PITUITARY DISORDERS

Weighing less than one gram and situated below the brain in the skull base is your master gland “the pituitary gland”. The gland secretes hormones for controlling various functions of the body and also regulates many other glands such as adrenal, thyroid and reproductive.

The pituitary gland produces various hormones including:

1. Growth Hormone: It regulates body and brain development, bone maturation, metabolism and is important for healthy muscles.
2. Luteinizing Hormone and Follicle Stimulating Hormone: These hormones control the production of estrogen and testosterone as well as maturation and release of sperm and egg.
3. Prolactin: It stimulates secretion of breast milk.
4. Thyroid Stimulating Hormone: It stimulates the thyroid gland to release thyroid hormones.
5. Adrenocorticotropic Hormone: It triggers the adrenal glands (situated above the kidneys) to release the hormone cortisol which in turn, regulates carbohydrate, fat, and protein metabolism and is important in the stress response.
6. Vasopressin (anti-diuretic hormone): It promotes water to be reabsorbed by the kidneys and maintains balance of water and electrolyte in the body.

The cells of the pituitary gland may divide uncontrollably and form benign tumor (non-cancerous growth). The gland will then produce too much of hormone. Other tumors of the pituitary gland can become large and cause compression of the gland leading to decreased or no hormone production. Damage to the pituitary gland can also be due to various other conditions including:

1. Radiation
2. Surgery
3. Infections such meningitis

Hormones released by the pituitary gland have broad range of effects on growth and development, sexuality and reproductive function, metabolism, response to stress and quality of life. The health problems that may arise due to a dysfunctional pituitary gland are as follows:

1. In acromegaly, Cushing disease, the pituitary gland produces too much of one or more hormone.
2. In adult-onset growth hormone deficiency, diabetes insipidus, the pituitary gland produces less amount of one or more hormones.

The effect of an underactive pituitary gland depends on which hormones the pituitary gland is not producing. For example, if the gland does not produce enough growth hormone in a child, they may have a permanent short stature, if it does not produce enough follicle stimulating hormone or luteinizing hormone, it might cause problems with sexual function, menstruation and fertility.

Blood tests and urine tests are the primary tests used to know the hormone levels in the body, if a pituitary tumor is suspected from the results of tests, then it is confirmed by imaging tests such as MRI (magnetic resonance imaging) or CT (computerized tomography) scan, to examine the pituitary gland and the surrounding parts of the brain.

The pituitary tumors are benign glandular tumors called pituitary adenomas. They grow very slowly and sometimes they grow into the bony walls of sell a turcica (bony depression which contains pituitary gland) and nearby tissues, like blood vessels, nerves and sinuses leading to problems like vision changes or headaches. Rarely, the large tumor spreads to other parts of the body.

Diabetes insipidus is a rare disease that develops when damage to the pituitary gland disrupts the normal production of hormone vasopressin, which helps control the volume of water in the body. As a result, kidneys remove too much fluid from the body in the form of increased urine. In severe cases, a person may pass up to 30 liters of urine per day. Diabetes insipidus may cause dehydration and eventually coma due to loss of electrolytes in urine.