How is hormone replacement therapy for total anterior pituitary hypofunction?

  Hormone replacement therapy for anterior hypopituitarism is a simple and complex matter at the same time. I say it is simple because replacement therapy can be done according to the principle of supplementing whatever hormone is missing. It is complicated because each patient metabolizes the drug differently. The same dose of a drug may be too much for one patient, but not enough for another. It’s like being in school with the same teacher, some students feel like they are learning too much and can’t finish. Some bright students feel like they are not learning enough and can’t get enough.  In general, there is a sequence of supplementation for anterior pituitary hormone deficiency. The first supplement is adrenal glucocorticoid hormone, then thyroid hormone, and then growth hormone and gonadal hormone can be supplemented. Just like adding various necessities to your home, the first thing you need is water and electricity, then you can have a TV and washing machine, and finally you can have a refrigerator and air conditioner.  Adrenal glucocorticoid supplementation is usually prednisone 5mg per day, however, this drug dose is not suitable for every patient. If you have a chubby build and gain weight gradually during treatment, suggesting an overdose, perhaps half a tablet per day is a more appropriate dose for you. If you experience frequent nausea and vomiting and progressive weight loss, suggesting that the medication dose may be inadequate, an additional 1/4 tablet or more per day may be needed. In the case of colds and fevers, transitional fatigue, trauma, etc., the dose of prednisone needs to be increased to 2-3 tablets per day. When the acute disease state has passed, the medication still needs to be reduced back to the original dose.  Thyroid hormone needs to be taken for a long time. Generally, thyroid hormone levels need to be rechecked every 2 weeks when you start taking it, but if the hormone levels have stabilized, then thyroid hormone levels can be rechecked at intervals of 6 months or a year.  Long-term growth hormone supplementation is also necessary for patients who are financially able to do so. In children, growth hormone can help children increase in height. In adults, growth hormone supplementation is advocated because it can help patients maintain a normal body shape, reduce the fat content of the body, and enhance and improve the patient’s mood.  After giving these hormones, it is also necessary to adjust the dosage of hormones according to the patient’s weight change, self-perception, and blood sugar and blood pressure changes, and finally reach the ideal dosage. It should be noted that: 1. Long-term adherence to the medication will enable you to obtain an almost normal life. Rashly stopping the medication may lead to a life-threatening condition.  2.Be sure to use the medication under the guidance of an experienced physician and learn the knowledge of medication use. It is more beneficial to treat the disease if you can learn about it by yourself.  Androgen replacement therapy is usually performed after supplementation of other hormones. It can promote youthful development in adolescent males, maintain erectile function in adult males, increase lean body mass, and reduce the occurrence of diabetes and obesity. Therefore, for adult males, if there are no contraindications, all should be supplemented with physiological doses of androgens to ensure the daily needs of the organism.