Hypopituitarism, the symptoms of which, in the absence of an adequate diagnosis, can be confused with the signs of other serious pathologies, is a rare pituitary disorder. In this disease, the pituitary gland either does not produce enough hormones, or does not produce one or more hormones necessary for the normal functioning of the human body.
The pituitary gland is a small bean-shaped 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 are often manifested in the form of stunted growth and physical development, in adults - in impaired blood pressure and reproductive function.
When making such a diagnosis, you may have to drink medications all your life, but the signs of the disease can be controlled.
Symptoms
The analyzed pathology in most cases is progressive in nature. It is not always possible for a doctor to immediately diagnose “hypopituitarism”: symptoms in children and adults can either appear suddenly or gradually develop over several years. Often, the signs of a violation are even so insignificant that the patient simply does not pay enough attention to them for a long time.
Symptoms of the disease vary depending on the hormone that the body lacks due to pituitary dysfunction. In addition, it matters how acute a deficiency of a particular substance is. The patient may experience:
- feeling of chronic fatigue;
- decreased sex drive;
- increased sensitivity to low temperatures, cold;
- loss of appetite.
In addition to the above sensations, the signs of pathology include:
- unexplained weight loss;
- puffiness of the face;
- anemia;
- infertility;
- in women, hot flashes, irregular or non-regular periods, loss of pubic hair, inability to produce breast milk for feeding newborns;
- in men, hair loss growing on the face or body;
- in children - short stature.
When to see a doctor
If you suspect that you have hypopituitarism, the symptoms of which are listed above, sign up for a consultation with a qualified specialist.
Contact your 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 may mean that sudden bleeding (apoplexy) has opened in the pituitary gland, requiring urgent medical intervention.
Causes
This violation can be a consequence of congenital pathologies, but more 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, exerting a negative effect on the production of hormones. In addition, the tumor can compress the optic nerves, thereby causing various visual impairments and hallucinations.
Other diseases, as well as certain circumstances, can also damage the pituitary gland and initiate hypopituitarism (symptoms, photos we provide in this article). Symptoms of the disease may vary depending on the factor that triggered the development of pathology. These factors include:
- head injuries;
- brain or pituitary tumors;
- brain surgery;
- radiotherapy treatment;
- autoimmune inflammation (pituitary gland);
- stroke;
- infectious diseases of the brain (e.g., meningitis);
- tuberculosis;
- infiltrative diseases (sarcoidosis - inflammation in several internal organs; histiocytosis of Langerhans cells - 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 tissues);
- large blood loss during delivery, which can damage the front of the pituitary gland ( Simmonds-Glinsky disease or postpartum pituitary necrosis);
- genetic mutations leading to impaired hormone production in the pituitary gland;
- diseases of the hypothalamus - a fragment of the brain located directly above the pituitary gland - can also cause hypopituitarism.
Symptoms (the photo reflects the process of the disease) arise 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 a visit to the doctor
First, you should sign up for a medical consultation with a therapist. If necessary, he will redirect you to a specialist in hormonal disorders - an endocrinologist.
- Find out in advance if 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 at home. If you suspect hypopituitarism, 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 major changes in life or noticeable changes in your ability to tolerate stress.
- Record basic medical information, including recent surgery, names of regularly taken medications, and chronic illnesses. The doctor will also want to find out if you have suffered recent head injuries.
- Take along a relative or friend who will not only be ready to provide moral support, but will 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 draw up a list of the issues that are of most interest to you 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 the symptoms and treatment of pathology), 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 are necessary to pass?
- Is my condition temporary or chronic?
- What treatment method would you recommend?
- How long should you take your recommended medications?
- How will you track the effectiveness of therapy?
- I have a chronic illness. How to provide simultaneous treatment of all disorders?
- Do I need to comply with any restrictions?
- Are there any analogues of your prescribed medications?
- I would like more information about what hypopituitarism is. Symptoms and diagnosis are already clear; What materials about various methods of therapy can you advise?
Do not hesitate to ask other questions, if during the consultation you want to find out 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?
- 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?
- Did signs of pathology change over time?
- Have you noticed any visual impairment?
- Do you suffer from severe headaches?
- Has your appearance changed? Perhaps you have lost weight or found a decrease in the volume of hair on the body?
- Have you lost interest in sex? Has your menstrual cycle changed?
- Are you currently undergoing treatment? Or, perhaps, have been treated in the recent past? What diseases have been diagnosed?
- Have you recently given birth to a baby?
- Have you had any head injuries lately? Were they treated with neurosurgery?
- Have your close relatives been diagnosed with pituitary or hormonal disorders?
- What do you think helps relieve symptoms?
- What do you think aggravates the symptoms?
Diagnostics
Can a doctor immediately suspect hypopituitarism? The symptoms and causes of your unhealthy condition will surely prompt a specialist to make this initial diagnosis, to confirm which you will need to pass several tests to determine the levels of various hormones in the body. A recent head injury or a completed course of radiotherapy can serve as a reason for making such a diagnosis - these risk factors are quite capable of entailing the development of pathology.
Standard diagnostic tests include:
- Blood tests. Relatively simple tests make it possible to detect a deficiency of certain hormones resulting from pituitary dysfunction. For example, according to the results of blood tests, one can judge the 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. It is even difficult for a specialist to recognize hypopituitarism; Symptoms in a child may even be similar to signs of a variety of hereditary diseases. To get accurate diagnostic results, the doctor will most likely refer you to a special clinic for endocrinological research, where you will first be asked to take safe medications to stimulate the production of hormones, and then they will check how much the volume of secretion has increased.
- Imaging studies of the brain. Magnetic resonance imaging (MRI) of the brain can detect pituitary tumors and other structural abnormalities.
- Vision test. Special tests determine if pituitary tumor growth has affected the ability to see or the field of view.
Treatment
Hypopituitarism, the symptoms and description of which are presented above, is almost always 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 treatment of the initial ailment for any reason turned out to be impossible or ineffective, the treatment of hypopituitarism with hormonal drugs is carried out. 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 strictly compensate those hormones and in the amount in which they are presented in a healthy body. Substitution therapy can last a lifetime.
If the tumor caused hypopituitarism, symptoms, treatment, and subsequent restorative therapy will depend on the structural nature of the neoplasm. Usually prescribed surgery to remove the pathological element. In some cases, radiation therapy is performed.
Preparations
Deputy drugs can be represented by the following drugs:
- Corticosteroids. These drugs (hydrocortisone and prednisone are examples) replace hormones normally secreted by the adrenal cortex. They are lacking due to adrenocorticotropic insufficiency. Corticosteroids are taken orally.
- Levothyroxine (Levoxyl and others). This drug replaces thyroid hormones with the appropriate disorders.
- Sex hormones. As a rule, for men it is testosterone, for women it is estrogen or a combination of estrogen with progesterone. If you suspect hypopituitarism, the symptoms and prevention of pituitary disorders can be similar to signs and methods of preventing disorders associated with sex hormones. If the pathology is diagnosed by a doctor, to replace the missing hormones, drugs are used in specific forms: a gel or injection of testosterone for men and tablets, gels or patches for women.
- A growth hormone. In endocrine disorders, this substance, called somatropin in medical science, enters the body through subcutaneous injection. Somatropin allows the body to grow, providing normal growth in children. Adults are also prescribed replacement injections that improve the general condition of the patient, but normal growth can no longer be restored.
Monitoring
An endocrinologist will monitor your blood hormone levels to provide an adequate but not excessive amount of vital substances.
You may need to change the dosage of corticosteroids if you are seriously ill or suffer severe physical stress. At such a time, the body produces the additional hormone cortisol. A change in dosage may also be necessary in those cases when you catch a cold, suffer from diarrhea or vomiting, or undergo surgery or dental treatment. Periodic CT or MRI are prescribed for many patients.