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.
Causes of hypopituitarism have been linked to tumors, radiation exposures, surgery, meningitis, and other diseases. In many individuals with the condition, the causes are not known.
What Are the Treatments for Hypopituitarism?
The main treatments for hypopituitarism are medications to replace hormones that the pituitary gland has slowed or stopped producing or influencing, given by mouth, patch, or injection, with the goal of returning the patient's hormone levels to normal levels:
- Corticosteroids
- Somatropin (growth hormone)
- Levothyroxine
- Testosterone, estrogen, and progesterone (sex hormones)
- Gonadotropins (fertility hormones)
Pituitary tumors are treated by surgical removal and radiation. Other medications may be added to control underlying causes.
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Hypopituitarism in Children
Hypopituitaryism is a condition in which the pituitary gland at the base of the brain does not produce as much of one or more hormones as it is supposed to. These hormones include growth hormone (GH), prolactin, and others. Hypopituitaryism in children can cause jaundice, short stature, fatigue, mental development delay, mental and nervous system problems, and other serious symptoms. Drugs are used to replace the missing hormones to treat hypopituitaryism.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.