The pituitary gland, is considered the “master gland”, which controls multiple endocrine glands in the body. Is is a very important part of the endocrine system. Pituitary disorders are complex conditions, and it is important for their evaluation and management to be done by an experienced endocrinologist.
See below for some information about the pituitary gland and pituitary disorders:
The pituitary gland is located in the skull base, behind the eyes, under the optic chiasm, inside an area called the sella turcica. It is connected to the brain via the pituitary stalk. Its function is regulated by the hypothalamus inside the brain. It also has feedback mechanisms to respond to hormones produced by multiple peripheral glands. All these mechanisms help achieve tight regulation of hormonal balance in the body, when there is appropriate function of the endocrine system.
The pituitary gland has 2 parts (lobes).
The anterior lobe, or adenohypophysis, produces multiple hormones, including:
TSH (Thyroid Stimulating Hormone), regulating the thyroid.
ACTH (Adrenocorticotropic Hormone), regulating the adrenal cortex/cortisol.
GH (Growth Hormone).
LH (Luteinizing Hormone) and FSH (Follicle-stimulating Hormone), regulating the gonadal function (ovaries, testicles).
Prolactin, regulating breast milk production in breastfeeding women.
The posterior lobe, or neurohypophysis, produces other hormones, including:
ADH (Antidiuretic hormone), regulating water and sodium balance.
Oxytocin, regulating uterine contractions during childbirth, assisting in lactation after childbirth, while having additional functions as well.
Pituitary disorders can include the following:
Pituitary adenomas. These are tumors of the pituitary gland, which are almost always benign. They can cause problems if they overproduce pituitary hormones (each hormone overproduction can cause specific syndromes, eg. Cushing’s disease, acromegaly, etc.), or if they are large enough to cause compressive symptoms, such as vision loss or headaches. Some pituitary adenomas are treated with medication (eg. many prolactinomas), surgery (if there is a surgical indication), radiation, observation (if there is no indication for medication or surgery), or a combination of these treatment modalities.
Hypopituitarism. This is seen when there are pituitary hormone deficiencies. There are a lot of conditions that can cause hypopituitarism. Treatment is tailored based on the specific clinical scenario, depending on multiple factors, such as the underlying cause, the specific pituitary hormone deficiencies, etc.
Sheehan Syndrome.
Hypophysitis.
Infiltrative pituitary disorders.
Tumors adjacent to or near the pituitary gland that directly affect it (eg. craniopharyngioma, lymphoma, meningioma, hypothalamic tumors or disorders, metastases to the pituitary from other distant tumors, etc.).
Other pituitary or hypothalamic disorders.
Symptoms of pituitary disorders can be highly variable, and are dependent on the specific pituitary disease and/or underlying condition.
Care for pituitary disorders many times requires a multidisciplinary team, which may include an Endocrinologist, Neurosurgeon, Ophthalmologist, or sometimes additional specialists such as Radiation Oncologist, etc.
