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Pituitary Gland Disorders

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What Are Pituitary Disorders?

Your pituitary is a small gland at the base of your brain. Pituitary disorders develop because of problems with your pituitary gland. A growth (tumor) in or near the pituitary often causes these problems. Sometimes, pituitary problems are genetic. Usually, people with genetic pituitary disorders get a diagnosis during childhood.

What Does the Pituitary Gland Do?

Your pituitary gland produces hormones that send signals to other glands in your body. It’s sometimes called the master gland because it controls the function of many other glands.

Types of Pituitary Disorders

There are three main types of pituitary gland disorders:

The symptoms of pituitary disorders vary significantly depending on the condition.

Pituitary Tumors

Most pituitary tumors are benign, meaning noncancerous. However, they can cause symptoms that disrupt your daily life:

  • Double vision

  • Headaches

  • Problems with eye movements

  • Vision changes, especially affecting your peripheral (side) vision

These symptoms happen because the tumor presses on the structures nearby the pituitary gland including the nerves that control eyes and report vision to your brain. Some pituitary tumors also make hormones, which disrupt your hormone balance. The result can be problems related to high hormone levels.

Disorders of Pituitary Hormone Over-Production

You can develop problems if a pituitary tumor produces high amounts of certain hormones.

Acromegaly 

Acromegaly means you have high levels of growth hormones. Acromegaly can cause several symptoms:     

  • Carpal tunnel syndrome

  • Changes in facial features, such as a bigger jaw, wideset teeth, or prominent brows

  • Colon polyps and colon cancer

  • Frequent sweating

  • Insulin resistance, meaning your body doesn’t respond as it should to insulin, a hormone that controls blood sugar

  • Irregular bone growth, causing you to unexpectedly outgrow items such as clothing, shoes, or rings

  • Irregular skin growth, causing thick skin and skin tags

  • Sleep apnea

  • Type 2 diabetes

Cushing’s Disease 

Cushing's disease means you have high steroid (cortisol) levels. It happens when you overproduce a hormone called adrenocorticotropic hormone (ACTH). This condition can lead to several symptoms:

  • Abdominal stretch marks

  • Blood clots

  • Fatigue, easy bruising, and frequent infections

  • High blood pressure

  • Insulin resistance

  • Muscle weakness

  • Mood changes, including anxiety and depression

  • Weight gain and obesity

High Prolactin 

High prolactin may occur when you have a pituitary tumor that produces prolactin. Prolactin is the hormone that makes milk in females. It doesn’t have an established role in males, although males produce the hormone as well. Excess prolactin can affect men and women differently: 

  • Irregular periods, absence of periods, infertility, and milk leaking from nipples in women

  • Erectile dysfunction and low sex drive in men

  • Bone loss and increased risk of bone fractures in all sexes 

Overactive Thyroid 

An overactive thyroid can develop when you have a tumor that produces too much thyroid-stimulating (TSH). TSH is a pituitary hormone that controls your thyroid. Your thyroid is a gland that’s responsible for many functions, including metabolism. High thyroid hormone levels lead to symptoms of hyperthyroidism:

Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)

SIADH occurs when you have low sodium levels. It develops because you have too much antidiuretic hormone (ADH). This hormone controls your body’s salt and fluid balance. SIADH causes you to produce tiny amounts of dark yellow, burnt orange, or brown urine.

Disorders of Pituitary Hormone Under-Production

You can also develop symptoms if you have low levels of certain hormones.

Adrenal Insufficiency

Adrenal insufficiency can develop when you have low steroid levels. It usually happens when a tumor presses on your pituitary gland and interferes with ACTH hormone production. You may experience several symptoms:

  • Fatigue

  • Lightheadedness, dizziness, or fainting

  • Low blood pressure

  • Nausea and vomiting

  • Weight loss

Arginine Vasopressin Deficiency

Previously called diabetes insipidus,  arginine vasopressin deficiency means you have high sodium (salt) levels. High sodium develops when you don’t have enough ADH. Arginine vasopressin deficiency can lead to a variety of symptoms:

  • Feeling uncontrollable urges to urinate

  • Getting up at night to urinate

  • Producing a lot of very pale urine

  • Urinating frequently

  • Urinating a large volume

Growth Hormone Deficiency

A growth hormone deficiency means you have low growth hormones. This condition can cause a variety of symptoms:

  • Decreased muscle mass

  • Fatigue

  • Low bone density, which increases your risk of fractures

  • Muscle weakness

Low Luteinizing Hormone (LH) and Follicle-stimulating Hormone (FSH) Deficiency

LH and FSH deficiency may develop because a tumor presses on your pituitary gland. It can also develop because a tumor produces too much prolactin. Symptoms of low LH and FSH are similar to symptoms of high prolactin:

  • Irregular periods, absence of periods, infertility, and milk leaking from nipples in women

  • Erectile dysfunction and low sex drive in men

  • Bone loss and increased risk of bone fractures in all sexes 

Underactive Thyroid 

An underactive thyroid can develop when your pituitary gland doesn’t produce enough TSH. You typically have symptoms of hypothyroidism:

  • Cold intolerance

  • Constipation

  • Low energy

  • Skin and hair changes

  • Slow metabolism

  • Weight gain

Find a Pituitary Disorder Specialist

Causes of Pituitary Disorders

Most people who develop a pituitary disorder in adulthood have it because of another problem:

  • A growth (tumor) in or near their pituitary gland

  • A significant head injury

  • Complications of surgery near their pituitary gland

  • History of radiation treatment

Some people have genetic pituitary disorders. They were born with a condition that affects their pituitary function. Usually, people with genetic pituitary disorders get diagnosed in childhood.

Rarely, some people have pituitary problems for no known reason. These are called idiopathic pituitary disorders.

How Are Pituitary Disorders Diagnosed?

An endocrinologist is a provider who specializes in hormone conditions. A neurosurgeon is a doctor who specializes in surgery in the brain, including the pituitary. A neurosurgeon often works with an ear, nose, and throat (ENT) surgeon to perform pituitary surgery through the nose. These experts work together to provide team-based care for pituitary disorders.

Your team will evaluate you for a pituitary disorder. They typically use several tests:

  • Blood tests—We take a blood sample to assess your hormone levels. You typically fast overnight and get a blood draw in the morning. This test shows a broad picture of your pituitary function.

  • Dynamic blood tests—You get another blood test after taking a medication. You may take the medicine at home, in the clinic, or at an infusion center. Dynamic tests provide more detailed evaluations of specific hormones.

  • Imaging tests—You may get imaging scans if you have signs of a pituitary tumor. We usually order an MRI, a test that uses magnets and radio waves to take pictures of the inside of your body. You get an injection of a contrast dye, then lay in an MRI machine while we take the images. The contrast dye causes certain tissues to show up more clearly on the MRI.

Pituitary Disorder Treatment

Pituitary disorder treatment varies based on the specific condition and symptoms you have. Pituitary tumor treatment may include:

  • ³§³Ü°ù²µ±ð°ù²â—You may need surgery to remove a pituitary tumor. Our surgeons often use endoscopic approaches, where we operate through your nose. This technique allows us to avoid opening your skull to access the pituitary gland.

  • ²Ñ±ð»å¾±³¦²¹³Ù¾±´Ç²Ô²õ—You may take pills at home or get medication injections at the clinic. Usually, the goal is to relieve or eliminate your symptoms. For some tumors, you may take medications. Some medications can also shrink pituitary tumors.

  • Radiation therapy and radiosurgery—Radiation therapy may treat cancerous or noncancerous pituitary tumors. A radiation therapist delivers precise, high doses of radiation to a pituitary tumor. The goal of radiation treatment is to shrink and destroy tumor tissue.

Your endocrinologist may recommend hormone therapy to treat disorders affecting pituitary hormones: You take medicines to replace certain hormones. Hormone therapy is common for people who have more than one type of pituitary problem, which is known as panhypopituitarism.

Usually, treatment for pituitary disorders is very effective. With the right treatment, many people experience long periods of no symptoms (remission).

Why Choose Ï㽶ÊÓƵ of Utah Health?

At U of U Health, you have access to a team of experts. Our multidisciplinary approach means you see an endocrinologist and skull base neurosurgeon in the same appointment. We work together to get you the right treatment plan in the most efficient manner. Our skull base surgeons perform high volumes of pituitary surgeries, which leads to low complication rates and better outcomes.

Our nursing team works hard to answer all your questions and coordinate your care. We treat many patients who travel long distances and ensure the right specialists review your test results before your visit. Our goal is to deliver coordinated, advanced, effective care with compassion.

Schedule an Appointment

Call 801-581-7761 to request an appointment with endocrinology.

Please fill out our online referral form or fax 801-585-6087 to refer a patient to our pituitary care team.