HYPOPITUITARISM

There are several causes of hypopituitarism and for further detailed information on this disorder we suggest you look at www.pituitary.org.uk Hypopituitarism is a life-long condition which requires replacement treatment with several hormones and in particular hydrocortisone which makes up for the loss of cortisol (stress hormone).

Cortisol is made in the adrenal glands and is made in response to Adrenocorticotropic Hormone (ACTH) which is produced by the pituitary gland in the brain. ACTH tells the adrenal glands to release cortisol. ACTH production is regulated by the hormone Corticotropin Releasing Hormone (CRH) which is produced by the Hypothalamus. The Hypothalamus senses the amount of cortisol concentrations in the blood and then releases CRH. This means that cortisol is regulated by the Negative-Feed Back Loop system.

If there is a loss or problem with the production of ACTH caused by either being born without a pituitary gland or maybe a pituitary tumour that destroys the gland, or even brain surgery then ACTH will be deficient and no cortisol is produced, leaving the patient with adrenal insufficiency. Our leaflets look at the replacement of cortisol in hypopituitarism which is the same for all other conditions that result in adrenal insufficiency and this includes illness and emergency care.

However all patients who in addition take Desmopressin (DDAVP) need to seek further individualised advice from their paediatric endocrinologist on what to do with their DDVAP medication in illness and emergencies. For this reason we have not covered this aspect.

The following leaflets are for patients with hypopituitarism:

Emergency Letter

Ambulance Information

Surgery Protocol

GP Letter

Extra Hydrocortisone dose at 4am in Illness

A guide for Illness and Emergencies

Quick Guide to Illness Flow Chart

Adrenal Crisis Pathway of Events Hypopit

The Value of 24 Hour Profiles to Assess and Fine-tune Cortisol Replacement

Using Pump Therapy to deliver Cortisol

Circadian Dosing