“My son's pituitary glands are malfunctioning?”
My son's doctor said that his pituitary glands are malfunctioning. What does this mean? What does he need next?
4 Answers
Endocronologist(Pediatric)Endocrinology
The pituitary gland is responsible for the production and regulation of several important hormones. The effect on the body depends upon the nature of the pituitary gland problem. The next step is follow up with an Endocrine Specialist.
Please take your son as soon as possible to a pediatric endocrinologist.
He should be seen by an endocrinologist to assess the severity.
The pituitary gland is a pea-sized gland found at the base of the brain. It is contained within a bony frame work called the sella turcica (the Turkish saddle). It is about 12.5 mm in size and about 0.5 grams in the average adult. It is smaller in children. The pituitary gland is divided in to two portions or lobes. The larger front one is called anterior pituitary (80%) and the back or posterior pituitary is smaller (20%). It produces several important hormones. The anterior pituitary produces 7 or more important hormones. The posterior pituitary gland stores 2 important hormones. The anterior pituitary produces hormones while the posterior pituitary only stores and releases hormones made in the hypothalamus. The anterior and posterior pituitary are connected to the hypothalamus by a bundle of blood vessels and nerve fibers called the pituitary stalk. The anterior pituitary is controlled from hormones of the hypothalamus. The hypothalamic hormones can have stimulatory or inhibitory effect on the pituitary hormones. The posterior pituitary is controlled by hypothalamic nerve fibers. It does not produce hormones. It is only storage of hormones made in the hypothalamus. Pituitary hormones have circadian rhythm. Most hormones are released in pulses every 1-3 hours and may only last up to 20 minutes per pulse. There is also duirenal change in the hormone levels. Most pituitary hormones are high before awakening in the morning and hit nadir just after bed time. The anterior pituitary hormones are:
1) Prolactin (Pr); involved the breasts milk production. It is controlled by dopamine
2) Growth hormone (GH); mainly controls growth and bone health and muscle mass.
3) Adrenocorticotropic hormone ( ACTH); controls the adrenal glands to produce cortisol and androgens.
4) Thyroid-stimulating hormone (TSH); This hormone controls the thyroid gland. It is essential in brain growth, bodies energy and metabolic systems.
5) Follicle-stimulating hormone (FSH); It stimulates ovarian folliculogenesis and testicular spermatogenesis.
6) Luteinizing hormone (LH); Stimulates ovaries to produce estrogen and progesterone and mediates ovulation. In the testis it stimulates production of testosterone.
FSH and LH are called gonadotropins.
7) Other hormones such as beta-melanocyte stimulating hormone, enkephalins and endorphins. and ones that inhibit pain sensations ( and and help control the immune system (endorphins). These hormones control skin pigmentation and pain sensation.
Posterior pituitary hormones are;
1) Oxytocin; is involved in milk let down (milk ejection from the nipples and helps in uterine contraction during labor to prevent excess bleeding.
2) Vasopressin; also known as antidiuretic hormone controls water loss in the kidneys through the kidneys aquapores in the distal collecting tubes. It maintains blood volume and blood pressure and electrolytes.
Abnormalities of the pituitary gland:
The pituitary gland could malfunction in many ways:
1) Adenomals or noncancerous tumors. This adenomas can be small <10 mm or large >10mm. They can be functional or non functional. Functional is when they are producing excess of one or more hormone. They can also produce one or more excess hormones and suppress other hormones through mass effect.
None functioning adenomas can cause suppression of the function of one or more hormones through their mass effect. Adenomas may also involve in visual problems as they can press on the optic nerve under them. They may cause various degrees of headaches.
2) Suprasellar tumors: can cause pituitary hormone deficiencies, headaches and visual field defects.
3) Leaking or filling of the pituitary gland with cerebrospinal fluid depress the pituitary gland and may cause empty sell syndrome.
4) Congenital anomalies including septooptic dysplasia, hypoplastic pituitary gland can cause pituitary hormone deficiencies.
5) Pituitary apoplexy or bleeding in to the pituitary gland can cause pituitary hormone deficiencies.
6) Ischimia or interruption of blood supply can cause pituitary hormone deficiencies.
7) Infections, abscess, or cysts may cause pituitary hormone deficiencies.
8) Surgical procedures: If surgical procedure of the pituitary is performed for pituitary adenomal, few or all of the pituitary hormones may be abnormal.
Diseases of the pituitary hormone Abnormalities:
1) Growth hormone deficiency causes growth failure.
2) Gigantism; due to growth hormone excess in children
3) Acromegaly; causes excess growth in adults
4) Galactorrhea; Milk production in non pregnancy due to excess prolactin.
5) Gynecomastia: overproduction of prolactin may cause enlarged breast tissue in children and adults.
6) Precocious puberty: Early sexual development due to excess gonadotropins (LHand FSH)
7) Delayed puberty low gonadotropins
8) Hypogonadism; due to low gonadotropins
9) Erectile dysfunction; due to low testosterone or gonadotropins
10) infertility; Due to low gonadotropins
11) Amenorrhea: due to gonadotropins
12) Central hypothyroidism: due to low TSH
13) Central diabetes insipidus: due to low antidiuretic hormone
14) Adrenal insufficiency: due to low ACTH.
15) panhypopitiutarism: due to multiple pituitary hormone deficiencies.
If the person is suspecting pituitary hormone problems his/her doctor can run simple blood test such as Comprehensive metabolic panel, IGF1, TSH, FT4, LH, FSH, cortisol, estrogen, serum and urine osmolality, prolactin and testosterone. The selection of the test for hormone levels can be determined by the doctor based on the presenting symptoms age and gender of the patient. Imaging studies such as MRI of the pituitary gland can be determined by the doctor as well.
Good luck.
1) Prolactin (Pr); involved the breasts milk production. It is controlled by dopamine
2) Growth hormone (GH); mainly controls growth and bone health and muscle mass.
3) Adrenocorticotropic hormone ( ACTH); controls the adrenal glands to produce cortisol and androgens.
4) Thyroid-stimulating hormone (TSH); This hormone controls the thyroid gland. It is essential in brain growth, bodies energy and metabolic systems.
5) Follicle-stimulating hormone (FSH); It stimulates ovarian folliculogenesis and testicular spermatogenesis.
6) Luteinizing hormone (LH); Stimulates ovaries to produce estrogen and progesterone and mediates ovulation. In the testis it stimulates production of testosterone.
FSH and LH are called gonadotropins.
7) Other hormones such as beta-melanocyte stimulating hormone, enkephalins and endorphins. and ones that inhibit pain sensations ( and and help control the immune system (endorphins). These hormones control skin pigmentation and pain sensation.
Posterior pituitary hormones are;
1) Oxytocin; is involved in milk let down (milk ejection from the nipples and helps in uterine contraction during labor to prevent excess bleeding.
2) Vasopressin; also known as antidiuretic hormone controls water loss in the kidneys through the kidneys aquapores in the distal collecting tubes. It maintains blood volume and blood pressure and electrolytes.
Abnormalities of the pituitary gland:
The pituitary gland could malfunction in many ways:
1) Adenomals or noncancerous tumors. This adenomas can be small <10 mm or large >10mm. They can be functional or non functional. Functional is when they are producing excess of one or more hormone. They can also produce one or more excess hormones and suppress other hormones through mass effect.
None functioning adenomas can cause suppression of the function of one or more hormones through their mass effect. Adenomas may also involve in visual problems as they can press on the optic nerve under them. They may cause various degrees of headaches.
2) Suprasellar tumors: can cause pituitary hormone deficiencies, headaches and visual field defects.
3) Leaking or filling of the pituitary gland with cerebrospinal fluid depress the pituitary gland and may cause empty sell syndrome.
4) Congenital anomalies including septooptic dysplasia, hypoplastic pituitary gland can cause pituitary hormone deficiencies.
5) Pituitary apoplexy or bleeding in to the pituitary gland can cause pituitary hormone deficiencies.
6) Ischimia or interruption of blood supply can cause pituitary hormone deficiencies.
7) Infections, abscess, or cysts may cause pituitary hormone deficiencies.
8) Surgical procedures: If surgical procedure of the pituitary is performed for pituitary adenomal, few or all of the pituitary hormones may be abnormal.
Diseases of the pituitary hormone Abnormalities:
1) Growth hormone deficiency causes growth failure.
2) Gigantism; due to growth hormone excess in children
3) Acromegaly; causes excess growth in adults
4) Galactorrhea; Milk production in non pregnancy due to excess prolactin.
5) Gynecomastia: overproduction of prolactin may cause enlarged breast tissue in children and adults.
6) Precocious puberty: Early sexual development due to excess gonadotropins (LHand FSH)
7) Delayed puberty low gonadotropins
8) Hypogonadism; due to low gonadotropins
9) Erectile dysfunction; due to low testosterone or gonadotropins
10) infertility; Due to low gonadotropins
11) Amenorrhea: due to gonadotropins
12) Central hypothyroidism: due to low TSH
13) Central diabetes insipidus: due to low antidiuretic hormone
14) Adrenal insufficiency: due to low ACTH.
15) panhypopitiutarism: due to multiple pituitary hormone deficiencies.
If the person is suspecting pituitary hormone problems his/her doctor can run simple blood test such as Comprehensive metabolic panel, IGF1, TSH, FT4, LH, FSH, cortisol, estrogen, serum and urine osmolality, prolactin and testosterone. The selection of the test for hormone levels can be determined by the doctor based on the presenting symptoms age and gender of the patient. Imaging studies such as MRI of the pituitary gland can be determined by the doctor as well.
Good luck.
