Question

Excessive blood loss during child birth can result in an inadequate amount of blood volume in mothers body. With decreased blood volume and pressure, the heart becomes incapable of pumping necessary amount of blood to all the tissues resulting in damage to the brain specifically the pituatary gland. Sheehan's syndrome occurs in wome when the pituatry gland reduces the amount of hormones it secrets after child birth.

Sheehan's syndrome is initially suspected when a mother is unable to produce milk after having undergone a difficult child birth resulting in shock from blood loss. Since difficulty with lactation is not an uncommon occurence, many individuals affected are not diagnosed.

Maria resting gave child birth and is having difficulty with lactation, furthermore she is experiencing weight gain and hair loss. She is also complaining about constant faitgure and needing to wear additional layers to keep warm.

1) Which hormone secreted from the pituatry gland is responsible for wright gain, hair loss, and fatigue? Describe the hormone feed back loop for this individual.
2) Upon hearing about Marias symptoms, her doctor ordered blood tests to determine her blood glucose and sodium levels. Identify the hormons and the gland involved in regulating blood glucose and sodium. Would the expected blood glucose and sodium levels be high or low if Marina is affected by Sheehans syndrom

Answer 1

1. Pituitary galnd produces number of hormones of which stimulate the functioning of other endocrine glands in the body. TSH is one such hormone produced by pituitary which will stimulate the thyroid gland to releases its hormone "thyroxine" in to blood. In this case due to lack of secretion of the TSH by pituitary, there is little thyroxine in the blood causing hypothyroidism. Since thyroxine controls the metabolic rate of the body, it effects all the cells that are dividing and also effects the energy levels and causes lethargy and weight gain. THe person is also feeling cold because , low thyroxine levels will lower the metabolsim ,leading to less heat production in the body.

TSH produced by pituitary activates thyroid gland to release thyroxin. The levels of thyroxin will in blood and the increased levels of thyroxine will be inhibitory to pituitary and it stops producing TSH till the levels of thyroxine become low. The cycle repeats to maintain the thyroxine levels in blood under normal conditions. This is the feed back loop of the thyroid hormone.

But in this case, pituitary is not producing TSH, so the symptoms of hypothyroidism are observed.

The gland involved is thyroid gland.

2. Pituitary produces another hormone called ACTH which controls the hormones such as cortisol and aldosterones produced by adrenal cortex. Cortisol controls blood glucose levels under stressed conditions by gluconeogenesis and aldosterone controls Na levels by reabsorbing Na from nephrons under normal conditions. So when ACTH is not produced by pituitary, blood glucose levels will be very low and blod Na levels also will be low.

Here adrenal gland is involved.