hormonal and metabolic disorders
Hypopituitarism
Treatment of Hypopituitarism
Treatment of cause Replacing deficient hormones Treatment is directed at the cause of pituitary underactivity (when possible) and at replacing deficient hormones. When the cause of the pituitary hormone deficiency is a tumor, surgical removal of a tumor is often the most appropriate first treatment. Tumor removal also usually reduces any pressure symptoms and vision problems caused by the tumor. For all but the largest tumors, surgery can usually be done through the nose (transphenoidal). Supervoltage or proton beam irradiation of the pituitary gland can be used to destroy a tumor. Large tumors and those that have extended beyond the bony structure at the base of the brain where the pituitary is located (sella turcica) may be impossible to remove with surgery alone. If so, doctors use supervoltage irradiation after surgery to kill the remaining tumor cells. Irradiation of the pituitary gland tends to cause a slow loss of any remaining normal pituitary function. The loss may be partial or complete. Therefore, the function of the target glands is generally evaluated every 3 to 6 months for the first year and yearly thereafter for at least 10 years after treatment. Prolactinoma can be treated with medications that act like Treatment also focuses on replacing the deficient hormones, usually not by replacing pituitary hormones, but rather, by replacing their target hormones. For example, people deficient in thyroid-stimulating hormone are given thyroid hormone. Those deficient inACTHare given adrenocortical hormones such ashydrocortisone. Those deficient in luteinizing hormone and follicle-stimulating hormone are given estrogen,progesterone, ortestosterone. Some may be treated with these hormones to induce fertility. Growth hormone is the only pituitary hormone thatisreplaced. Growth hormone treatment must be given by injection. When given to children who have growth hormone deficiency before the growth plates in their bones close, replacement growth hormone prevents them from being exceptionally short. In adults with growth hormone deficiency, treatment with growth hormone improves body composition, increases bone density, and improves quality of life. 