Pituitary dysfunction and Pituitary adenoma
What does the pituitary gland do?
The Pituitary gland is located in the brain and is often considered the ‘master gland’ because it secretes many hormones that regulate the release of hormones from the other glands. It releases growth hormone and other hormones which regulate the function of the thyroid gland, adrenal gland, testes and ovaries.
The hypothalamus is located above the pituitary gland and regulates the release of hormones from the pituitary gland. It is responsible for body temperature, appetite, sleep-wake cycles and moods.
What are the most common pituitary gland disorders?
There are multiple commonly occuring pituitary gland disorders. Alongisde Cushing’s syndrome, other pituitary gland disorders are as follows:
- prolactinoma
- acromegaly
- pituitary apoplexy
- craniopharyngioma
- growth hormone deficiency
- rathke’s cleft cyst
- prolactinoma
- empty sella syndrome
- diabetes insipidus
- sheehan’s syndrome
Causes of adrenal insufficiency can be classified as primary, secondary, or from chronic cortisol exposure. Primary adrenal insufficiency is also called addison’s disease and occurs when the adrenal gland fails to produce enough cortisol or aldosterone. This can be due to infection, bleeding into the adrenal glands, tumours or an autoimmune disease.
Secondary or central adrenal insufficiency occurs when the pituitary gland fails produce ACTH to signal the adrenal gland to produce enough cortisol leading to inadequate cortisol levels. This can be due to pituitary surgery, infection or pituitary tumours.
Regular and prolonged exposure to high levels of cortisol such as taking steroid medications for cancer, autoimmune disease or severe asthma can result in the adrenal glands being suppressed and therefore fails to produce enough of the body’s own cortisol hormone. Adrenal insufficiency can also be due to removal of the adrenal glands by surgery due to cancers such as neuroblastomas.
What are the signs to recognise for pituitary gland disorders?
Signs and symptoms of a pituitary gland disorder often dependo n the specific disorder and hormone that is affected. However, there are some frequently occuring signs and symptoms which include:
- diabetes
- hair loss
- anxiety
- depression
- irregular periods
- low energy
- low sex drive
- stunted growth
- unexplained weight gain
- changes in vision
How are pituitary gland disorders diagnosed?
There are numerous tests which can be carried out in order to diagnose pituitary gland disorders. These include:
Hormone tests
There are multiple hormone tests which can confirm a diagnosis of a pituitary gland disorer including blood, urine or saliva tests.
Dynamic tests
Dynamic tests may increase or suppress the productionoof certain hormones in order to test how the body responds to this. Dynamic tests include:
- A glucose suppression test – if glucose levels do not fall, his signifies that the body is producing too mucho f the hormone.
- Growth hormone stimulation tests – if the hormone levels do not rise to the expected levels, this is an indicator of a growth hormone deficiency.
- Dexamethasone suppression tests – if hormone levels remain high following the test, this is an indicator of Cushing’s disease.
Imaging
Scans such as MRIs can be used in order to diagnose pituitary tumors. There are various MRI scans which can be used including rapid dynamic gadolinium-enhanced pituitary imaging, intraoperative MRI and open MRI.
Neuropathological tests
Some neuropathological tests performed in order to diagnose pituitary gland disorders include molecular pathology, cytogenetics and ultrastructural analysis.
How are pituitary gland disorders treated?
Pituitary gland disorders can be treated through hormone replacement therapy and medication. In some cases, surgery or radiation therapy is required to treat these conditions.