(Hyperpituitarism)
Having an overactive pituitary gland is called hyperpituitarism. It is most commonly
caused by noncancerous tumors. This causes the gland to secrete too much of certain
kinds of hormones related to growth, reproduction, and metabolism, among other
things.
The pituitary gland is a tiny pea-sized endocrine gland located in a bony cavity in the
base of the brain. Endocrine glands secrete hormonal substances into the bodys
bloodstream.
The pituitary gland plays a major role in regulating a wide range of biological functions.
It secretes hormones involved in:
Metabolism
Growth
Blood pressure
Sexual maturation and function
Blood vessels connect the pituitary gland to a part of the brain known as the
hypothalamus. The brain tells the pituitary to increase or decrease the secretion of
certain hormones.
Sometimes the pituitary is called the master gland because it controls the activity of
other endocrine glands. The pituitary gland consists of three parts: the anterior,
intermediate, and posterior lobes.
The anterior lobe, which makes up about 80% of the gland, secretes these hormones:
The posterior lobe stores and lets out two hormones that are produced by the
hypothalamus:
Post-op nursing care for Neuro checks to monitor for signs of cerebral edema. Monitor serum sodium and
surgical removal urine output and specific gravity for signs of diabetes insipidus. Watch for signs and
symptoms of target gland deficiency for all hormones
Several disorders related to an overactive pituitary gland can occur. These include:
Prolactinoma: A tumor on the pituitary known as a prolactinoma may cause the gland
to secrete too much prolactin. High levels of prolactin can disrupt normal reproductive
functions in men and women by interfering with hormones produced by the testes and
ovaries.
A prolactinoma can cause women who are not pregnant or nursing to experience
tenderness of the breasts and start to produce breast milk (galactorrhea). Their
menstrual periods may become irregular or might stop altogether. Women may become
infertile or lose interest in having sex. Having intercourse may be painful due to vaginal
dryness.
For men, the most common symptom of prolactinoma is erectile dysfunction. Men also
may experience a decrease in or loss of sex drive, lower fertility, or loss of energy. In
rare cases, men may secrete milk from their breasts or, when the prolactinoma is large,
blindness or difficulty seeing can occur.
Nervousness
Rapid or irregular heartbeat
Weight loss
Fatigue
Muscular weakness
Benign tumors are the most frequent cause of an overactive pituitary. Generally it is not
known why these tumors occur. Depending on which types of cells are affected, the
pituitary gland will start to secrete excessive amounts of one or two hormones. In some
cases, pituitary tumors may result from an inherited condition known as multiple
endocrine neoplasia type 1(MEN1). This disorder also causes benign tumors of the
pancreas and parathyroid glands. In rare cases, a cancerous tumor or a disorder of the
hypothalamus may be the underlying cause.
Small benign pituitary tumors (adenomas) are fairly common. They may be either
secreting (releasing excess amounts of hormones) or non-secreting and do not cause
any symptoms. Prolactinomas are the most common type of pituitary tumors, occurring
in about 1 out of 10,000 people. They are more common in women than in men.
Acromegaly is a very rare disorder that occurs in only about 3 out of 1 million people
each year. It generally is diagnosed in adults age 40 to 45.
Cushings syndrome is a relatively rare disorder that occurs mainly in adults from age
20 to 50 years old. When the syndrome is caused by an adenoma, it is about 5 times
more common in women than in men.
Your doctor will ask you about your medical history and any symptoms you are having.
He or she may order laboratory tests to measure the levels of hormones in your blood
or urine. Various diagnostic tests will be performed depending on the underlying
disorder that may be present.
If a prolactinoma is suspected, tests will be performed to measure prolactin levels in the
blood. Hypothyroidism (an underactive thyroid) can also cause elevated prolactin levels,
so tests should be done to rule out this possibility.
In the case of acromegaly, blood levels of growth hormone are usually elevated. GH
levels can change over time because the pituitary gland secretes the hormone in spurts.
Often an oral glucose tolerance test is performed to diagnose acromegaly. Healthy
people experience a drop in blood GH levels after drinking glucose, unlike people with
acromegaly.
In the case of Cushings syndrome, tests may be ordered to rule out other causes, such
as a tumor on the adrenal gland or the use of glucocorticoid drugs. Other tests include
the high-dose dexamethasone suppression test and specialized blood sampling, in
which a blood sample is taken from the veins of the sinuses that drain blood from the
pituitary gland.
If laboratory diagnostic tests suggest that a tumor is present, radiologic imaging tests will
be performed to determine the size and location of the tumor. Usually magnetic
resonance imaging (MRI) is more sensitive in this case than a computerized tomography
(CAT) scan. CAT scans may be used with patients who cannot undergo MRI, such as
those with pacemakers or other implants.