Pituitary Disorders: A Practical Guide for Patients & Primary Care Physicians
Author: Dr. Md. Abdul Bari Robel, MBBS, DEM
Diabetes, Thyroid, Obesity & Hormone Specialist
Introduction
The pituitary gland is the master endocrine gland regulating thyroid, adrenal, gonadal, growth and water balance. Disorders may result from hormone excess, deficiency or pituitary tumors.
Table 1. Pituitary Hormones
| Hormone | Target | Main Function |
| TSH | Thyroid | Stimulates thyroid hormone production |
| ACTH | Adrenal | Stimulates cortisol secretion |
| LH/FSH | Gonads | Reproduction |
| GH | Liver/Bone | Growth and metabolism |
| Prolactin | Breast | Lactation |
| ADH (posterior pituitary) | Kidney | Water balance |
Table 2. Common Pituitary Disorders
| Disorder | Key Features | Initial Evaluation |
| Hyperprolactinaemia | Galactorrhoea, infertility, hypogonadism | Prolactin, pregnancy test, MRI if indicated |
| Acromegaly | Enlarged hands/feet, facial changes | IGF-1 ± GH suppression test |
| Hypopituitarism | Multiple hormone deficiencies | Pituitary hormone profile |
| Diabetes insipidus | Polyuria, polydipsia | Serum/urine osmolality |
| Pituitary apoplexy | Sudden headache, visual loss | Emergency MRI/CT |
Diagnostic Algorithm
Clinical suspicion → Baseline pituitary hormone profile → MRI pituitary (when indicated) → Visual field assessment for macroadenomas → Disease-specific management.
Treatment Overview
| Condition | Treatment |
| Hyperprolactinaemia | Dopamine agonist first-line in most prolactinomas |
| Acromegaly | Surgery ± medical therapy/radiotherapy |
| Hypopituitarism | Individualized hormone replacement |
| Diabetes insipidus | Desmopressin and treat underlying cause |
| Pituitary apoplexy | Emergency endocrine and neurosurgical assessment |
Follow-up
Regular clinical review, hormone monitoring, MRI when indicated, visual field assessment for macroadenomas, and lifelong endocrine follow-up in many patients.
References
- Endocrine Society Clinical Practice Guidelines.
- Pituitary Society Consensus Statements.
- European Society of Endocrinology Clinical Guidance.