Hypopituitarism – The Missing Puzzle Pieces

There has been a lot of talk in the support groups about the hormones that our pituitary glands create that science and medicine have not studied for our condition yet.  Extensive studies have been done on replacement hormones for Adrenal, Thyroid, Sexual Function, Antidiuretic, Prolactin and Growth hormone,  but no tests with hypopituitarism patients in regards to Beta Endorphines, Oxytocin and Melanocyte Stimulating Hormones.  All of these come from the same gland. This of course surprises me as who else is better to do research and trials on but those of us with non functioning pituitary glands.

I ask you my readers to comment if any of you have any experience or knowledge of replacing these hormones that can be shared with other patients like myself.

Beta Endorphines

Endorphins are a natural body chemical produced in the central nervous system and anterior pituitary gland. They produce the feeling of happiness and are released during exercise, danger, pain, excitement, an orgasm, or even by eating spicy food. They also work as a natural pain-killer. The term endorphin is an amalgamation of endogenous and morphine, which suggests that it is a naturally produced morphine. In terms of pain, endorphins are released in order to prevent nerve cells from releasing more pain signals.  Endorphins are the primary regulators of the immune system, representing 90% of immune system hormonal control. Ninety percent of the day’s endorphins are produced by the pituitary and adrenal glands between 2 a.m. and 4 a.m.

A deficiency of endorphins causes depression, chronic unexplained pain, and a low tolerance for pain. In many instances, low endorphin levels are misdiagnosed as depressive disorders.. Also known as endorphin deficiency disorder (EDS), a deficiency of endorphins can be difficult for doctors to diagnose initially until testing shows the lack of endorphins. Many of the symptoms associated with EDS are similar to the symptoms that occur in depressive disorders, such as manic depression and bipolar disorder. Depression, chronic or intermittent, and general body aches are the two most common symptoms, and a person may also have a tendency to cry without a logical reason or feel pain more easily. EDS makes it difficult for people to be generally happy in their lives.

I have read of depression patients utilizing opiates to stimulate levels of beta endorphins and reducing depression and anxiety symptoms.  Unfortunately the medications I read about only increase the existing and are not a replacement in those that possibly don’t create endorphins anymore. I have not found any replacements for us in the works or studies being done at this time.

Oxytocin

Oxytocin is produced by the hypothalamus and stored and secreted by the posterior pituitary gland. Oxytocin creates intimacy, trust, and builds healthy relationships. It’s released by men and women during orgasm, and by mothers during childbirth and breastfeeding. Studies on Oxytocin have shown an increases fidelity; men in monogamous relationships who were given a boost of oxytocin interacted with single women at a greater physical distance then men who weren’t given any oxytocin. The cultivation of oxytocin is essential for creating strong bonds and improved social interactions.  In addition, low oxytocin has been linked to depressive symptoms and it has been proposed as a treatment for depressive disorders.

Scientific research has uncovered brain oxytocin’s specific ability to modulate social behavior, including effects on motherly care and aggression, bonding between couples, sexual behavior, social memory, and trust. Brain oxytocin also reduces stress responses, including anxiety – and these anxiolytic effects have been demonstrated in a number of species.

A new study has found that higher levels of the “cuddle” hormone oxytocin are linked to stronger social skills in both healthy children and in children with autism. The research is published in the journal Proceedings of the National Academy of Sciences.  It was previously believed that low levels of oxytocin were the cause of autism. The new study reveals that a deficiency in oxytocin does not cause the disorder but that the hormone’s ability to increase social skills may still help treat a subset of autistic children.  The researchers found that higher oxytocin levels were linked to better social functioning in all three study groups.

A study was published in the International Journal of Psychology in August of 2013 that provides the first evidence that Oxytocin increases people’s willingness to share their emotions. Importantly, Oxytocin did not make people more talkative (word counts were comparable across the two groups) but instead increased the willingness to share the specific component that is responsible for the calming and bonding effects of social sharing: emotions. The findings are all the more remarkable because they were obtained among men, who may be less inclined than women to express their emotions.

There have been no studies that I can find on Oxytocin deficiency in hypopituitarism patients.  There are few patients that I have talked with that have found doctors willing to prescribe it in either nasal spray or tablet form although none know for sure if there will be any long term effects.  So in essence, we as patients become guinea pigs in order to try to find solutions. A 24-hour urine test is required to capture a full day’s secretion.  This 24-hour perspective is critical because oxytocin secretion can be highly situational, triggered by social and sexual activities.  A 24-hour perspective therefore affords a more comprehensive oxytocin assessment compared to other methods that only measure an isolated snapshot in time.

Melanocyte Stimulating Hormone

Melanocyte-stimulating hormone also called intermedin or melanotropin is a collective name for a group of peptide hormones produced by the skin, pituitary gland and hypothalamus in response to ultraviolet radiation.  It plays a key role in producing colored pigmentation found in the skin, hair and eyes.  It does this by inducing specialized skin cells called melanocytes to produce a pigment called melanin; melanin protects cells from DNA damage which can lead to skin cancer (melanoma).

Although known for its stimulation effect on pigment cells, studies have shown that melanocyte-stimulating hormone can also suppress appetite by acting on receptors in the hypothalamus in the brain.  This effect is enhanced by leptin, a hormone released from fat cells.  Its is also thought to affect a range of other processes in the body; it has anti-inflammatory effects, can influence the release of the hormone aldosterone which controls salt and water balance in the body and is also thought to have an effect on energy homeostasis and sexual behavior.

A deficiency in melanocyte stimulating hormone results in a lack of skin pigmentation and subsequent loss of natural protection from UV rays of the sun.  In secondary adrenal insufficiency, damage to the pituitary gland prevents release of adrenocorticotropic hormone and melanocyte stimulating hormone and there is reduced pigmentation of the skin.  Melanocyte stimulating hormone deficiency can cause increased inflammation, pain, and sleeping problems as well as a reduction in the levels of antidiuertic hormone which causes thirst and frequent urination.   Melanocyte stimulating hormone deficiency may also result in increased food intake and obesity.  Apparently it also plays a critical role in the ability of our gut to function properly and is being studied as a treatment for celiac disease and bowel disease because of its anti inflammatory effects.

Synthetic versions of MSH have been developed for human use. Two of the better known are afamelanotide (melanotan-1), developed at the University of Arizona and is in testing by Clinuvel Pharmaceuticals in Australia.  Clinuvel has warned consumers against the use of what it terms are “counterfeit”, drugs sold as “melanotan I and II” that are promoted by citing research on afamelanotide.

In the US. Bremelanotide is being developed by Palatin Technologies in New Jersey.  The strange thing with Bremelanotide is it was also effective in treating sexual dysfunction in both men (erectile dysfunction) and women (sexual arousal disorder).  It is still in Phase studies and not available to patients yet.

Melanocyte Stimulating Hormone can be measured measured by direct radioimmunoassay. Reference Ranges:
Children: Up to  25 pg/ml
Adults: Up to 5.0 pg/ml

So there is a quick rundown on the three missing pieces to the Hypopituitarism puzzle as I know it at the moment.  As i mentioned earlier, if anyone has more information, is taking them or has been tested I would love to hear your comments.

And I am sorry I did not link or show references to the studies mentioned.  I am not a professional writer and have not figured out how to do that yet.  But if anyone wants them I am happy to share.