Hypopituitarism: Symptoms, Causes, Diagnosis & Treatment Options

Hypopituitarism is a condition where you lack one or more hormones produced by the pituitary gland. Hormones are responsible for coordinating various functions in the body as they carry messages to different organs, tissues and muscles, through the blood. These signals help the body understand what and when to do.

The hormones produced by the pituitary gland help control important functions in the body including reproduction, metabolism and growth and development. This pea-sized gland located near the base of the brain is part of the endocrine system.

The pituitary gland is connected to the hypothalamus with nerves and blood vessels known as the pituitary stalk. The hypothalamus communicates with the pituitary gland through this pituitary stalk and instructs it to release certain hormones. Hypopituitarism can be caused due to damage or disorders of the hypothalamus or pituitary gland.

Symptoms of Hypopituitarism

Hypopituitarism symptoms will depend on the particular hormones that the pituitary gland is failing to produce. For instance, a lack of growth hormones can result in a person’s short stature. If the pituitary gland is not producing enough luteinizing hormone or follicle-stimulating hormone, it can lead to impairment of menstruation, sexual function and fertility.

Symptoms of Growth Hormone Deficiency

• Short stature
• Fatigue
• Changes in the body’s fat composition
• Muscle weakness
• Social isolation
• Lack of ambition

Symptoms of Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) deficiency

A deficiency of both these hormones has a negative effect on your reproductive system. 

Common symptoms include:

• Absence of or irregular periods
• Hot flashes
• Inability to produce milk after delivery
• Loss of pubic hair
• Mood changes
• Reduced body and facial hair growth
• Erectile dysfunction

Symptoms of Thyroid-stimulating hormone (TSH) deficiency

A low level of thyroid hormone in the body can lead to symptoms like:

• Weight gain
• Dry skin
• Constipation
• Fatigue
• Hypersensitivity to cold

Symptoms of Adrenocorticotropic Hormone (ACTH) Deficiency

This hormone assists the normal working of your adrenal glands and the body’s reaction to stress. Common symptoms of its deficiency include:

• Low blood pressure
• Fainting
• Severe fatigue
• Confusion
• Nausea and vomiting

Symptoms of Anti-Diuretic Hormone (ADH) deficiency

This hormone helps the body balance its fluid levels. Common symptoms include:

• Excessive thirst
• Excessive urination
• Electrolyte imbalance

Common Causes of Hypopituitarism

Trauma is one of the most common causes due to which your pituitary gland stops producing appropriate amounts of one or more hormones. Brain infection, brain surgery or a head injury can also affect the working of the pituitary gland.

Some tumours can also hinder the proper functioning of the pituitary gland. These include:

• Tumours in the pituitary gland
• Tumours in the brain
• Tumours in the hypothalamus 

Other possible causes of hypopituitarism include:

• Hemochromatosis: A hereditary disease, which leads to the accumulation of iron in the body.

• Histiocytosis X: A rare autoimmune condition in which the immune cells start attacking the body’s organs.

• Sarcoidosis: A chronic lung disorder.

• Tuberculosis: An infectious lung disorder

• Sheehan syndrome: Blood loss during childbirth

• Traumatic brain injury: Usually causes hypopituitarism in newborns, children and infants.

• Radiation therapy: A type of cancer treatment.

• Lymphocytic hypophysitis: An autoimmune disorder, which causes inflammation of the pituitary gland.

How is Hypopituitarism Diagnosed?

If your doctor believes there is a problem with your pituitary gland, they may order several tests to check the levels of hormones produced by them. These tests include:

• Blood Tests: This is the most common method used for measuring your body’s hormonal levels. For instance, a blood test can help the doctor identify low levels of adrenal, sex or thyroid hormones. This will help the doctor understand if the low levels are being caused due to hypopituitarism.

• Dynamic or Stimulation Testing: These tests help measure the levels of hormones in the body as well. You will be asked to visit a clinic specializing in endocrine conditions to get these tests done. You will be given certain medications to help stimulate hormone production after which your hormone levels will be checked.

• Brain Imaging: MRI or CT scan of the brain may also be done to detect a pituitary tumour or problems with the pituitary gland.

• Vision tests: In some cases, the pituitary tumour can grow and impair your visual field or sight. This test may be done to check for the same.

Treatment Options For Hypopituitarism

For treating hypopituitarism, the most common treatment is known as hormone replacement as the dosage is prescribed to ensure it matches the amount your body is unable to produce. In most cases, you may require medication throughout your life to keep the hormone levels steady.

Commonly prescribed hormone replacement medications include:

• Corticosteroids: These medications, including prednisone and hydrocortisone, are used for replacing adrenal hormones that the pituitary gland is unable to produce. These medications can be taken orally.

• Levothyroxine (Synthroid, Levoxyl, etc.): These medications are useful for treating low thyroid levels. Low levels of thyroid-stimulating hormone can lead to a condition known as hypothyroidism.

• Testosterone, Progesterone and Estrogen: Lack of these sex hormones can lead to a number of issues in both men and women. Men may be prescribed testosterone if their pituitary gland is unable to produce it in enough amounts. Testosterone is usually administered through the skin using a gel or patch or by injection. On the other hand, women may be given estrogen and progesterone if they have hypopituitarism. Female hormone replacement may be done using gels, patches or pills.

• Somatropin: Somatropin, also known as the growth hormone, may be given to a person whose body is not producing it in enough amounts. This treatment is administered through an injection below the surface of the skin. It helps promote growth, which is necessary for achieving a normal height in children.

• Gonadotropins: This treatment is offered to patients who have become infertile and require fertility treatment. Gonadotropins can be given by injection to help regulate sperm production in the case of males and stimulate ovulation in females.

Conclusion

Hypopituitarism may require lifelong treatment and regular monitoring of hormone levels. Getting diagnosed with hypopituitarism can be scary, but it is important to clarify your doubts and questions with your doctor to better understand this condition.