Hypopituitarism - A matter of Hormones.

HYPOPITUITARISM.


It is the decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain. If there is decreased secretion of most pituitary hormones, the term panhypopituitarism (pan meaning "all") is used.

The signs and symptoms of hypopituitarism vary, depending on which hormones are undersecreted and on the underlying cause of the abnormality. The diagnosis of hypopituitarism is made by blood tests, but often specific scans and other investigations are needed to find the underlying cause, such as tumors of the pituitary, and the ideal treatment. Most hormones controlled by the secretions of the pituitary can be replaced by tablets or injections.

Hypopituitarism is a rare disease, but may be significantly underdiagnosed in people with previous traumatic brain injury. The first description of the condition was made in 1914 by the German physician Dr Morris Simmons.

THE SYMPTOMS OF HYPOPITUITARISM.

The hormones of the pituitary have different actions in the body, and the symptoms of hypopituitarism  depends  on which hormone is deficient. The symptoms may be subtle and are often initially attributed to other causes. In most of the cases, three or more hormones are deficient. The most common problem is insufficiency of follicle 
stimulating hormone (FSH)  or luteinising hormone (LH) leading to sex hormone  abnormalities.

Sometimes, there are additional symptoms that arise from the underlying cause; for instance, if the hypopituitarism is due to a growth hormone-producing tumor, there may be symptoms of  acromegaly (enlargement of the hands and feet, coarse facial features), and if the tumor extends to the optic nerve there may be visual field defects. Headaches may also accompany pituitary tumors, as well as pituitary apoplexy and such. 

Apoplexy, in addition to sudden headaches and rapidly worsening visual loss, may also be associated with double vision that results from compression of the nerves in the adjacent carvernous sinus that control the eye muscles.

Pituitary failure results in many changes in the skin, hair and nails as a result of the absence of pituitary hormone action on these sites.

CAUSES OF HYPOPITUITARISM.

Hypopituitarism is frequently triggered by a tumor of the pituitary gland. As a pituitary tumor increases in size, it can compress and damage pituitary tissue, interfering with hormone production. A tumor can also compress the optic nerves, causing visual disturbances.

The cause of hypopituitarism can also be other diseases and events that damage the pituitary, such as:

• Head injuries

• Brain tumor

• Brain surgery

• Radiation treatment

• Autoimmune inflammation (hypophysitis)

• Stroke

• Infections of the brain, such as meningitis

• Tuberculosis

• Infiltrative diseases, such as sarcoidosis, which is an inflammatory disease occurring in various organs; histiocytosis X, in which abnormal cells cause scarring in numerous parts of the body, such as the lungs and bones; and hemochromatosis, which causes excess iron deposition in the liver and other tissues

• Severe loss of blood during childbirth, which may cause damage to the front part of the pituitary gland (Sheehan syndrome, or postpartum hypopituitarism)

• Genetic mutations resulting in impaired pituitary hormone production

Diseases of the hypothalamus, a portion of the brain situated just above the pituitary, also can cause hypopituitarism. The hypothalamus produces hormones of its own that directly affect the activity of the pituitary.

In some cases, the cause of hypopituitarism is unknown.

 PREVENTION METHODS.

Some of the helpful INSTRUCTIONS :

1.  Avoid any head injuries or trauma, as this can damage the pituitary gland and possibly lead to hypopituitarism. If possible, avoid any blockage in blood supply to the pituitary gland, pituitary tumors, any infection or inflammatory diseases, autoimmune diseases, radiation therapy, or amyloidosis or sarcoidosis.

2.  Seek a doctor or endocrinologist if you develop any signs of hypopituitarism. Symptoms may include any or all of the following: fatigue, loss of energy, weak muscles, constipation, nausea, change in weight, loss of appetite, headaches, low blood pressure, excess urination, thirst, hoarseness, facial puffiness, stiff joints, loss of underarm and pubic hair, visual disturbances, sensitivity to cold, and abdominal discomfort.

 3.  Have your doctor perform tests to find out if you do have hypopituitarism. They may run some blood tests, do stimulation or dynamic tests, brain imaging (via CT or MRI), vision tests, or x-rays to try to determine if there is any damage to the pituitary gland.