CHP Saint-Grégoire (Saint Gregory Private Hospital), the first Breton hospital in France specializing in Surgery, was established in 2004 when three medical facilities -- Saint Vincent Clinic, Volney Polyclinic, Bréquigny Maternity -- merged into a single site.
This is a disorder which occurs when there is decreased secretion of some or all of the hormones produced by the pituitary gland. Hypopituitarism may also be referred to as pituitary insufficiency.
Causes of hypopituitarism include:
Brain tumor
Head trauma
Brain surgery
Subarachnoid hemorrhage
Radiation therapy
Stroke
Tumors of the pituitary gland or hypothalamus
Infections or inflammation of the brain and the tissues that support the brain
Sometimes hypopituitarism is due to metabolic diseases or uncommon immune system such as:
Sarcoidosis
Hemochromatosis
Lymphocytic hypophysitis
Histiocytosis
Symptoms
Symptoms may develop slowly and may greatly vary depending on the number of hormones that are missing, the severity of the disorder and the organs they affect. They include:
Dizziness or fainting
Excessive urination and thirst
Lack of sex drive
Abdominal pain
Decreased appetite leading to loss of weight
Low blood sugar
Failure to lactate
Fatigue and weakness
Loss of body hair
Headaches
Infertility in both men and women
Sensitivity to cold
Low blood pressure
Short height of less than 5 feet
Changing voice or hoarseness
Joint stiffness
Slowed growth and sexual development in children
Stopping of menstrual periods in women
Vision problems
Face swelling
Unintentional weight gain
Diagnostic tests may include:
Brain CT scan
Pituitary MRI
Serum estradiol (estrogen)
Serum ACTH
Serum cortisol
Serum luteinizing hormone (LH)
Serum follicle stimulating hormone (FSH)
Serum insulin-like growth factor 1 (IGF-1)
Serum testosterone level
Thyroid hormone (T4)
Serum thyroid stimulating hormone (TSH)
Treatment
Treatment of hypopituitarism is based on three factors: treating the underlying cause, treating the hormone deficiencies and addressing any other problems that arise from the hormone deficiencies.
Underlying cause
The tumor may be removed surgically by an operation through the nose and sinuses. This procedure is known as Trans-sphenoidal surgery. In addition to addressing symptoms related to the tumor, it may also improve pituitary function. However, the gland is sometimes further damaged as a result of the surgery.
The tumor may be removed by opening the skull, a procedure known as a craniotomy. Recovery from this procedure is less likely although sometimes this is the only suitable way to approach the tumor. Retesting the pituitary hormone levels is then performed two to three months after the surgery because it may take some time for hormone levels to change significantly.
Some tumors may respond to dopamine agonist treatment. This is a medication that imitates the action of dopamine. This approach usually improves pituitary hormone secretion and makes supplementary treatment unnecessary.
Other specific underlying causes are treated as normally.
Hormone replacement
If your hypopituitarism is caused by low levels of hormones you will need lifelong hormone medicines. These will replace hormones that are no longer made by organs under the control of the pituitary gland. These may include:
Thyroid hormone
Growth hormone
Corticosteroids (cortisol)
Sex hormones such as testosterone for men and estrogen for women
Medications are also available to treat related infertility that occurs in men and women
Prognosis
Once hypopituitarism develops, it is usually permanent and requires lifelong treatment with one or more medications. You can expect a normal lifespan although the quality of life may be reduced.
About Hypopituitarism Treatment
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