Pituitary Gland Disorders

What does the pituitary gland do?

It is a small organ situated at the bottom of the brain, the dimension of a pea, and considered the master gland of the body.  The main function of this gland is to produce various hormones to facilitate various functions in the body.  It is important for the pituitary gland to function appropriately for the smooth functioning of other parts of the body.

The gland is divided into two parts namely the anterior pituitary gland and the posterior pituitary gland.  This gland is connected to the hypothalamus of the brain which controls the activity of the gland.  The anterior portion is connected to the brain through few vessels whereas the posterior portion is actually a part of the brain that secretes various hormones into the bloodstream as directed by the brain.

Hormones of the pituitary gland

The following are the hormones secreted by the anterior pituitary gland:

Somatotropin

An important hormone responsible for regulating growth in children as well as maintain body composition in a healthy manner.  It helps in regulating muscle mass and bone mass in adults.  Contributes to the distribution of fat molecules throughout the body.

Prolactin

his hormone is responsible for various functions of the reproductive system.  It is involved in stimulating the breast after childbirth for the production of milk.  It is responsible for producing the sex hormones from the ovaries of women and testes of men.

Corticotropin

Regulates the adrenal glands to produce cortisol adequately.  Cortisol is essential for our survival since it is considered the stress hormone.  Cortisol regulates blood pressure as well as blood sugar in the body.

Thyroxine and triiodothyronine

Regulates thyroid gland to produce the essential thyroid hormones.  Thyroid hormones play an important role in managing the body’s metabolism, energy levels, as well as the activities of the nervous system.

Luteinizing hormone

This hormone is responsible for testosterone production and ovulation.

Gonadotropins

This hormone regulates sperm production and estrogen production in women.  Gonadotropins and luteinizing hormone work together to promote the normal functioning of the testes and ovaries.

Endorphins

These are hormones that are connected to the pleasure centers of the brain and provides pain relief.

Enkephalins

These hormones promote pain relief and are closely related to endorphins and provide a similar effect.

Beta-melanocyte-stimulating hormone

This hormone is responsible for increasing pigment levels when the skin is exposed to ultraviolet radiation.

Hormones stored in the posterior pituitary gland

Antidiuretic hormone

It is commonly known as vasopressin, which manages the water levels in the body.  It is responsible for keeping the body hydrated by limiting the loss of water in the form of urine.

Oxytocin

An important hormone that helps during pregnancy, which helps labor to progress.  After childbirth, it helps the milk to flow from the breasts for breastfeeding.

Disorders associated with the pituitary gland

Pituitary Tumors

Pituitary tumors are quite familiar in adults and are considered the most common type of pituitary disorder.  Tumors affecting the pituitary gland are not considered cancerous in the majority of the cases.  Pituitary tumors are classified as secretory tumors and nonsecretory tumors.  Secretory tumors lead to production of excess hormone from the pituitary gland.  On the other hand, nonsecretory tumors do not produce hormones.  Problems arise from the tumors when they grow bigger and may obstruct the normal functioning of the gland.  The problems caused by these tumors are divided into three main categories and include:

• Hypersecretion – Excess secretion of hormones triggered by a pituitary tumor.
• Hyposecretion – Hormone secretion is hindered due to the presence of a large pituitary tumor, which obstructs the gland to perform its functions. Radiation and surgery also can lead to hyposecretion.
• Tumor mass effects – This is a condition which occurs when a pituitary tumor becomes larger and creates problems for the gland as well as to the brain. Symptoms of headache, vision problems, and other related issues may arise due to the mass effect of the tumor.

Other pituitary conditions

Craniopharyngioma

This is considered a rare type of tumor affecting the pituitary gland.  Craniopharyngioma can cause pressure on the hypothalamus of the brain where the posterior portion of the gland is connected.  These tumors grow faster in children and slower in adults.  These tumors can cause headaches, vision problems, as well as affect thirst, hunger, and sleep patterns.  These tumors can affect the production of growth hormones as well as cause early onset of puberty.

Empty Sella Syndrome

This is a disorder affecting the bony structure that surrounds the pituitary gland called sella turcica.  Empty Sella syndrome is divided into two types namely primary and secondary.  During primary Empty Sella syndrome, the pituitary gland flattens and tends to become smaller due to an anatomical defect affecting the gland.  This condition is generally associated with people who are obese or have high blood pressure.

This does not affect the functioning of the gland and generally functions normally until being discovered when a brain MRI is done.  Secondary Empty Sella syndrome is caused due to the regression of pituitary gland within the cavity.  This condition may cause early onset puberty in children, deficiency in growth hormone, etc.  They may also cause problems with menstrual periods, infertility, and also cause fatigue.

Sheehan’s Syndrome

This syndrome generally affects women who experience severe uterine hemorrhage during childbirth.  This may cause severe blood loss causing tissue death in the pituitary gland and cause hypopituitarism.  Abnormalities of the placenta and multiple childbirth such as twins and triplets lead to hemorrhage in the uterine cavity.

Multiple Endocrine Neoplasia

This is an inherited syndrome which is passed down from the family.  When a person is affected by this syndrome, multiple glands in the endocrine system may develop growths and lead to increased production of hormones.  This can lead to various complications and can only be diagnosed when more than one gland is affected.

Lymphocytic Hypophysitis

This is another cause of hypopituitarism which is associated with childbirth.  It is considered to be highly rare and the reason behind this occurrence is yet to be found.

Hypopituitarism

A condition where the gland produces a little or insufficient amount of hormones.  This can affect the growth as well as the reproductive system.

Acromegaly

Increased amounts of growth hormones are produced during this condition.  This leads to excessive growth of the hands and feet.

Diabetes insipidus

Excess secretion of vasopressin hormone leads to this condition.  The main cause is due to head injury, surgery, or a tumor.  People with this condition experience frequent urination that is heavily diluted.  It can also lead to an increased amount of thirst.

Cushing’s disease

The noncancerous adenoma formed on the pituitary gland releases increased adrenocorticotropic hormone.  This leads to easy bruising weight gain, high blood pressure, and weakness.

Hyperprolactinemia

Excess amount of prolactins are found in the bloodstream.  This causes infertility as well as decreased libido.

Symptoms of pituitary gland condition

The above-discussed condition can cause numerous symptoms related to the pituitary gland and these include headache, memory loss, hypertension, weakness and fatigue, weight gain, problems with the reproductive system such as erectile dysfunction, infertility, irregular periods, insomnia, lactating when you are not breastfeeding, etc.  These symptoms can be easily treated when the underlying cause is identified.

Diagnosis of pituitary gland problems

Laboratory testing is used to determine the excess or deficient hormones leading to pituitary problems.  It can also indicate the severity of the disorder and can be done on regular intervals to manage the hormone levels.  Few pituitary disorders are inherited and hence needs to be monitored regularly throughout the lifetime.

Laboratory testing includes measuring the hormone levels from the pituitary glands as well as from the endocrine glands.  Some of the hormones that are tested include prolactin, LH and FSH, TSH and free T4, ACTH and cortisol, GH and IGF-1.

Pituitary hormones are released in the blood in order to allow the blood to perform certain functions such as remain relatively constant with the help of TSH hormone, vary over the course of a day with the use of cortisol hormone, vary over a cycle with the help of FSH and LH during the menstrual cycle, and increase in specific situations with the help of prolactin and ACTH when breastfeeding or during a stressful situation.

Since hormones cause so many variations in the blood, tests are undertaken after the person has taken medication to either suppress or stimulate the production of hormones.  For example, testing the urine and serum osmolality can diagnose diabetes insipidus.  In certain conditions, imaging tests are conducted to evaluate and detect tumors with the use of CT scans and MRI.

Conventional treatment for problems related to the pituitary gland

The cause of the disorder determines the treatment for this condition.  The following treatments are rendered when a pituitary tumor affects the gland.

• Surgery is recommended when the tumor is diagnosed and causing problems with daily activities. Transsphenoidal surgery is undertaken by accessing the tumor through the nose.  This is a highly complex surgery and requires a high level of expertise.
• Medications are prescribed to block hormone action, as well as to shrink pituitary tumors. This helps in reducing the compression caused by the tumor.
• Hormone replacement therapy with the use of supplements is provided to add a missing or deficient hormone.
• Finally, targeted radiation therapy is attempted in conjunction with other treatments to reduce the size of the tumor size.

Treatment may or may not work to resolve the problem.  In some cases, surgery or radiation can cause further complications and lead to more severe problems.

Natural ways to treat pituitary related problems

Adaptogen Herbs

These are herbs that balance, restore, as well as protect the body.  They help in normalizing physiological functions.  These herbs are particularly helpful to boost the reproductive health of both men and women by improving fertility and libido.  Adaptogens also help protect the heart by regulating blood pressure.  People suffering from hypopituitarism have a higher risk of acquiring cardiovascular issues and hence adaptogens help reduce this risk factor.  Ginseng, holy basil, ashwagandha are some of the examples for adaptogens.

Healthy Fats

Consuming healthy fats in the form of avocados, coconut oil, olive oil, as well as salmons can balance hormones naturally.  Short, medium and long-chain fatty acids are essential for the body to create hormones.  They help in reducing inflammation and improve cardiovascular health.

Exercise

Growth hormones can be increased with the help of exercise.  Studies have documented that exercise can increase growth hormone levels by 300 to 500%.

Sleep

Following a healthy sleeping pattern with at least 7 to 8 hours of sleep every night is essential for normal hormone balance.  The body regulates cortisol levels in the middle of the night by working on a schedule.  This helps the stress hormones to be balanced and provide energy during the day.

References
https://www.healthline.com/human-body-maps/pituitary-gland
https://www.ncbi.nlm.nih.gov/books/NBK459247/
https://www.ncbi.nlm.nih.gov/books/NBK526130/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039019/
https://labtestsonline.org/conditions/pituitary-disorders