How do you fix a pituitary gland problem

The pituitary gland is a pea size organ that sits inside the sella, a bony structure located in the middle of the head, beneath the brain and behind the nose and sinuses. The pituitary gland is considered the “master endocrine gland” because it produces and releases a number of hormones that control other glands in the body to regulate many biological functions. These hormones include:

• Adrenocorticotropic hormone (ACTH)-stimulates the adrenal gland to make the hormone cortisol that is required for response to stress
• Antidiuretic hormone (ADH)-regulates water balance in the body
• Growth hormone (GH)-regulates growth
• Follicle-stimulating hormone (FSH)-regulates production of egg and sperm
• Luteinizing hormone (LH)-stimulates release of estrogen in women and testosterone in men
• Prolactin-stimulates breast milk production after pregnancy 
• Thyroid stimulating hormone (TSH)-stimulates the thyroid gland to make thyroid hormone that is essential for regulation of metabolism, temperature and other bodily functions

Common Pituitary Conditions

Because of its location and role in regulating hormones within the body, any abnormality of the pituitary gland can be associated with a wide range of symptoms and disorders. For example, if the pituitary gland grows in size, this can cause pressure on the optic chiasm, a bundle of nerve fibers that communicates information from the eyes to the brain, which can lead to vision issues or headaches.

Pituitary tumors are one of the more common disorders involving the pituitary gland. While these tumors are nearly all benign (noncancerous), they can still lead to hormonal abnormalities, causing increased or decreased hormone production and impacting overall health. Not all tumors will have symptoms, but once they are discovered it is important that the patient undergo a comprehensive evaluation by an expert team to prevent the condition from worsening.

A list of the more common pituitary disorders include:

• Functinal pituitary adenomas that result in overproduction of hormones
• Prolactinoma
• Cushing’s disease
• Acromegaly
• Non-functional pituitary adenomas
• Pituitary apoplexy

• Pituitary cysts, including Rathke’s cleft cysts
• Craniopharyngiomas
• Empty Sella Syndrome
• Pituitary hormone deficiencies and panhypopituitarism
• Diabetes insipidus
• Lymphocytic hypophysitis 
• Sheehan’s syndrome

Coordinated Care, Integrated Approach

Due to the complex nature of pituitary disorders, most patients require coordinated care by experts in many specialties. At the University of Chicago Medicine, we take an integrated, multidisciplinary approach to the diagnosis, evaluation and treatment of individuals with pituitary disorders. Whether a patient needs hormonal or visual assessment or a neurosurgical procedure, our team of specialists have the resources and expertise to provide advanced and comprehensive care.

Patients with pituitary disorders can have variable symptoms depending on the cause of the disorder. Pituitary tumors, cysts or other growths can cause headaches or problems with vision or in severe cases nausea and vomiting. Low levels of pituitary hormones can cause many symptoms such as fatigue, sexual dysfunction and changes in body composition, appearance or weight.

Conditions that are associated with too much hormone production include:

• Acromegaly caused by overproduction of growth hormone that can lead to enlargement of hands and feet among other symptoms
• Cushing’s syndrome caused by overproduction of ACTH and subsequently cortisol that can lead to weight gain especially in the abdominal and trunk areas in addition to increased risk for fractures, diabetes, hypertension and other complications
• Hyperprolactinemia that can lead to abnormal menses, infertility and sexual dysfunction

Diagnosis of pituitary disorders involves a comprehensive approach that includes a hormonal evaluation by an endocrinologist as well as imaging studies such as MRI scans to evaluate for presence of pituitary gland abnormalities. Depending on the abnormality, patients may require formal evaluation of vision by a neuro-ophthalmologist. 

Treatment of pituitary disorders often involves collaboration between endocrinologists, neurosurgeons, neuro-ophthalmologists, radiation oncologist and otolaryngologists (ENT). Treatments include surgical intervention, medications, hormone replacement in case of hormone deficiencies and at times radiation therapy. At UChicago Medicine, we are proud to offer minimally invasive, endoscopic surgical approaches.

Preparing for Your Appointment

In preparation for your visit, please obtain all your prior medical records such as results of hormonal testing and imaging studies including actual images obtained on a CD for review by our team.

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