IHC, FSH Tips

The pituitary gland is a small, pea-sized attached to the base of the brain. It controls growth, functioning and development of other hormonal glands. Deficit of one or more pituitary hormones is a state of Hypopituitarism. This clinical term is used by endocrinologists to mean that one or more pituitary glands are deficient. In hypopituitarism, the pituitary gland does not produce the normal amounts of hormones.

Causes-

Hypopituitarism has the following causes

Brain tumours

Sarcoidosis (A lung disorder)

Tumours in the pituitary gland

Hemochromatosis (Too much iron in the body)

Tumours in hypothalamus (Controls the production of hormones)

Histiocytosis X (A rare autoimmune disease where the immune cells damage the organs)

Tuberculosis

Stroke

Sheehan syndrome (Excessive blood loss during childbirth)

Lymphocytic hypophysitis (An inflammation in the pituitary gland)

Radiation treatments like chemotherapy

Symptoms-

Symptoms depend on which hormones is not being produced.

Adrenocorticotropic Hormone (ACH): Lack of ACH affects the adrenal glands (endocrine glands producing hormones) and cortisol (steroid hormone). Symptoms include

Fatigue

Low sodium levels

Loss of weight

Pale skin

Thyroid-stimulating Hormone (TSH): Deficient TSH mostly affects the thyroid (produces growth-regulating hormones) gland. The symptoms are

Fatigue

Weight gain

Skin dryness

Sensitivity to cold

Constipation

Luteinizing hormone (LH): Low luteinizing hormone in women affects their ovaries and ovulation. Symptoms include-

irregular periods

loss of libido

infertility

In men, lack of LH affects their testes and sperm production. Symptoms include-

loss of libido

erectile dysfunction

impotence

infertility.

Follicle-stimulating hormone (FSH): This hormone affects men and women the same way the luteinizing hormone does. Thus the symptoms are the same.

Growth Hormone: In children, the growth hormone affects their bone, fat and muscle. They have the following symptoms

Lack of height

Increase in body fat

Abnormal peak bone mass (bone tissue present after the skeleton matures)

In adults, the whole body is affected. Body fat increases while muscle and bone mass decreases.

Prolactin: Prolactin deficiency only affects women. The prolactin hormone gets the production of milk started after childbirth. Lack of prolactin thus affects breastfeeding.

Antidiuretic Hormone (ADH): The kidneys are affected by lack of ADH. Symptoms include

Diluted urine

Frequent urination

Feeling excess thirst

Oxytocin: Lactation and childbirth are affected by lack of oxytocin.

The body functions are controlled by hormones which are produced by various endocrine glands (named so because these glands secrete hormones directly into the body). There are various endocrine glands, and these are controlled by the master endocrine gland which is the pituitary gland.

The pituitary gland produces prolactin which helps regulate milk production when a woman is breast-feeding. To a smaller extent, it also has some effect on other hormones.

Prolactinoma is a benign tumour of the pituitary gland which produces large amount of prolactin. The cells in the pituitary gland multiply to produce large amounts of prolactin. In people with prolactinoma, there are reduced amounts of oestrogen in females and testosterones in males.

Causes: Though the cause is unknown, a genetic connection believed to exist. They can develop in men as well.

Types: Depending on the size of the tumour, the tumour is of two main types microprolactinoma (when the tumour measures less than 10 mm) and macroprolactinoma (when the tumour measures more than 10 mm).

Signs and symptoms: Though the most important function of prolactin is the regulation of breast milk production, it also has various other functions in both men and women. The symptoms, therefore, would depend on the gender and the age group.

Men: Reduced libido, erectile dysfunction, reduced fertility, and gynecomastia and sometimes even production of milk.

Women: Menstrual disorders, including lack of periods or irregular periods, reduced fertility, reduced libido, increased facial hair, and spontaneous leakage of milk from the breasts.

In addition to the above symptoms, as the tumour continues to grow, there could be pressure on the surrounding nerves, leading to headaches, blurred of vision, and even double vision. As the tumour grows, the normal pituitary functioning may be affected, and other hormones may not be produced and accordingly the symptoms would appear.

Treatment:

It is the only pituitary tumor which shrink in size with drugs known as dopamine agonist. Patient might require the treatment for 2-3 years. In some cases surgery and radiotherapy is needed.

So, the answer to the question is yes there is treatment for Prolactinoma and its medicine in majority of the cases.

Consult your endocrinologist for details!

Pituitary tumors are a rare occurrence, and not all of them show some kind of symptoms. However, in some cases, the patients may display few symptoms. This totally depends on whether the tumor is functional or non-functional. When the tumor is functional, it means that they are releasing excess hormones while non-functional tumor would not cause excess release of hormones.

Types of pituitary tumors:
As already pointed, there are two variants of pituitary tumors- functional and non-functional.

Functional adenomas can lead to issues owing to the hormones they release. Typically, a functional adenoma creates an excess amount of a single hormone. The symptoms are dependent on the type of hormone secreted by them.
Tumors which do not lead to excess secretion of hormones tend to become large even before they are noticed. They may lead to different kinds of symptoms when they press against other parts of the brain or nerves or other areas of the pituitary.
Non-functional adenomas which do not lead to any symptoms are often found owing to the MRI or CT scan performed for other health troubles. These tumors are becoming more common since CT scans and MRIs are done more commonly, and these are the most prevalent type of tumors. There is no need to treat them as long as they do not cause any discomfort or symptoms.
Symptoms caused by pituitary tumors:
The carcinomas, as well as macroadenomas, are large enough to press on a nearby nerve or other parts of the brain regardless of whether they are functional or not. This may lead to signs and symptoms such as loss of peripheral vision, headaches, dizziness, facial numbness or pain, blurred or double vision and loss of consciousness. Sudden bleeding into the tumor can lead to loss of consciousness and even death. Depending on the type of nerves affected by the pituitary tumor can cause weakness, unexplained loss or gain of weight, nausea, feeling tired and cold, menstrual changes, erectile dysfunction, and reduced interest in sex, particularly in men.

Treatment of pituitary tumors:
Many patients suffering from pituitary tumors do not need any treatment. However, there are various factors like the size, type, and reach of the tumor that play an important role in deciding whether the patients require treatment or not. Moreover, the age of the patients and overall health conditions are the most crucial aspect in the decision of the same.

Surgical removal of the pituitary tumor is generally advised by the doctor when the tumor is pressing on the optic nerves or when the tumor is overproducing some hormones. On the other hand, radiation therapy makes use of high-energy X-rays for destroying tumors. Lastly, treatment with medicines can help in blocking excess secretion of hormone and even shrink certain types of pituitary tumors.