As the “master gland”, most of the effects of the pituitary gland is on the other endocrine glands of the body. Disorders of the pituitary gland is often only detected by the signs and symptoms of various diseases attributed to these other glands. Pituitary gland problems can be seen either as an excess or deficiency of pituitary hormones or local effects of masses. Other related problems like resistance to pituitary hormones like growth hormone or ACTH is not due to a disorder of the pituitary gland itself. Due to close relationship with the hypothalamus, many pituitary gland problems stem from a disorder within the hypothalamic region that disrupts the regulation of the production and secretion of the pituitary hormones.
Types of Pituitary Gland Problems
The presentation of the pituitary gland problem will depend on the area that is affected, specific cells that are compromised and nature of the causative lesion. Generalized signs and symptoms, as well as reproductive system features, are listed under endocrine disorders symptoms.
The pituitary hormones and hormones secreted by the other endocrine glands that it targets are discussed under the List of Endocrine Glands.
Commonly referred to as an overactive pituitary gland, hyperpituitarism is essentially an excess secretion of pituitary hormones. This is often a result of growths like a benign tumor or enlargement of the gland or cancer. Dysfunction within the hypothalamus or secretion of hormones from tumors outside of the pituitary gland may also be responsible.
The signs and symptoms of hyperpituitarism will depend on the area of the pituitary gland that is affected and the excess of specific hormones. One or sometimes two hormones are simultaneously secreted in excess although an excess of more than two hormones is possible but rare.
This is a deficiency in the secretion of pituitary hormones and is also referred to as an underactive pituitary gland. Hypopituitarism is usually a result of destruction of the entire or portion of the pituitary gland. This may be caused by inflammatory reactions, ischemia, surgical removal, radiation or non-secretory pituitary adenomas. Just as with hyperpituitarism, a hypothalamic dysfunction has to also be considered as a possible cause of pituitary hormone deficiency.
The signs and symptoms of hypopituitarism will depend on the area of the pituitary gland that is affected and the deficiency of specific hormones. The signs and symptoms will vary accordingly although majority of the different pituitary cell types as described under pituitary gland function has to be destroyed or malfunctioning for hypopituitarism to ensue. If only a few cells are affected, the remaining cells can increase hormone production and secretion to compensate and no endocrine disruption will be present.
Non-Secretory Pituitary Problems
Some masses of the pituitary gland may not affect the production or secretion of the pituitary hormones. It may go unnoticed until it disturbs surrounding structures due to its size and infiltration into adjacent tissues. Most masses are slow-growing so the onset and development of the associated signs and symptoms will be gradual. This may include :
- Visual disturbances
- Nausea and/or vomiting
- Dizziness and/or fainting
- Mood and behavior changes
Not all masses are solid in nature. A pituitary abscess may be seen with infectious causes and hemorrhage (bleeding) can cause a rapidly enlarging mass that can lead to a life-threatening condition known as apoplexy. This is of sudden onset, develops rapidly and is considered as a medical emergency.