General Practice 2022

How to identify and treat panhypopituitarism

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How to identify and treat panhypopituitarism
How to identify and treat panhypopituitarism

Panhypopituitarism is a rare disease that corresponds to the decrease or lack of production of several hormones due to alteration in the pituitary gland, which is a gland located in the brain responsible for regulating several other glands in the body and, thus, leading to the production of hormones essential for the proper functioning of the organism.

The lack of hormones can lead to the emergence of various symptoms, such as weight loss, change in menstrual cycle, decreased stature, excessive tiredness and fertility problems, for example. Thus, the main way to reduce the symptoms of panhypopituitarism is through hormone replacement, which must be done according to the endocrinologist's guidance.

Main symptoms

The symptoms of panhypopituitarism depend on which hormones are not produced or are produced in a lower concentration, such as:

  • Weight loss due to decreased thyroid hormones;
  • Loss of appetite;
  • Excessive fatigue;
  • Mood changes;
  • Difficulty getting pregnant and dysregulation of the menstrual cycle, due to decreased production of female sex hormones;
  • Decreased ability to produce milk in women;
  • Decreased height and delayed puberty in children, as growth hormone (GH) production is compromised;
  • Beard loss and fertility-related problems in men, due to decreased testosterone production and, consequently, sperm maturation.

From the symptoms described by the person and laboratory tests that aim to measure the hormones in the blood, the endocrinologist is able to conclude the diagnosis and indicate which medications the person should take.

People with panhypopituitarism are more likely to develop diabetes insipidus, which happens due to decreased production of antidiuretic hormone (ADH), which leads to increased blood glucose concentration due to decreased water concentration, in addition to dehydration and a lot of thirst. Learn more about diabetes insipidus.

How the treatment is done

Treatment is done according to the endocrinologist's orientation and is done through hormone replacement through the use of medication. As the pituitary gland controls the production of several hormones, it may be necessary for the person to replace:

  • ACTH, also called adrenocorticotropic hormone or corticotropin, which is produced by the pituitary gland and stimulates the production of cortisol, which is a hormone responsible for controlling the stress response and for allow the physiological adaptation of the organism to new situations.Understand what cortisol is for;
  • TSH, also called thyroid-stimulating hormone, which is produced by the pituitary gland and is responsible for stimulating the thyroid to produce T3 and T4 hormones, which play key roles in metabolism;
  • LH, known as luteinizing hormone, which stimulates the production of testosterone in men and progesterone in women, and FSH, known for follicle stimulating hormone, which allows the regulation of sperm production and egg maturation. Thus, when there is a decrease in the production of these hormones due to problems in the pituitary, for example, there is a decrease in the fertility of men and women, in addition to hair loss and deregulation of the menstrual cycle, for example. Learn more about the FSH hormone;
  • GH, known as growth hormone or somatotropin, is produced by the pituitary gland and is responsible for the growth of children and adolescents, in addition to assisting in the body's metabolic functions.

In addition, due to changes in mood due to hormonal changes, the doctor may indicate the use of mild antidepressants and even anxiolytics to reduce symptoms related to sudden changes in mood.

The doctor may also recommend replacing calcium and potassium, which are important minerals for various metabolic processes in the body, since some hormonal changes lead to a decrease in the concentration of these minerals in the blood.

Possible causes

The most common cause of panhypopituitarism is a pituitary tumor, which, depending on the stage of the tumor, may require removal of the pituitary. However, not always having a tumor in the pituitary means that the person will suffer from panhypopituitarism, which only happens when the gland needs to be removed.

Furthermore, panhypopituitarism can occur due to infections that affect the brain, such as meningitis, for example, Simmonds syndrome, which is a congenital disease, or even be a consequence of the effects of radiation.

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