The pituitary gland is in the brain. It produces several important hormones that control the production of other hormones made by glands in the body.
The pituitary gland is responsible for many body functions, including the following: GrowthBlood pressureSex organ functionThyroid gland functionBreast milk production and other aspects of pregnancy and birthWater balance in the bodySome reactions to stress
Hypopituitarism is an insufficient production of one or more hormones. A problem in the pituitary can cause the amount of hormones from other glands to diminish as well.
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There are several factors that may cause this condition: Tumors of the pituitary gland, hypothalamus, or brainPoor blood supply to the pituitary glandHead traumaRadiation therapy
to pituitary gland, head, or neck
StrokeInfections and inflammatory diseasesUncommon immune system or metabolic diseasesA rare complication after pregnancy, called Sheehan’s syndrome
Metastatic cancer from
Factors that may increase the chance for hypopituitarism include: History of childhood cancer—some treatments can damage the pituitaryInfectionsGeneticsType 1 diabetesSickle cell anemiaReduced blood volume or hypovolemia
Compression of the tumor on local structures, especially the nerves of the eyes, can cause: Blurred visionLoss of visual fieldPoor temperature control
Symptoms often begin gradually and are not specific since hormones control a variety of body functions. They may not be recognized for a while. Specific symptoms will depend on the type and level of hormone affected. For example:
Growth hormone deficiency:
Poor overall growthShort statureObesityMuscle weakness
Sensitivity to coldWeight gainConstipationHair that is brittle and coarseSlow heart rateDry skinMuscle weakness or fatigue
Adrenocorticotropic hormone (ACTH) deficiency:
Fatigue and weaknessWeight lossDecrease in skin pigmentationThe absence of a menstrual period in women of reproductive age
Follicle-stimulating hormone and luteinizing hormone
Infertility in men
womenVaginal drynessLoss of some gender-specific sexual characteristics—women may lose hair from their underarms, body, and pubic areaReduced interest in sexThe absence of a menstrual period in women of reproductive ageDifficulty maintaining an erectionMuscle weaknessSmall testesBreast enlargement in men—gynecomastia
Antidiuretic hormone deficiency (rare):
Excessive thirst and frequent urinationNight-time urination
You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to an endocrinologist. This is a type of doctor that focuses on hormone disorders.
Tests to determine hypopituitarism include taking a blood sample to do the following: Measure the levels of hormones produced by the pituitary glandMeasure the levels of hormones produced by target endocrine glands, which are influenced by the pituitary gland
Pituitary function tests may be done such as: Growth hormone-releasing hormone (GHRH) testArginine stimulation testClonidine stimulation testInsulin tolerance testAdrenocorticotropic hormone (ACTH) stimulation test
After the diagnosis is confirmed, imaging tests will be done to identify problems such as tumors or abnormal tissue and growth or shrinkage of the pituitary gland. This can be done with an
Talk with your doctor about the best treatment plan for you. This condition is likely permanent, depending on the cause. It will likely need to be treated for life. Treatment options include:
If the condition is caused by a tumor, it may be first treated with medications such as: BromocriptineCabergolineOctreotide
Medication may not always work. In this case, surgery may be needed. If a tumor is involved, then it will be removed. Part or all of the gland may be removed as well.
Hormone replacement therapy is needed after surgery or if other hormone deficiencies are found.
When the target hormone levels are inadequate, they must be replaced. In most cases, therapy does not replace the hormones that the pituitary gland produces. Instead, the hormones of the other target glands that it stimulates are replaced. Examples include: Glucocorticoids (adrenal hormone)—prednisone, hydrocortisone, dexamethasoneThyroid hormone, such as levothyroxineTestosterone (male)—can be replaced with patches, gels, or injectionsEstrogen and progesterone (female)—can be replaced with oral pill or patchesGrowth hormone—usually a daily injectionAntidiuretic hormone (ADH)—can be given as pill, subcutaneous injection, or nasal puff
Treatment with radiation may be used after drug or surgical treatment or if they have failed.
In general, this condition is not preventable. Be aware of the risks and symptoms. This will make early diagnosis and treatment possible.
Schneider HJ, Aimaretti G , Kreitschmann-Andermahr I, et al. Hypopituitarism.
Tomlinson JW. Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group.
Lancet. 2001; 357:425.
Last reviewed February 2016 by Kim Carmichael, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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