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Pituitary Disease As Explained by a Concierge Doctor Pituitary Disease As Explained by an Endocrinologist

Your pituitary gland is located right in the middle of your skull. It’s not actually part of the brain, but it’s controlled by the hypothalamus, which is part of the brain. The hypothalamus secretes a variety of hormones, which in turn, cause the pituitary gland to secrete a variety of hormones.
The pituitary is often called the master gland because it controls many other glands including the adrenal gland.  The pituitary gland produces adrenocorticotropic hormone (ACTH) which causes the adrenal glands to produce cortisol, which is essential to staying alive.  The pituitary gland also secretes Thyroid stimulating hormone (TSH) which controls the thyroid glan.  In addition, the pituitary gland secretes the reproductive hormones LH, FSH, which control estrogen production and menstruation in the female, and testosterone and sperm production in the male.  So if a woman’s periods stop, she should see a gynecologist or endocrinologist. If a man loses the ability to obtain erections he should see a urologist or endocrinologist.  If either a man or a woman hasa change in desire for sex, chances are you would benefit from having an endocrine evaluation.  In addition to the above hormones, the pituitary also controls secretion of prolactin. This hormone is normally only secreted to help produce milk for a newborn.  Finally, the pituitary produces growth hormone. People thing that growth hormone is only important when you’re a child, but that’s not true. You should have growth hormones when you’re an adult as well. On the other hand, too much growth hormone can cause deformity and even early death, because it will cause the bones and other organs to continue to grow.
A common pituitary problem is a pituitary tumor, which is usually not cancer, but can grow large and cause over-secretion or under-secretion of hormones.  1 in 10 people has a pituitary tumor. The most common types are those that do not produce hormones and those that over-produce prolactin. Too much prolactin in females will lower estrogen and shut off menstrual periods and lower testosterone in men. It can also cause milk secretion from a breast when the woman is not pregnant, or an increase in breast size in men. So any man with an increase in breast size should see an endocrinologist.  Tumors that do not secrete hormones, and even some that do, can grow very large and cause problems such as blindness, stroke and other problems.  Other more rare tumors include those that over-produce growth hormone.  If you get a pituitary tumor that over-produces growth hormone and your bones are not finished growing, you could actually get gigantism. For example, the tallest man in the world has gigantism from a pituitary tumor that produced growth hormone. If your bones are finished growing, they will, as a result of too much growth hormone, get thicker and you will have a complete change in the way you look. This condition is called acromegaly, and can change the structure of your jaw and brow as well as other bones. Often dentists will detect acromegaly. Finally, overproduction of ACTH that leads to over-production of cortisol is called Cushing’s disease and can lead to increase fat around the middle, muscle wasting and diabetes among other problems.
Any pituitary problem within the pituitary gland, whether its low pituitary hormones or high pituitary hormones, needs to be addressed by an endocrinologist.
Author Dr. Joseph J. Pinzone serves as the endocrinologist and primary concierge medicine physician for AMAI patients, board-certified in Internal Medicine as well as Endocrinology, Diabetes and Metabolism.
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