Panhypopituitarism is a rare condition in which the pituitary gland stops producing enough pituitary hormones. It can affect people of all ages, including children.

The pituitary gland is a tiny organ located in the center of the brain. It produces and secretes hormones that control growth, sexual development, metabolism, and the body’s response to stress.

Panhypopituitarism occurs when the production and release of the pituitary hormones are reduced or stopped. This could be due to an issue with the pituitary gland or the hypothalamus.

Pituitary hormones include:

Panhypopituitarism is rare. The Rare Genetics Institute reports research indicates the estimated incidence rate is 4.2 cases per 100,000 per year.

This article explores potential causes of panhypopituitarism, along with symptoms, diagnosis, treatment, and outlook.

What’s the difference between panhypopituitarism and hypopituitarism?

Panhypopituitarism is when the production and secretion of all pituitary growth hormones are reduced. Hypopituitarism is when the production and release of just some of the pituitary hormones are reduced.

The hypothalamus, located just above the pituitary gland, regulates hormone production and secretion from the pituitary gland. If hormone production is reduced, it could signal a problem with either the hypothalamus gland or the pituitary gland.

Potential issues with either of these glands that might cause panhypopituitarism include:

  • a tumor on or near the hypothalamus or pituitary gland
  • an underdeveloped or poorly formed pituitary gland
  • trauma or injury to either gland during the birth process
  • infection
  • an autoimmune reaction
  • pressure on either gland from a buildup of cerebrospinal fluid in the brain (hydrocephalus)
  • surgery on or near the hypothalamus or pituitary gland
  • radiation therapy

What are the potential complications of panhypopituitarism?

Complications of panhypopituitarism are associated with the decreased levels of pituitary hormones circulating in the body.

For example, a decrease in growth hormone may lead to short stature in children or frequent bone fractures in adults. A deficiency in thyroid-stimulating hormone (TSH) may lead to hypothyroidism.

People with panhypopituitarism are also known to have higher cardiovascular risks, such as for stroke or coronary artery disease.

Symptoms of panhypopituitarism can vary depending on which hormones are affected and to what degree the production of hormones is reduced. Symptoms can also vary according to one’s age.

Symptoms of panhypopituitarism in infants, children, and adolescents

Symptoms in infants, children, and adolescents include:

  • prolonged jaundice in infants
  • limited appetite
  • unexplained weight loss or weight gain
  • unusual slowing of growth
  • unusually dry skin
  • delayed puberty
  • excessive thirst and excessive need to pee
  • less frequent menstrual periods
  • low blood sugar (hypoglycemia)
  • sensitivity to cold
  • nausea or dizziness
  • fatigue or drowsiness
  • small penis in males

Symptoms of panhypopituitarism in adults

Symptoms of panhypopituitarism in adults include:

  • nausea
  • dizziness
  • fatigue
  • depression or anxiety
  • frequent infections
  • low blood sugar
  • sensitivity to cold
  • dry skin
  • unintended weight gain or weight loss
  • unusual cholesterol levels
  • quick heart rate (sinus tachycardia)
  • excessive thirst and need to pee
  • irregular menstruation
  • infertility in males and females

Symptoms of panhypopituitarism can often resemble other medical conditions. If you or your child are experiencing any of these symptoms, schedule a consultation with a doctor to discuss your concerns.

Bring with you to your doctor’s appointment a list of health concerns you are noticing and when you first noticed them.

A doctor will typically begin a visit by asking you a series of questions about your health, including symptoms you have noticed and how long you have had them. They’ll then perform a physical examination.

Diagnostic tests for infants and children

If a child’s medical visit is to determine and confirm a diagnosis, the doctor will assess their growth and weight gain. If panhypopituitarism is suspected, they may order the following diagnostic tests:

  • neurological exam to check mental status, reflexes, and muscle function
  • eye test to check for vision
  • blood and urine tests to check hormone levels
  • MRI or CT scans of the pituitary gland, brain, and spinal cord
  • X-ray of the left hand and wrist to determine “bone age,” a growth marker

Diagnostic tests for adults

For adults suspected of panhypopituitarism, diagnostic tests will also include imaging tests (brain MRI and brain CT), along with the following pituitary hormone tests:

  • blood tests to check TSH, prolactin, FSH, and LH levels, and potentially thyroxine, estrogen, and testosterone levels
  • ACTH stimulation test to measure how your adrenal glands respond to adrenocorticotropic hormone (the test involves an injection of synthetic adrenocorticotropic hormone and timed blood draws)
  • growth hormone stimulation test to measure your GH levels (the test involves an injection that stimulates your pituitary gland to release growth hormone; samples of your blood are then taken to measure how much GH is released)
  • insulin tolerance test can help diagnose GH and ACTH deficiencies

In children and adults, treatment for panhypopituitarism is determined by what’s causing the reduction in hormone production.

Common treatments for panhypopituitarism include:

  • Surgery: If a tumor in your brain, hypothalamus, or pituitary gland is causing panhypopituitarism, your doctor may recommend surgery to remove the tumor.
  • Radiation therapy: Your doctor may also recommend radiation therapy to shrink a brain tumor that may be affecting your hypothalamus or pituitary gland function.
  • Hormone replacement therapy: If your medical team cannot treat or reverse the underlying cause of your panhypopituitarism, they may prescribe hormone therapy to return the pituitary hormones to healthy levels.
    • Corticosteroids: Your doctor may also prescribe corticosteroids to replace the ACTH hormones that your body needs when it’s under stress.

In certain situations, treating the underlying causes, such as removing a tumor that may be pressing against the pituitary gland, can cure panhypopituitarism.

However, in most cases, the hormone deficiencies panhypopituitarism causes require long-term hormone treatments.

For most children with panhypopituitarism, hormone therapy is effective in restoring normal hormone levels.

The outlook for adults living with panhypopituitarism depends on factors such as:

  • their age when they received a diagnosis
  • how quickly they receive a diagnosis and begin treatment
  • the reduced levels of each pituitary hormone and how long they’ve been reduced

A 2025 Korean study found that adults with panhypopituitarism had higher risks of cardiovascular and cerebrovascular diseases as well as increased mortality compared to people without the condition. Researchers found these risks to be more prominent in women.

For this reason, continued hormone therapy and careful monitoring and treatment of associated risk factors — such as cardiovascular disease — are recommended in people living with panhypopituitarism.

Discuss with your doctor how often to test your hormone levels to ensure replacement therapy is working and how often you need to receive screenings for risk factors associated with panhypopituitarism.

Panhypopituitarism is a rare disease characterized by the pituitary gland’s inability to produce healthy amounts of pituitary hormones.

Pituitary hormones are critical to your health as they control your body’s growth, sexual development, metabolism, and response to stress.

Causes of panhypopituitarism include brain tumors that may compress the hypothalamus or pituitary gland, an underdeveloped or poorly formed pituitary gland, or injury to either gland.

If a brain tumor is the cause, surgery or radiation therapy can potentially cure panhypopituitarism.

Other causes may require long-term hormone therapy and monitoring for risk factors associated with panhypopituitarism, such as cardiovascular disease.