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Thursday, May 19, 2016

Pituitray disease is progressive and often fatal if not detected




It is not uncommon for a woman to damage or destroy their pituitary during pregnancy. One of the reasons is that the pituitary increases its size by one-third during pregnancy. The pituitary sits behind the nose in a a bony carapace called the sella.

If an empty sella condition is identified during an MRI of your brain, your are missing your pituitary, which can be a serous and often fatal disease.

Sometimes the pituitary stalk will take over for the pituitary and you may be only deficient in just one pituitary hormone. Pituitary disease iS progressive. It may take may years for the endocrine system to fail.

When you are in the process of losing the entire endocrine system, the term panhypopituitarism is used

First to go is the growth hormone (GH), next the gonadotropins (LH and FSH) which control sexual/reproductive functions, followed by thyroid stimulating hormone (TSH) which controls thyroid hormone release, and finally the Adrenocorticotropic hormone (ACTH) which controls adrenal function.

If you have low LH and FSH you may also lose your sense of smell and taste.

Most endocrinologists (endo) will look for hypothyroidism first because there is really no replacement therapy for LH and FSH. Often the blood tests for thyroid simulating hormone (TSH) are inconclusive even after months of testing. An endo may give you a small dose levothyroxine to see if your feel better. People who are hypothyroid may be sensitive to cold and have a low pulse (bradycardia). Most people with thyroid conditions do not feel well at all.


Adrenal insufficiency is dangerous because you need cortisol in your system to survive. If cortisol get too low you may vomit, feel like your are spinning in a room and have and adrenal episode or crises. The latter results in death about 20 per cent of the time,

Adrenal insufficiency is not easy to test for. An endo has to inject an ACTH stimulator and monitor the response of the adrenal glands.

A damaged or missing pituitary may also result in diabetes insipidus a disease that is not related to diabetes mellitus I or II. In this case you wil constantly drink water and urinate every hour because you are missing the anitdiuretic hormone (ADH) that is actually produced in the hypothalamus.

The hypothalamus has a connection to the pituitary, providing a junction between the nervous system and the endocrine system,

If you are diagnosed with hypopituitarism or panhypopituitarism, it is important to have your GH tested, An endo can test your insulin-like growth factor-1 (IGF-1) level. If it is too low you need to be put on a somatropin or a growth hormone regimen.

This is important because people with pituitary disease have shortened life spans. Daily Somatropin injections have many benefits, but extending your life is the most important.

sources:
https://labtestsonline.org/understanding/analytes/growth-hormone/tab/test/
http://www.pathguy.com/lectures/pituitar.htm
https://en.wikipedia.org/wiki/Growth_hormone
http://www.medkorat.in.th/admin/ckfinder/userfiles/files/panhypopituitarism.pdf




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