Hypopituitarism

What is hypopituitarism?

Hypopituitarism (also called pituitary insufficiency) is a rare condition in which your pituitary gland doesn't make enough of certain hormones. Your body can't work properly when important glands, such as your thyroid gland and adrenal gland, don't get the hormones they need from your pituitary gland. Hypopituitarism can develop very slowly, over several months or even over several years.

What can cause hypopituitarism?

Hypopituitarism can be caused by:

• Tumors in or near the pituitary gland (which are usually benign, meaning not cancer)
• Radiation treatment for a tumor, which can destroy pituitary gland tissue
• Chemotherapy
• Brain surgery
• Traumatic brain injury, such as with a head injury from an accident
• Severe bleeding in the brain or severe blood loss during childbirth
• Tuberculosis or meningitis
• Certain conditions present at birth

Sometimes, the cause is unknown.

What are the symptoms of hypopituitarism?

Symptoms can include one or more of the following:

• Stomach pain, decreased appetite, nausea and vomiting, and constipation
• Excessive thirst and urination
• Fatigue and/or weakness
• Anemia, meaning weakness from not having enough red blood cells
• Headache and dizziness
• Sensitivity to cold
• Weight loss or weight gain
• Stiffness in the joints
• Hypophysitis (inflammation of the pituitary gland) 
• Histiocytosis 
• In women: loss of armpit or pubic hair, decreased sex drive, infertility, problems with breast feeding, irregular or no menstrual periods, and hot flashes
• In men: loss of hair (on the face, or in the armpits or pubic area), decreased sex drive, infertility
• In children, problems with growth (including height) and sexual development

How is hypopituitarism diagnosed?

Your doctor will check your hormone levels with blood tests. You may have other tests, such as an MRI of your pituitary gland, to help find the cause of your hypopituitarism.

What is the treatment for hypopituitarism?

Treatment usually includes taking the hormones you're missing, sometimes for life. Your doctor also will teach you how to take extra cortisone (a hormone) when you are sick or under stress. If a tumor is causing your hypopituitarism, you might need surgery to remove it and/or possibly radiation treatment. If needed, you can take medicine for infertility.

You will need to get regular check-ups. It's wise to wear medical identification, such as a bracelet or pendant, which provides information about your condition in case of an emergency.

What is the long-term outlook for me with hypopituitarism?

You can expect a normal life span, as long as you regularly take the medications recommended by your doctor.

Questions to ask your doctor

• What tests do I need to find out what's wrong with my pituitary?
• Will my pituitary ever start working again?
• What medicines do I need to take?
• Do I need other types of treatment?
• How long will I need treatment?
• How often will I need check-ups and blood tests?
• If I get sick or have an emergency, how should I adjust the dose of medicine I take?