An individual with hyperpituitarism does not produce enough hormones from the pituitary gland, a small gland located at the base of the brain. In addition to regulating growth, metabolism, reproduction, and stress response, hormones are chemical messengers that regulate many functions in the body. The pituitary gland produces several hormones, including:
Growth hormone (GH), which stimulates growth and development of bones, muscles, and organs
Thyroid-stimulating hormone (TSH), which stimulates the thyroid gland to produce thyroid hormones that regulate metabolism and energy
Adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to produce cortisol and other hormones that help cope with stress and inflammation
Luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which regulate the production of sex hormones and fertility in both men and women
Prolactin (PRL), which stimulates breast milk production in women and affects sexual function in both men and women
Antidiuretic hormone (ADH), which regulates the balance of water and salt in the body and prevents dehydration
Oxytocin, which stimulates uterine contractions during labor and delivery and promotes bonding and social behavior
Hypopituitarism can be caused by various factors that damage the pituitary gland or interfere with its function, such as:
Tumors, such as pituitary adenomas (benign growths) or craniopharyngiomas (cysts that develop near the pituitary gland)
Surgery or radiation therapy to treat pituitary or brain tumors
Head trauma or brain injury
Infections, such as meningitis, encephalitis, or tuberculosis
Autoimmune diseases, such as lymphocytic hypophysitis (inflammation of the pituitary gland) or Sheehan’s syndrome (pituitary gland failure due to severe blood loss during childbirth)
Genetic disorders, such as Kallmann syndrome (absence of the part of the brain that controls the pituitary gland) or Prader-Willi syndrome (a rare disorder that causes obesity, intellectual disability, and hypopituitarism)
Medications, such as opioids, steroids, or dopamine agonists
Other conditions, such as iron overload (hemochromatosis), sarcoidosis, or amyloidosis
Hypopituitarism may not cause any symptoms if it is mild or affects only one hormone. However, if it is severe or affects multiple hormones, it may lead to various complications, such as:
Short stature, poor growth, or delayed puberty in children
Weight gain, fatigue, low blood pressure, or intolerance to cold in adults
Loss of muscle mass, strength, or bone density
Reduced sex drive, erectile dysfunction, or infertility in men
Irregular periods, vaginal dryness, or infertility in women
Low breast milk production or failure to lactate in women who have given birth
Changes in hair, skin, or nails
Mood swings, depression, or anxiety
Headaches, vision problems, or nausea
Increased thirst, urination, or dehydration
Difficulty bonding, socializing, or trusting others
The levels of pituitary hormones and their target hormones in the body can be measured using a blood test to diagnose hypopituitarism. Other tests may also be ordered by the doctor to assess the level of glucose, electrolytes, and iron in the blood, as well as thyroid, adrenal, and reproductive gland function. To visualize the pituitary gland and detect any tumors or abnormalities, the doctor may also perform a physical examination, inquire about the patient's medical history, symptoms, and medications, and order imaging tests, such as magnetic resonance imaging (MRI) or computed tomography (CT).
Treatment for hypopituitarism depends on the cause, severity, and symptoms of the condition. The main goal is to replace the missing hormones with synthetic hormones that mimic their natural counterparts.
A growth hormone replacement therapy involves injecting growth hormone under the skin once a day to stimulate growth and development in children and improve body composition, metabolism, and quality of life in adults.
Thyroid hormone replacement therapy, which involves taking oral tablets of levothyroxine (a synthetic form of thyroid hormone) once a day to regulate metabolism and energy
Cortisol replacement therapy, which involves taking oral tablets of hydrocortisone (a synthetic form of cortisol) once or twice a day to cope with stress and inflammation
Levothyroxine (a synthetic form of thyroid hormone) is taken once a day to regulate metabolism and energy levels as part of thyroid hormone replacement therapyne (female sex hormones) to restore sexual function and fertility in both men and women
Stress and inflammation can be treated with cortisol replacement therapy, which involves taking oral tablets of hydrocortisone (a synthetic form of cortisol) once or twice a dayion in women who have given birth
To prevent dehydration and maintain water and salt balance in the body, antidiuretic hormone replacement therapy involves taking oral tablets or nasal sprays of desmopressin (a synthetic form of antidiuretic hormone).
Oxytocin replacement therapy, which involves taking oral tablets or nasal sprays of oxytocin (a synthetic form of oxytocin) to promote bonding and social behavior
The dosage and frequency of hormone replacement therapy may vary depending on the individual needs and response of the patient. Doctors may monitor blood hormone levels and adjust treatment accordingly. In order to prevent a life-threatening condition called adrenal crisis, the patient may also have to take extra cortisol during times of stress, such as illness, surgery, or injury.
Hypopituitarism can be prevented by avoiding or treating the factors that damage the pituitary gland or interfere with its function, such as:
Seeking medical attention for any symptoms of pituitary or brain tumors, such as headaches, vision problems, or nausea, and following the doctor’s advice on the best treatment options, such as surgery, radiation therapy, or medication
Protecting the head from trauma or injury by wearing a helmet, seat belt, or airbag when riding a bike, car, or motorcycle, and seeking medical attention for any head injuries
Preventing or treating infections, such as meningitis, encephalitis, or tuberculosis, by getting vaccinated, practicing good hygiene, and taking antibiotics as prescribed
Managing autoimmune diseases, such as lymphocytic hypophysitis or Sheehan’s syndrome, by taking anti-inflammatory drugs or hormone replacement therapy as prescribed
Screening for genetic disorders, such as Kallmann syndrome or Prader-Willi syndrome, by undergoing genetic testing or counseling before or during pregnancy
Following the doctor’s advice on the use of medications, such as opioids, steroids, or dopamine agonists, and reporting any side effects
Treating other conditions, such as iron overload, sarcoidosis, or amyloidosis, by taking chelation therapy, steroids, or chemotherapy as prescribed
It is possible to prevent or minimize the complications of hypopituitarism by following a hormone replacement therapy regimen and consulting a doctor regularly.
