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What is the Pituitary gland?
The pituitary glad is a tiny gland is responsible for sending the hormone signals to the other glands in the body to get them to produce their hormones in turn.
Pituitary tumours and cysts
It is common on CT and MRI scans of the brain to notice small tumours (adenomas) in the pituitary. Mostly these are small and of no consequence but it is important to ensure that these are not affecting the pituitary function by overproducing pituitary hormones or causing underproduction of any hormones.
Conditions with an Overactive Pituitary
This commonest hormone that is overproduced is prolactin. There are many causes of a high prolactin in the blood and a small ‘microprolactinoma’ is a common one. A high prolactin can disrupt a woman’s periods and cause unexpected milk production from the breasts, or in men can cause a low testosterone resulting in impotence. This is usually easily treated with medication.
Other conditions associated with pituitary tumours include acromegaly (an excess of growth hormone) and Cushing’s disease (leading to an excess cortisol level). These conditions require experience to correctly investigate and treat which our team are able to provide at OneWelbeck.
Conditions with an Underactive Pituitary
There are many causes of an underactive or partially underactive pituitary and it is important to correctly interpret any tests of pituitary function. Causes range from the unexplained through to pituitary tumours, previous surgery or traumatic brain injury.
Treatment for Pituitary Disorders
In most cases pituitary tumours are identified incidentally when a patient has a scan for another reason and if the tumour is small and not creating a problem with pituitary function, usually there is no treatment required, although some surveillance may be advised. Where the tumour is large it may cause problems with nearby structures (particularly affecting vision) and an operation to remove the tumour may be recommended in which case you will be referred to a specialist pituitary neurosurgeon. Similarly if the tumour is making an excess of a particular hormone, treatment will be recommended which may be medical or surgical.
Conditions with an overactive pituitary
Depending on the size of the tumour and the hormone being produced, medical and surgical options for treatment will be discussed. For the most common hormone produced (prolactin), there is an excellent medical treatment which usually both lowers the hormone level and shrinks the tumour. Importantly, however, like all drugs, there can be specific side effects and these will be discussed in detail before any treatment is started.
Conditions with an underactive pituitary
Where the pituitary is unable to make sufficient hormones for good health, it is essential to replace the missing hormones. This must be done carefully with the aim of replacing the blood levels to physiological levels. Having too much hormone at the wrong time can be just as harmful as having too little. Our specialists are experts at perfecting this replacement treatment for maximum quality of life.