Patient education: Panhypopituitarism (The Basics)

What is the pituitary gland? — The pituitary gland is a small organ found at the base of the brain (figure 1). It is called the "master gland" because it controls all of the other glands in the body.

The pituitary gland makes many different hormones. Hormones are chemical messengers that turn on and off different processes in the body. Here is a list of some of the hormones made by the pituitary gland and an explanation of what those hormones do:

●Corticotropin (also called "ACTH") – Corticotropin tells the adrenal glands to release a hormone called cortisol. Cortisol helps control how the body uses sugar (figure 2).

●Thyroid-stimulating hormone (called "TSH") – TSH tells the thyroid gland to release hormones called "T3" and "T4." These hormones control how the body uses and stores energy (figure 3).

●Gonadotropins – In females, gonadotropins tell the ovaries to release the hormones estrogen and progesterone. They also tell the ovaries to prepare and release eggs. In males, these hormones tell the testicles to make testosterone and sperm.

●Growth hormone – Growth hormone helps children grow to a normal height. In adults, it helps keep the right balance of fat and muscle in the body.

●Prolactin – Prolactin helps control the development of breasts. It also tells the breasts to make milk after giving birth.

What is panhypopituitarism? — Panhypopituitarism is the medical term for when the pituitary gland does not make enough of the hormones it is supposed to make. This can happen when the pituitary gland is damaged or when there is a problem higher in the brain (in the part called the "hypothalamus"). The pituitary gland can be damaged by abnormal growths that sometimes form on the gland. Or it can be damaged by the treatment used to control those abnormal growths, such as surgery or radiation. Some people are born without 1 or more of the pituitary hormones.

When the pituitary gland does not make enough of its hormones, the other glands that the pituitary gland controls also do not make enough of the hormones they are supposed to make. This can cause serious problems.

What are the symptoms of panhypopituitarism? — The symptoms are different, depending on which hormones are most affected by the disorder. In general, the symptoms can include:

●Feeling tired

●Losing weight

●Being bothered by the cold

●Decreased appetite

●Having less interest in sex

●Having trouble getting pregnant or getting someone else pregnant (called infertility)

●In females:

•Irregular or missed periods

•Loss of pubic hair

•Being unable to make milk for breastfeeding

●In males:

•Decreased facial or body hair

•Testicles that have shrunk

●In children:

•Being shorter than other children of the same age

•No signs of puberty by age 12 in girls and age 14 in boys

Will I need tests? — Yes, if your doctor suspects you have panhypopituitarism, you will need blood tests to check for different hormone levels. You might also need an imaging test, such as an MRI. These tests create pictures of the inside of your body. They can show if there is something pressing on or damaging your pituitary gland.

How is panhypopituitarism treated? — Treatment usually involves taking hormone medicines to replace the hormones that the body is missing. People who are treated for panhypopituitarism usually must take these medicines for the rest of their life. They also need to have regular blood tests to check their hormone levels.

People who have a tumor or growth on their pituitary gland might also need surgery or other treatments (such as radiation therapy) to remove or destroy the tumor or growth.

What if I want to have children? — If you want to try to get pregnant, or get a partner pregnant, tell your doctor or nurse. Parts of your treatment might need to be different while you are trying to have a baby. For example, you might need to get treated with certain hormones that make it possible to get pregnant or get a partner pregnant. With the right treatment, most people with panhypopituitarism can have children.

More on this topic

Patient education: Addison disease (The Basics)
Patient education: Hypothyroidism (underactive thyroid) (The Basics)
Patient education: Prolactinoma (The Basics)
Patient education: Pituitary adenoma (The Basics)
Patient education: Thyroid-stimulating hormone test (The Basics)

Patient education: Adrenal insufficiency (Beyond the Basics)
Patient education: Hypothyroidism (underactive thyroid) (Beyond the Basics)
Patient education: High prolactin levels and prolactinomas (Beyond the Basics)