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Hypophysis Disorders

more about Hypophysis Disorders


Pituitary Disorders


  • The human pituitary gland is small pea-sized tissue located in a saddle like structure (Sella turcica) at the base of the skull.  The pituitary sits behind and between the eyes where the optic nerves (carry information from the eyes to the back of the brain) cross.  The gland is also surrounded by other nerves (cranial nerves III, IV, V, VI) and internal carotid arteries, which supply blood to the brain.  Pituitary glands are called the master gland, because it regulates the function of other glands in the body by releasing chemicals known as hormones.  These hormones include:
    1. TSH (thyroid stimulating hormone) stimulates the thyroid gland to release hormones that regulate the body's metabolism (energy generation, burning of food as fuel)
    2. ACTH (Adrenocorticotrophic) -- stimulates the adrenals glands, which in turn, release hormones that regulate metabolism of fats, glucose, Proteins and the immune system (Body's defenses).
    3. GH (Growth Hormone) -- stimulates the growth of the body (muscles, bones etc.)
    4. LH (Luteinizing hormone) and FSH (Follicle stimulating hormone) -- Regulate sexual functions in males and females.
    5. Prolactin or PRL -- plays a part in breast development and milk production.
    6. ADH (Antidiuretic hormone) -- regulates water levels in the body by working on the kidneys.
    7. Oxytocin -- contraction of the uterus (womb) and milk secretion during pregnancy.
    8. MSH (Melanocyte stimulating hormone) -- stimulates pigmented cells in the skin (as with tanning).
    9. Disorders that directly affect the pituitary affect the particular functions under its control.

  • Symptoms of the functions of the target gland
  • Retarded growth -- dwarf or short stature
  • Excess growth -- giant features such as large hands, feet, jaw, forehead etc.
  • Delayed or absent sexual development at puberty -- such as small testes, lack of pubic hair, loss of body hair, cessation of menses, inability to get pregnant or to produce milk.
  • Visual field defects -- blindness (partial or total)
  • Weakness
  • Fatigue
  • Weight loss
  • Weight gain
  • Impotence
  • Excessive thirst or urination
  • Sensitivity to cold
  • Abdominal pain
  • Headache
  • Joint pain and swelling
  • Mental retardation

  • Tumors and lesions:
    1. Benign (non-cancerous) tumors can cause Acromegaly (Gigantism), which is due to excess growth hormone.
    2. Hyperplasia, over growth of the pituitary or a benign tumor, can result in excess production of the adrenal hormones, and give rise to Cushing's disease.
  • Hypopituitarism or deficiency of the pituitary hormones can be the result of:
    1. Tumors or lesions -- in children lesions that result in a decrease in GH can cause "Dwarfism."
    2. Trauma -- surgery, Stroke, or a radiation injury
    3. Diseases that infiltrate or invade the pituitary such as Sarcoidosis, Histiocytosis X, Hemochromatosis or Lymphocytic hypophysitis.
    4. Encephalitis infections of the brain
    5. Congenital or defects present at birth.
    6. Genetic or inherited such as Kallmann's syndrome (absence of portion of pituitary).
    7. Idiopathic -- No known cause.
    8. Blood disorders such as Thalassemia major

  • History:
    1. Symptoms
    2. Illnesses
    3. Surgeries or trauma
    4. Family history
    5. Medications
    6. Allergies
    7. Habits
  • Medical exam:
    1. Features of Gigantism or Dwarfism.
    2. Blindness detected on eye exam.
    3. In Cushing's disease -- moon face, fatty hump in the back of the neck, purple lines on the skin, bruises, High Blood Pressure or an increased in weight.
    4. Muscle weakness may be evident.
    5. Loss of body hair
    6. Large tongue
    7. Dark or light skin
    8. Small testes or breast
    9. May see joint problems as with Acromegaly
    10. Mental retardation may be detected.
  • Tests:
    1. Blood Chemistries for -- hormones, such as Thyroid, Cortisone, Estrogen, LH, FSH, Testosterone, ACTH and others can be measured.
    2. The blood levels of Electrolytes (Sodium, Potassium, etc.), glucose, Creatinine, BUN and other parameters are measured.
    3. A Complete blood count is performed (i.e., red and white blood cells).
    4. Knowing the urine levels of certain Electrolytes and hormones can be helpful.
    5. X-Rays of the chest, joints, spine and skull bones may be beneficial.
    6. MRI or a CAT scans provide detailed pictures of the brain and pituitary structures.
    7. The doctor may consult with an Endocrinologist (hormone specialist).

  • Trauma -- head injuries
  • Surgery -- brain or neurosurgery
  • Infections
  • Empty sella syndrome -- spinal fluid fills the area where the pituitary is located.  In a few cases, the pituitary function is abnormal (high Prolactin levels, milk leakage and menstrual problems.)
  • Other disorders

  • Medications such as Bromocriptine can decrease the excess GH secretion.
  • Testosterone creams or injections can help if the levels are low.
  • Rehabilitation -- exercise, physical and occupational therapy may help with pain, muscle weakness or joint problems.
  • Psychiatric counseling for sexual problems, Depression or mental retardation.
  • Surgery to remove the tumor or lesion
  • Radiation therapy -- radioactive rays can reduce the size of a pituitary tumor.

  • The pituitary problems can range from excessive, normal, to low levels of hormone production with a variety of symptoms.  If you suspect problems contact your physician.

  • Diseases of the specific glands:
    1. Hypothyroidism -- low levels of thyroid hormones
    2. Addison's Disease -- low levels of adrenal hormones
    3. Primary hypogonadism -- low levels of sex hormones




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