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Hypopituitarism

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DIABETES AND ENDOCRINE SYSTEM

Endocrine System

Hypopituitarism is a disorder in which your pituitary gland fails to produce one or more of its hormones, or doesn't produce enough of them. A short supply of one or more of these pituitary hormones can affect any number of your body's routine functions.

While physicians rarely diagnose hypopituitarism, they should be aware of the signs and symptoms that characterize this disorder. The pituitary gland plays a major role in the endocrine system, linking the endocrine system and the CNS.

The pituitary is a small bean-shaped gland located at the base of your brain, somewhat behind your nose and between your ears. It's part of your endocrine system, which consists of glands that produce hormones that regulate processes throughout your body. Besides the pituitary gland, the endocrine system includes the thyroid gland, parathyroid glands, adrenal glands, pancreas, ovaries (in females) and testicles (in men).

Treatment

Successful treatment of the underlying condition causing hypopituitarism may lead to a complete or partial recovery of your body's normal production of pituitary hormones. The usual treatment for pituitary tumors is surgery to remove the growth. In some instances, doctors also recommend radiation treatment.

If hormone deficiencies persist after treatment, then you'll need prescriptions of one or more hormone-replacement medications. These drugs are considered as "replacement" rather than treatment, because the dosages are set to match the amounts that your body would normally manufacture if it didn't have a pituitary problem. Treatment is usually lifelong.

Hormone-replacement medications may include:

  • Corticosteroids. These drugs, such as hydrocortisone and prednisone, replace the adrenal hormones that aren't being produced because of an adrenocorticotropic hormone (ACTH) deficiency. You take them by mouth.

  • Levothyroxine. This medication replaces deficient thyroid hormone levels caused by modest TSH production.

  • Sex hormones. These include testosterone in men and estrogen or a combination of estrogen and progesterone in women. Testosterone is administered through the skin with either a patch, a gel or by injection. Female hormone replacement can be administered with either pills or patches.

  • Vasopressin or desmopressin. You take these hormones to replace ADH and to reduce your body's loss of water through frequent urination.

  • Growth hormone. Also called somatropin, growth hormone is taken through an injection beneath your skin. It promotes growth, thus producing more normal height in children. Adults with a growth hormone deficiency may also benefit from growth hormone replacement, but they won't become taller.

If you've become infertile, preparations containing LH and FSH, also called gonadotropins, can be administered by injection to stimulate ovulation in women and sperm production in men.

Use of hormone-replacement drugs rarely causes complications. To help reduce any drug-related risks, an endocrinologist, a doctor who specializes in endocrine disorders, may regularly monitor the levels of these hormones in your blood. Generally, your hormone levels are checked every few weeks or months at the beginning of treatment, and eventually every year.

An endocrinologist may want to adjust your dosage if you become seriously ill or experience major physical stress. During these times, your body would ordinarily produce extra cortisol hormone. The same kind of fine-tuning of dosage may be necessary when you have the flu, experience diarrhea or vomiting, or have surgery or dental procedures. Adjustments in dosage may also be necessary during pregnancy or with marked changes in weight. You may need periodic CT or MRI scans as well to monitor a pituitary tumor or other diseases causing the hypopituitarism.

Wear a medical alert bracelet or pendant, and carry a special card, notifying others — in emergency situations, for example — that you're taking corticosteroids and other medications.

The long-term outlook for people with hypopituitarism is usually excellent once treatment begins. The signs and symptoms of this disease should disappear once you're taking hormone-replacement medications.

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