Barts and The London Endocrinology Centre
The pituitary gland is as small as a thumb nail and is located at the base of the brain. It is often referred to as the ‘master gland’. It produces several hormones, which in turn control the hormone production of many other glands in the body. Pituitary disorders are complex and rare. Patients with pituitary disorders receive care from our multidisciplinary team of experts.
Some of the pituitary gland disorders we see and treat and Barts and The London Endocrinology Centre include:
This is one of the most common types of tumour of the pituitary gland and may lead to underproduction of pituitary hormones. Large tumours may cause headaches if they compress on the pituitary gland and / or visual disturbance if they compress on the optic nerves. These types of tumours tend to be slow growing and may be present for several years before a diagnosis is made. They are non cancerous and are usually treated by surgical removal and sometimes followed by radiotherapy.
This is a prolactin-producing tumour of the pituitary gland. Prolactin is the hormone associated with the production of breast milk. Excessive production of prolactin may disturb the menstrual cycle in women and is sometimes associated with fertility problems.
These types of tumours are usually very small - less than one centimetre in size is known as a micro prolactinoma. Those that are larger than one centimetre are known as a macro-prolactinoma. These types of tumour cause the production of breast milk in women when they are not feeding an infant. In men, elevated prolactin levels often lead to abnormally low levels of testosterone and is associated with lack of potency. Most patients with this type of tumour can be treated successfully with tablet medication which will shrink the size of the tumour.
Acromegaly is a rare condition. In adults, acromegaly causes soft tissue enlargement, some typical symptoms include coarsening of facial features, enlargement of hands and feet, fatigue and excessive sweating. In children, acromegaly causes gigantism (growing too much). In adults, acromegaly may cause diabetes, hypertension and premature arthritis. This condition is caused by a pituitary tumour producing too much growth hormone.
Treatment options for patients with acromegaly include surgery, radiotherapy to the pituitary gland and various medical treatments including cabergoline tablets, somatostatin analogue injections or, in selected cases, injections of the growth hormone blocking drug pegrisomant. Our centre has huge experience in all these treatment options for patients diagnosed with this rare condition.
Growth hormone deficiency (adults)
Growth hormone is a protein made in the pituitary gland and is passed from there into the blood stream. Growth hormone effects virtually every part of the body and in children, its primary use is to improve their growth. In adults with growth hormone deficiency they may experience symptoms such as fatigue and low vitality. Adults can be treated with growth hormone replacement and advice on administering growth hormone injection is provided by our specialist growth hormone nurse. Our department has the largest experience in the country of treating growth hormone deficiency.
Craniopharyngiomas are rare, non-cancerous tumours occurring in the region of the pituitary gland. They can be solid cystic (containing fluid). Treatment may include external beam radiotherapy which involves 3 radio beams being aimed at the same point on the pituitary gland. Patients will wear a tightly fitting mask made to fit their face perfectly – this allows for all the radiation to be supplied to one tiny spot allowing for healthy tissue to remain so. A small dose of radiation is given every day for five weeks and this is given to patients visiting our hospital on a daily basis.
This is a disorder in which the kidneys are unable to retain water. Patients with this condition need to pass large amounts of urine, which in turn makes them feel extremely thirsty. This condition is usually caused by a lack of water-retaining hormone called vasopressin. Patients with diabetes insipidus are given hormone treatment which replenishes the levels of vasopressin the body would naturally produce. For details of our diabetes service at Barts and The London, please click here.
HypopituitarismThe pituitary gland produces a number of hormones which are all released into the blood to control other glands in the body. If the pituitary gland is not producing one or more of these hormones, or even not enough, this is a condition known as hypopituitarism. This condition is normally caused by a non cancerous tumour of the pituitary gland and the under-activity of the hormone production may be caused by the pressure of the tumour. Treatment of this condition is by hormone replacement therapy and a decision of how much replacement is given will depend entirely on the patient’s symptoms along with detailed monitored blood endocrine tests.