Diagnosis

If your doctor suspects a pituitary disorder, he or she will likely order several tests to check levels of various hormones in your body. Your doctor may also want to check for hypopituitarism if you've had a recent head injury or radiation treatment that might have put you at risk of damage to your pituitary gland.

Tests your doctor may order include:

  • Blood tests. They can help detect deficits in hormones as a result of pituitary failure. For example, blood tests can identify low levels of thyroid, adrenal or sex hormones, and can determine if these low levels are associated with inadequate pituitary hormone production.
  • Stimulation or dynamic testing. Your doctor may suggest you go to a specialized endocrine clinic for these tests, which check your body's secretion of hormones after you've taken certain medications that can stimulate hormone production.
  • Brain imaging. Magnetic resonance imaging (MRI) of your brain can detect a pituitary tumor or other structural abnormality.
  • Vision tests. These tests can determine if growth of a pituitary tumor has impaired your sight or visual fields.

Treatment

Successful treatment of the underlying condition causing hypopituitarism may lead to a complete or partial recovery of your body's normal production of pituitary hormones. Treatment with the appropriate hormones is often the first step. These drugs are considered as "replacement," rather than treatment, because the dosages are set to match the amounts that your body would normally manufacture if it didn't have a pituitary problem. Treatment may be lifelong.

Treatment for pituitary tumors may involve surgery to remove the growth. In some instances, doctors also recommend radiation treatment.

Hormone replacement medications may include:

  • Corticosteroids. These drugs, such as hydrocortisone or prednisone, replace the adrenal hormones that aren't being produced because of an adrenocorticotropic hormone (ACTH) deficiency. You take them by mouth.
  • Levothyroxine (Levoxyl, Synthroid, others). This medication replaces deficient thyroid hormone levels caused by low or deficient TSH production.
  • Sex hormones. These include testosterone in men and estrogen or a combination of estrogen and progesterone in women. Testosterone is administered through the skin with either a patch or a gel or by injection. Female hormone replacement can be administered with pills, gels or patches.
  • Growth hormone. Also called somatropin, growth hormone is taken through an injection beneath your skin. It promotes growth, thus producing more normal height in children. Adults with a growth hormone deficiency also may benefit from growth hormone replacement, but they won't grow taller.

If you've become infertile, LH and FSH (gonadotropins) can be administered by injection to stimulate ovulation in women and sperm production in men.

Monitoring and adjusting

A doctor who specializes in endocrine disorders (endocrinologist) may monitor the levels of these hormones in your blood to ensure you're getting adequate — but not excessive — amounts.

Your doctor will advise you to adjust your dosage of corticosteroids if you become seriously ill or experience major physical stress. During these times, your body would ordinarily produce extra cortisol hormone. The same kind of fine-tuning of dosage may be necessary when you have the flu, experience diarrhea or vomiting, or have surgery or dental procedures. Adjustments in dosage may also be necessary during pregnancy or with marked changes in weight. You may need periodic CT or MRI scans as well to monitor a pituitary tumor or other diseases causing the hypopituitarism.

In case of emergency

Wear a medical alert bracelet or pendant, and carry a special card, notifying others — in emergency situations, for example — that you're taking corticosteroids and other medications.

Preparing for your appointment

You're likely to start by seeing your family doctor or a general practitioner. However, in some cases, when you call to set up an appointment, you may be referred to a specialist called an endocrinologist.

Here's some information to help you prepare for your appointment.

What you can do

  • Be aware of any pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do to prepare for common diagnostic tests.
  • Write down all symptoms and changes you're experiencing, even if they seem unrelated to each other.
  • Write down key personal information, including any recent life changes or a noticeable difference in your ability to tolerate stress.
  • Make a list of your key medical information, including recent surgical procedures, the names of all medications you're taking and any other conditions for which you've been treated. Your doctor will also want to know about any recent injuries to your head.
  • Take a family member or friend along, if possible. Someone who accompanies you may help you remember what your doctor tells you.
  • Write down questions to ask your doctor.

Create a list of questions before your appointment so that you can make the most of your time with your doctor. For hypopituitarism, some basic questions to ask your doctor include:

  • What is likely causing my symptoms or condition?
  • Other than the most likely cause, what are other possible causes for my symptoms or condition?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What treatment approach do you recommend?
  • How long will I need to take medications?
  • How will you monitor whether my treatment is working?
  • I have other health conditions. How can I best manage them together?
  • Are there restrictions I need to follow?
  • Is there a generic alternative to the medicine you're prescribing?
  • Do you have brochures or other printed material I can take with me? What websites do you recommend?

Don't hesitate to ask any questions you have during your appointment.

What to expect from your doctor

Your doctor is likely to ask you some questions, such as:

  • What are your symptoms, and when did you first notice them?
  • How have your symptoms changed over time?
  • Have you noticed any changes in your vision?
  • Do you experience severe headaches?
  • Has your appearance changed, including your weight or the amount of your body hair?
  • Have you lost interest in sex? Has your menstrual cycle changed?
  • Are you currently being treated or have you recently been treated for any other medical conditions?
  • Have you recently had a baby?
  • Have you had a recent head injury or neurosurgery?
  • Have any of your family members been diagnosed with pituitary or hormonal conditions?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Aug. 22, 2017
References
  1. Generalized hypopituitarism. Merck Manual Professional Version. http://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/pituitary-disorders/generalized-hypopituitarism. Accessed Jan. 26, 2016.
  2. Longo DL, et al., eds. Hypopituitarism. In: Harrison's Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.com. Accessed Jan. 26, 2016.
  3. Gardner DG, et al. Hypothalamus and pituitary gland. In: Greenspan's Basic & Clinical Endocrinology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://accessmedicine.com. Accessed Jan. 26, 2016.
  4. Nippoldt, TB (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 3, 2016.