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The Pituitary Gland

The Pituitary Gland is at the anatomical and functional crossroads of the brain, mind and body. Weighing less than one gram and measuring a centimeter in width, the pituitary is often called the "master gland" since it controls the secretion of the body’s hormones. These substances when released by the pituitary into the blood stream have a dramatic and broad range of effects on growth and development, sexuality and reproductive function, metabolism, the response to stress and overall quality of life. 

This small, bean-shaped gland is located below the brain in the skull base, in an area called the sella turcica. The gland is regulated by a brain region called the 
hypothalamus which is connected to the pituitary gland by a thin delicate vascular connection called the pituitary stalk or infundibulum. The pituitary is divided into a larger anterior region (adenohypophysis) and smaller posterior region (neurohypophysis). Directly above the pituitary are the optic nervesand the optic chiasm as they project to the eyes. On each side of the pituitary is the cavernous sinus which is a venous channel through which runs the carotid arteries that carry blood to the brain, and important nerves that control eye movements and facial sensation. Because of the proximity of the pituitary to these major intracranial nerves and blood vessels, and the vital hormonal control the pituitary provides, disorders of the pituitary can cause a wide spectrum of symptoms, both hormonal and neurological.  

   

Listed below are the specific hormones produced by the pituitary:

Growth Hormone (GH): This is the principal hormone that, among many other functions, regulates body and brain development, bone maturation, metabolism and is essential for healthy muscles. 

Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH): These hormones control the production of sex hormones (estrogen and testosterone) as well as sperm and egg maturation and release.
 
Prolactin (PRL): This hormone stimulates secretion of breast milk. 

Thyroid Stimulating Hormone (TSH):  This hormone stimulates the thyroid gland to release thyroid hormones. Thyroid hormones control basal metabolic rate and play an important role in growth and maturation. Thyroid hormones affect almost every organ in the body. 

Adrenocorticotropic Hormone (ACTH): This hormone triggers the adrenal glands (located above the kidneys) to release the hormone cortisol which in turn, regulates carbohydrate, fat, and protein metabolism and is essential in the stress response. 

Vasopressin - Also called anti-diuretic hormone (ADH): This hormone promotes water to be reabsorbed by the kidneys and is thus essential in water and electrolyte balance.

In disease states, the pituitary may under- or over-produce hormones. Decreased pituitary hormone production is called 
Hypopituitarism or pituitary failure. The symptoms and treatments for pituitary failure are listed below:
 

 

Hormone Deficient 

 Symptoms 

 Treatment 

GH 

Children: Growth delay
Adults: Decreased muscle mass, increased body fat, elevated cholesterol, low bone density (osteoporosis), impaired psychological well-being,poor quality of life
 

Recombinant Human Growth Hormone- Given once daily as an injection under the skin 

LH/FSH 

Decreased libido, erectile dysfunction, irregular or absent menses, decreased body hair, decreased muscle strength, hot flashes, mood changes 

Men: Testosterone- Given as either topical gel or patch or injections

Women: Estrogen + Progesterone-Given as either topical patch or pills
 

ACTH 

Poor appetite, nausea, weakness, vomiting, low blood sugar, low blood pressure, dizziness, body aches 

Hydrocortisone or Prednisone-Given as daily pills 

TSH 

Fatigue, weakness, cold intolerance, dry skin, constipation, heavy/painful menses, weight gain, memory loss, mood disturbance 

Levothyroxine: Given as daily pills (some examples include Synthroid or Levoxyl or Levothroid or Armour Thyroid) 

Prolactin 

Inability to lactate 

No treatment available 

Vasopressin (ADH) 

Increased thirst and frequent urination 

DDAVP: Given either as daily pills or nasal spray