If your doctor suspects a problem with your pituitary hormones, he or she will likely order several tests to check hormone levels in your body and search for a cause.
Your doctor may order tests including:
- Blood tests. These tests measure your hormone levels. For example, blood tests can identify low levels of thyroid, adrenal or sex hormones. The tests can determine if these low levels are associated with pituitary hormone production.
- Stimulation or dynamic testing. These tests also measure your hormone levels. Your doctor may suggest that you go to a clinic that specializes in endocrine conditions for these tests. These tests check your body's hormone levels after you've taken certain medications to stimulate hormone production.
- Brain imaging. Magnetic resonance imaging (MRI) or high-resolution computerized tomography (CT) of your brain can detect a pituitary tumor or other pituitary gland problems.
- Vision tests. These tests can determine if growth of a pituitary tumor has impaired your sight or visual fields.
The first step in treating hypopituitarism is often medication to help your hormone levels return to normal. This is usually called hormone replacement, because the dosages are set to match the amounts that your body would produce if it didn't have a pituitary problem. You may need to take the medication for the rest of your life.
In some cases, treatment of the condition causing hypopituitarism may lead to a complete or partial recovery of your body's ability to produce pituitary hormones.
Hormone replacement medications may include:
- Corticosteroids. These drugs, such as hydrocortisone (Cortef) or prednisone (Rayos), 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 treats the low thyroid hormone levels (hypothyroidism) that a thyroid-stimulating hormone (TSH) deficiency can cause.
- Sex hormones. These include testosterone in men and estrogen or a combination of estrogen and progesterone in women. Testosterone is administered either by injection or through the skin with a patch or a gel. Female hormone replacement can be administered with pills, gels or patches.
- Growth hormone. Also called somatropin (Genotropin, Humatrope, others), growth hormone is administered through an injection beneath your skin. It promotes growth, which helps produce a more normal height in children. Adults with symptoms of growth hormone deficiency also may benefit from growth hormone replacement, but they won't grow taller.
- Fertility hormones. If you've become infertile, gonadotropins can be administered by injection to stimulate ovulation in women and sperm production in men.
Monitoring and adjusting medication
A doctor who specializes in endocrine disorders (endocrinologist) may monitor your symptoms and the levels of these hormones in your blood to ensure you're getting the appropriate amounts.
If you're taking corticosteroids, you'll need to work with your doctor to adjust your medication dosage during times of major physical or emotional stress. During these times, your body would usually produce extra cortisol hormone to help you manage the stress.
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.
Surgery or other procedures
You may need periodic CT or MRI scans to monitor a pituitary tumor or other diseases causing hypopituitarism. Treatment for pituitary tumors may involve surgery to remove the growth. In some cases, radiation treatment or medications are recommended to control the underlying cause.
In case of emergency
If you have hypopituitarism, it's important to wear a medical alert bracelet or pendant and carry a special card notifying others — in emergency situations, for example — of your condition. This is especially important if you're taking corticosteroids for an ACTH deficiency.
Preparing for your appointment
You're likely to start by seeing your family doctor. However, in some cases, when you call to set up an appointment, you may be referred to a doctor who specializes in endocrine disorders (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 prior injuries to your head or complications during childbirth.
- 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 long-term?
- 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 significant head injury or neurosurgery?
- Have you ever had radiation treatment for a head or neck tumor?
- 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?