Clara, 34, visits her doctor because of persistent fatigue, recurrent headaches, and unexplained weight changes. After several tests, the doctor suspects a possible disorder involving a small gland that is still largely unknown to the general public: the pituitary gland. Its dysfunctions, often subtle at first, can nevertheless have significant consequences throughout the body.
But what exactly is the role of the pituitary gland? How do its dysfunctions manifest, and how are they identified?
Here I am — Dr. Joy, hello!
In this article, I will review these disorders and the symptoms that should raise concern
I – The crucial role of the pituitary gland
The pituitary gland, sometimes referred to as the “master gland”, is a pea-sized organ located at the base of the brain, just beneath the hypothalamus. Despite its small size, it plays a fundamental role in regulating hormones throughout the body.
Indeed, the pituitary produces several hormones that influence:
- Growth, body composition and bone health (growth hormone, GH)
- Thyroid funcion (thyroid-stimulating hormone, TSH)
- Adrenal gland function (adrenocorticotropic hormone, ACTH)
- Reproduction and gonadal function (follicle-stimulating hormone, FSH, and luteinizing hormone, LH)
- Milk production and menstrual irregularities (prolactin)
- Water and sodium balance (antidiuretic hormone, ADH)
II – Types of pituitary disorders
Pituitary dysfunctions may cause either excessive or insufficient hormone production; in most cases, pituitary disorders do not present with neither hormonal deficiency or hypersecretion (non-functioning tumors). Pituitary lesions can be benign (most frequently) or malignant.
Common examples include prolactinomas, characterized by excess prolactin; acromegaly, caused by overproduction of growth hormone (GH); and Cushing’s disease, associated with excess ACTH. Prolactinomas are the most common ones, occurring most frequenty in women of reproductive age.
Hypopituitarism refers to a deficiency in one or more pituitary hormones and can lead to fatigue, weight loss, menstrual irregularities, or decreased libido. Diabetes insipidus results from a deficiency in antidiuretic hormone (ADH), causing excessive thirst and urination. Macroadenomas (pituitary adenomas with more than 1 cm) can causa headaches and visual defects.
III – Possible causes
Pituitary disorders can arise from multiple causes. They may be due to benign or malignant tumors, head trauma, or surgical interventions or radiotherapy. Most recently, the use immunotherapy in oncology patients can cause hypophysits which is an inflammation of the pituitaty gland. In some cases, pituitary disorders y can also be linked to genetic disorders or inflammatory conditions affecting the gland (like sarcoidosis and histiocytosis).
IV – Symptoms and detection
Most pituitary disorders remain asymptomatic and are usually discovered incidentally during brain imaging (CT scan or MRI) ou, rarely, in routine blood tests.
Common signs of hormone excess include:
- abnormal growth of the hands, feet, or facial features (acromegaly)
- menstrual irregularities or infertility
- fatigue and mood changes
- unexplained weight gain or loss
- galactorrhea (inappropriate production and secretion of milk or milk-like fluid from the breast, unrelated to pregnancy).
Common signs of hormone deficiency include:
- chronic fatigue and loss of strength
- muscle weakness and hair loss
- low blood pressure, hypoglycemia, nausea or lack of apetite
- decreased libido or sexual dysfunction
- polyuria and polydipsia (caused by ADH deficiency)
V – Diagnosis and treatment
Incidental pituitary findings are often discovered during brain imaging (CT or MRI) done for unrelated reasons, such as headaches, trauma, or neurological symptoms. In most cases, blood tests to measure hormone levels are necessary, as well as specificy MRI of the sellar region to better visualize the pituitary gland. Additional tests may be performed depending on the hormones involved and the symptoms observed.
Treatment depends on the underlying condition. In some cases, surgery is required to remove a tumor. Medications can be prescribed to regulate hormone production, while hormone replacement therapy is used in the case of hormone deficiencies. In many cases, surveillance with blood tests and MRI is sufficient.
Early detection and specialized follow-up often help reduce complications and improve patients’ quality of life.
⚠️ If you experience symptoms suggestive of a pituitary disorder, if your tests show a hormonal imbalance or if a pituitary lesion is detected incidentally on brain imaging, consult a healthcare professional. For an accurate diagnosis and personalized care, you can schedule an appointment directly at Alegria Medical Centre with our endocrinologist, Dr. Sara Pinheiro.
Beijinhos !
Dr Joy
This information is not a substitute for medical advice.
You must seek the advice of your doctor or another qualified health professional with any questions you may have regarding your health condition.
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