Panhypopituitarism is a rare condition that involves a lack of all the hormones your pituitary gland makes. These hormones are essential for several different body functions. Because of this, panhypopituitarism causes many different symptoms. It’s treatable with hormone replacement therapy and other treatments.
Panhypopituitarism is a rare condition in which there’s a lack (deficiency) of all of the hormones your pituitary gland makes. It can affect infants, children and adults.
Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, muscles and other tissues. These signals tell your body what to do and when to do it.
Your pituitary gland is a pea-sized gland located at the base of your brain below your hypothalamus (the part of your brain that controls your autonomic nervous system). It’s a part of your endocrine system.
The pituitary hormones are in charge of several important functions in your body, such as metabolism, growth and reproduction.
Normally, your body carefully controls hormone levels. If the levels of any of these hormones are unbalanced, it causes symptoms and health issues. Panhypopituitarism causes several symptoms since all of your pituitary hormone levels are lower than what they should be.
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Panhypopituitarism is a type of hypopituitarism.
If you have a deficiency (lack) of one or multiple hormones your pituitary gland makes, you have hypopituitarism.
Panhypopituitarism happens when there’s a deficiency in all of the hormones your pituitary makes. The prefix “pan-” means “all.”
Your pituitary gland makes and releases the following hormones:
Your pituitary gland stores and releases the following hormones, but your hypothalamus produces them:
Panhypopituitarism can affect anyone at any age.
Panhypopituitarism is rare. There are approximately four cases of panhypopituitarism per 100,000 people across the globe per year.
Yes, panhypopituitarism can be life-threatening, especially if you have a significant deficiency of adrenocorticotropic hormone (ACTH or corticotropin).
Adrenal crisis (acute cortisol insufficiency) is a life-threatening complication of panhypopituitarism. The cause is a lack of ACTH, which is a hormone that controls your cortisol levels. It’s treatable but requires immediate medical treatment.
Signs and symptoms of adrenal crisis include:
If you or your child are experiencing these symptoms, call 911 or get to the nearest hospital as soon as possible.
The signs and symptoms of panhypopituitarism vary widely based on how much of each of the pituitary hormones is lacking and whether the condition develops rapidly or slowly.
Symptoms of panhypopituitarism that children and adults can have include:
Additional symptoms of panhypopituitarism that are specific to infants, children and/or adolescents include:
These symptoms may resemble other conditions or medical issues. It’s important to always consult your healthcare provider if you’re experiencing new or prolonged symptoms to get a proper diagnosis.
Many conditions and situations can cause panhypopituitarism. In some cases, healthcare providers can’t determine the cause. This is called idiopathic panhypopituitarism.
In general, the cause of panhypopituitarism is some type of damage to your hypothalamus and/or pituitary gland that causes either or both of them to not function properly.
Understanding the possible causes of panhypopituitarism involves understanding how your hypothalamus and pituitary gland work together.
Together, your pituitary gland and hypothalamus form a hypothalamus-pituitary complex that serves as your brain’s central command center to control vital bodily functions.
Your hypothalamus is the part of your brain that’s in charge of some of your body’s basic operations. It sends messages to your autonomic nervous system. Your hypothalamus also tells your pituitary gland to produce and release hormones that affect other areas of your body.
Your pituitary gland connects to your hypothalamus through a stalk of blood vessels and nerves (the pituitary stalk). Through that stalk, your hypothalamus communicates with your pituitary gland.
Your hypothalamus makes the following hormones to communicate with and stimulate your pituitary gland:
Since your pituitary gland and hypothalamus work together so closely, if one of them becomes damaged, it can affect the hormonal function of the other. This can result in panhypopituitarism.
Conditions or situations that can damage your pituitary gland and cause panhypopituitarism include:
Conditions or situations that can damage your hypothalamus and cause panhypopituitarism include:
If you’re experiencing symptoms of panhypopituitarism, your healthcare provider will ask detailed questions about your symptoms and medical history and perform a physical exam.
They’ll then order tests to confirm a panhypopituitarism diagnosis and/or to rule out other conditions that could be causing your symptoms.
Healthcare providers typically order multiple tests to diagnose panhypopituitarism, including imaging and hormone levels tests.
Since panhypopituitarism results from damage to your hypothalamus or pituitary gland, your provider may order the following imaging tests to help determine the cause of panhypopituitarism:
If you have symptoms of panhypopituitarism, your provider will need to measure the levels of all the hormones your pituitary gland releases to check how deficient each one is and to help rule out other conditions.
While some pituitary hormones normally maintain a fairly stable level in your bloodstream, other pituitary hormone levels normally vary widely throughout the day. Because of this, some hormone tests are simple blood tests and others are specialized stimulation tests.
Hormone level tests include:
The treatment for panhypopituitarism greatly depends on how deficient each pituitary hormone is and the cause of the condition. Because of this, treatment is very individualized. Your healthcare team will determine what the best treatment plan is for you. Common treatment options for panhypopituitarism include:
In some cases, panhypopituitarism is reversible by treatment of the underlying cause, such as surgically removing a pituitary adenoma that was compressing the pituitary gland without causing damage. But in most cases, the hormone deficiencies from panhypopituitarism require lifelong treatment.
In most cases, you can’t prevent panhypopituitarism. But there are ways to catch it in its early phase if you’re at risk for developing it.
If you’ve experienced any of the following situations, you’re at greater risk for developing panhypopituitarism:
Your healthcare provider will likely recommend regular testing to check the function and health of your pituitary gland and/or hypothalamus if you’re at a greater risk for developing panhypopituitarism.
The prognosis (outlook) for panhypopituitarism depends on several factors, including:
Panhypopituitarism is associated with significant decreases in quality of life and life expectancy.
People with panhypopituitarism often develop obesity, decreased lean body mass and an increased risk of cardiovascular disease. People with panhypopituitarism may also have an increased risk of osteoporosis and bone fractures.
Careful, thorough treatment with hormone replacements and aggressive monitoring and treatment for cardiovascular disease risk factors may improve outcomes.
If you have symptoms of panhypopituitarism or received a diagnosis of the condition, you’ll likely need to see an endocrinologist — a healthcare provider who specializes in treating hormone-related conditions.
You’ll need to see your endocrinologist regularly throughout your life to ensure that your hormone replacement therapy is working well and to prevent excessive hormone replacement.
A note from Cleveland Clinic
A new diagnosis can be scary, but don’t be afraid to ask your healthcare provider questions about panhypopituitarism. Most cases of panhypopituitarism require lifelong treatment and monitoring of your hormones, so it’s important to see your provider regularly. Be sure to contact your provider if you have new or concerning symptoms. They’re available to help.
Last reviewed by a Cleveland Clinic medical professional on 08/03/2022.
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