Hypopituitarism

What is hypopituitarism?

Hypopituitarism is a condition in which the pituitary gland does not produce normal amounts of hormones. The pituitary gland is a small bean-shaped gland situated at the base of the brain that secretes hormones that influence nearly every part of the body.  In hypopituitarism, patients have a short supply of one or more of these pituitary hormones. This deficiency can affect any number of the body’s routine functions, such as growth, blood pressure, and reproduction.

The hormones released by the pituitary gland (and their functions) are:

• Adrenocorticotropic hormone (ACTH): stimulates the adrenal gland to release cortisol, which helps maintain blood pressure and blood sugar
• Antidiuretic hormone (ADH): controls water loss by the kidneys
• Follicle-stimulating hormone (FSH): controls sexual function and fertility
• Growth hormone (GH): stimulates growth of tissues and bones
• Luteinizing hormone (LH): controls sexual function and fertility in males and females
• Oxytocin and Prolactin: stimulates the uterus to contract during labor and milk production in breasts
• Thyroid-stimulating hormone (TSH): stimulates the thyroid gland to release hormones that affect the body’s metabolism

What are the symptoms of hypopituitarism?

The following are symptoms of hypopituitarism:

• Fatigue
• Weight loss
• Decreased sex drive
• Sensitivity to cold or difficulty staying warm
• Decreased appetite
• Facial puffiness
• Anemia
• Infertility
• Hot flashes, irregular or no periods, loss of pubic hair, and inability to produce milk for breast-feeding in women
• Decreased facial or body hair in men
• Short stature in children

What causes hypopituitarism?

In hypopituitarism, there is a lack of one or more pituitary hormones, causing a loss of function in the gland or organ that the hormone controls. Hypopituitarism may be caused by:

• Brain surgery, tumor, infections, or inflammation
• Head trauma (traumatic brain injury)
• Death of an area of tissue in the pituitary gland
• Radiation therapy to the brain
• Stroke
• Subarachnoid hemorrhage (from a burst aneurysm)
• Tumors of the pituitary gland or hypothalamus
• Too much iron in the body (hemochromatosis)
• Abnormal increase in immune cells called histiocytes
• Autoimmune condition that causes inflammation of the pituitary (lymphocytic hypophysitis)
• Inflammation of various tissues and organs

How is hypopituitarism diagnosed?

Doctors may order several tests to check levels of various hormones in the body. Doctors may also want to check for hypopituitarism if you’ve had a recent head injury or radiation treatment that might have put you at risk of damage to your pituitary gland.

Blood tests, stimulation/dynamic tests, brain imaging, and/or vision tests may also be done to aid in a diagnosis.

What treatments are available for hypopituitarism?

If hypopituitarism is caused by a tumor, surgery may be required to remove the tumor. Radiation therapy may also be needed. In addition, lifelong hormone medicines may be needed to replace hormones that are no longer made by organs under the control of the pituitary gland. These may include:

• Corticosteroids
• Growth hormones
• Sex hormones (testosterone for men, and estrogen for women)
• Thyroid hormones

Where can I find out more about hypopituitarism?

• Medline Plus
• Medscape
• Mayo Clinic