Hypopituitarism symptoms can lead to various health problems, such as infertility or growth retardation. Proper treatment helps reverse them.
The human body has glands, many of them, which produce substances that regulate different processes. One of the most important is the pituitary, as it functions as the center of the endocrine system. Unfortunately, conditions like hypopituitarism can alter its function.
The pituitary gland is small, located in the lower part of the brain, connected to the hypothalamus through a small stalk. The main function is to produce various hormones, the target organ of which is usually another gland.
This structure has 2 different lobes; each one in charge of producing specific hormones. The one that usually gets affected in hypopituitarism is the anterior. The appearance of this condition can be due to many causes, being brain injury very common, according to various studies.
What is hypopituitarism?
Hypopituitarism, also known as pituitary insufficiency, is a condition in which the pituitary is unable to synthesize adequate amounts of one or more hormones. The decrease in synthesis can affect different functions.
It can also appear due to the alteration hypothalamus’ function. This is a region of the brain responsible for producing factors that stimulate the release of pituitary hormones. In this sense, the functioning of the pituitary depends on the hypothalamus.
The mechanism by which hypopituitarism appears involves direct lesions in the pituitary or hypothalamus, as well as inflammatory changes in the central nervous system. Therefore, the most frequent causes include pituitary tumors, head injuries and radiation treatments.
The hormones whose synthesis decreases when this alteration occurs are those produced in the anterior lobe of the pituitary. The synthesis of at least one of the following will be altered:
- Adrenocorticotropic hormone (ACTH).
- Luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
- Thyrotropic or thyroid stimulating hormone (TSH).
- Growth hormone (GH).
- Thyroid problems.
The hormones affected, such as the thyroid, depend on stimulating factors that originate from the pituitary gland.
The symptoms people with hypopituitarism exhibit can vary, depending on the hormones that are affected. The pathology can manifest itself differently in each person, however, studies show that children with hypopituitarism present short stature, cognitive alterations and delayed puberty.
In adults, doctors need to monitor the clinical manifestations of the condition, depending on the altered hormones. In this way, the following symptoms may occur.
Adrenocorticotropic hormone deficiency
This hormone stimulates the release of cortisol and other substances produced in the adrenal glands. Cortisol helps in the maintaining of blood pressure and blood glucose levels, hence, helps the body to react properly to stress.
Patients with hypopituitarism and adrenocorticotropic hormone deficiency may experience the following symptoms:
- Low blood pressure.
- Frequent fainting.
- Intense fatigue.
- Nausea, vomiting or pain in the abdomen.
- Frequent infections.
- Luteinizing and follicle-stimulating hormone deficiency.
Both hormones are responsible for intervening in the reproduction process. In women they regulate the menstrual cycle, while in men they stimulate the production of semen and testosterone. In turn, they also generate the appearance of secondary sexual characteristics.
The deficiency of these hormones can cause obvious symptoms, both in adults and children. In the youngest, it usually causes puberty delay and absence of secondary sexual characteristics.
On the other hand, in adults there may be the following symptoms:
- Decrease in the production of estrogens and testosterone (sex hormones).
- Alterations in menstruation and decrease in sperm production.
- Reduction of sexual desire.
- Erectile dysfunction.
Prolactin is the hormone responsible for stimulating the production of breast milk for lactation. Fortunately, a deficiency of the same does not usually have any impact on health while you are not pregnant. However, it is associated with a rare condition called Sheehan syndrome during childbirth, which can also prevent breastfeeding.
Thyrotropic or thyroid stimulating hormone deficiency
The main function of this hormone is to stimulate the release of the thyroid hormones triiodothyronine and thyroxine. They have a fundamental function in regulating the cellular metabolism of the entire organism.
Thyroid hormone deficiency causes a decrease in basal metabolism, with symptoms similar to hypothyroidism, such as the following:
- Weight gain.
- Fatigue and weakness.
- Difficulty regulating body temperature.
- Dry skin.
Growth hormone deficiency
Growth hormone deficiency acquires greater importance in children, because cells are constantly dividing, and a significant delay in development may appear. On the other hand, in adults some of the following symptoms may be reported:
- Fatigue and muscle weakness.
- Changes in the arrangement of fatty tissue.
- Psychiatric disorders that simulate depression.
How can doctors diagnose hypopituitarism?
The specialist should analyze the symptoms presented by the patient in order to identify the hormone that is affected by hypopituitarism. This requires a thorough questioning and a proper physical examination.
Subsequently, the doctor will order blood tests to measure hormone levels in basal conditions and verify the decrease. There is a test called a dynamic test or stimulation, which measures hormone levels after the administration of exogenous pituitary hormones. It allows to determine if the deficit is due to a problem in the pituitary or in the target glands.
Imaging, such as a CT scan, is often needed in some cases. This is to detect the presence of a mass that explains the disorder. Some tumors can affect vision, so a visual acuity test may also be necessary.
Available treatments for hypopituitarism
The treatment indicated to relieve the symptoms of hypopituitarism will depend on the hormones affected. In general terms, the main technique used is hormone replacement therapy. It consists of the exogenous administration of altered hormones in precise doses.
Hormone replacement therapy can restore the body’s ability to synthesize affected hormones. However, it is not a cure in all cases, so it may be necessary to take prescribed drugs for life.
Among the medications indicated to treat hypopituitarism, the following stand out:
- Corticosteroids, such as prednisone or hydrocortisone in the case of ACTH deficiency.
- Levothyroxine, in order to increase thyroid hormone levels due to the absence of TSH.
- Sex hormones, such as estrogens and testosterone, in the absence of FSH and LH.
- Somatotropin, especially in children with a decrease in GH.
- Fertility hormones to increase sperm and egg production.
A rare condition with multiple manifestations
Hypopituitarism is nothing more than the inadequate functioning of the pituitary gland, which generates a decrease in the synthesis of one or more hormones. The affected substances are usually synthesized in the anterior lobe of the gland, so the clinical manifestations of the disease are very varied.
Fortunately, the diagnosis is simple and it is only necessary to measure the levels of hormones in the blood in baseline conditions. The deficiency interferes with the proper functioning of the body and can generate severe complications. It is important to consult the doctor immediately in the presence of any signs.
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