Hypopituitarism – Wikipedia, the free encyclopedia

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Hypopituitarism is the decreased (hypo) secretion of one or more of the eight hormones normally produced by the pituitary gland at the base of the brain.[1][2] If there is decreased secretion of most pituitary hormones, the term panhypopituitarism (pan meaning "all") is used.[3]

The signs and symptoms of hypopituitarism vary, depending on which hormones are undersecreted and on the underlying cause of the abnormality. The diagnosis of hypopituitarism is made by blood tests, but often specific scans and other investigations are needed to find the underlying cause, such as tumors of the pituitary, and the ideal treatment. Most hormones controlled by the secretions of the pituitary can be replaced by tablets or injections. Hypopituitarism is a rare disease, but may be significantly underdiagnosed in people with previous traumatic brain injury.[1] The first description of the condition was made in 1914 by the German physician Dr Morris Simmonds.[4]

The hormones of the pituitary have different actions in the body, and the symptoms of hypopituitarism therefore depend on which hormone is deficient. The symptoms may be subtle and are often initially attributed to other causes.[1][5] In most of the cases, three or more hormones are deficient.[6] The most common problem is insufficiency of follicle-stimulating hormone (FSH) and/or luteinizing hormone (LH) leading to sex hormone abnormalities. Growth hormone deficiency is more common in people with an underlying tumor than those with other causes.[1][6]

Sometimes, there are additional symptoms that arise from the underlying cause; for instance, if the hypopituitarism is due to a growth hormone-producing tumor, there may be symptoms of acromegaly (enlargement of the hands and feet, coarse facial features), and if the tumor extends to the optic nerve or optic chiasm, there may be visual field defects. Headaches may also accompany pituitary tumors,[1] as well as pituitary apoplexy (infarction or hemorrhage of a pituitary tumor) and lymphocytic hypophysitis (autoimmune inflammation of the pituitary).[7] Apoplexy, in addition to sudden headaches and rapidly worsening visual loss, may also be associated with double vision that results from compression of the nerves in the adjacent cavernous sinus that control the eye muscles.[8]

Pituitary failure results in many changes in the skin, hair and nails as a result of the absence of pituitary hormone action on these sites.[9]

Deficiency of all anterior pituitary hormones is more common than individual hormone deficiency.

Deficiency of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), together referred to as the gonadotropins, leads to different symptoms in men and women. Women experience oligo- or amenorrhea (infrequent/light or absent menstrual periods respectively) and infertility. Men lose facial, scrotal and trunk hair, as well as suffering decreased muscle mass and anemia. Both sexes may experience a decrease in libido and loss of sexual function, and have an increased risk of osteoporosis (bone fragility). Lack of LH/FSH in children is associated with delayed puberty.[1][5]

Growth hormone (GH) deficiency leads to a decrease in muscle mass, central obesity (increase in body fat around the waist) and impaired attention and memory. Children experience growth retardation and short stature.[1][5]

Adrenocorticotropic hormone (ACTH) deficiency leads to adrenal insufficiency, a lack of production of glucocorticoids such as cortisol by the adrenal gland. If the problem is chronic, symptoms consist of fatigue, weight loss, failure to thrive (in children), delayed puberty (in adolescents), hypoglycemia (low blood sugar levels), anemia and hyponatremia (low sodium levels). If the onset is abrupt, collapse, shock and vomiting may occur.[1][5] ACTH deficiency is highly similar to primary Addison's disease, which is cortisol deficiency as the result of direct damage to the adrenal glands; the latter form, however, often leads to hyperpigmentation of the skin, which does not occur in ACTH deficiency.[10]

Thyroid-stimulating hormone (TSH) deficiency leads to hypothyroidism (lack of production of thyroxine (T4) and triiodothyronine (T3) in the thyroid). Typical symptoms are tiredness, intolerance to cold, constipation, weight gain, hair loss and slowed thinking, as well as a slowed heart rate and low blood pressure. In children, hypothyroidism leads to delayed growth and in extreme inborn forms to a syndrome called cretinism.[1][5]

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Hypopituitarism - Wikipedia, the free encyclopedia

Hypopituitarism: Causes, Symptoms, & Treatment

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What Is an Underactive Pituitary Gland?

Your pituitary gland is located just below your brain. It releases eight hormones that each plays its own role in your body processes. Functions range from stimulating bone growth to prompting your thyroid gland to release hormones that control your metabolism.

Hormones produced by the pituitary gland include:

Sometimes, your pituitary gland does not release enough of one or more of these hormones. This underactivity is called hypopituitarism.

Your pituitary gland may stop producing enough of one or more of its hormones if it has suffered trauma. For example, if you have had brain surgery, a brain infection, or a head injury, your pituitary gland may be affected.

Certain tumors can also affect the function of this gland. These include:

Other possible causes of hypopituitarism include:

Sometimes, doctors cant figure out what caused a particular case of hypopituitarism.

The symptoms of hypopituitarism depend on which hormones your pituitary gland is not producing enough of. For example, if the pituitary does not produce enough growth hormone in a child, he or she may have a permanently short stature. Alternately, if it doesnt produce enough follicle-stimulating hormone or luteinizing hormone, it might cause problems with sexual function, menstruation, and fertility.

In some cases, you may not have any symptoms at all. For example, if you are an adult and your pituitary gland does not produce enough growth hormone, you will probably not notice because you have already finished growing. In children, however, this condition is far more noticeable.

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Hypopituitarism: Causes, Symptoms, & Treatment

Hypothyroidism Symptoms – Endocrine Diseases: thyroid …

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The most common thyroid disorder is hypothyroidism. Hypo- means deficient or under(active), so hypothyroidism is an underactive thyroid gland. Recognizing the symptoms of hypothyroidism is extremely important. The sooner you detect the symptoms, the sooner you can receive proper treatment to manage the disorder.

Common Symptoms of Hypothyroidism Below are major symptoms associated with hypothyroidism.

You don't have to encounter every one of these symptoms to be diagnosed with hypothyroidism. Every patient's experience with the disorder is different. While you may notice that your skin and hair have become dry and rough, another patient may be plagued more by fatigue and depression.

The thyroid stimulating hormone (TSH) level reflects the severity of the hypothyroidism. For example, if you have a mild form of hypothyroidism and a relatively lower TSH level, you may not noticeor even havesymptoms. That's because your hormone levels haven't decreased to the point where they have a major impact on your metabolism. The more hypothyroid you become, the more symptomatic you'll be.

The symptoms of hypothyroidism aren't always noticeable, but it's important that you understand what to look out for. Recognizing hypothyroidism early on will allow you to manage the disorder and prevent it from interfering with your life.

Updated on: 06/02/14

Causes of Hypothyroidism

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Hypothyroidism-Symptoms – WebMD

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Symptoms of hypothyroidism usually appear slowly over months or years. Symptoms and signs may include:

Some less common symptoms may include:

In general, how bad your symptoms are depends on your age, how long you have had hypothyroidism, and the seriousness of the condition. The symptoms may be so mild and happen so slowly that they go unnoticed for years.

Mild (subclinical) hypothyroidism often causes no symptoms or vague symptoms that may be attributed to aging, such as memory problems, dry skin, and fatigue.

Symptoms of hypothyroidism during and after pregnancy include fatigue, weight loss, dizziness, depression, and memory and concentration problems.

Because of the range of symptoms, hypothyroidism can be mistaken for depression, especially during and after pregnancy. In older people, it may be confused with Alzheimer's disease, dementia, and other conditions that cause memory problems.

Although rare, hypothyroidism can occur in infants, children, and teens. In infants, symptoms of a goiter include a poor appetite and choking on food. Symptoms of hypothyroidism may include dry, scaly skin. In children and teens, symptoms include behavior problems and changes in school performance. Children and teens may gain weight and yet have a slowed growth rate. Teens may have delayed puberty and look much younger than their age.

WebMD Medical Reference from Healthwise

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Hypothyroidism | American Thyroid Association

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There can be many reasons why the cells in the thyroid gland cant make enough thyroid hormone. Here are the major causes, from the most to the least common:

Autoimmune disease. In some peoples bodies, the immune system that protects the body from invading infections can mistake thyroid gland cells and their enzymes for invaders and can attack them. Then there arent enough thyroid cells and enzymes left to make enough thyroid hormone. This is more common in women than men. Autoimmune thyroiditis can begin suddenly or it can develop slowly over years. The most common forms are Hashimotos thyroiditis and atrophic thyroiditis.

Surgical removal of part or all of the thyroid gland. Some people with thyroid nodules, thyroid cancer, or Graves disease need to have part or all of their thyroid removed. If the whole thyroid is removed, people will definitely become hypothyroid. If part of the gland is left, it may be able to make enough thyroid hormone to keep blood levels normal.

Radiation treatment. Some people with Graves disease, nodular goiter, or thyroid cancer are treated with radioactive iodine (I-131) for the purpose of destroying their thyroid gland. Patients with Hodgkins disease, lymphoma, or cancers of the head or neck are treated with radiation. All these patients can lose part or all of their thyroid function.

Congenital hypothyroidism (hypothyroidism that a baby is born with). A few babies are born without a thyroid or with only a partly formed one. A few have part or all of their thyroid in the wrong place (ectopic thyroid). In some babies, the thyroid cells or their enzymes dont work right.

Thyroiditis. Thyroiditis is an inflammation of the thyroid gland, usually caused by an autoimmune attack or by a viral infection. Thyroiditis can make the thyroid dump its whole supply of stored thyroid hormone into the blood at once, causing brief hyperthyroidism (too much thyroid activity); then the thyroid becomes underactive.

Medicines. Medicines such as amiodarone, lithium, interferon alpha, and interleukin-2 can prevent the thyroid gland from being able to make hormone normally. These drugs are most likely to trigger hypothyroidism in patients who have a genetic tendency to autoimmune thyroid disease.

Too much or too little iodine. The thyroid gland must have iodine to make thyroid hormone. Iodine comes into the body in food and travels through the blood to the thyroid. Keeping thyroid hormone production in balance requires the right amount of iodine. Taking in too much iodine can cause or worsen hypothyroidism.

Damage to the pituitary gland. The pituitary, the master gland, tells the thyroid how much hormone to make. When the pituitary is damaged by a tumor, radiation, or surgery, it may no longer be able to give the thyroid instructions and the thyroid may stop making enough hormone.

Rare disorders that infiltrate the thyroid. In a few people, diseases deposit abnormal substances in the thyroid and impair its ability to function. For example, amyloidosis can deposit amyloid protein, sarcoidosis can deposit granulomas, and hemochromatosis can deposit iron.

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Hypothyroidism | American Thyroid Association

Hypothyroidism Symptoms – Mayo Clinic

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The signs and symptoms of hypothyroidism vary, depending on the severity of the hormone deficiency. But in general, any problems you have tend to develop slowly, often over a number of years.

At first, you may barely notice the symptoms of hypothyroidism, such as fatigue and weight gain, or you may simply attribute them to getting older. But as your metabolism continues to slow, you may develop more obvious signs and symptoms. Hypothyroidism signs and symptom may include:

When hypothyroidism isn't treated, signs and symptoms can gradually become more severe. Constant stimulation of your thyroid gland to release more hormones may lead to an enlarged thyroid (goiter). In addition, you may become more forgetful, your thought processes may slow, or you may feel depressed.

Advanced hypothyroidism, known as myxedema, is rare, but when it occurs it can be life-threatening. Signs and symptoms include low blood pressure, decreased breathing, decreased body temperature, unresponsiveness and even coma. In extreme cases, myxedema can be fatal.

Although hypothyroidism most often affects middle-aged and older women, anyone can develop the condition, including infants. Initially, babies born without a thyroid gland or with a gland that doesn't work properly may have few signs and symptoms. When newborns do have problems with hypothyroidism, they may include:

As the disease progresses, infants are likely to have trouble feeding and may fail to grow and develop normally. They may also have:

When hypothyroidism in infants isn't treated, even mild cases can lead to severe physical and mental retardation.

In general, children and teens who develop hypothyroidism have the same signs and symptoms as adults do, but they may also experience:

See your doctor if you're feeling tired for no reason or have any of the other signs or symptoms of hypothyroidism, such as dry skin, a pale, puffy face, constipation or a hoarse voice.

You'll also need to see your doctor for periodic testing of your thyroid function if you've had previous thyroid surgery; treatment with radioactive iodine or anti-thyroid medications; or radiation therapy to your head, neck or upper chest. However, it may take years or even decades before any of these therapies or procedures result in hypothyroidism.

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Hypothyroidism Symptoms - Mayo Clinic

Hypothyroidism: Causes, Symptoms, & Treatment

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What is Hypothyroidism?

The thyroid gland is an important endocrine gland that controls the bodys metabolism. It is a small butterfly-shaped gland located in the front of the neck just below the Adams apple. The thyroid gland produces the hormones tetraiodothyronine (T4) and triiodothyronine (T3).

Together these hormones regulate how your cells use energy. The pathways by which cells use energy is called metabolism. Your bodys general metabolism determines blood pressure, heart rate, and weight.

Hypothyroidism is a condition where your thyroid gland does not make enough thyroid hormone. Low levels of thyroid hormone interfere with the bodys ability to perform normal metabolic functions such as efficient use of energy from food products, regulation of many chemical reactions in the body, and maintenance of healthy cells, bones and muscles, to name a few.

There is no known prevention for hypothyroidism, nor is there a cure. Once you have it, you have it for life.

The most common causes are surgical removal of your thyroid, autoimmune diseases, and radiation treatment.

This may be necessary to treat hyperthyroidism, or tumors of the thyroid gland. Hypothyroidism will occur when the entire gland is removed.

These diseases cause the production of antibodies that attack your thyroid gland. Autoimmune thyroiditis, which can appear suddenly or develop over several years, is more common in women. Hashimotos thyroiditis and atrophic thyroiditis are the most common types.

Radiation treatment for Hodgkin lymphoma and cancers of the head and neck can injure the thyroid gland. If this occurs, the gland cannot produce enough thyroid hormone to keep your metabolism running smoothly. Radioactive iodine (I-131) destroys the thyroid gland and can be used to treat people with Graves disease and thyroid cancer. Graves disease is an autoimmune disease that causes hyperthyroidism.

Some children are born without a thyroid gland or they may have one that doesnt function properly.

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Hypothyroidism: Causes, Symptoms, & Treatment