The pituitary gland is in the brain. It produces important hormones. These hormones control the production of other glands in the body.
The pituitary gland is responsible for many body functions, including the following:
- Blood pressure
- Sex organ function
- Thyroid gland function
- Breast milk production and other aspects of pregnancy
- Conversion of food into energy
- Water balance in the body
Hypopituitarism is an insufficient production of one or more hormones. It is not a common disorder. A problem in the pituitary can cause the amount of hormones from other glands to diminish as well. This can be a serious problem. It will require care from your doctor.
There are several factors which may cause this condition:
- Tumors of the pituitary gland, hypothalamus, or brain
- Poor blood supply to the pituitary gland
- Head trauma]]>
- ]]>Radiation]]> to pituitary gland, head, or neck
- Infections and inflammatory diseases
- Uncommon immune system or metabolic diseases
- A rare complication after pregnancy, called Sheehan’s syndrome
- Metastatic cancer from ]]>lung]]> , ]]>colon]]> , ]]>prostate]]> , or ]]>melanoma]]>
Factors that increase your the chance for hypopituitarism include:
Symptoms often begin gradually. They may not be recognized for a while. Specific symptoms will depend on the type and level of hormone effected, for example:
Growth hormone deficiency:
- Poor overall growth
- Short stature
- Increased blood pressure
- Central obesity]]>
- Muscle weakness
- Small heart
- Sensitivity to cold
- Weight gain
- Hair that is brittle and coarse
- Heart rate slowed
- Dry skin
- Muscle weakness or fatigue
Adrenocorticotropic hormone (ACTH) deficiency:
- Fatigue and weakness
- Low blood pressure
- Weight loss
- Increase in skin pigmentation
- Follicle-stimulating hormone and luteinizing hormone deficiency:
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may refer you to an endocrinologist. This is a type of doctor that focuses on hormone disorders.
Tests to determine hypopituitarism include taking a blood sample to do the following:
- Measure the levels of hormones produced by the pituitary gland
- Measure the levels of hormones produced by target endocrine glands, which are influenced by the pituitary gland
Provocative tests of pituitary function may also be done such as:
- Growth hormone-releasing hormone (GHRH) test
- Arginine stimulation test
- Clonidine stimulation test
- Insulin tolerance test
- Adrenocorticotropic hormone (ACTH) stimulation test
Once the diagnosis is confirmed:
- Lateral skull x-ray imaging tests (eg, an MRI]]> )—to identify problems such as abnormal tissue and growth or shrinkage of the pituitary gland
Talk with your doctor about the best plan for you. This condition is permanent. It will likely need to be treated for life. Treatment options include:
If the condition is caused by a tumor, it is first treated with medications such as:
Medication may not always work. In this case, surgery may be needed. If a tumor is involved it will be removed. Part or all of the gland may be removed as well.
Hormone replacement therapy is needed after surgery.
Hormone Replacement Therapy
When the target hormone levels are inadequate, they must be replaced. In most cases, therapy does not replace the hormones that the pituitary gland produces. Instead, the hormones of the other target glands that it stimulates are replaced. Examples include:
- Thyroid hormone
- Testosterone (male)
- Estrogen and progesterone (female)
- Growth hormone
- Antidiuretic hormone
Treatment with radiation is used after drug or surgical treatment.
Pituitary Disorders Education and Support
Pituitary Network Association
The Pituitary Society
Thyroid Foundation of Canada
Beers MH, Fletcher AJ, Jones TV, et al. The Merck Manual of Medical Information: Second Home Edition . Whitehouse Station, NJ: Merck Research Laboratories; 2003.
Hypopituitarism. Medline Plus website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000343.htm . Accessed on July 22, 2005.
Schneider HJ, Aimaretti G , Kreitschmann-Andermahr I, et al. Hypopituitarism. Lancet. 2007;369:1461-1470.
Tomlinson JW, et al. Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group. Lancet . 2001; 357:425.
Last reviewed January 2009 by ]]>Rosalyn Carson-DeWitt, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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