Doctor's Notes on Hypopituitary
Hypopituitarism (hypopituitary) 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 to function normally. Hormones produced by the pituitary include prolactin, adrenocorticotropic hormone (ACTH), growth hormone (GH), thyroid-stimulating hormone (TSH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH); each hormone has its particular effects.
- Prolactin – little or no milk production, fatigue, loss of underarm and pubic hair
- ACTH – fatigue, low blood pressure, weight loss, depression, nausea, vomiting
- GH – short stature, low energy, weight gain, decreased exercise tolerance, anxiety, depression
- TSH – constipation, sensitive to cold, weight gain, muscle soreness
- LH and FSH – in women, irregular or no periods, infertility; in men, weakness, loss of body and facial hair, erectile dysfunction, infertility
In addition, the condition may reduce ADH levels resulting in increased thirst and urination.
Some persons may have no symptoms or a gradual onset of symptoms. In other persons, the symptoms may be sudden and dramatic. The symptoms depend on the cause, rapidity of onset, and the hormone that is involved.
- ACTH deficiency: Symptoms include fatigue, low blood pressure, weight loss, weakness, depression, nausea, or vomiting.
- TSH deficiency: Symptoms include constipation, weight gain, sensitivity to cold, decreased energy, and muscle weakness or aching.
- FSH and LH deficiency: In women, symptoms include irregular or stopped menstrual periods and infertility. In men, symptoms include loss of body and facial hair, weakness, lack of interest in sexual activity, erectile dysfunction, and infertility.
- GH deficiency: In children, symptoms include short height, fat around the waist and in the face, and poor overall growth. In adults, symptoms include low energy, decreased strength and exercise tolerance, weight gain, decreased muscle mass, and feelings of anxiety or depression.
- Prolactin deficiency: In women, symptoms include lack of milk production, fatigue, and loss of underarm and pubic hair. No symptoms are seen in men.
- ADH deficiency: Symptoms include increased thirst and urination.
A loss of function of the pituitary gland or hypothalamus results in low or absent hormones. Tumors can cause damage to the pituitary gland or hypothalamus and can therefore result in a loss of function. Damage to the pituitary gland can also be caused by radiation, surgery, infections (eg, meningitis), or various other conditions. In some cases, the cause is unknown.
It's hard to tell if you have thyroid abnormalities. You might feel run down and tired, or have what is known as "brain fog." You may be gaining weight, pregnant, or experiencing hair loss. Others may feel "hyper," anxious, or sweat a lot more than usual. All of these are common symptoms of thyroid disorders. The thyroid gland regulates many processes within the body, and women are particularly likely to have disorders that affect the function of this essential gland. Recognizing and treating these conditions is critical for optimum health and preventing long-term health problems.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.