Disorders of Pituitary Gland: Symptoms, Diagnosis, Treatments, Types, Causes

What Is The Pituitary Gland?

The pituitary gland, also referred to as the "master gland," is, actually a small, pea-sized organ located at the base of the brain. In the light of available evidence, it has been associated with a central role in the endocrine system, as this organ controls other endocrine glands and therefore maintains hormonal balance within the human body.

Some of the hormones released by the pituitary control several physiological activities, such as growth, metabolism, reproduction, and stress response. It is important in regulating and integrating a wide spectrum of physiological activities in influencing the normal functioning of many organs and systems in the body.

Anatomy And Function Of The Pituitary Gland

The pituitary gland is differentiated into two distinct parts: the anterior pituitary (adenohypophysis) and the posterior pituitary (neurohypophysis).

Location of the Pituitary Gland

The Pituitary Gland lies at the base of the brain, within a bony cavity known as sella turcica, below the hypothalamus to which it is attached via a stalk.

Structure: Anterior and Posterior Pituitary

The anterior pituitary is larger and comprises glandular tissue, while the posterior pituitary consists of neural tissue.

Functions of the Pituitary Gland

The pituitary gland is often referred to as the "master controller" associated with several physiological processes as a result of its hormone secretion, which controls other endocrine glands and many body functions, including growth, metabolism, and reproduction.

Hormones produced by the Anterior Pituitary

• Growth Hormone (GH): Stimulates the growth and reproduction of cells.

• Thyroid-stimulating hormone (TSH): Stimulates thyroid hormone production in the thyroid.

• Adrenocorticotropic Hormone (ACTH): Stimulates the adrenal cortex to produce cortisol.

• PRL (Prolactin): Stimulates milk production in mammals.

• FSH (Follicle-Stimulating Hormone): Determines the growth of ovarian follicles in females and spermatogenesis in males.

• LH (Luteinizing Hormone): Induces ovulation and synthesizes sex hormones in both sexes.

Hormones of the Posterior Pituitary

Oxytocin: Causes uterine contraction during childbirth and milk ejection during lactation.

Vasopressin (Antidiuretic Hormone, ADH): This hormone maintains the balance of water content in the body by increasing the reabsorption of water in the kidneys.

Common Disorders Of The Pituitary Gland

Although small, the pituitary gland organ performs a crucial role in controlling many bodily hormonal operations.

Introduction to pituitary gland disorders

The problems with the pituitary gland bring about high health complications because it has control over other endocrine glands and significant systems of the body.

Classification:

Pituitary gland disorders are, therefore, divided into four broad categories:

Hypopituitarism

Definition and causes

Hypopituitarism is one of the pathologies of the endocrine system where the pituitary gland stops or is impaired in the production of one or more of its hormones or secretes them in inadequate quantities. The causes include pituitary tumours, traumatic brain injuries, infections, radiation therapy, autoimmune diseases, and genetic mutations.

Symptoms and diagnosis

Signs and symptoms vary depending on which hormone is deficient; however, they often include fatigue, weight loss, decreased libido, infertility, growth delays in children, and intolerance to cold. Diagnosis consists of blood tests that measure hormone levels, stimulation tests, and imaging studies like an MRI to outline the abnormalities within the pituitary gland.

Treatment options

Treatment is essentially a replacement of hormones to bring the levels back to normal to alleviate symptoms. Medications that may be taken include cortisol, thyroid hormones, sex hormones, and growth hormone. It is also essential to have treatment for the cause, for example, surgery or radiation if the cause is connected to tumours.

Hyperpituitarism

Definition and causes

It is the hyperproduction of hormones by the pituitary gland due to the benign tumour called adenomas. Causes associated with this system include genetic mutations and sporadic development of pituitary adenomas.

Symptoms and diagnosis

Symptoms depend on which hormone is overproduced. As mentioned above, too much growth hormone produces acromegaly in adults and gigantism in children. Too much prolactin causes galactorrhea and menstrual irregularities. Diagnosis includes hormone blood tests to identify which hormone is being overproduced by the pituitary adenoma and CT or MRI scans to detect any pituitary tumour. Visual field tests are also undertaken in cases where the tumour is affecting vision.

Treatment options

Treatment may include drugs to regularize hormone levels, such as dopamine agonists in the case of prolactinomas; surgical intervention to remove tumours; and radiation therapy to reduce the size of tumours. Hormone replacement treatment might also be necessary if the treatment affects the functioning of the pituitary gland.

Pituitary Tumors

Tumors of the pituitary can be divided into :

• Adenomas: This is a benign tumour and can be a microadenoma, which measures less than 10 mm, or a macroadenoma, which measures more than 10 mm in diameter.

• Carcinomas: These are highly rare, malignant pituitary tumours.

Symptoms and diagnosis

The symptoms depend on the size and type of tumour. Adenomas present headaches, visual disturbance and hormonal imbalance, thus manifesting signs and symptoms of either hyperpituitarism or hypopituitarism. Carcinomas manifest more severe symptoms. The diagnosis includes an MRI or CT scan to visualize the tumour, blood tests to check hormone levels and visual field tests.

Treatment options:

• Surgery: This is often the first line of treatment to remove tumours, particularly if they are producing significant symptoms or compressing surrounding structures.

• Radiation Therapy: This is used to reduce the size of tumours or as an adjunct to surgery.

• Medications: Symptoms can be treated and hormone levels controlled by medications such as dopamine agonists, somatostatin analogues, or hormone blockers, depending on the type of hormone produced.

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