Hypopituitarism: symptoms, methods of diagnosis and treatment

Hypopituitarism, whose symptoms in the absence of adequate diagnosis can be confused with the signs of other serious pathologies, is a rare disorder of the pituitary gland. In this disease, the pituitary gland either produces an inadequate amount of hormones, or does not produce one or more hormones necessary for the normal functioning of the human body.

The pituitary gland is a small beaked 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 problem of regulation is performed by hormones - their lack can indicate hypopituitarism. Symptoms in children are often manifested in the form of delayed growth and physical development, in adults - in violations of blood pressure and reproductive function.

Probably, at statement of such diagnosis to you it is necessary to drink all life a medical preparation, however signs of disease can be kept under the control.

Symptoms

The pathology analyzed in most cases has a progressive nature. Not always the doctor can immediately diagnose "hypopituitarism": the symptoms in children and adults can both appear suddenly, and gradually develop for several years. Often, the signs of violation are completely so insignificant that the patient for a long time simply does not give them due attention.

Symptoms of the disease vary depending on the hormone that the body lacks due to pituitary dysfunction. In addition, it matters how acute is the deficit of a particular substance. The patient may experience:

• Feeling of chronic fatigue;
• Decreased sexual desire;
• Increased sensitivity to low temperatures, cold;
• Deterioration of appetite.

In addition to the above feelings, the signs of pathology include:

• Unexplained weight loss;
• Puffiness of face;
• anemia;
• infertility;
• Women - hot flashes, irregular menstruation or lack of it, loss of pubic hair, inability to produce breast milk for feeding newborn babies;
• In men, loss of hair growing on the face or body;
• In children - low growth.

When to see a doctor

If you suspect hypopituitarism, the symptoms of which are listed above, apply for a consultation with a qualified specialist.

Consult a doctor immediately if any signs of the disease occur suddenly or are accompanied by severe headache, visual impairment, disorientation in time and space, or a sharp drop in blood pressure. This is no longer hypopituitarism - symptoms of this nature can mean that a sudden bleeding (apoplexy) has opened in the pituitary gland, requiring urgent medical intervention.

Causes

This disorder can be a consequence of congenital pathologies, but most often it is acquired. In most cases, hypopituitarism is caused by a pituitary tumor. As the neoplasm becomes larger and larger, it compresses and damages the tissues of the organ, adversely affecting the production of hormones. In addition, the tumor can compress the optic nerves, thus causing various visual impairments and hallucinations.

Other diseases, as well as certain circumstances, are also capable of damaging the pituitary gland and initiating hypopituitarism (the symptoms, the photos we give in this article). Symptoms of the disease may vary depending on the factor that triggered the development of pathology. Such factors include:

• Head trauma;
• Brain tumor or pituitary gland;
• Surgical operations on the brain;
• Treatment by radiotherapy;
• Autoimmune inflammation (hypophysitis);
• stroke;
• Infectious diseases of the brain (eg, meningitis);
• tuberculosis;
• Infiltrative diseases (sarcoidosis - inflammation in several internal organs, histiocytosis of Langerhans cells - a violation 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 tissues);
• A large loss of blood during delivery, which can damage the anterior part of the pituitary gland (Simmonds-Glinsky disease or postnatal necrosis of the pituitary gland);
• Genetic mutations that led to disturbances in the production of hormones in the pituitary gland;
• Disease of the hypothalamus - a fragment of the brain located directly above the pituitary - can also cause hypopituitarism.

Symptoms (photo reflects the course of the disease) arise from the fact that 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 a visit to a doctor

First, you should register for a medical consultation with the therapist. If necessary, he will redirect you to a specialist in hormonal disorders - the endocrinologist.

• Find out in advance whether you need to comply with 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, which at first glance are not related to pituitary dysfunction, should also be included in this list.
• Record in writing key personal data, including large-scale changes in life or noticeable changes in your ability to withstand stress.
• Record basic medical information, including recent surgical procedures, the names of regularly taken medications and chronic diseases. The doctor will also want to know if you have suffered a recent head injury.
• Take with you a relative or friend who will not only be willing to provide moral support, but will also help remember all the recommendations of a specialist.
• Make a list of questions that you would like to ask your doctor.

Questions to the endocrinologist

It is advisable to compile a list of the issues most interesting for you in advance, so that during the consultation, important details are not lost. If you are concerned about hypopituitarism (the symptoms and methods of treating the pathology you are interested in), include the following questions in your list:

• What disorder causes my symptoms and current condition?
• Is it possible that the signs of the disorder are caused by another disease?
• What examinations need to be completed?
• Is my condition temporary or chronic?
• What kind of treatment do you recommend?
• How long does it take to take your recommended medications?
• How will you track the effectiveness of therapy?
• I have chronic diseases. How to ensure the simultaneous treatment of all violations?
• Do I need to comply with any restrictions?
• Are there analogues of your prescription drugs?
• I would like to get more information about what hypopituitarism is. Symptoms and diagnosis are already clear; What materials about different therapies can you advise?

Do not hesitate to ask other questions, if during the consultation you want to learn something specific from a specialist.

What the doctor will say

The endocrinologist, in turn, will ask you a number of your own questions. Among them, most likely, will be the following:

• Why do you suspect hypopituitarism?
• Symptoms and causes of pathology, which you found in yourself, converge with the description of the disease in the medical literature?
• Have the signs of pathology changed over time?
• Have you noticed any visual impairment?
• Do you suffer from severe headaches?
• Has your appearance changed? Perhaps you lost weight or found a decrease in body hair volume?
• Have you lost interest in sex life? Has your menstrual cycle changed?
• Are you currently undergoing treatment? Or, perhaps, have been treated in the recent past? What diseases were diagnosed?
• Have you recently given birth to a child?
• Have you recently received head injuries? Were they subjected to neurosurgical treatment?
• Have your pituitary relatives diagnosed with pituitary dysfunction or hormonal disorders?
• What do you think helps to relieve the symptoms?
• What, in your opinion, contributes to worsening of symptoms?

Diagnostics

Can the doctor immediately suspect hypopituitarism? Symptoms and reasons for your unhealthy condition will certainly encourage the specialist to put this initial diagnosis, for the confirmation of which you will need to undergo several tests to determine the levels of various hormones in the body. The reason for setting such a diagnosis can serve as a recent head injury or a completed course of radiotherapy - these risk factors are quite capable of entailing the development of pathology.

Standard diagnostic tests include:

• Blood tests. Relatively simple tests can detect a deficiency of certain hormones that has arisen due to pituitary dysfunction. For example, according to the results of blood tests, it is possible to judge the low levels of hormones produced by the thyroid gland, the adrenal cortex or the genital organs - a deficiency of these substances is often associated with impaired functioning of the pituitary gland.
• Stimulation or dynamic tests. Even a specialist may find it difficult to recognize hypopituitarism; Symptoms in a child may not be the same as signs of a variety of hereditary diseases. To get accurate diagnostic results, the doctor will most likely send you to a special endocrinology clinic where you will first be asked to take safe medications to stimulate the production of hormones and then check how much the secretion volume has increased.
• Visualization of the brain. Magnetic resonance imaging (MRI) of the brain can detect pituitary tumors and other structural abnormalities.
• Eyesight check. Special tests determine whether the growth of the pituitary tumor affects the ability to see or the field of vision.

Treatment

Hypopituitarism, the symptoms and description of which are presented above, almost always represents a consequence, not an independent disease. Treatment of its root 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 illness for any reason was impossible or ineffective, the treatment of hypopituitarism with hormonal drugs is performed. In fact, such an effect on the body is not so much treatment, as a substitution for missing substances. Dosages should prescribe only a highly qualified endocrinologist, as they are calculated individually and reimburse strictly those hormones and in the amount in which they are presented in a healthy body. Substitution therapy can last a lifetime.

If the tumor causes hypopituitarism, the symptoms, treatment and subsequent recovery therapy will depend on the structural nature of the neoplasm. Usually, a surgical operation is performed to remove the pathological element. In some cases, radiation therapy is performed.

Preparations

Substitution medications can be represented by the following drugs:

• Corticosteroids. These drugs (examples can serve as hydrocortisone and prednisolone) replace hormones that are normally produced by the adrenal cortex. They are not sufficient due to adrenocorticotropic insufficiency. Corticosteroids are taken orally.
• "Levothyroxine" ("Levoxil", etc.). This drug replaces hormones of the thyroid gland with appropriate disorders.
• Sex hormones. As a rule, for men this is testosterone, for women - estrogen or a combination of estrogen with progesterone. If you suspect hypopituitarism, the symptoms and prophylaxis of a pituitary gland disorder can be similar to the signs and methods of preventing disorders associated with sex hormones. If the pathology is diagnosed by a doctor, in order to replace the missing hormones, drugs are used in specific forms: a gel or testosterone injection for men and tablets, gels or patches for women.
• A growth hormone. With endocrine disorders, this substance, called in medical science, somatropin, enters the body through a subcutaneous injection. Somatropin allows the body to grow, providing normal growth in children. Adults are also prescribed replacement injections that improve the overall condition of the patient, but normal growth is no longer subject to recovery.

Monitoring

An endocrinologist will monitor the levels of your hormones in your blood to provide adequate, but not excessive, amounts of vital substances.

You may need to change the dosage of corticosteroids, in case you are seriously ill or suffer serious physical stress. At this time, the body produces an additional hormone cortisol. You may need to change the dosage also in cases where you catch cold, suffer from diarrhea or vomiting, or undergo a surgical operation or dental treatment. Many patients are prescribed periodic CT or MRI.