Hypopituitarism is known to be a rare disorder where the affected person’s pituitary gland fails in producing one or more hormones, or where the gland does not produce the required amount of hormones. There are several ways to test hypopituitarism. In this article we have mentioned about how they test hypopituitarism and also if hypopituitarism can be cured. Hope this would be a valuable read for you.
Hypopituitarism: An Overview
Pituitary gland is a gland which is kidney-bean shaped and is situated at the base of the brain. Hypopituitarism is actually a chronic endocrine disease occurring due to varied etiologies. It is linked with an increased mortality as well as morbidity and thus, an early diagnosis along with prompt treatment for the condition is required.
Hypopituitarism is defined as the partial or total loss of the function of the posterior and anterior pituitary gland and is caused by hypothalamic or pituitary disorders. (1)
Hypothyroidism is a condition when the affected person has a short supply or a deficiency of one or more pituitary hormones. The deficiency of these hormones can affect a lot of routine functions of the body, such as blood pressure, growth, or reproduction. Symptoms of hypopituitarism usually vary, and are based on the hormones or hormone that one is missing. General symptoms of hypopituitarism include excessive urination and thirst, stomach pain, reduced appetite, constipation, vomiting and nausea, weakness and fatigue, anemia, dizziness and headache, sensitivity to cold, weight gain or weight loss.
If you are having hypopituitarism, you will more likely require taking the prescribed medicines for the rest of your life. Medications for hypopituitarism help in replacing the missing hormones, which aids in controlling the symptoms of your condition.
How Do They Test Hypopituitarism?
Below are certain ways to test hypopituitarism:
First of all your doctor would go for a physical examination on you while testing for hypopituitarism. During the examination, it might be required to inspect your thyroid gland, sexual organs, as well as your eyes, for any signs of any kind of hormone insufficiency and symptoms of hypopituitarism.
In case any sign of hypopituitarism is noted in the inspected organs, further investigations would be required for confirming a diagnosis of the condition of hypopituitarism.
Blood tests would help in measuring the levels of various hormones. For example, blood tests can help in identifying the lower levels of thyroid, sex hormones and adrenal hormones. These blood tests can determine in case these low levels of hormones are associated with the production of pituitary hormone.
Following hormones might be tested for investigating various functions of your pituitary gland.
- ACTH or Adrenocorticotropic hormone
- TSH or Thyroid stimulating hormone.
- Gonadotropin hormone
- GH or Growth hormone
- FSH or Follicle stimulating hormone
- Testosterone or Estradion for detecting hypogonadism
- Antidiuretic hormone.
A stimulation test might be required in some cases to determine if there is any deficiency in specific hormones, especially the growth hormone or the cortisol. This test involves administration of a bio-equivalent hormone or synthetic hormone, which is followed by monitoring of the hormone levels. Stimulation tests actually check the hormone levels of your body after you have taken specific medications for stimulating the production of hormone.
Several Other Tests:
There are certain cases, where urine tests are done in the process of diagnosis for hypopituitarism. A 24-hour urine collection test might help in measuring the urine concentration, which might be a diagnostic indicator for conditions such as, antidiuretic hormone deficiency or diabetes insipidus.
For men having a deficiency of FSH or LH who are willing to father a child, there is the requirement of a sperm analysis test that may benefit in determining the sperm count and also the potency of ejaculation.
Hypopituitarism can also be tested with the help of brain imaging of the patient. MRI or the Magnetic resonance imaging or high resolution CT (computerized tomography) of the brain can help in detecting pituitary tumor or any other problem of the pituitary gland.
Vision tests are essential to determine if there is a growth of pituitary tumor that has impaired your eye sight or the visual fields.
Can Hypopituitarism Be Cured?
It must be noted that although there is no absolute cure for the condition of hypopituitarism, it is usually treatable. Hypopituitarism can be treated with the help of hormone replacement therapy, that might help the affected person to live a normal life, feel good, and not have the symptoms of hormone deficiency. Hormone replacement therapy is often done with the medications which aid you in returning the hormone levels to normal. However, you might require taking the medications for rest of your life.
Hormone Replacement Therapy: Medications:
Some of the medications used in hormone replacement therapy for hypopituitarism include the following.
Corticosteroids are the medications or drugs, such as prednisone (Rayos) or hydrocortisone (Cortef), which replace the adrenal hormones which are not being produced because of a deficiency of ACTH or adrenocorticotropic hormone deficiency. These drugs can be taken orally.
Sex hormones include estrogen or a combination of estrogen and progesterone in case of women while testosterone in case of men. Testosterone hormone is administered by either injection or via the skin with the help of a patch or a gel. Replacement of female hormones can be done via pills, patches or gels.
Treating men with testosterone deficiency by the help of replacement of the testosterone hormone might improve the sexual function in men and also strengthen the bones. Testosterone is also known to increase the muscle mass and reduce the fat mass.
Estrogen hormone replacement is advised generally for premenopausal females who suffer from estrogen deficiency, who are often at risk of developing osteoporosis.
Gonadotropins are the hormones that can be administered in you by means of injection for stimulating ovulation in women and for the production of sperm in case of men.
Gonadotropin generally requires to be injected intramuscularly twice or thrice every week, although subcutaneous injection is even available, and the use of this hormone requires regular analysis of sperm for determining the efficacy of the treatment. (2)
Levothyroxine( Levoxyl, Synthroid, Others):
This drug is known to treat the low levels of thyroid hormone or hypothyroidism that can be caused due to a TSH or thyroid stimulating hormone deficiency. It is advisable to start the medication treatment with 25 µg to 50 µg each day and then slowly and gradually increase this dose to about 75 µg to 125 µg per each day. It is also important to take the medicine only on an empty stomach.
Growth hormone or Somatropin is administered via an injection just beneath the skin of the affected person. This enhances the growth, which in turn aids in producing a more normal height in case of children. Adults having symptoms of deficiency of growth hormone might benefit from the replacement of growth hormone; however, they won’t turn taller. Some studies show that there is an improvement in the cholesterol measures, and also an enhanced cardiac function with the growth hormone replacement.
Though earlier growth hormone replacement therapy was used to treat the growth disorders in case of children, now there are recent developments in case of recombinant human growth hormone that has made it quite possible for treating adult patients with hypopituitarism or a reduced secretion of growth hormone. (3)
The recommended dose of growth hormone initially is 0.5 units per day. However, this dose can be steadily increased in a few weeks.
Surgery And Other Treatment Procedures:
You might require periodic MRU or CT scans for monitoring a pituitary tumor or any other diseases resulting in hypopituitarism. Treating pituitary tumors might involve surgery so as to remove the tumor growth. In certain cases, radiation treatments of medicines are also recommended for controlling the underlying cause of the conditions.
It must be strictly noted that in case you have hypopituitarsim, you must wear a medical alert bracelet or an alert pendant and also carry a special card so as to notify others in case of any emergency condition. This is specifically essential in case you are taking corticosteroids for the deficiency of ACTH.
NOTE: Always keep in mind that hypopituitarism is a medical condition that needs strict medical help. So, it is important to consult with your doctor if you suspect having the condition.