According to abbreviationfinder, PI stands for pituitary insufficiency. Pituitary insufficiency is an underfunction of the pituitary gland. Since messenger substances for other hormone glands are produced in the pituitary gland, there is a general hormone deficiency in the event of insufficiency. The causes lie either in the pituitary gland itself or in the hypothalamus.
What is pituitary insufficiency?
The symptoms of pituitary insufficiency are varied. Usually only the anterior lobe is affected by the insufficiency.
In pituitary insufficiency, the anterior lobe of the pituitary gland does not produce enough hormones. The secretion of stimulating hormones for the thyroid, the adrenal cortex and the gonads is thus limited. These hormones are in particular growth hormones, LH, TSH, FSH and ACTH. Due to the reduced stimulation of the adrenal cortex, the gonads and the thyroid gland, fewer hormones are also produced in these glands.
The most important hormones of the adrenal cortex include the stress hormones adrenaline and noradrenaline. The best-known hormones of the thyroid are thyroxine and calcitonin, while the sex hormones are mainly produced in the gonads. Pituitary insufficiency is therefore associated with a corresponding number of complaints. The entire hormonal balance becomes imbalanced in the course of the disease, since the secretion of the pituitary gland regulates the release of various hormones.
A special form of insufficiency is the pituitary coma. A sudden functional failure of the pituitary gland causes the thyroid gland and the adrenal cortex to stand still from one second to the next.
Causes
Various phenomena can be considered as causes of pituitary insufficiency. For example, tumors in this area or in the area of the hypothalamus can impair the secretion of the pituitary hormone. Inflammation in the pituitary gland or in the hypothalamus can also cause insufficiency. Likewise, autoimmune diseases and strokes sometimes lead to pituitary insufficiency.
Causal injuries are also conceivable. In particular, craniocerebral trauma can play a role in the insufficiency. Many of these traumas are birth traumas resulting from a breech delivery. However, injuries can also occur as a result of operations or radiation therapy for brain tumors. Another cause of the pituitary hypofunction can be brain necrosis, such as occurs in Sheehan’s syndrome.
In some cases, the cause of pituitary insufficiency remains unclear. This means that with the current state of research, not all connections are known and the disease has not yet been conclusively researched. Pituitary coma is usually always caused by an accident or sudden injury to the pituitary gland.
Symptoms, Ailments & Signs
The symptoms of pituitary insufficiency are varied. Usually only the anterior lobe is affected by the insufficiency. Rarely, there is insufficiency for the entire pituitary gland. Growth disorders such as short stature are one of the main symptoms. Since the lipid metabolism slows down due to the lack of hormones, obesity can also occur.
In women, these symptoms are usually accompanied by disorders of the menstrual cycle, since the sex hormone estrogen is no longer produced in sufficient quantities. The development of secondary sexual characteristics can also be inhibited because of this hormone deficiency. Diabetes insipidus often occurs as well. This disease causes an increased feeling of thirst. Patients urinate more frequently.
What symptoms a patient with pituitary insufficiency has in addition to these key symptoms can vary significantly. Basically, the occurring disturbances result from the physiological effect of the respective hormone deficiency of gonadal, adrenal cortex and thyroid hormones. In the case of a pituitary coma, there is a lack of drive and a slow pulse. The body temperature drops and those affected lose consciousness.
Diagnosis & course of disease
Diagnosis starts with a hypophyseal function with a comprehensive anamnesis. Based on the medical history, the doctor can, for example, find out about treatments or diseases that may have caused the hypofunction. In the blood, the doctor determines the amount of growth hormone, LH and FSH, thyroid stimulating hormone, adrenocorticotropic hormone and prolactin.
In addition, a urine or blood test is carried out to determine sex hormones, thyroid hormones and glucocorticoids. The doctor uses a stimulation test to narrow down the localization of the damage. If the disturbance originates from the hypothalamus, then the stimulation test leads to the production of hormones.
In this test, the hypothalamic messenger substances for stimulating the pituitary gland are injected into the body. Imaging may be ordered to determine the cause. The prognosis for pituitary insufficiency is generally favorable because the phenomenon can now be treated easily. However, pituitary coma can be life-threatening.
Complications
First and foremost, the pituitary insufficiency leads to growth disorders and thus to short stature. In most cases, this becomes apparent in the early years of the patient. Furthermore, metabolic disorders also occur, so that most patients also suffer from obesity and thus also from being overweight.
In women, menstrual disturbances and other sexual disturbances occur and the onset of puberty is delayed. Diabetes does not develop, which is why most patients suffer from increased thirst. The patient’s resilience also drops drastically and physical exertion can lead to a loss of consciousness. This is often associated with pallor and a very low heart rate.
Pituitary insufficiency can be treated in a variety of ways, with the treatment option usually depending on the cause of the disease. In most cases, either the tumor or the inflammation must be removed, although there are no particular complications. The earlier the disease is diagnosed and treated, the higher the chances of a complete cure for the patient.
When should you go to the doctor?
Since there is no improvement in the symptoms of pituitary insufficiency and therefore no self-healing, a doctor must be consulted in any case with this disease. The symptoms can be very different, so that no general prediction can be made about them. However, if they occur over a longer period of time and make life difficult for the person concerned, an examination by a doctor should always be carried out.
Growth disturbances can indicate the disease. Many patients suffer from short stature and a disturbed lipid metabolism, so that obesity can also occur. Diabetes can also be a sign of the disease. A doctor should be consulted if the patient suffers from a slow heart rate and reduced exercise capacity.
In the first place, a general practitioner can be consulted in the case of pituitary insufficiency. This can examine the complaints and further diagnose the disease. Further treatment usually requires examinations by other specialists.
Treatment & Therapy
Therapy for pituitary insufficiency depends on the cause of the disease. Tumors, for example, have to be removed in an operation. Depending on the malignancy, surgery may be combined with radiation therapy. In the case of inflammatory processes, cortisone is usually administered to allow the inflammation to subside. If the cause of the insufficiency cannot be determined more precisely, hormone replacement therapy is usually used.
Which hormones have to be taken depends heavily on the extent of the insufficiency. Above all, the intake of correctly dosed glucocorticoids is vital. The dosage of these stress hormones must be increased as soon as the patient is under stress. Failure to do this increase in dose can have life-threatening consequences. All patients with glucocorticoid deficiency should carry an emergency card, just in case.
The intake of growth hormones is also often part of the therapy for pituitary insufficiency. The same applies to the administration of sex hormones. As a rule, the missing hormones in the case of pituitary insufficiency of unknown cause are taken for life. Only in the case of prolactin deficiency and oxytocin deficiency no hormone replacement is necessary.
Prevention
Pituitary insufficiency can be prevented indirectly, for example by adequately clarifying craniocerebral trauma.
Aftercare
In the case of pituitary insufficiency, follow-up care begins four to six weeks after the surgery date. After the actual therapy, a drug treatment takes place. In connection with this, precise control of medication adjustment and the state of health of patients is required. This means that the individual dose is adjusted over time.
In principle, no noticeable changes appear in those affected after a few years. When the condition is associated with an infection, such as a bacterially inflamed pituitary gland, it is important to boost the immune system. This type of aftercare focuses on the improved healing process and also serves as a preventive measure.
The strengthening of the immune system can be ensured by a balanced diet with lots of natural foods. Regular physical activity is also useful. In the ideal case, there is a frequent alternation between phases of tension and breaks for relaxation. In this way, the patients can break down the accumulated stress hormones particularly well.
At the same time, active relaxation helps to successfully combat pathogenic germs. In the course of a better body awareness, patients learn to be mindful. This plays an essential role in the healing process. Efficient aftercare ensures stable health and better well-being.
You can do that yourself
The pituitary or pituitary gland has a significant influence on the control of various bodily functions. It can be regarded as one of the most important hormonal control centers in the body. It performs its control function by producing control hormones or directly effective hormones. This means that depending on the severity, pituitary insufficiency has a significant impact on certain bodily functions and on the psyche.
A detected pituitary insufficiency should be treated as soon as possible in order to combat the cause. Almost no self-help measures are known. If the disease is due to inflammation of the pituitary gland by bacteria or other pathogenic germs, strengthening the immune system can support the healing process and prevent new infections.
The immune system can be strengthened through a varied diet, which also contains natural foods, as well as through regular exercise and constant alternation between phases of tension and relaxation. For example, stress hormones, which can accumulate over the course of the day if no active relaxation phases have been interposed, can be reduced more effectively through light exercise than by relaxing on the sofa. The immune system is strengthened and can fight pathogenic germs much more effectively.
An adaptation of everyday behavior to hypophysis insufficiency consists in consciously perceiving the existing symptoms and, above all, in avoiding dangerous situations that can arise from various – hormonally induced deficits.
