Hypopituitarism, whose symptoms can be confused with signs of other serious pathologies in the absence of adequate diagnosis, is a rare disorder of the pituitary gland. In this disease, the pituitary gland either produces an insufficient amount of hormones, or does not produce at all one or more hormones necessary for the normal functioning of the human body.
The pituitary gland is a small bean gland located at the base of the brain, behind the nose and between the ears. Despite its small size, this gland performs vital functions: its secret regulates the functioning of almost all internal organs and parts of the body. The task of regulation is performed by hormones - their deficiency may indicate hypopituitarism. Symptoms in children often manifest as stunted growth and physical development, and in adults as impaired blood pressure and reproductive function.
Perhaps when stagingwith such a diagnosis, you will have to take medications all your life, but the signs of the disease can be kept under control.
Symptoms
The analyzed pathology in most cases is progressive. It is not always possible for a doctor to immediately diagnose hypopituitarism: symptoms in children and adults can either appear suddenly or develop gradually over several years. Often, the signs of a violation are completely so insignificant that the patient simply does not pay due attention to them for a long time.
Signs of the disease vary depending on the hormone that the body lacks due to dysfunction of the pituitary gland. In addition, it matters how acute the deficiency of a particular substance is. Patient may experience:
- feeling chronically tired;
- reduced sex drive;
- increased sensitivity to low temperatures, cold;
- loss of appetite.
In addition to the above sensations, signs of pathology include:
- unexplained weight loss;
- puffy face;
- anemia;
- infertility;
- women - hot flashes, irregular or no menstruation, loss of pubic hair, inability to produce breast milk to feed newborn babies;
- in men - loss of hair growing on the face or body;
- children have short stature.
When to see a doctor
If you suspect you havehypopituitarism, the symptoms of which are listed above, make an appointment with a qualified specialist.
See your doctor promptly if any of the signs of illness occur suddenly or are accompanied by severe headache, visual disturbances, disorientation in time and space, or a sudden drop in blood pressure. This is no longer hypopituitarism - symptoms of this nature may mean that a sudden bleeding (apoplexy) has opened in the pituitary gland, requiring urgent medical attention.
Reasons
This disorder may be the result of congenital pathologies, but most often it is acquired. In most cases, hypopituitarism is caused by a pituitary tumor. As the neoplasm grows larger, it compresses and damages the tissues of the organ, negatively affecting the production of hormones. In addition, the tumor can compress the optic nerves, thereby causing various visual disturbances and hallucinations.
Other diseases, as well as certain circumstances, can also damage the pituitary gland and initiate hypopituitarism (symptoms, photos are given in this article). Symptoms of the disease may vary depending on the factor that triggered the development of pathology. These factors include:
- head injury;
- brain or pituitary tumors;
- brain surgery;
- radiotherapy treatment;
- autoimmune inflammation (hypophysitis);
- stroke;
- infectious diseases of the brainbrain (e.g. meningitis);
- tuberculosis;
- infiltrative diseases (sarcoidosis - inflammation in several internal organs; Langerhans cell histiocytosis - a disorder in which abnormal cells cause scarring in various organs and parts of the body, mainly in the lungs and bones; hemochromatosis - excessive accumulations of iron in the liver and other fabrics);
- major blood loss during delivery that can damage the anterior pituitary gland (Simmonds-Glinsky disease or postpartum pituitary necrosis);
- genetic mutations that led to impaired hormone production in the pituitary gland;
- disorders of the hypothalamus - a piece of the brain located directly above the pituitary gland - can also cause hypopituitarism.
Symptoms (the photo reflects the course of the disease) occur because the hypothalamus produces its own hormones that regulate the functioning of the "neighboring" bean gland.
In some cases, the genesis of the disease remains unknown.
Before visiting the doctor
First, you should sign up for a medical consultation with a therapist. If necessary, he will refer you to a specialist in hormonal disorders - an endocrinologist.
- Find out in advance if you need to meet any requirements to ensure the accuracy of diagnostic tests.
- Make a detailed list of all the signs of pathology that you observe in yourself. If you suspect hypopituitarism, the symptoms of the disease, onat first sight not related to pituitary dysfunction should also be included in this list.
- Write down key personal details, including major life changes or noticeable changes in your ability to handle stress.
- Write down basic medical information, including recent surgery, regular medications, and chronic illnesses. Your doctor will also want to know if you've had any recent head trauma.
- Take a relative or friend with you who will not only be ready to provide moral support, but also help to remember all the recommendations of a specialist.
- Make a list of questions you would like to ask your doctor.
Questions to the endocrinologist
It is advisable to make a list of the most interesting questions in advance so that during the consultation you do not lose sight of important details. If you are concerned about hypopituitarism (you are interested in symptoms and treatments), include the following questions on your list:
- What disorder is causing my symptoms and current condition?
- Is it possible that the signs of the disorder are caused by another disease?
- What tests do I need to have?
- Is my condition temporary or chronic?
- Which treatment would you recommend?
- How long should I take the medicines you recommend?
- How will you monitor the effectiveness of therapy?
- I have a chronic illness. How to ensure that all disorders are treated simultaneously?
- Do I need to follow any restrictions?
- Are there any analogues of the medicines prescribed by you?
- I would like more information about what hypopituitarism is. Symptoms and diagnosis are already clear; what resources would you recommend on various therapies?
Feel free to ask other questions if you would like to ask a specialist during the consultation.
What the doctor will say
The endocrinologist, in turn, will ask you a series of questions of his own. Among them, most likely, will be the following:
- Why do you suspect hypopituitarism?
- Do the symptoms and causes of the pathology that you have found in yourself agree with the description of the disease in the medical literature?
- Have the signs of pathology changed over time?
- Did you notice any visual impairment?
- Do you suffer from severe headaches?
- Has your appearance changed? Have you lost weight or noticed a decrease in body hair?
- Have you lost interest in sexual activity? Has your menstrual cycle changed?
- Are you currently in treatment? Or perhaps you have been in therapy in the recent past? What diseases have been diagnosed?
- Have you recently had a baby?
- Have you had a head injury recently? Have you undergone neurosurgical treatment?
- Have any close relatives been diagnosed with pituitary or hormonal disorders?
- What do you think helps relieve symptoms?
- What do you think makes your symptoms worse?
Diagnosis
Will a doctor immediately suspect hypopituitarism? The symptoms and causes of your unhe althy condition will certainly push the specialist to make this particular initial diagnosis, for confirmation of which you will need to undergo several tests to determine the levels of various hormones in the body. The reason for making such a diagnosis can also be a recent head injury or a completed course of radiotherapy - these risk factors are quite capable of leading to the development of pathology.
Standard diagnostic tests include:
- Blood tests. Relatively simple tests can detect a deficiency of certain hormones due to pituitary dysfunction. For example, blood tests can indicate low levels of hormones produced by the thyroid gland, adrenal cortex, or genitals - a lack of these substances is often associated with impaired functioning of the pituitary gland.
- Stimulation or dynamic tests. Even a specialist can find it difficult to recognize hypopituitarism; symptoms in a child may even be similar to signs of a variety of hereditary diseases. In order to get accurate diagnostic results, the doctor will most likely refer you to a special clinic.endocrinological studies, where you will first be asked to take safe medications to stimulate hormone production, and then they will check how much the secretion has increased.
- Imaging studies of the brain. Magnetic resonance imaging (MRI) of the brain can detect pituitary tumors and other structural abnormalities.
- Vision check. Special tests determine whether the growth of a pituitary tumor has affected the ability to see or the field of vision.
Treatment
Hypopituitarism, the symptoms and description of which are presented above, is almost always a consequence, and not an independent disease. Treatment of its underlying cause in most cases allows you to permanently get rid of the symptoms of hormonal disorders associated with pituitary dysfunction. If the therapy of the initial disease for any reason turned out to be impossible or ineffective, hypopituitarism is treated with hormonal drugs. In fact, such an effect on the body is not so much a treatment as a replacement for the missing substances. Dosages should be prescribed only by a highly qualified endocrinologist, since they are calculated on an individual basis and compensate strictly for those hormones and in the amount in which they are present in a he althy body. Replacement therapy can last a lifetime.
If the tumor has caused hypopituitarism, symptoms, treatment, and subsequent restorative therapy will depend on the structural nature of the tumor. Usually prescribedsurgical operation to remove the pathological element. In some cases, radiation therapy is performed.
Drugs
Substitute drugs can be represented by the following drugs:
- Corticosteroids. These drugs (examples are hydrocortisone and prednisolone) replace hormones normally produced by the adrenal cortex. They are lacking due to adrenocorticotropic insufficiency. Corticosteroids are taken by mouth.
- "Levothyroxine" ("Levoxil" and others). This drug replaces thyroid hormones for thyroid disorders.
- Sex hormones. As a rule, for men it is testosterone, for women it is estrogen or a combination of estrogen and progesterone. If you suspect that you have hypopituitarism, the symptoms and prevention of a pituitary disorder may be similar to the signs and treatment for sex hormone disorders. If the pathology is diagnosed by a doctor, drugs are used in specific forms to replace the missing hormones: testosterone gel or injection for men and tablets, gels or patches for women.
- Growth hormone. With endocrine disorders, this substance, called somatropin in medical science, enters the body through a subcutaneous injection. Somatropin allows the body to grow, ensuring normal growth in children. Adults are also prescribed replacement injections, which improve the general condition of the patient, but normal growth can no longer be restored.
Monitoring
The endocrinologist will monitor your blood hormone levels to ensure adequate but not excessive amounts of vital nutrients.
You may need to change your corticosteroid dosage if you become seriously ill or experience severe physical stress. At such times, the body produces additional hormone cortisol. You may also need to change your dosage if you catch a cold, suffer from diarrhea or vomiting, or undergo surgery or dental treatment. Many patients are prescribed periodic CT or MRI.
