You can think of your pituitary gland as the "master gland" and central regulator gland of your body. It’s a small, pea‑sized ball of tissue at the base of the brain, nestled behind your nasal cavities. Pituitary gland disorders can cause many problems with your body, depending on their extent and location.
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You can think of your pituitary gland as the "master gland" and central regulator gland of your body. It’s a small, pea‑sized ball of tissue at the base of the brain, nestled behind your nasal cavities. Pituitary gland disorders can cause many problems with your body, depending on their extent and location.
Your pituitary gland has two major lobes:
Anterior pituitary. This lobe produces six hormones:
Growth hormone (GH)
Adrenocorticotropic hormone (ACTH)
Thyroid-stimulating hormone (TSH)
Prolactin
Luteinizing hormone (LH)
Follicle-stimulating hormone (FSH)
Posterior pituitary. This lobe stores and releases hormones made in your hypothalamus, including vasopressin (also called antidiuretic hormone or ADH) and oxytocin.
Pituitary gland disorders can occur due to factors such as tumors, surgical complications, genetics, or any other condition that causes tissue damage to your pituitary gland.
Managing pituitary disorders often requires seeing multiple specialists, such as endocrinologists, neurosurgeons, and eye doctors.
The symptoms of pituitary disorders can vary based on factors such as:
Pituitary hormone production
Whether a tumor or other growth is pushing on surrounding tissues
Whether or not other parts of the brain are also affected
There are many potential signs and symptoms of a pituitary gland disorder. Here are some of the most common.
When a pituitary tumor enlarges and compresses nearby tissues (known as a mass effect), it can cause a variety of signs and symptoms, including:
Headaches
Vision problems
Nausea or vomiting
Fatigue
Pituitary hormone deficiencies
Many pituitary hormone deficiency symptoms can develop due to pituitary tumors or other causes of pituitary damage. It’s possible to experience a deficiency in one hormone or many, called hypopituitarism.
Low thyroid-stimulating hormone (TSH) from pituitary dysfunction causes secondary (central) hypothyroidism, and it can cause symptoms such as:
Weight gain
Menstrual irregularities in women
Cold intolerance
Low LH and FSH levels from pituitary dysfunction cause secondary hypogonadism, leading to low testosterone and symptoms such as:
Decreased spontaneous erections
Fatigue
Loss of body hair
Vision changes
Loss of smell
Shrinking testicle size
Hot flashes
Pituitary tumors and some other conditions can also cause high hormone levels. Tumors that produce excess hormones are known as functioning tumors. The following are the three most common functioning pituitary gland tumors:
A prolactinoma can causeproblems in men, such as:
Fertility problems
Decreased sex drive
Excess prolactin (hyperprolactinemia) can also sometimes cause breast milk production in males.
These can cause problems such as:
Enlarged hands/feet (acromegaly)
Coarse facial features
Joint pain
In children, these tumors can lead to gigantism, a condition characterized by excess height.
ACTH-secreting tumors can lead to a collection of symptoms known as Cushing syndrome, including:
Weight gain (especially in your face and belly)
Purple stretch marks
Muscle weakness
High blood pressure
Problems with the release of vasopressin from your posterior pituitary gland can lead to diabetes insipidus. This condition is characterized primarily by frequent urination and excessive thirst.
Many pituitary problems occur due to unknown reasons. In other cases, you might be able to identify particular risk factors such as the following.
Pituitary adenomas often occur without any known cause. But some genetic conditions can increase your risk of developing pituitary and other types of tumors, including:
Multiple endocrine neoplasia type 1 (MEN1)
Multiple endocrine neoplasia type 4 (MEN4)
Carney complex
Familial isolated pituitary adenomas
These conditions are only responsible for a small percentage of pituitary adenomas.
Other potential risk factors for developing a pituitary disorder include:
Prior surgery or radiation to your brain
Having an infection such as meningitis
Undergoing activities with a high risk of head injury
Not wearing proper safety equipment, such as a helmet during contact sports or a seatbelt when driving
Having a family history of certain conditions
Getting diagnosed with a pituitary disorder may require a number of tests. Your healthcare provider will want to rule out other conditions and confirm that your pituitary gland is causing your symptoms.
Tests you might receive include:
A review of your personal and family medical history
A physical exam, where your healthcare provider looks for characteristic signs of a pituitary problem, such as vision changes or breast discharge
A review of your symptoms
You’ll likely also need additional tests, such as:
Blood tests to measure your pituitary and other hormone levels
An MRI to visualize your pituitary gland
A vision test, if your vision is affected
A genetic blood test, if your healthcare provider suspects you have a genetic condition
The best treatment for a pituitary disorder depends on the underlying cause. Here are the most common options.
Pituitary adenomas may not require treatment if they aren’t causing symptoms. If you do need treatment, you’ll usually have a minimally invasive procedure called a transsphenoidal resection.
In some cases, you may receive medications to shrink your tumor instead of surgery. For example, dopamine agonists are often prescribed for prolactinomas.
Other treatments you may receive for pituitary conditions include:
Hormone replacement to replenish hormones that are too low
Surgery to treat other conditions, such as pituitary cancer or pituitary apoplexy
Radiation therapy to treat pituitary cancer
Chemotherapy, such as temozolomide, to treat pituitary cancer
Immunosuppressive therapy for autoimmune conditions
High doses of corticosteroids for pituitary apoplexy
Antibiotics or antifungals for infections
Emergency supportive treatment for infections, trauma, and some other serious conditions
Many pituitary disorders aren’t preventable or are only partially preventable. Although many of these problems may be out of your control, taking the following steps may help reduce your risk of certain conditions or help you receive treatment earlier:
Talk to your doctor about radiation therapy techniques that minimize exposure to your pituitary gland if you require radiation to treat another head or neck cancer.
If you’ve been diagnosed with a pituitary adenoma, attend all your follow-up appointments for regular monitoring.
Visit your healthcare provider as soon as you suspect you may have a problem with your hormone levels.
Follow good overall lifestyle habits like eating a balanced diet, getting regular exercise, and prioritizing sleep.
Make sure you follow your healthcare provider’s testing guidance if you have a family history of genetic syndromes that can affect the pituitary gland.
Your pituitary gland plays a critical role in regulating your endocrine system and influencing many aspects of your overall health. Many conditions, such as tumors, genetic conditions, and infections, can affect your pituitary gland.
The good news is that the majority of pituitary tumors aren’t cancerous. However, they may still cause symptoms if they grow large and push on healthy brain tissue or start producing hormones.
It’s important to seek prompt medical attention if you suspect you may have a problem with your pituitary gland. Your doctor can help you identify the underlying cause of your symptoms and recommend the best treatment.
Pituitary disorders have many potential causes. Here’s a look at some of the more common causes.
Pituitary adenomas are benign, usually slow-growing, and noncancerous. They’re often found after imaging forunrelated reasons.
These tumors are thought to occur in roughly 1 in 1,000 people.
The vast majority (about 90 percent) of pituitary tumors are adenomas, and almost all of these tumors are non-cancerous.
Pituitary carcinomas, malignant tumors that spread beyond the pituitary or metastasize, are extremely rare. These spread more aggressively and don’t respond to standard therapy.
Along with tumors, some other conditions can affect the structure of your pituitary gland, including:
Cysts. Cysts like Rathke’s cleft cysts often don’t cause problems, but can push on surrounding structures if they grow large. They’re generally only removed if they grow large enough to cause symptoms.
Craniopharyngiomas. These slow-growing, non-cancerous tumors most often occur in children. They’re very rare, estimated to occur in just 1 in 500,000 to 2 million people per year.
Empty sella syndrome. ESS occurs when a buildup of cerebrospinal fluid around your pituitary gland compresses it and makes it look flat in imaging. It’s referred to as primary empty sella syndrome when no underlying cause can be identified. This most often occurs in pregnant women and people with obesity. Secondary ESS occurs when the pituitary gland shrinks due to factors such as radiation therapy, a tumor, or surgery.
Hypophysitis is a generic term that refers to inflammation of your pituitary gland, which can lead to hormonal problems. It can develop due to an autoimmune condition or factors such as:
Some pituitary gland tumors may be curable. For example, many adenomas are treatable with a minimally invasive type of surgery called transsphenoidal surgery.
Pituitary adenomas are thought to be relatively common. Adenomas big enough to cause symptoms affect about 1 in 1,000 people, and autopsy studies suggest that small adenomas occur even more frequently.
Yes, some pituitary conditions that disrupt levels of gonadotropins (LH and FSH) can affect fertility. LH tells your testicles to produce testosterone, and FSH plays an important role in the formation and maturation of sperm.
Your anterior pituitary gland produces the hormone adrenocorticotropic hormone, which tells your adrenal glands to produce more cortisol. Problems with your pituitary gland can lead to high or low cortisol levels.
High cortisol due to high ACTH is called Cushing disease. Low levels of these hormones are known as adrenal insufficiency.
Some mediations
Infections
Pregnancy
Pituitary hemorrhage or pituitary apoplexy is bleeding into the pituitary gland. It most often occurs as a complication of pituitary adenomas and can lead to pituitary ischemia, where the pituitary gland loses its blood supply.
Some infections can cause damage to your pituitary gland, such as:
Meningitis
Tuberculosis
Syphilis
HIV
Tick-borne illness
Varicella zoster virus (Chickenpox or shingles virus)
Congenital or genetic conditions are those that you’re born with or inherit from a family member. Several can cause pituitary problems, including:
Pituitary hypoplasia or aplasia. Hypoplasia is the underdevelopment of the pituitary gland. Pituitary aplasia is the complete lack of pituitary gland development
Kallmann syndrome. Kallmann syndrome is a genetic condition that causes underdevelopment of the olfactory gland. It can also cause delayed or absent puberty.
Septo-optic dysplasia (De Morsier syndrome). Septo-optic dysplasia is a group of developmental problems that involve the underdevelopment of structures around the pituitary gland. Examples include the underdevelopment of the optic nerves, defects in the midbrain, and pituitary gland dysfunction.
Holoprosencephaly. Holoprosencephaly is a developmental problem that can cause midbrain problems and malformation of the pituitary gland.
Pituitary stalk interruption syndrome. PSIS is a rare condition where the pituitary stalk, the part of the gland that connects to your hypothalamus, is thin or missing.
Any kind of physical trauma can lead to damage to your pituitary gland. Damage can be caused by a traumatic injury or a complication of surgery to treat surrounding structures.
High doses of radiation therapy can also cause damage to the pituitary gland.
Some medications may alter pituitary gland function. These include:
Glucocorticoids
Opioids
Dopamine and dopamine agonists
Somatostatin analogues
Immune checkpoint inhibitors
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