Hypopituitarism Treatment in Asheville, NC
If you're struggling with chronic fatigue, joint stiffness, low libido, anemia or infertility you may have hypopituitarism, a progressive pituitary gland disorder that disrupts hormone levels. It can also stunt children's growth.
Your pituitary gland is located at the base of your brain. This gland secretes hormones that affect nearly every part of your body. Hypo is Greek for "below normal" – hypopituitarism is the underproduction of one or more hormones by the pituitary gland.
It's rarely fatal and symptoms can usually be managed successfully with multiple treatments which affect individuals differently depending on age, genetics, severity of condition, general health, and other environmental factors. To speak with a hypopituitarism specialist today in Asheville, call (423) 482-8711 or contact Dr. Dalal Akoury online.
What are the symptoms of hypopituitarism?
Because your pituitary gland secretes hormones that perform a vast array of bodily functions, hypopituitarism can cause a wide variety of symptoms that either appear suddenly or develop slowly over time. These include:
- chronic fatigue
- decreased sex drive
- excessive thirst and urination
- pituitary gland inflammation
- stomach pain
- nausea and vomiting
- short stature (in children)
- unexplained weight loss
- cold sensitivity
- low appetite
- facial puffiness
- hot flashes, irregular or no periods, loss of pubic hair, and low or absent milk production (in women)
- decreased facial or body hair (in men)
Symptoms also vary widely depending which hormones are deficient and how severe your deficiency is. As they may be subtle or similar to symptoms of a different medical condition, hypopituitarism can be overlooked for a long time.
What causes hypopituitarism?
The pituitary gland may be under producing any of these hormones:
- adrenocorticotropic hormone (ACTH): controls production of the adrenal gland hormones cortisol and dehydroepiandrosterone (DHEA)
- thyroid-stimulating hormone (TSH): controls thyroid hormone production
- luteinizing hormone (LH) and follicle-stimulating hormone (FSH): control fertility in both sexes and the secretion of sex hormones (estrogen and progesterone from the ovaries in women and testosterone from the testes in men)
- growth hormone (GH): required for growth in childhood and has effects on the entire body throughout life.
- prolactin (PRL): required for breast feeding
- oxytocin: required during labor and delivery and for lactation and breast feeding
- antidiuretic hormone (also known as vasopressin)
Hypopituitarism can be genetic (enzymatic disorder of the thyroid) or acquired through chronic iodine deficiency, autoimmune disorder, TRH deficiency or a hypothalamic lesion. The most common causes include:
- pituitary gland tumors: can interfere with hormone producing ability and optic nerves
- head injuries
- brain tumors
- radiation therapy
- autoimmune inflammation
- brain infections like meningitis
- genetic mutation causing impaired hormone production
- severe childbirth blood loss (Sheehan syndrome or postpartum pituitary necrosis)
- inflammatory diseases affecting your organs (sarcoidosis)
- abnormal cell scarring (Langerhans cell histiocytosis)
- hemochromatosis causing excess iron to collect in your liver or other tissues
Diseases of the hypothalamus - a part of your brain located just above your pituitary gland - can also cause hypopituitarism because this part of your brain produces hormones that affect your pituitary function.
How is hypopituitarism diagnosed?
Hypopituitarism may involve the loss of one, several or all of the pituitary hormones. So determining which hormone or hormones are deficient and need to be replaced requires a thorough evaluation.
Your healthcare provider will usually diagnose hypopituitarism by doing physical examination to diagnose or rule out any underlying medical conditions causing your symptoms. He or she will discuss your current health and family medical history and ask whether you've experienced a head injury or are undergoing radiation therapy.
Hypopituitarism is usually confirmed by a number of tests, such as:
- blood test: to measure your sex hormones and hormones produced by your thyroid and adrenal glands
- stimulation testing: to check your body's hormone secretion after you take certain medications that stimulate hormone production
- brain imaging: CT scan or MRI imaging to identify pituitary tumors or other abnormalities
- vision tests: determines whether pituitary abnormalities or a tumor has damaged vision
Once your condition is identified and your hormone imbalances accessed, you and your medical provider can customize a treatment plan best suited for your specific case and symptoms.
How is hypopituitarism treated?
If you don't have a pituitary tumor, hormone replacement therapy is a common therapy which must be customized to fit your specific needs.1 Hormone replacement medications may include:
- bioidentical hormone replacement: custom combinations of estrogen and progesterone and testosterone via pellet, patch, gel, or injection; must be monitored regularly so as to maintain healthy balance
- corticosteroids: hydrocortisone or prednisone can replace adrenal hormones; not used longer than 3 months because they can cause diabetes, osteoporosis, rapid heartbeat, cataracts and glaucoma
- levothyroxine: replaces deficient thyroid hormones; long term use can cause irregular heart beat and heart attack symptoms
- somatropin: a synthetic version of peptide hormone that stimulates growth, cell production and regeneration; potential side effects include vision changes, numbness, swelling, high blood sugar, weight loss, stomach pain and vomiting
- LH and FSH: stimulate male sperm production and female ovulation
Throughout your treatment, your healthcare provider will monitor your hormone levels and adjust them as your needs change.1
Although the following treatments can be taken at home, a healthcare provider must manage and access their efficacy throughout your treatment, as your hormone levels fluctuate:
- arginine: this amino acid stimulates production of certain hormones, commonly found in supplements and foods like eggs, yogurt, beef, liver, walnuts, and almonds
- probiotics: stimulate gut flora for a metabolic response, can be taken by supplement and is found in fermented foods
- copper: a deficiency can intensify symptoms, so eating copper-rich foods nuts, seeds, seafood, beans, liver, and oysters may help prevent deficiency and maintain hormone balance
- glycine: an amino acid that may increase your hormone levels, but evidence is mixed when tested in patients with an existing growth hormone deficiency1
- melatonin: a hormone that may increase the quality and duration of your sleep and may enhance growth hormone production
- optimize sleep: getting enough sleep can help normalize your growth hormone levels
- exercise: daily physical activity may temporarily spike your growth hormone levels, it can also help you lose weight and decrease body fat to balance levels long-term
- reducing sugar intake: increasing your insulin levels may lower growth hormone production, so reducing your levels may help optimize your hormone production
- GABA: this non-protein amino acid acts as a calming agent and may raise growth hormone levels; however, studies have shown that these gains are typically short-lived2
- adaptogen herbs: ginseng, basil, rhodiola, ashwagandha, and astragalus root may improve fertility and sex drive while promoting cardiovascular health
If you have developed a pituitary tumor, surgery to remove it is usually the first step. In many cases, your healthcare provider will also recommend radiation.
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Although hypopituitarism is rare, it's common enough to be of medical concern. It can't be cured outright, but hypopituitarism can usually be managed with medications and other treatment approaches that may help stabilize your hormones, reduce or eliminate your symptoms, and improve your quality of life.
1. Arwert, L.i., et al. "Effects of An Oral Mixture Containing Glycine, Glutamine and Niacin on Memory, GH and IGF-I Secretion in Middle-Aged and Elderly Subjects." Nutritional Neuroscience, vol. 6, no. 5, 2003, pp. 269–275., doi:10.1080/10284150310001612195.
2. Powers, Michael E., et al. "Growth Hormone Isoform Responses to GABA Ingestion at Rest and after Exercise." Medicine & Science in Sports & Exercise, vol. 40, no. 1, 2008, pp. 104–110., doi:10.1249/mss.0b013e318158b518.
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