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Specialists in the Field of Pituitary Insufficiency
Information About the Field of Pituitary Insufficiency
What Is Hypopituitarism?
Pituitary insufficiency describes a functional limitation of the pituitary gland. This hypofunction results in decreased secretion of some important hormones, which are responsible for many processes in the body. These hormones include growth hormone, some sex hormones, thyroid hormones, and ACTH, which, among others, play a role in regulating blood pressure. Most often, pituitary insufficiency is caused by a tumor of the glandular tissue. Other causes of hypopituitarism may include brain injury, inflammation, or vascular disease in the brain.
Causes: What Causes Hypopituitarism?
In most cases, a tumor in the pituitary region causes the gland to become hypofunctional due to spatial displacement. Although these tumors are often benign, they constrict the pituitary gland to the extent that average hormone production is no longer possible. Other possible causes of insufficiency can be vascular diseases , such as pathological vasoconstrictions or bulges. In addition, some infectious diseases, such as tuberculosis or abscesses, can cause damage to the brain that negatively affects the function of the pituitary gland. Pituitary insufficiency can also occur after brain injuries, such as after an accident.
Signs and Symptoms of Pituitary Insufficiency
Because the pituitary gland is responsible for secreting some hormones in the body, symptoms are more likely to result from the hormone deficiency than from the primary cause of the conditions, such as a tumor or vascular disease.
- Due to the deficiency of growth hormone, children, in particular, may experience a reduced growth process and low body height. In adults, the lack of growth hormone is more likely to lead to osteoporosis and other metabolic disorders.
- The loss of the sex hormones LH (luteinizing hormone) and FSH (follicle-stimulating hormone) is usually accompanied by a reduced libido, but in the long term, it can also lead to the loss of axillary and pubic hair. In addition, this hormone deficiency also increases the risk for osteoporosis.
- In later stages of pituitary insufficiency, there is also a deficiency of the thyroid hormone TSH (thyroid-stimulating hormone) and ACTH (adrenocorticotropic hormone).
- TSH plays an essential role in controlling thyroid hormones, and a deficiency leads to hypothyroidism or thyroid hypofunction.
- ACTH is particularly responsible for regulating cortisol secretion from the adrenal gland. Cortisol plays an essential role in the body's stress response and contributes to the immune response. A cortisol deficiency leads to fatigue, low blood pressure, decreased performance, and weight loss.
Diagnosis: How Is Hypopituitarism Diagnosed?
The diagnosis of pituitary insufficiency is usually made with a combination of the patient's clinical picture and a detailed blood test. In addition, to check the activity of the pituitary gland, some tests can be performed that would result in the release of some hormones in a healthy body, but not in pituitary insufficiency. These include, for example, the insulin hypoglycemia test. In this test, intravenous administration of insulin induces a blood glucose deficiency that the pituitary gland should usually correct via the secretion of ACTH (and consequently cortisol). However, if this is not the case, hypoglycemia can be assumed.
In addition, after the diagnosis has been made, brain imaging is carried out to identify a possible tumor as the cause.
Treatment and Life Expectancy
After diagnosis, the first step is to investigate the exact cause of the insufficiency. For example, if it is a tumor, its surgical removal can often lead to a complete cure of hypopituitarism. In the case of other causes, only symptomatic therapy is usually possible. The missing hormones are replaced by medication, thus bringing about a relatively average hormone balance.
Patients with pituitary insufficiency can lead a normal life with the right therapy. However, life expectancy may be reduced due to an increased cardiovascular burden, although the exact process is currently not fully understood. If left untreated, hypopituitarism has a significantly limited life expectancy.
Which Physicians Are Specialists in the Diagnosis and Treatment of Hypopituitarism?
Usually, the diagnosis and therapy of hypopituitarism are carried out by an endocrinologist. These are the specialists in hormone balance and all related glands in the body. They have the necessary examination methods and expertise to make accurate hormone measurements in the blood and work out a long-term therapy. Because pituitary insufficiency cannot always be completely cured, the treatment relationship between patients and physicians usually lasts from the time of diagnosis for the rest of the patient's life.
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