Hypopituitarism

Hypopituitarism can occur due to lesions in the hypothalamus or the pituitary gland.

Hypothalamic Lesions

1. Tumors – hypothalamic tumors – craniopharyngiomas, malignant tumors
2. Infiltrative lesions of the pituitary – Sarcoidosis, Langerhans histiocytosis
3. Radiation
4. Infections- like meningitis
5. Traumatic brain injury
6. Stroke

Pituitary Disorders

1. Pituitary masses – Large tumors of the pituitary gland – benign(non-cancerous) or malignant (cancerous)
2. Damage to the pituitary gland – surgery or radiation.
3. Hypophysitis – inflammation of the pituitary gland – autoimmune, infiltrative, or medication-induced (immunotherapy)
4. Pituitary infarction – decreased blood supply to the pituitary gland following severe bleeding following delivery of a baby or stroke.
5. Pituitary infection or absence
6. Pituitary stalk interruption
7. Empty sella

The symptoms of hypopituitarism depend on which hormone is deficient.

1. The common symptoms include generalized tiredness, loss of weight, cold intolerance, decreased libido, and hair loss.
2. Women may experience irregular or absent menstrual periods, infertility, and inability to breastfeed following the delivery of the baby.
3. Men may have decreased facial or body hair, small testicles, and hypogonadism.
4. Children may have a failure to thrive, short stature, and delayed or absent puberty by age.

Twelve in girls and age 14 in boys.

Dr Reena Thomas will help diagnose this condition with a comprehensive medical evaluation. She will order blood tests to evaluate the deficient hormones and radiological tests, such as an MRI examination of the brain/pituitary gland, to determine the cause of this condition. Getting the appropriate tests is important to determine why you have this condition and get the appropriate treatment.

The treatment of this condition depends on the optimal replacement of the hormones. Dr Reena Thomas will start you on the appropriate hormone replacement medications and monitor the levels of the relevant hormones at regular intervals. It is important to start on the right order of hormone replacement therapy.

The different types of hormone replacement therapies are:

1. Steroids deficiency – steroids
2. Thyroid hormone replacement therapy.
3. Testosterone replacement therapy in males and estrogen alone or combination with progesterone in pre-menopausal females.

You will need long-term follow-up with an endocrinologist. During your follow-up, Dr Thomas will perform a comprehensive medical evaluation and examination. She will arrange for you to have relevant blood tests to guide optimal hormone replacement therapy.