Pituitary Conditions

The pituitary gland is an endocrine gland that is located in the brain. It is a pea-sized gland and is also known as the master gland because it produces hormones that affect the growth and functioning of the other glands. The thyroid gland, ovaries, testicles, and adrenal gland are some of the glands that are controlled by the pituitary gland.

With pituitary disorders, the pituitary gland is either too active or not active enough. Pituitary disorders can be caused by injuries too but the pituitary tumor is the most common reason. It can cause many symptoms that can be difficult to diagnose. Some traits are:

  • One or more hormones may be raised or lowered by the pituitary gland.
  • With hormonal imbalance, there are physical and mood changes. Pituitary disorders also develop slowly and it may be late until you notice symptoms.

As the symptoms of pituitary disorders are similar to those of other diseases, it is sometimes misdiagnosed or go undiagnosed. And, misdiagnosis is considered to be one of the main problems. It is a rare condition and it is estimated that in the UK around 70,000 people are diagnosed with this.

Symptoms of pituitary disorder

  • Anxiety or depression
  • Diabetes
  • Hair loss
  • High blood pressure
  • Irregular menstrual periods
  • Unexplained weight gain
  • Vision changes

Some of the common pituitary conditions are

  • Acromegaly
  • Adult Growth Hormone Deficiency
  • Craniopharyngioma
  • Cushing's Disease
  • Diabetes Insipidus

Some of the rare conditions are

  • Empty Sella Syndrome
  • Kallmann's Syndrome
  • Rathke's Cleft Cysts

Causes of pituitary disorder

One of the most common causes of pituitary disorder is a noncancerous pituitary tumor. Acromegaly is a disorder that is caused when the body produces too much or too little of a hormone due to a tumor.

Other reasons of the pituitary disorder can be:

  • Injury in the head
  • Cancer treatments and medications
  • Wolfram Syndrome
  • Bleeding in or near the pituitary gland

Types of pituitary disorder

Pituitary disorders are of two types:

Secretory tumors: They are also known as functioning adenomas because they don’t affect the production of hormones. Hypersecretion is a condition when a person produces hormones in excess. Hyposecretion is a condition when a person does not have enough hormones.

Non-secretory tumors: They are also called non-functioning adenomas they do not have any impact on the production of the hormone. Though they do not have any impact but if they grow large, then they can create pressure on the pituitary gland and parts of the brain leading to vision problems and headaches.

Diagnosis

Usually, hormone blood tests and brain scans are done to diagnose pituitary disorders. A hormone blood test takes hormones randomly but other tests may require special testing with a substance that evokes either release or prevent release in some conditions. To check pituitary abnormalities like pituitary adenoma or cysts, an MRI scan is preferred.

Other tests can be Brain imaging, urine test, and vision testing.

Treatment

Most pituitary tumors do not require any treatment and it completely depends on the type of the tumor, size, and how much it has grown. Age and other health factors also matter.

Some methods are:

Surgery –

It is done when the tumor is creating pressure on the optic nerve or it is over-producing hormones. Surgical techniques are of two types:

  • Endoscopic transnasal transsphenoidal approach
  • Transcranial approach (craniotomy)

Radiation therapy –

It is used to destroy the tumor with the use of high-energy radiation sources. It can be performed without surgery or even after the surgery. It includes:

  • Stereotactic radiosurgery
  • External beam radiation
  • Intensity-modulated radiation therapy (IMRT)
  • Proton beam therapy

Medications –

Several medications can be used to reduce the size of the various tumors like:

  • Prolactin-secreting tumors (prolactinomas)
  • ACTH-producing tumors (Cushing syndrome)
  • Growth hormone-secreting tumors

Replacement of pituitary hormones –

Replacement hormones are needed to maintain normal hormone levels. Surgery or tumor may reduce hormone production and people with radiation treatment may also need replacement hormone.

Medication

To reduce the PTH production by the parathyroid gland, a medication called calcimimetics is advised. To treat primary HPT due to parathyroid cancer and secondary HPT due to dialysis, Cinacalcet is approved.

Dietary Supplements

People who have undergone surgery for parathyroid tissue removal and have a low level of calcium need to take calcium supplements throughout life. Vitamin D supplements are prescribed to people with primary HPT. Calcium is given endovenously to people who have prolonged muscle contractions and life-threatening attacks of low calcium levels.