Specialized treatment for pituitary disorders by Endorinologist - Dr Kalyan

Pituitary Disorders

The pituitary gland is the master controller of most of the vital hormones required for our general well being. It is located in the lower part of the brain, behind the temple of the forehead.  Through various hormones secreted into the blood, it controls the thyroid gland, the adrenal gland, and the testes/ovaries in men and women respectively. It  secretes vital hormones like growth hormone responsible for vertical growth of the body until the age 14-18. It also secretes Prolactin which is responsible for milk production in breastfeeding mothers. Antiduretic hormone is crucial in maintaining water balance in the body.

These disorders of the pituitary gland  can affect the above mentioned hormone axes in the body leading to illness. The various symptoms that a patient with pituitary problems include one or more of the following :

• Generalised chronic weakness, fatigue, lethargy

• Increased sleepiness

• Low mood and desire

• Early/delayed puberty in adolescents

• Growth failure in children

• Decreased sexual drive

• Aches and pains all over

• Puffiness of face and body, and weight gain

• Inability to conceive

• Passing excess amount of urine

The various problems that can affect the pituitary gland are:

• Pituitary tumours 

These are slow growing generally benign overgrowths of the pituitary tissue, which can either produce excess of a certain hormone and/or deficiency of other pituitary hormones

• Acromegaly is caused by growth hormone excess in adults 

• Cushing’s syndrome is caused by excess ACTH hormone which stimulates the adrenal gland to produce excess steroids. This leads to many pathological features in the body as summarised in the picture- see adrenal disorders

• Prolactinoma is an excess of prolactin hormone which causes unwarranted milk secretion from the breast and infertility issues

• Diabetes insipidus (DI) is a condition where a huge amount of water is lost from the kidneys without reabsorption due to the lack of a hormone called ADH. DI is usually caused by tumours in the brain which invade the pituitary gland.

• Hypopituitarism
  This means that one or more of the functions of the pituitary gland is impaired. It can be because of a 

• Pituitary tumour as described above

• Pituitary infarction, where previous pituitary tumour which dissolved by itself along with the normal pituitary.

• Pituitary haemorrhage: A bleed into the gland destroying its function

• Previous pituitary surgery or radiation

• Idiopathic cause, where no cause can be found

These disorders are identified by endocrine function testing which generally involves a series of blood tests. An MRI scan of the pituitary gland is also essential. The pituitary gland tumours are treated with surgery or radiation, but ONLY after a thorough endocrine preoperative and postoperative evaluation. Prolactinomas can generally be treated by medicine alone. If one or more of the pituitary hormones are deficient, then it is very important for the patient to take the prescribed medicine for life, and to follow up regularly with the endocrinologist.