Dr Prudwiraj Endocrinologist

17/08/2025

14/07/2025

Sheehan’s Syndrome: Symptoms, Diagnosis, and Management

Definition:
Sheehan’s syndrome is a rare condition caused by severe postpartum hemorrhage leading to pituitary infarction and hypopituitarism due to ischemic necrosis. It results in partial or complete pituitary hormone deficiency.

Symptoms:

Symptoms may develop acutely or insidiously, often years after delivery:

Early signs: Failure to lactate (lack of prolactin), fatigue, hypotension (ACTH deficiency).

Chronic symptoms:

ACTH deficiency: Weakness, hypoglycemia, weight loss, hyponatremia.

TSH deficiency: Fatigue, cold intolerance, bradycardia, dry skin.

LH/FSH deficiency: Amenorrhea, infertility, loss of pubic/axillary hair, decreased libido.

Growth hormone (GH) deficiency: Reduced muscle mass, dyslipidemia, poor quality of life.

ADH deficiency (rare): Diabetes insipidus (polyuria, polydipsia).

Diagnosis:

Clinical Suspicion: History of postpartum hemorrhage with subsequent pituitary dysfunction.

Hormonal Evaluation:

Low pituitary hormones:

ACTH → Low cortisol (confirmed by ACTH stimulation test).

TSH → Low free T4 with inappropriately normal/low TSH.

LH/FSH → Low estrogen (♀) or testosterone (♂).

Prolactin → Low levels (failure to lactate postpartum).

MRI Pituitary: May show empty sella or pituitary atrophy.

Management:

Hormone Replacement Therapy:

Glucocorticoids (Hydrocortisone or Prednisone): First-line for ACTH deficiency (stress-dose steroids may be needed in illness/surgery).

Levothyroxine: For TSH deficiency (start only after glucocorticoid replacement to avoid adrenal crisis).

Estrogen/Progesterone (♀) or Testosterone (♂): For LH/FSH deficiency.

GH Replacement (in select cases): For persistent fatigue or metabolic complications.

Monitoring: Regular assessment of hormone levels and symptom control.

Patient Education: Adherence to medications, sick-day rules for steroids.

Prognosis:

Lifelong hormone replacement is usually required.

Early diagnosis and treatment improve quality of life and prevent complications (e.g., adrenal crisis).

Sheehan’s syndrome

06/04/2025

29/03/2025

Happy Ugadi 💐🎉🎁

25/01/2025

Male Obesity-Related Secondary Hypogonadism: Understanding the Link and Management:

Male obesity-related secondary hypogonadism (MOSH) is a syndrome in which excessive body weight causes a drop in testosterone levels due to hormonal abnormalities. This illness is getting more widespread as the worldwide obesity rate rises. Understanding MOSH is critical for dealing with its health implications and managing its consequences.

Pathophysiology

MOSH pathophysiology is complex, involving multiple processes. Excess body fat raises levels of leptin and insulin, which can result in insulin resistance. This resistance inhibits the production of kisspeptin receptors, a neuropeptide that regulates gonadotropin secretion. Obesity also raises the activity of the aromatase enzyme, which converts testosterone to estrogen, hence increasing hypogonadism.

Clinical implications

MOSH causes symptoms of s*x hormone imbalance, including decreased libido, erectile dysfunction, exhaustion, and decreased muscle mass. It also carries a number of metabolic risk factors, such as type 2 diabetes, cardiovascular disease, and reduced fertility.

Management

The major strategy for controlling MOSH is weight loss. Lifestyle changes, such as a healthy diet and regular exercise, are necessary. In some circumstances, weight loss drugs or bariatric surgery may be recommended. Testosterone replacement medication can also help patients who do not respond well to lifestyle changes alone.

Endocrinologists are the best specialists at recognizing and treating hormonal abnormalities. They are the most knowledgeable on the endocrine system, which includes glands such as the thyroid, pancreas, and adrenal glands. These specialists use the most advanced technologies and procedures to assist patients in managing ailments such as diabetes, thyroid issues, and metabolic diseases. Their experience ensures that patients receive the best possible therapy for hormonal balance and overall health. If you are concerned about your hormones, an endocrinologist is the best medical specialist to visit.

Dr. Prudwiraj Sanamandra

20/12/2024

Symptoms of PCOS span from menstrual irregularities like prolonged cycles, to physical changes such as weight gain, acne, and excessive hair growth on the face and body. The condition can also manifest through thinning scalp hair and darkened skin patches. These symptoms often emerge due to elevated androgen levels. Some women may also experience infertility or depression. To Consult Dr. Prudwiraj Sanamandra, Endocrinologist and Diabetologist, Filmnagar, Jubilee Hills, Hyderabad, Visit: https://docprudwiraj.com/ Call: 7663000999

17/12/2024

It was another fantastic experience at IIM-Ahmedabad, this time attending the program on "Leadership and Delegation in Health Care". Thank you, Dr. Rajesh Chandwani and Prof. Chitra Singla, for your enlightening, thought-provoking, and perspective-changing presentations. It was great to engage with distinguished colleagues and faculty, which transformed my view on leadership. Both trips to IIM Ahmedabad left me RICH in memories.

IIM-AHMEDABAD