitary gland, limited blood supply (as experienced in a stroke), trauma or abnormal iron storage (hemochromatosis). There appears to be a predictable loss of hormonal function with increasing damage. The progression from most vulnerable to least vulnerable is usually as follows:
Additional symptoms that may be associated with this disease:
Men develop testicular suppression with decreased libido, impotence, decreased ejaculate volume, loss of body and facial hair, weakness, fatigue and often anemia. On testing, blood levels of testosterone are low and should be replaced. In the United States, testosterone may be given as a bi-weekly intramuscular injection, in a patch form or as a gel or creme preparation. In some countries, oral preparations of testosterone are available.
Thyroid Stimulation Hormone (TSH) Deficiency Deficiency of thyroid hormone causes a syndrome consisting of decreased energy, increased need to sleep, intolerance of cold (inability to stay warm), dry skin, constipation, muscle aching and decreased mental functions. This variety of symptoms is very uncomfortable and is often the symptom complex that drives patients with pituitary disease to seek medical attention. Replacement therapy consists of a either T4 (thyroxine) and/or T3 (triiodothyronine). The correct dose is determined through experimentation and blood tests.
Adrenal Hormone Deficiency Deficiency of ACTH resulting in cortisol deficiency is the most dangerous and life-threatening of the hormonal deficiency syndromes. With gradual onset of deficiency over days or weeks, symptoms are often vague and may include weight loss, fatigue, weakness, depression, apathy, nausea, vomiting, anorexia and hyperpigmentation. As the deficiency becomes more serious or has a more rapid onset (Addison crisis), symptoms of confusion, stupor, psychosis, abnormal electrolytes (low serum sodium, elevated serum potassium), and vascular collapse (low blood pressure and shock) can occur. Treatment consists of cortisol administration or another similar steroid (like prednisone). For patients with acute adrenal insufficiency, rapid intravenous administration of high dose steroids is essential to reverse the crisis.
Posterior Pituitary Antidiuretic Hormone (ADH) Deficiency Replacement of antidiuretic hormone resolves the symptoms of increased thirst and urination seen in diabetes insipidus. Antidiuretic hormone (ADH) is currently replaced by administration of a synthetic type of ADH either by subcutaneous injection, intranasal spray, or by tablet, usually once or twice a day.
Endocrine substitution therapy is indicated for replacement of hormones for the affected organs. These include corticosteroids, thyroid hormone, sex hormones (testosterone for men and estrogen for women), and growth hormone. Drugs are available to treat associated infertility in men and women.
Growth hormone is only available in injectable form and is usually given 6-7 times per week. Homeopathic GH or IGF has been proven to provide benefits in blinded trials.
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Hypopituitarism - Symptoms, Diagnosis, Treatment and ...
What Is an Underactive Pituitary Gland?
Your pituitary gland is located just below your brain. It releases eight hormones that each plays its own role in your body processes. Functions range from stimulating bone growth to prompting your thyroid gland to release hormones that control your metabolism.
Hormones produced by the pituitary gland include:
Sometimes, your pituitary gland does not release enough of one or more of these hormones. This underactivity is called hypopituitarism.
Your pituitary gland may stop producing enough of one or more of its hormones if it has suffered trauma. For example, if you have had brain surgery, a brain infection, or a head injury, your pituitary gland may be affected.
Certain tumors can also affect the function of this gland. These include:
Other possible causes of hypopituitarism include:
Sometimes, doctors cant figure out what caused a particular case of hypopituitarism.
The symptoms of hypopituitarism depend on which hormones your pituitary gland is not producing enough of. For example, if the pituitary does not produce enough growth hormone in a child, he or she may have a permanently short stature. Alternately, if it doesnt produce enough follicle-stimulating hormone or luteinizing hormone, it might cause problems with sexual function, menstruation, and fertility.
In some cases, you may not have any symptoms at all. For example, if you are an adult and your pituitary gland does not produce enough growth hormone, you will probably not notice because you have already finished growing. In children, however, this condition is far more noticeable.
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Hypopituitarism: Causes, Symptoms, & Treatment
Hypopituitarism is the decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain. If there is decreased secretion of most pituitary hormones, the term panhypopituitarism (pan meaning "all") is used.
The signs and symptoms of hypopituitarism vary, depending on which hormones are undersecreted and on the underlying cause of the abnormality. The diagnosis of hypopituitarism is made by blood tests, but often specific scans and other investigations are needed to find the underlying cause, such as tumors of the pituitary, and the ideal treatment. Most hormones controlled by the secretions of the pituitary can be replaced by tablets or injections. Hypopituitarism is a rare disease, but may be significantly underdiagnosed in people with previous traumatic brain injury. The first description of the condition was made in 1914 by the German physician Dr Morris Simmonds.
The hormones of the pituitary have different actions in the body, and the symptoms of hypopituitarism therefore depend on which hormone is deficient. The symptoms may be subtle and are often initially attributed to other causes. In most of the cases, three or more hormones are deficient. The most common problem is insufficiency of follicle-stimulating hormone (FSH) and/or luteinizing hormone (LH) leading to sex hormone abnormalities. Growth hormone deficiency is more common in people with an underlying tumor than those with other causes.
Sometimes, there are additional symptoms that arise from the underlying cause; for instance, if the hypopituitarism is due to a growth hormone-producing tumor, there may be symptoms of acromegaly (enlargement of the hands and feet, coarse facial features), and if the tumor extends to the optic nerve or optic chiasm, there may be visual field defects. Headaches may also accompany pituitary tumors, as well as pituitary apoplexy (infarction or hemorrhage of a pituitary tumor) and lymphocytic hypophysitis (autoimmune inflammation of the pituitary). Apoplexy, in addition to sudden headaches and rapidly worsening visual loss, may also be associated with double vision that results from compression of the nerves in the adjacent cavernous sinus that control the eye muscles.
Pituitary failure results in many changes in the skin, hair and nails as a result of the absence of pituitary hormone action on these sites.
Deficiency of all anterior pituitary hormones is more common than individual hormone deficiency.
Deficiency of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), together referred to as the gonadotropins, leads to different symptoms in men and women. Women experience oligo- or amenorrhea (infrequent/light or absent menstrual periods respectively) and infertility. Men lose facial, scrotal and trunk hair, as well as suffering decreased muscle mass and anemia. Both sexes may experience a decrease in libido and loss of sexual function, and have an increased risk of osteoporosis (bone fragility). Lack of LH/FSH in children is associated with delayed puberty.
Growth hormone (GH) deficiency leads to a decrease in muscle mass, central obesity (increase in body fat around the waist) and impaired attention and memory. Children experience growth retardation and short stature.
Adrenocorticotropic hormone (ACTH) deficiency leads to adrenal insufficiency, a lack of production of glucocorticoids such as cortisol by the adrenal gland. If the problem is chronic, symptoms consist of fatigue, weight loss, failure to thrive (in children), delayed puberty (in adolescents), hypoglycemia (low blood sugar levels), anemia and hyponatremia (low sodium levels). If the onset is abrupt, collapse, shock and vomiting may occur. ACTH deficiency is highly similar to primary Addison's disease, which is cortisol deficiency as the result of direct damage to the adrenal glands; the latter form, however, often leads to hyperpigmentation of the skin, which does not occur in ACTH deficiency.
Thyroid-stimulating hormone (TSH) deficiency leads to hypothyroidism (lack of production of thyroxine (T4) and triiodothyronine (T3) in the thyroid). Typical symptoms are tiredness, intolerance to cold, constipation, weight gain, hair loss and slowed thinking, as well as a slowed heart rate and low blood pressure. In children, hypothyroidism leads to delayed growth and in extreme inborn forms to a syndrome called cretinism.
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Hypopituitarism - Wikipedia, the free encyclopedia
How to Pronounce Hypopituitarism
This video shows you how to pronounce Hypopituitarism.
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Traveling with Hypopituitarism
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Traveling with Hypopituitarism - Video