Hypopituitarism - What are the risks of hormone treatment(s)?

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Hormone replacement at doses higher than needed especially in the case of cortisol may have harmful effects on the heart, bones (osteopenia or osteoporosis) and other organs. In fact, patients on long-term cortisol therapy should have periodic bone density tests. Too much cortisol can increase the risk for infection. Individuals treated with too low a dose of cortisol run the risk of adrenal insufficiency. All patients must take additional cortisol under stressful situations.

Side effects of hGH replacement include ankle swelling, joint aches, and an increase in blood sugar levels. Treatment with hGH may require increased doses of cortisol in patients with low adrenal function.

An overdose of desmopressin may be dangerous, resulting in water retention and reduced sodium levels in the blood. When the sodium level drops too low patients may get quite sick and have seizures.

As with the general population, patients with hypopituitarism should be screened for additional cardiovascular risk factors and take steps to control the risk by conventional means: avoid obesity by adopting a healthy lifestyle (don’t smoke, eat a healthy diet and exercise regularly); take blood pressure medication to manage high blood pressure and use lipid lowering drugs to control high cholesterol levels. Patients should work closely with health care specialists such as endocrinologists, primary care physicians, nurses, and support workers to ensure that each pituitary hormone deficiency is appropriately assessed and, where appropriate, replaced.