Pituitary hormone replacement

Higham, Claire; Shalet, Stephen; Trainer, Peter J.

doi:10.1016/j.mpmed.2009.05.004

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Volume 37, Issue 8 , Pages 399-402, August 2009

Pituitary hormone replacement

Claire Higham BA DPhil MRCP is a Specialist Registrar in Diabetes and Endocrinology in Manchester, UK. Her research interests include pituitary disorders, particularly acromegaly and the metabolic consequences of endocrine conditions. Competing interests: none declared.

Stephen Shalet MD FRCP is a Professor and Consultant Endocrinologist at The Christie Hospital, Manchester, UK. His research interests include pituitary disorders, abnormalities of growth hormone secretion and the endocrine complications of cancer treatment. Competing interests: has received research support from Pfizer, Novartis and Novo Nordisk.

Peter J Trainer MD FRCP is a Professor and Consultant Endocrinologist at The Christie Hospital, Manchester, UK. His research interests are pituitary and adrenal disease, particularly Cushing's syndrome, acromegaly and glucocorticoid receptors. Competing interests: has received research support from Pfizer, Ipsen, Novartis and Novo Nordisk.

Abstract

Hypopituitarism is associated with increased morbidity and mortality. Hormone replacement therapies are available for effective treatment of anterior pituitary deficiencies of growth hormone: adrenocorticotropic hormone, thyroid-stimulating hormone, luteinizing hormone and follicle-stimulating hormone. The posterior pituitary antidiuretic hormone can also be replaced. The aim of replacement therapy is to mimic as far as possible the normal physiology of the hormone and to avoid over-treatment. Currently available hormone preparations and their advantages and disadvantages are discussed.

Keywords: adrenocorticotropic hormone, dehydroepiandrosterone, growth hormone, hydrocortisone, hypopituitary, oestrogen, testosterone, thyroxine