Pituitary gland is a pea shaped gland located in the base of the brain.It is known as the “master gland” in the body. This is because it secretes hormones and also controls the secretion of many hormones in the body. It is divided into 2 parts. An anterior lobe called as adenohypophysis and a posterior lobe known as neurohypophysis. It has a stalk which communicates with the hypothalamus which again secretes various regulatory hormones
Anterior lobe of pituitary secretes the following hormones
  • ACTH - It stimulates the adrenal gland to produce cortisol and androgens. Cortisol is a very important stress hormone which regulates blood pressure ,blood sugars and various other metabolic processes
  • FSH and LH - These act in harmony on the ovaries in females to regulate the menstrual cycle and in males to produce testosterone
  • TSH - Stimulates the thyroid gland to secrete thyroid hormones
  • Growth Hormone - Mainly important in growth in children . It also stimulates the growth of most of the tissues in the body. It has an important role in sugar and fatty acid metabolism
  • Prolactin - It helps in milk secretion in lactating woman
Posterior lobe of pituitary stores and secretes preformed hormone from the hypothalamus. It includes
  • Anti diuretic hormone - It helps in water retention by the kidneys. Also has a role in blood pressure control
  • Oxytocin - It is mainly required in woman during delivery time. This is the hormone which increases the uterine contraction and helps in delivery of the fetus. Oxytocin also helps in milk let down from the breasts.
Pituitary gland pathologies include
1. Increase secretion of hormones which are usually due to adenomas( tumors) which can be from microadenoma(less than 1 cm) or macroadenomas( more than 1 cm). Various hormone hypersecretion can occur like
  • Prolactinomas - These secrete prolactin hormone which results in delayed/absent periods,infertility and milk secretion from breasts(galactorrhea) in woman and loss of libido,erectile dysfunction and infertility in men.
  • Cushing disease – This results in cortisol hypersecretion . It presents with weight gain, round facies, abdominal stria, easy bruising, fractures, muscle weakness etc
  • Acromegaly - This is due to excess secretion of Growth hormone. Results in enlargement of hands and feet, excessive sweating, oiliness of skin, new onset or worsening diabetes and hypertension etc
  • Thyrotropinomas - These cause excessive Thyroid hormone secretion which results in thyrotoxicosis.

2. Hypopituitarism(Decreased secretion of hormones) – This causes decrease secretion of one or more pituitary hormones. This can be due to adenomas, cysts, meningioms, metastasis, infections, inflammatory disorders, hypophysitis etc which affect the pituitary. Also after pituitary surgeries, reduced secretion of pituitary hormones is very common.

Symptoms of hormone deficiency depends on the hormones that are deficient and can include
  • Low cortisol levels (secondary hypoadrenalism) - This can cause weakness , fatigue, postural dizziness, nausea, vomiting, decreased appetite , weight loss, low sodium levels etc
  • Low thyroid hormones ( secondary hypothyroidism) - This can cause fatigue, weight gain, constipation, hairfall, low sodium etc.
  • Growth hormone deficiency - In children deficiency can lead to decreased height and in adult’s deficiency can cause metabolic problems and obesity
  • Low sex steroids (secondary hypogonadism) - Decreased libido and weakness, absent cycles in females and impaired erection in males
  • Diabetes Insipidus - This is due to vasopressin deficiency leading to increased urination and therefore increased thirst

3. Compressive symptoms- Largetumors/adenomas in the pituitary region can result in headache and visual field defects

Pituitary diseases can be easily diagnosed and treated by an Endocrinologist. Proper replacement of deficient hormones and surgical/medical treatment for excess hormone levels, lead to improvement in quality of life , morbidity and mortality in patients.

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