Endocrine
Therapy for Hormone Deficiency
Any survivor who is at risk for thyroid or pituitary dysfunction as an adult should see an endocrinologist for detailed assessment.
Replacement therapy is generally effective
Thyroid replacement therapy is easy to take and does not have any major adverse side effects.
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This is a slow growing, inactive tumor (papillary carcinoma of the thyroid) and treated by initial thyroidectomy (removal of the thyroid and sampling of the adjacent lymph nodes).
Children who have GH deficiency and who are given GH replacement therapy will achieve a height within normal range (if treated prior to puberty). In British Columbia it is recognized that this is essential therapy and GH therapy is covered by the Medical Services Plan.
Adults who have GH deficiency are not covered by this plan. GH deficiency in adults is associated with low bone density, reduced lean muscle mass and lack of energy. This treatment is not covered by the BC Medical Services Plan.
Therapy is very expensive. Since 1985, recombinant human growth hormone has been produced by genetically engineered bacteria using recombinant DNA technology.
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Gonadotrophin deficiency (FSH and LH deficiency)
This is treated with sex hormone replacement therapy:
- Testosterone replacement therapy can be given to men
- Estrogen and progesterone therapy for women
Replacement therapy can ensure that children go into puberty and can restore normal reproductive function in adults.
Adrenocorticotropic hormone deficiency (ACTH deficiency)
The symptoms of ACTH deficiency can be very non-specific with general malaise and weight loss.
Treatment is with regular cortisone supplements.
It is important that patients with this condition wear a medic alert bracelet.
ACTH deficiency may cause death in the setting of severe infection, trauma or illness if it is unrecognized by medical staff. In these circumstances, patients need increased doses of steroids.
