(PHP; Underactive Pituitary Gland)
Definition
Definition
The pituitary gland is found at the base of the brain. It produces several important hormones that control the production of other hormones made by glands in the body. In panhypopituitarism, the gland produces an insufficient amount of hormones.
Pituitary GlandCopyright © Nucleus Medical Media, Inc.
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Causes
Causes
This condition is most often caused by damage to the gland. In adults, it is usually a result of pituitary surgery. In children, damage to the pituitary gland may be caused by:
In some cases, the cause may be unknown.
Risk Factors
Risk Factors
Factors that may increase your chance of panhypopituitarism include:
- Damage to the pituitary gland, which may occur from trauma, radiation therapy, cancer spread, postpartum hemorrhage
- Tumor on the pituitary gland
Symptoms
Symptoms
Compression of the Tumor
Compression of the tumor on local structures, especially the nerves of the eyes, can cause:
- Blurred vision
- Loss of visual field
- Poor temperature control
Insufficient Hormones
-
Insufficient levels of gonadotropins
can cause:
- In premenopausal women—missed menstrual cycles, infertility, osteoporosis, vaginal dryness, loss or reduction in female characteristics
- In men—impotence, reduced size of testes, decreased production of sperm, infertility, breast enlargement, reduced muscle mass, loss or reduction in male characteristics like beard growth
-
Insufficient levels of growth hormone
can cause:
- In children—stunted growth or dwarfism
- In adults—weakness, obesity, reduced cardiac output, low blood sugar levels, and reduced exercise tolerance
-
Insufficient levels of thyroid-stimulating hormones
can lead to:
- Underactive thyroid, which causes confusion, hair loss, weakness, slow heart rate, muscle stiffness, intolerance to cold, constipation, weight gain, and dry skin.
-
Insufficient corticotrophic levels
can lead to:
- Underactive adrenal gland, which causes low blood pressure, low blood sugar, fatigue, weight loss, vomiting, and low stress tolerance (this can be life-threatening).
-
Excessive prolactin levels
can cause:
- In women—missed periods, infertility, and milk secretion
- In men—reduced facial and body hair, small testes
- Insufficient antidiuretic hormone (rare) can cause:
- Excessive thirst and frequent urination
- Night-time urination
Diagnosis
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include the following:
- Blood tests—to measure pituitary, as well as target gland hormone levels
- Stimulation tests—to test the maximum capacity of the endocrine glands, usually of the pituitary gland
- Semen analysis—in males suspected of infertility
- MRI scan—imaging test used to assess internal structures
Treatment
Treatment
Talk with your doctor about the best plan for you. Treatment depends on the cause of the condition. The goal of treatment is to restore normal blood hormone levels of thyroid, adrenal, estrogen or testosterone, and sometimes growth hormone.
Treatment options include:
- Hormone replacement therapy—based on what types of hormones are missing
- Tumor removal—done if the cause of the damage is a tumor
- Radiation therapy—done if the cause of the damage is a cancer or tumor
Prevention
Prevention
In most cases, the causes of panhypopituitarism are not preventable.
RESOURCES:
The Pituitary Network Association http://www.pituitary.org/
CANADIAN RESOURCES:
Health Canada http://www.hc-sc.gc.ca
References:
Hypopituitarism in children. Lucile Packard Children’s Hospital website. Available at:
http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/diabetes/hypop.html
Accessed February 6, 2015.
Randeva HS, Schoebel J, et al. Classical pituitary apoplexy: clinical features, management and outcome. Clin Endocrinol (Oxf). 1999;51:181-188.
Schneider HJ, Aimaretti G, et al. Hypopituitarism. Lancet. 2007;269:1461-1470.
Toogood AA, Stewart PM. Hypopituitarism: clinical features, diagnosis, and management. Endocrinol Metab Clin North Am. 1998;37:235-261
What is a growth disorder? Nemours Kids Health website. Available at:
http://kidshealth.org/parent/medical/endocrine/growth_disorder.html
Updated July 2014. Accessed February 6, 2015.
Last Updated: 3/1/2013