Pituitary Disorders

At the base of our brain lies the pituitary gland its day to day job is to produce a number of hormones such as physical growth, sexual development and reproductive functions. Area’s such as the thyroid, adrenal glands, ovaries and the testes are indirectly stimulated, to release their own hormones.

Disorder happens through a lack or excess of a pituitary hormone and depending on which hormone is causing the problem, will determine the seriousness of the disorder. Causes for excess prolactin levels include pituitary tumors (adenomas), hypothyroidism (under-active thyroid), and medications such as tranquilizers, some high blood pressure medications, antidepressants, anti-nausea drugs, and oral contraceptives.

Lack of the growth hormone (somatotropin) is the hormone responsible for normal growth in childhood and adolescence. Once a disorder has been diagnosed doctors would treat the condition with hormone replacement treatment, providing the disorder was caused by the lack of a particular hormone. Depending on how soon in life treatment has to be given regular treatment with somatotropin, which is a synthetic form of growth hormone, would usually be given until the end of adolescence, this then would usually allow for normal growth and development to take place.

Pituitary disorders that can be helped by drugs would be those involving growth hormone, anti-diuretic hormone, prolacin, agrenal hormones, and the gonadotrophins

There are times when the pituitary gland produces a excess of growth hormone, in children this would be known as gigantisim. If this was to happen in adulthood the condition is known as acromegaly. This kind of disorder would usually be caused by tumour, and it would involve a thickening of the skull, face, hands and feet. It may also involve enlargement of some internal organs.

An operation may be needed to remove the tumour or radiotheraphy may be used to destroy it. A minority of these tumors, however, do not respond to medication and must be treated by surgery or radiation. Drugs such as bromocriptine should be taken once or twice or thrice a day. While it is usually very effective in lowering blood prolactin levels, it can sometimes cause side effects. Octreotide is also used in the elderly to reduce the growth hormone levels. Octreotide is also used as added treatment before surgery and individuals with the problems of increased hormone growth occurring after surgery. If you have undergone surgery or/and radiotherapy you may need long term replacement with other hormones. These could include thyroid hormones, corticosteroids or female sex hormones.

Diabetes Insipidus

Diabetes insipidus is caused by damage to the pituitary from a lack of ADH also known as anti-diuretic hormone. These hormones act on the kidneys and control the amount of water the body retains and how much is returned to the blood. If you were to suffer this complaint the warning signs are much like those in diabetes mellitus such as: constant thirst and producing large amounts of water (urine). This is because the kidneys can not retain water which means large amounts are passed into the urine, and then passed out of the body more frequently than would be considered normal.

Diabetes insipidus is rare and would be treated with an antidiuretic ADH or a related synthetic drug. This type of medication would be to replace naturally produced ADH and can be given in the form of a nasal spray or by injection. In mild cases a drug can be given to increase the release of ADH from the pituitary gland and by sensitizing the kidneys to the effect of ADH. While on the other hand a thiazide may be used. These type of drugs are generally given to increase water production, but with diabetes insipidus they have the opposite effect and reduce water loss from the body.

Reducing Prolactin

Prolactin is produced in both men and women. With men it is said to be necessary for the production of sperm. However, unusually high amounts are suspected to be responsible for impotence and loss of libido galactorrhoea (milky nipple substance). In women prolactin controls the breast milk after childbirth, the act of an infant suckling the nipple stimulates the production of prolactin,

Some drugs may increase the levels of prolactin in the blood such as: antipsychotics, oestrogen, phenothiazine and methyldopa. However, Prolactinomas accounts for 30 to 40 percent of all diagnosed pituitary tumors. Medication alone can usually lower concentration of prolactin to normal levels as well as reducing the size of the tumour. This complaint is more commonly diagnosed in women below age 50 than in older women or in men.

Below is a list of the most common drugs used.

Growth Hormone Disorders

• Bromocriptine
• Lanreotide
• Octreotide
• Somatropin

Diabetes Insipidus

• Carbamazepine
• Cholrpropamide
• Chlortalidone
• Desmopressin
• Vasopressin (ADH)

Reducing Prolactin Levels

• Bromocriptine
• Cabergoline
• Quinagolide