Hypopituitarism - What are the symptoms of hypopituitarism?

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Symptoms depend on which hormone or hormones are missing.

  1. ACTH deficiency causing cortisol deficiency: Symptoms include weakness, fatigue, weight loss, abdominal pain, low blood pressure and low serum sodium levels. During a period of severe stress such as infection or surgery, cortisol deficiency may potentially result in coma and death. ACTH also stimulates DHEA secretion from the adrenal cortex.
  2. TSH deficiency causing thyroid hormone deficiency: Symptoms include fatigue, weakness, difficulty losing weight, generalized body puffiness, feeling cold, constipation, difficulty with memory and an inability to concentrate. Skin may become dry and the complexion pale. In addition, anemia, high cholesterol levels and liver problems may also occur. Patients with severe or long-term deficiency can appear lethargic. Rarely, severe thyroid hormone deficiency can cause coma, low body temperature, and even death.
  3. LH and FSH deficiency in Women : LH and FSH deficiency may cause loss of menstrual cycles, infertility, decrease in sex drive and vaginal dryness and osteoporosis, which can result in a tendency to develop bone fractures.
    LH and FSH deficiency in Men : LH and FSH deficiency may cause loss of libido (interest in sexual activity), difficulty in achieving and sustaining an erection and infertility due to a low sperm count, and osteoporosis, which can result in a tendency to develop bone fractures.
  4. GH deficiency: In children, GH deficiency causes slowing or lack of growth and an increase in body fat. In adults, GH deficiency may cause a decrease in energy and physical activity, change in body composition (increased fat, decreased muscle mass), a tendency toward increased cardiovascular risk factors/diseases and decreased quality of life (including an increased sense of social isolation).
  5. PRL deficiency: In the case of PRL deficiency, the mother might not be able to breast feed following delivery.
  6. Antidiuretic hormone deficiency: This hormone deficiency results in diabetes insipidus ( DI ). DI is not the same as diabetes mellitus, which is also known as type 1 or type 2 diabetes or sugar diabetes. Symptoms of DI include increased thirst and frequent urination, particularly at night. Pituitary adenomas themselves rarely cause DI unless it occurs after surgery. If DI occurs spontaneously, it usually indicates that some other sort of tumor or inflammation is present in the area.

Sexual desire in women is partially controlled by the hormone DHEA (which is controlled by ACTH). DHEA is a weak androgen (a male hormone like testosterone). In men, DHEA is of little functional relevance because much higher levels of the potent male hormone testosterone are present. However, in women, DHEA deficiency can contribute to impaired quality of life (tiredness, depression) and impaired sexual desire and enjoyment.

Schematic of pituitary gland, the hormones it produces and the organs that they affect. Effect of GH shown separately at left.

Table 2. Symptoms and Signs of Pituitary Hormone Deficiency
Pituitary Hormone Target Organs Effect of Deficiency
ACTH Adrenal glands: cortisol and DHEA Fatigue, low sodium in blood, weight loss, skin pallor
TSH Thyroid gland: thyroid hormone Fatigue, weight gain, dry skin, sensitivity to cold, constipation
LH and FSH in Women Ovaries: estrogen, progesterone; ovulation Loss of periods, loss of sex drive, infertility
LH and FSH in Men Testes, testosterone, sperm production Loss of sex drive, erectile dysfunction, impotence, infertility
GH in Children & Adolescents Bone, muscle, fat Lack of growth (height); increased body fat, failure to achieve normal peak bone mass
GH in Adults Whole body Poor quality of life, increased body fat, decreased muscle and bone mass
PRL Breast Inability to breast feed
Oxytocin Breast, Uterus Complete deficiency could make breast feeding difficult
Antidiuretic hormone (vasopressin) Kidney Frequent urination (day & night), dilute urine, excessive thirst