About Hypopituitarism Treatment
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What is hypopituitarism?
This is a disorder which occurs when there is decreased secretion of some or all of the hormones produced by the pituitary gland. Hypopituitarism may also be referred to as pituitary insufficiency.
Causes of hypopituitarism include:- Brain tumor
- Head trauma
- Brain surgery
- Subarachnoid hemorrhage
- Radiation therapy
- Stroke
- Tumors of the pituitary gland or hypothalamus
- Infections or inflammation of the brain and the tissues that support the brain
Sometimes hypopituitarism is due to metabolic diseases or uncommon immune system such as:
- Sarcoidosis
- Hemochromatosis
- Lymphocytic hypophysitis
- Histiocytosis
SymptomsSymptoms may develop slowly and may greatly vary depending on the number of hormones that are missing, the severity of the disorder and the organs they affect. They include:
- Dizziness or fainting
- Excessive urination and thirst
- Lack of sex drive
- Abdominal pain
- Decreased appetite leading to loss of weight
- Low blood sugar
- Failure to lactate
- Fatigue and weakness
- Loss of body hair
- Headaches
- Infertility in both men and women
- Sensitivity to cold
- Low blood pressure
- Short height of less than 5 feet
- Changing voice or hoarseness
- Joint stiffness
- Slowed growth and sexual development in children
- Stopping of menstrual periods in women
- Vision problems
- Face swelling
- Unintentional weight gain
Diagnostic tests may include:- Brain CT scan
- Pituitary MRI
- Serum estradiol (estrogen)
- Serum ACTH
- Serum cortisol
- Serum luteinizing hormone (LH)
- Serum follicle stimulating hormone (FSH)
- Serum insulin-like growth factor 1 (IGF-1)
- Serum testosterone level
- Thyroid hormone (T4)
- Serum thyroid stimulating hormone (TSH)
TreatmentTreatment of hypopituitarism is based on three factors: treating the underlying cause, treating the hormone deficiencies and addressing any other problems that arise from the hormone deficiencies.
Underlying cause- The tumor may be removed surgically by an operation through the nose and sinuses. This procedure is known as Trans-sphenoidal surgery. In addition to addressing symptoms related to the tumor, it may also improve pituitary function. However, the gland is sometimes further damaged as a result of the surgery.
- The tumor may be removed by opening the skull, a procedure known as a craniotomy. Recovery from this procedure is less likely although sometimes this is the only suitable way to approach the tumor. Retesting the pituitary hormone levels is then performed two to three months after the surgery because it may take some time for hormone levels to change significantly.
- Some tumors may respond to dopamine agonist treatment. This is a medication that imitates the action of dopamine. This approach usually improves pituitary hormone secretion and makes supplementary treatment unnecessary.
- Other specific underlying causes are treated as normally.
Hormone replacementIf your hypopituitarism is caused by low levels of hormones you will need lifelong hormone medicines. These will replace hormones that are no longer made by organs under the control of the pituitary gland. These may include:
- Thyroid hormone
- Growth hormone
- Corticosteroids (cortisol)
- Sex hormones such as testosterone for men and estrogen for women
Medications are also available to treat related infertility that occurs in men and women
PrognosisOnce hypopituitarism develops, it is usually permanent and requires lifelong treatment with one or more medications. You can expect a normal lifespan although the quality of life may be reduced.
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