Is your pituitary gland overactive? (Hyperpituitarism) Let's talk about this simply!

Have you suddenly noticed big changes in your body? Maybe you've suddenly gained weight, your face has changed, or you feel tired all day no matter how much sleep you get? We often forget about these things, thinking they're normal. But did you know that behind some of these things, there may be a change in the functioning of a tiny, but very important gland in our brain. That's what we're talking about today.

What is this pituitary gland called? Why is it so important?

Imagine your body as a big company. The chief executive of that company, the boss who controls everything, is the pituitary gland . This is a small gland, about the size of a pea, located at the base of our brain, about the size of a cherry. Although it is small, it does a lot of work. That is why it is sometimes called the "master gland."

Simply put, it controls the work of other endocrine glands in our body. For example, the thyroid gland, adrenal glands, and our reproductive system, such as the ovaries or testes, are controlled by hormones released by the pituitary gland.

Just like the thermostat in our house. It constantly monitors the temperature in the house and keeps the temperature at the same level by turning the AC or heater on/off, right? In the same way, the pituitary gland constantly monitors the hormone levels in our body and sends signals to other glands to release the necessary hormones at the right time.

So what is this hyperpituitarism?

Simply put, Hyperpituitarism is when the aforementioned pituitary gland becomes overactive, releasing more hormones into our blood than necessary. It's like the boss at the company working too much and messing everything up.

Most of the time, that is, about 99% of the time, the cause is a small, non- cancerous (benign) tumor. In medical terms, we call this a pituitary adenoma . This tumor stimulates the gland and causes it to produce more hormones than it should.

Hormones produced by the pituitary gland and their functions

There are three main parts of the pituitary gland. Each part releases different hormones. Let's take a look at what they are and what happens to them.

Diseases that can occur due to overactive pituitary gland

The disease condition that occurs varies depending on which hormone is produced in excess by the pituitary gland. Let's look at the main conditions that are seen.

• Cushing's Syndrome: If the ACTH hormone is produced in excess, the level of cortisol in our body increases significantly. This is called Cushing's Syndrome.
• Acromegaly: This condition occurs when growth hormone (GH) is produced in excess during adulthood. This causes the bones of the hands, feet, and face to grow abnormally large. If this occurs during childhood, it is called gigantism .
• Hyperthyroidism: If too much TSH is produced (this is somewhat rare), the thyroid gland becomes overactive and the body's metabolism speeds up.
• Prolactinoma: A tumor (adenoma) in the cells that produce the hormone prolactin causes excessive production of the hormone. This can have a significant impact on reproductive health.

What are the symptoms of these diseases?

The symptoms that come with each of these conditions are different. If you have any of these symptoms, it is very important to see a doctor.

How does this situation affect children?

Hyperpituitarism is very rare in children. If it does occur, it is often caused by a small pituitary adenoma. The most common type of tumor in children is a prolactin-producing tumor (Prolactinomas).

• For girls: Delayed puberty, cessation of menstruation (amenorrhea), and ovarian dysfunction may occur.
• Boys: Large tumors (macroprolactinomas) are more likely to develop. Because these tumors are large, they can press on nerves in the brain, causing headaches and vision problems. They can also cause delayed puberty and growth problems.

How does the doctor diagnose this disease?

When you tell us about your symptoms, the doctor will first examine you carefully. Then, they may do several tests to confirm the diagnosis.

1. Blood and urine tests: These will measure the levels of hormones in your blood and possibly urine. For example, they will check your levels of prolactin, cortisol, and growth hormone.

2. Imaging Scans: If an abnormality in hormone levels is seen, a scan is done to check for a pituitary tumor. The most common scan used for this is an MRI (Magnetic Resonance Imaging) scan. For someone who cannot have an MRI (e.g. someone with a pacemaker), a CT (Computed Tomography) scan may also be done.

3. Specialized tests: Sometimes, to accurately diagnose conditions like Cushing's syndrome, specialized tests, such as measuring salivary cortisol levels, may be necessary.

What are the treatments?

Treatment for this condition depends on factors such as the type of condition you have, the size of the tumor, and your overall health. There are three main treatment options.

1. Medication

Often, the first treatment is medication. These medications are used to:

• Controlling hormone levels.
• Sometimes reducing the size of the tumor.
• Medications are particularly effective for prolactinoma, with hormone levels returning to normal in over 80% of cases.

2. Surgery

If medications cannot control the tumor, or if the tumor has grown large enough to affect vision, the next step is to surgically remove the tumor.

• The most common surgery is called a transsphenoidal adenomectomy . This involves making a small incision through the nose or inside the upper lip to reach the pituitary gland and remove the tumor without damaging the brain.
• If this surgery is performed by an experienced surgeon, the success rate is more than 80%.

3. Radiation Therapy

Radiation therapy is used if part of the tumor remains after surgery, or if surgery is not possible.

• This involves targeting high-energy rays to the tumor and destroying those cells.
• Modern methods like stereotactic therapy can greatly reduce damage to surrounding healthy tissue.

Is it possible to be healthy with this condition?

Yes, absolutely. Most conditions caused by hyperpituitarism can be managed well with medication and other treatments. The most important thing is to seek medical advice as soon as symptoms appear and follow the prescribed treatment exactly. Some conditions may require long-term medication or medical supervision. However, with proper management, most people can live healthy, happy, and normal lives.

Hyperpituitarism, Pituitary Gland, Hormonal Problems, Cushing's Syndrome, Acromegaly, Prolactinoma, Hormonal Imbalance