The pituitary gland at the base of our brain controls the functioning of many other glands and tissues. It is controlled by another part of the brain called the hypothalamus. Hypopituitarism can result from damage to or dysfunction of the brain or the pituitary gland itself. The damage may affect one, or all, pituitary hormones, so it’s impossible to list all the complications of hypopituitarism. However, I will discuss the hormones the gland secretes and the more common problems resulting from hypopituitarism.
There are also many different causes of hypopituitarism, including tumors, congenital defects, and vascular problems. Different causes produce different sets of complications. Some conditions affect only the anterior pituitary, the production site of most of the hormones. Other causes involve both the anterior and posterior parts of the gland. The effect of hypopituitarism will also vary with age, since some hormones are necessary for growth and sexual maturation.
The posterior pituitary secretes only one hormone, anti-diuretic hormone, which controls the kidney’s ability to concentrate urine. Loss of this hormone results in diabetes insipidus, a condition that causes a person to produce vast amounts — gallons per day — of diluted urine. A nasal spray form of the hormone usually allows this to be controlled.
The anterior pituitary produces many hormones, which I will describe individually:
Growth hormone — Loss of this hormone before attaining full growth and maturity will result in failure to grow further. The effect of the loss of this hormone in adults is less certain, but it may cause excessive wrinkling of the skin and obesity. An injectable replacement is available.
Thyroid stimulating hormone — Loss of this hormone will result in hypothyroidism. This condition is easily treated with thyroid replacement.
Adrenocorticotropin — This stimulates the adrenal gland to produce cortisone-type hormones. The loss of this hormone can be quite dangerous. Replacement in pill form is easy.
Luteinizing hormone — This stimulates the ovaries in women and the testes in men. Its loss will interfere with the menstrual cycle in women and affect fertility in both sexes.
Follicle stimulating hormone — Effects of the loss of this hormone are similar to those of luteinizing hormone. There is no replacement for this hormone, but replacing ovarian and testicular sex hormones is straight-forward.
Prolactin — Prolactin stimulates the female breast to produce milk. Loss of this hormone prevents lactation. The effect of its loss in men is unclear.
Oral medication makes replacement of thyroid, adrenal, and ovarian hormones easy. Testosterone replacement is available by injection or patch. If a woman with hypopituitarism wishes to become pregnant, more complex hormonal treatments are required.
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