What is Hypopituitarism

Posted by Dr. Michael White, Updated on November 19th, 2021
Reading Time: 6 minutes
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Hypopituitarism is a medical condition in which the pituitary gland is unable to produce hormones that are normally produced by the gland sufficiently.

Several hormones are produced by the pituitary, and Hypopituitarism can refer to a deficiency in any individual hormone, as well as multiple hormones. This deficiency can be partial or total.

Many forms of Hypopituitarism, especially Total Hormone Deficiencies, are quite rare, whereas other, partial, and age-related types of Hypopituitarism, are more common.

What is the Pituitary Gland and Where is It Located?

The pituitary gland is located at the base of the human brain, it is relatively small, but it performs vital functions necessary to maintain hormone homeostasis. The pituitary is around the size and shape of a lima bean.

You can approximate the location of the pituitary gland by moving directly back from the nose to just behind the midpoint of the skull, right between the ears.

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Although the pituitary is quite small, it has an enormous amount of influence on the body, with its reach extending to nearly every organ and physiological process of the body. Procedures that the pituitary gland is directly involved in include reproduction, blood pressure, and growth.

Hypopituitarism is a severe condition, and its effects depend on the particular hormone or hormones not being produced sufficiently.

In most cases, Hypopituitarism is chronic, meaning that it can't be cured, but can be adequately treated with Hormone Replacement Therapy, to the extent that the patient will not experience significant symptoms.

In many cases, Hypopituitarism starts slowly and progresses over time. For example, concerning Age-Related HGH Deficiency, around the age of thirty, Human Growth Hormone Levels drop around one percent per year.

For many patients, HGH Deficiency never becomes a significant issue, but for others, Hormone Levels start to lead to unwanted physiological changes.

Gradual Hormone Depletion associated with many forms of Hypopituitarism can go unnoticed or unrealized for years, often mistaken, undiagnosed, or simply brushed off as simple aging.

Because Hypopituitarism refers to a class of Hormone Deficiencies, the symptoms that the patient experiences depend on which hormones are not being produced sufficiently and the severity of that deficiency. The following are some symptoms that patients may experience as a result of Hypopituitarism:

  • Infertility
  • Anemia
  • Edema
  • Loss of Appetite
  • Issues with Temperature Regulation
  • Loss of Libido
  • Erectile Dysfunction
  • Lack of Energy
  • Weight Loss
  • Weight Gain
  • Muscle Atrophy
  • Reduced Presence of Hair in Men
  • Menstrual Issues or Breast-Feeding Issues in Women
  • Growth Problems in Children

When Should I See a Doctor If I Show Symptoms of Hypopituitarism?

If you show signs of Hypopituitarism which onset abruptly, you need to visit a doctor or hospital immediately. If you experience a rapid decline in blood pressure, combined with changes in vision or a painful headache, this is a sign that bleeding in the brain is flooding the pituitary, and this could be potentially life-threatening.

Hypopituitarism Often the Result of Tumors

Hypopituitarism is sometimes a genetic issue that patients are born with, but it usually occurs as a result of illness or aging later in life. Severe Hypopituitarism of sudden onset is typically the result of a pituitary tumor, which limits the ability of the gland to produce one or more hormones.

Tumors may also suppress some hormones while leading to the over-production of one particular hormone. As the tumor grows, this can lead to migraines and visual issues, both the result of changes in pressure in the brain, or compression of nerves due to the growing tumor.

Causes of Hypopituitarism

Hypopituitarism is caused by any condition which suppresses the activity of the pituitary or damages the gland, including:

  • Tuberculosis
  • Brain Infection
  • Stroke
  • Inflammation
  • Radiation
  • Surgery
  • Tumors
  • Trauma
  • Aging
  • Hypothalamic Diseases
  • Genetic Disorders
  • Sometimes, the reason for Hypopituitarism is unclear.

How Do Doctors Diagnose Hypopituitarism?

If there is a reason to believe that you may be suffering from Hypopituitarism, your physicians can order several tests designed to measure your pituitary hormone levels or assess whether your body is responding to those hormones appropriately.

If you have experienced radiation or head trauma, your doctor may perform these tests to assess your hormone state before it becomes problematic.

Hypopituitarism Tests

Blood Testing – Hormones produced by the pituitary travel through the body via the bloodstream. Either by assessing the Hormone Concentrations directly or via their metabolites, it is possible to measure the activity of hormones produced by the Pituitary.

Hormone Stimulation Testing – These tests are performed to assess the ability of the pituitary to produce certain hormones, and can establish whether the Pituitary Insufficiency is the result of a malfunctioning Pituitary, or a Hypothalamic condition preventing the Pituitary from releasing hormones appropriately.

In these tests, the patient is dosed with certain chemicals which are known to stimulate the production of specific pituitary hormones directly.

Brain Scan – If the patient shows severe hypopituitarism signs, the doctor may order an MRI to assess the physical state of the brain. This testing will reveal any potential tumors or other abnormalities affecting the pituitary.

Visual Assessment – Because pituitary tumors can impair eyesight, Vision tests can provide evidence of tumors.

How Successful is Hypopituitarism Treatment?

In some cases, effective treatment may partially or totally restore the impaired Pituitary function. In other cases, the patient may require ongoing treatment for Pituitary Insufficiency, which may be needed for the rest of the patient's life.

In spite of the chronic condition, most patients can go on just as if their pituitary were functioning correctly because Hormone Replacement Therapy restores healthy hormone balance, which has been naturally impaired by Hypopituitarism.

Hypopituitarism Treatment

For patients with pituitary tumors, it will likely be necessary to undergo brain surgery or receive radiation treatments to destroy or remove the tumor. In the case of the Hormone Deficiency itself, the procedure will depend on which hormone or hormones are not being produced sufficiently.

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Hormone Therapy Treatments:

Human Growth Hormone – This hormone is produced by cells known as Somatotrophs. In children, this hormone is necessary for healthy growth, and in adulthood, this hormone is required to maintain optimal cellular metabolism and cellular homeostasis.

Sex Hormone Replacement – For a regular function, men need testosterone, and women need estrogen (at least until menopause). Testosterone Replacement Therapy is available in many forms, including Low-T Injections, Patches, and Creams. Estrogen and Estrogen/Progesterone Therapy is generally administered via patch, gel, or pill.

Luteinizing Hormone and Follicle-Stimulating Hormone – For patients with Sex Hormone Deficiency that are interested in having children, Luteinizing Hormone and Follicle-Stimulating Hormone Therapy will be necessary. These hormones promote the production of sperm and ovulation, depending on sex.

Synthroid/Levothyroxine – For patients unable to produce Thyroid-Stimulating Hormone typically, these treatments can maintain the normal function of the Thyroid Gland.

Corticosteroids – These medications, which include Prednisone and Hydrocortisone, are designed to restore healthy adrenal hormone levels that are deficient as the result of ACTH Deficiency. These drugs can be taken orally.

Maintaining Hypopituitarism Treatment

As a patient is taking medication for Hypopituitarism, he or she will have to undergo an occasional evaluation to assess the safety and effectiveness of treatment. The goal of Hormone Replacement is to restore Hormone Levels to those that would be normal in a healthy patient. Too many of these hormones can also cause their own problems.

Also, certain medications may require the patient to take them in response to symptoms. Although HGH and Sex Hormones are generally produced in a steady pattern, for example, Corticosteroids are released in response to pain, stress, and other stimulation. The body produces cortisol as a direct response to these conditions.

Patients with Pituitary Deficiencies can live perfectly healthy lives. All hormones produced by the pituitary have Bio-Identical or Functionally Identical analogs which can be used to mimic the normal function and release of hormones by the pituitary.

Reference

Diagnosis and Treatment of Hypopituitarism

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