Diagnosis and Treatment of Hypopituitarism


The goal of treatment is to bring all your hormone levels back to normal which can be done by an endocrinologist.

March 19, 2018

Diagnosis and Treatment of Hypopituitarism

Hypopituitarism is a rare disorder of pituitary gland in which it either fails to produce one or more of its hormones or doesn't produce enough of them.

Diagnosis of Hypopituitarism:

Your doctor will ask for a recent head injury or radiation treatment you had that might have put you at risk of damage to your pituitary gland.
Several tests can be done to check the levels of various hormones in your body. These include:

Blood tests:

Blood test can help detect the levels of hormones which can diagnose pituitary failure. These tests can identify low levels of thyroid, adrenal or sex hormones, and can determine if these low levels are associated with inadequate pituitary hormone production. For example checking for T4 levels can reveal a problem with your pituitary gland. Having low levels of T4 indicates the occurrence of hypopitutarism.

Stimulation or dynamic testing:

Specific medications are prescribed to take before doing this blood tests. These medications will stimulate the production of specific hormones in your body which can help your doctor better understand your pituitary gland function.

Imaging Test:

X-rays are used to create detailed cross-sectional images of part of your body. CT scans can find a pituitary tumors if it is large enough. MRI scans are used much more often to look at the brain and pituitary gland. Magnetic resonance imaging (MRI) of your brain can detect a pituitary tumor or other structural abnormality. Radio waves and strong magnets are used in MRI to create detailed pictures of the brain and spinal cord. These are considered to be the best way to find pituitary tumors of all types. They can show macroadenomas of the pituitary gland, as well as most microadenomas.
MRI images are usually more detailed than those from CT scans. These tests can help your doctor figure out if a tumor on your pituitary gland is affecting its function.

Vision tests:

These tests can determine if growth of a pituitary tumor has impaired your sight or visual fields.
Once the blood test is done for different hormone levels, it is easier to determine which levels are low or which hormone is deficient. Based on that the parts of your body or target organs should be considered which has affected by the hormone.
Sometimes, the problem does not associated with your pituitary gland, but rather with the target organs.

Treatments of Hypopituitarism:

The goal of treatment is to bring all your hormone levels back to normal which can be done by an endocrinologist. There is no single course of treatment because this condition may affect a number of hormones. The treatment may involve taking medications to replace the hormones your pituitary gland is not producing properly. In this case, your hormone levels will be checked in regular intervals. This allows your doctor to adjust the doses of medications you are taking to make sure you are getting the correct dose. These medications are considered as replacement, rather than treatment, because the dosages are set to match the amounts that your body would normally produce if it didn't have a pituitary problem. Treatment may be lifelong. Treatment of the underlying condition causing hypopituitarism may lead to a complete or partial recovery of normal production of pituitary hormones by your body.
Hormone replacement medications may include:

Corticosteroids:

Hydrocortisone or prednisone are corticosteroids medicines , which replaces the adrenal hormones that are not being produced because of an adrenocorticotropic hormone (ACTH) deficiency. You take these orally.

Levothyroxine :

Levoxyl, Synthroid are levothyroxine medication which replaces deficient thyroid hormone levels caused by low or deficient TSH production.

Somatropin:

This growth hormone is taken through an injection beneath your skin. It promotes growth, thus producing more normal height in children. Adults with a growth hormone deficiency also may benefit from growth hormone replacement. But these hormone replacement will not affect the height in case of adults.

Gonadotropins:

LH and FSH can be administered by injection to stimulate ovulation in women and sperm production in men for treatment of infertility.
Sex hormones include testosterone in men and estrogen or a combination of estrogen and progesterone in women. Testosterone is administered through the skin with either a patch or a gel or by injection. Female hormone replacement can be administered with pills, gels or patches.
Treatment for pituitary tumors may involve surgery to remove the growth. Surgery may restore your hormone production to normal. In some cases, radiation therapy is recommended especially when surgery is not an option. Radiation therapy uses high-energy x-rays or other particles to destroy tumor cells. Mostly it is used after surgery.