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Treatments and drugs
By Mayo Clinic staffSuccessful treatment of the underlying condition causing hypopituitarism may lead to a complete or partial recovery of your body's normal production of pituitary hormones. The usual treatment for pituitary tumors is surgery to remove the growth. In some instances, doctors also recommend radiation treatment.
If hormone deficiencies persist after treatment, then you'll need prescriptions of one or more hormone replacement medications. 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 is usually lifelong.
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 either pills or patches.
- Desmopressin (DDAVP). You take this hormone to replace ADH and to reduce your body's loss of water through frequent urination. Desmopressin is taken as a nasal spray or oral tablet or by injection.
- 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 become taller.
If you've become infertile, preparations containing LH and FSH, also called 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.
- Generalized hypopituitarism. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec12/ch151/ch151c.html. Accessed July 22, 2010.
- Snyder PJ. Clinical manifestations of hypopituitarism. http://www.uptodate.com/home/index.html. Accessed July 7, 2010.
- Snyder PJ. Causes of hypopituitarism. http://www.uptodate.com/home/index.html. Accessed July 7, 2010.
- Snyder PJ. Treatment of hypopituitarism. http://www.uptodate.com/home/index.html. Accessed July 7, 2010.
- Growth disorders treatment options. The Hormone Foundation. http://www.hormone.org/Growth/treatment.cfm. Accessed July 22, 2010.
- Aron DC, et al. Hypothalamus & pituitary gland. In: Gardner GD, et al. Greenspan's Basic and Clinical Endocrinology. 8th ed. New York, N.Y.: McGraw-Hill; 2007. http://www.accessmedicine.com/content.aspx?aid=2628445. Accessed July 22, 2010.
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