Hyperpituitarism

Medically reviewed by Karen Gill, MD on November 13, 2017Written by Diana K. Wells on November 13, 2017

Overview

The pituitary gland is a small gland located at the base of your brain. It’s about the size of a pea. It is an endocrine gland. The condition hyperpituitarism occurs when this gland begins overproducing hormones. The pituitary gland produces hormones that regulate some of your body’s major functions. These major body functions include growth, blood pressure, metabolism, and sexual function.

Hyperpituitarism can adversely affect many of your body’s functions. These may include:

  • growth regulation
  • puberty in children
  • skin pigmentation
  • sexual function
  • breast milk production for women who are lactating
  • thyroid function
  • reproduction

Symptoms

The symptoms of hyperpituitarism vary based on the condition it causes. We will look at each condition and the accompanying symptoms individually.

Symptoms of Cushing syndrome may include the following:

  • excess upper body fat
  • unusual amount of facial hair on women
  • easy bruising
  • bones easily broken or fragile
  • abdominal stretch marks that are purple or pink

Symptoms of gigantism or acromegaly may include the following:

  • hands and feet that grow larger
  • enlarged or unusually prominent facial features
  • skin tags
  • body odor and excessive sweating
  • weakness
  • husky-sounding voice
  • headaches
  • enlarged tongue
  • joint pain and limited movement
  • barrel chest
  • irregular periods
  • erectile dysfunction

Symptoms of galactorrhea or prolactinoma may include the following:

  • tender breasts in women
  • breasts that begin to produce milk in women who are not pregnant and rarely in men
  • reproductive dysfunctions
  • irregular periods or menstrual cycle stops
  • infertility
  • low sex drive
  • erectile dysfunction
  • low energy levels

Symptoms of hyperthyroidism may include the following:

  • anxiety or nervousness
  • rapid heart rate
  • irregular heartbeats
  • exhaustion
  • muscle weakness
  • loss of weight

What are the causes?

A malfunction in the pituitary gland like hyperpituitarism is most likely caused by a tumor. The most common type of tumor is called an adenoma and is noncancerous. The tumor can cause the pituitary gland to overproduce hormones. The tumor, or fluid that fills in around, it may also press on the pituitary gland. This pressure can result in too much hormone being produced or too little being produced, which causes hypopituitarism.

The cause of these types of tumors is not known. However, the cause of the tumor may be hereditary. Some hereditary tumors are caused by a condition known as multiple endocrine neoplasia syndromes.

Treatment options

Treatment of hyperpituitarism will vary based on the specific diagnosis of the condition it is causing. However, the treatment may include one or more of the following:

Medication

If a tumor is causing your hyperpituitarism then medication may be used to shrink it. This may be done before surgery to remove the tumor. Medication may also be used on the tumor if surgery is not an option for you. For other hyperpituitarism conditions, medications may help treat or manage them.

Conditions that may need medication for management or treatment include:

  • Prolactinoma. Medications can lower your levels of prolactin.
  • Acromegaly or gigantism. Medication can lower the amount of growth hormones.

Surgery

Surgery is performed to remove a tumor from the pituitary gland. This type of surgery is called transsphenoidal adenomectomy. To remove the tumor, your surgeon will make a small cut in your upper lip or nose. This incision will allow the surgeon to get to the pituitary gland and remove the tumor. When done by an experienced surgeon, this type of surgery has more than an 80 percent rate of success.

Radiation

Radiation is another option if you’re unable to have surgery to remove the tumor. It can also help to remove any tumor tissue that may have been left behind from a prior surgery. Additionally, radiation can be used for tumors that don’t respond to medications. There are two types of radiation that may be used:

  • Conventional radiation therapy. Small doses are given over a four- to six-week period. Surrounding tissues may be damaged during this type of radiation therapy.
  • Stereotactic therapy. A beam of high-dose radiation is aimed at the tumor. This is usually done in a single session. When done in a single session, there is less possibility of damaging surrounding tissue. It may require ongoing hormone replacement therapy afterward.

How is it diagnosed?

Hyperpituitarism diagnostic tests differ depending on your symptoms and medical history. After discussing your symptoms and giving you a physical exam, your doctor will determine which diagnostic tests should be used. The type of tests may include:

  • blood tests
  • oral glucose tolerance test
  • specialized blood sampling tests
  • imaging tests with MRI or CT scan if a tumor is suspected

Your doctor may use one or a combination of these tests to come up with a proper diagnosis.

Complications and associated conditions

Hyperpituitarism can cause several different conditions. These conditions include the following:

  • Cushing syndrome
  • gigantism or acromegaly
  • galactorrhea or prolactinoma
  • hyperthyroidism

Complications of hyperpituitarism vary depending on what condition it causes. One possible complication following surgery to remove the tumor is that you may have an ongoing need to take hormone replacement therapy drugs.

Outlook

The outlook for those with hyperpituitarism is good. Some of the conditions it can cause will require ongoing medications for proper management of symptoms. However, it can be managed successfully with proper care, surgery if needed, and medications as directed. To receive appropriate treatment and management, you should be sure to consult medical professionals that are experienced with hyperpituitarism.

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