Hypopituitarism - Symptoms, causes and treatment

Hypopituitarism is disease that occurs due to a lack of hormones produced by a gland in the brain, called the pituitary or pituitary gland. This condition can lead to weight loss and infertility.

The pituitary gland or pituitary gland is a pea-sized gland located at the bottom of the brain. In general, this gland functions to produce hormones that regulate various functions of the body's organs.

Some of the hormones produced by the pituitary gland are:

  • Adrenocorticotropic hormone (ACTH)

    ACTH functions to trigger the adrenal glands to release a hormone called cortisol. Cortisol itself is useful for regulating the body's metabolism and blood pressure.

  • Thyroid stimulating hormone (TSH)

    TSH will stimulate the thyroid gland to produce thyroid hormone, a hormone that regulates the body's metabolism, and plays an important role in the process of growth and development.

  • Luteinizing hormone (LH) and follicle-stimulating hormone (FSH)

    LH and FSH function to regulate male and female genital organs to function normally.

  • Oxytocin

    Oxytocin This hormone or oxytocin functions to stimulate uterine contractions during labor and stimulate milk production.

  • Growth hormone (GH)

    Growth hormone or growth hormone serves to stimulate growth, including bones and body tissues.

  • Antidiuretic hormone (ADH)

    Antidiuretic hormone or ADH functions to control blood pressure and the release of body fluids into the kidneys.

  • Prolactin

    Prolactin or the hormone prolactin functions to stimulate breast growth and milk production.

When a person experiences a deficiency of one or more of these hormones, the body's functions which are regulated by the hormones produced by the pituitary gland will be disturbed. For example, a lack of GH will result in a person experiencing impaired bone growth.

Causes of Hypopituitarism

Hypopituitarism occurs because the pituitary gland cannot produce enough hormones. This condition can be caused by a variety of things, but most are caused by pituitary tumors. In addition to being caused by a tumor, hypopituitarism can also be caused by an injury to the gland, for example due to complications from surgery on the brain region.

There are several other causes of hypopituitarism besides tumors and injury, including:

  • Infections around the brain, such as meningitis or cerebral malaria
  • Inflammation of the pituitary gland, for example due to granulomatous hypophysitis and sarcoidosis.
  • Diabetes.
  • Subarachnoid hemorrhage.
  • lymphoma.
  • strokes.
  • Sheehan's syndrome or postpartum hypopituitarism.
  • Hemochromatosis.

Hypopituitarism can also occur as a side effect of chemotherapy or radiotherapy to the head area. In some cases, hypopituitarism has no known cause (idiopathic). Idiopathic hypopituitarism is thought to arise from abnormalities in the central nervous system during fetal development in the womb.

Symptoms of Hypopituitarism

The symptoms of this disease vary, depending on the causative factor, what hormones are affected, and how severe the disturbance is with those hormones. Below are some of the specific symptoms that appear based on the disturbed hormones:

  • Lack of ACTH

    If a person lacks the hormone ACTH, symptoms can include fatigue, nausea and vomiting, weight loss, and depression.

  • ADH deficiency

    Symptoms that can occur are frequent thirst and increased frequency of urination.

  • Lack of the hormone oxytocin

    Symptoms that can appear due to a lack of the hormone oxytocin are depression and lack of milk production in women.

  • TSH hormone deficiency

    Symptoms include difficulty defecating (constipation), inability to tolerate cold temperatures, weight gain, muscle aches, and muscle weakness.

  • Lack of prolactin hormone

    This disorder usually appears in women, in the form of little milk production, tired easily, and armpit hair and pubic hair does not grow. In men, this hormone deficiency does not cause any symptoms

  • FSH and LH . deficiency

    In women, a lack of this hormone can cause irregular periods, as well as infertility. Meanwhile, in men, symptoms include loss of facial hair or other body parts, decreased sexual desire, erectile dysfunction, and infertility.

  • Growth hormone deficiency

    Hypopituitarism can also be caused by a deficiency of GH or growth hormone. If it occurs in children, the symptoms caused include difficulty gaining height, accumulation of fat around the waist and face, and impaired growth.

When to go to the doctor

Immediately consult a doctor if you experience symptoms of hypopituitarism so that you can get treatment as soon as possible.

In addition, go to the ER immediately if you experience:

  • Huge headache
  • Lightly
  • Looks confused
  • Visual disturbance

The complaint is not a symptom of hypopituitarism, but a serious condition that occurs in the pituitary gland, namely: pituitary apoplexy. Pititary apoplexy is a condition due to bleeding or impaired blood supply in the pituitary gland or pituitary.

Diagnosis of Hypopituitarism

To diagnose hypopituitarism, the doctor will ask about the symptoms that appear and the patient's medical history. After that, if the doctor suspects a hormonal disorder, the doctor will perform a blood test to check hormone levels.

If hormone levels decrease, the doctor will perform further tests, such as an MRI or CT scan, to assist the doctor in determining the cause of the decrease in the hormone produced by the pituitary gland.

Hypopituitarism Treatment

There are several types of treatment that can be done to treat hypopituitarism. The first treatment is with drugs prescribed by a doctor. These drugs function as a substitute for hormones that the pituitary gland cannot produce properly.

There are several types of drugs used for pituitary hormone replacement therapy, namely:

  • Levothyroxine, to replace thyroid hormone that is lacking due to lack of TSH hormone production.
  • somatropin, to replace growth hormone (GH).
  • Sex hormones, such as testosterone and estrogen, to replace reproductive hormones that are lacking due to a lack of FSH and LH.
  • Corticosteroids, to replace the hormone that is lacking due to a lack of the hormone ACTH.

During therapy, patients need regular check-ups with a doctor to monitor hormone levels in the body. If needed, the doctor will change the dose of the hormone, if it is not appropriate. If medication does not treat hypopituitarism, surgery or radiotherapy may be performed, especially if the hypopituitarism is caused by a tumor.

Overall, the use of drugs and surgery is done to return the pituitary hormone levels to normal conditions. To make sure the tumor does not grow back, the patient can do a CT scan or MRI periodically.

Treatment for hypopituarism is often a lifelong treatment. However, with the consumption of drugs as recommended by the doctor, the symptoms can be controlled properly and the patient can live a normal life.

Complications of Hypopituitarism

It is not clear what complications that can arise in patients with hypopituitarism, but the following diseases are thought to appear in people with hypopituitarism:

  • Visual disturbance
  • Infectious disease
  • Heart disease
  • Myxedema coma

Prevention of Hypopituitarism

Basically, hypopituitarism cannot be prevented. Even so, routine pregnancy checks are known to prevent Sheehan's syndrome. In addition, discuss with your doctor about the benefits and risks of radiotherapy to the head, which can affect the pituitary gland.