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Many disorders of the pituitary gland require clinical care by a physician or other healthcare professional. Below are some of the conditions BSW Endocrine Center treat:

  • Acromegaly
  • Diabetes Insipidus
  • Empty Sella Syndrome
  • Hypopituitar​ism
  • Tumor​s


What is acromegaly?

When your pituitary gland makes too much growth hormone, abnormal growth occurs. This is called acromegaly. The abnormal growth starts in your hands and feet, as soft tissue begins to swell. This rare disease affects mostly middle-aged adults. It can lead to severe illness and even death if not treated.

In children, too much growth hormone causes a condition called gigantism. This leads to a significant increase in height.

What causes acromegaly?

Acromegaly happens when the pituitary gland makes too much growth hormone for a long time. Several reasons may cause this extra amount of hormone to be made. The most common is a benign tumor in the pituitary gland. Most people with the disease have this type of tumor. It is not cancer. Tumors in other parts of the body can also cause acromegaly. But that is rare.

What are the symptoms of acromegaly?

Each person’s symptoms may vary. They depend on how long you have had the disease. Symptoms may include:

  • Swelling of your hands and feet. You may find your rings no longer fit and you need to buy larger shoes.
  • Larger lips, nose, and tongue, as your bones grow
  • Larger jaw that sticks out more (protrudes)
  • Thicker body hair
  • Thicker, darker skin
  • More sweat and body odor
  • Deeper voice
  • Larger chest as your ribs get thicker
  • Joint pain
  • Degenerative arthritis
  • Your heart gets larger
  • Other organs get larger
  • Strange feelings and weakness in your arms and legs
  • Snoring and breaks in breathing during sleep (sleep apnea)
  • Lack of energy (fatigue) and weakness
  • Headaches
  • Loss of eyesight
  • Irregular menstrual cycles in women
  • Breast discharge in women
  • Impotence in men
  • These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is acromegaly diagnosed?

Symptoms may not be seen right away. So acromegaly is often not found until years later. Your healthcare provider will take your medical history and give you a physical exam. In addition, you may need:

  • Photos taken regularly over the years, to see physical changes
  • X-rays, to see bone thickening
  • Blood tests, to check your growth hormone level
  • MRI or CT scan, to find tumors

How is acromegaly treated?

Your healthcare provider will figure out the best treatment for you based on:

  • Your age, overall health, and medical history
  • How sick you are
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • What you would like to do

The goal of treatment is to fix the pituitary gland so it makes normal levels of growth hormone. Treatment of acromegaly depends on what is causing the disease. Most cases are caused by benign tumors on the pituitary gland. Others are caused by tumors in the pancreas, lungs, or adrenal glands. Treatment may include:

  • Surgery to remove or reduce the size of a tumor
  • Radiation therapy
  • Shots (injections) of medicines to block growth hormone

What are the complications of acromegaly?

If acromegaly isn’t treated, it can lead to several problems. These may include:

  • Heart disease
  • Arthritis
  • Diabetes and impaired glucose tolerance
  • High blood pressure

The disease also raises your risk for colon polyps. These are small growths on the lining of your colon. They may lead to colorectal cancer.

Living with acromegaly

You should see your healthcare provider on a regular basis. He or she can make sure your treatment is still working. Your provider can also check for any problems. Early treatment can then be started if needed.

When should I call my healthcare provider?

Tell your healthcare provider if your symptoms get worse or you have new symptoms.

Key points about acromegaly

  • Acromegaly is a rare disease. It occurs when your pituitary gland makes too much growth hormone for a long time. That causes abnormal growth.
  • Acromegaly starts in the hands and feet. It affects mostly middle-aged adults.
  • Most people with this condition have a benign tumor in the pituitary gland.
  • Symptoms depend on how long you have had the disease. Because symptoms can be missed, the disease is often not diagnosed until years later.
  • If not treated, acromegaly can lead to heart problems, arthritis, diabetes, high blood pressure, or even death.


What is diabetes insipidus?

Diabetes insipidus occurs when your body doesn’t make enough antidiuretic hormone (ADH) or your kidneys don’t respond to it. ADH helps keep the right amount of water in your body. Normally, ADH controls how much urine your kidneys put out. This keeps you from losing too much water (being dehydrated). If you are a bit dehydrated, ADH should increase.

ADH is made by the hypothalamus, a small gland at the base of the brain. It is stored in the pituitary gland and then sent into the bloodstream as needed.

Diabetes insipidus is not related to the more common type of diabetes (diabetes mellitus).

What is the cause of diabetes insipidus?

There are several types of diabetes insipidus:

  • Central. This type occurs when the pituitary doesn’t make or send out enough ADH. It can happen if the hypothalamus or pituitary gland are damaged. This can be caused by a head wound (including surgery on the pituitary gland,) a genetic problem, and other diseases.
  • Nephrogenic. This type occurs when the kidneys don’t respond to normal levels of ADH. It can be caused by medicines or lifelong (chronic) disorders such as kidney disease or sickle cell disease.
  • Dipsogenic. This type occurs when there is damage to the mechanism that controls thirst, found in the hypothalamus. As a result you are too thirsty and drink too many fluids. This slows down ADH production.
  • Gestational. This occurs only in pregnant women. In this type, an enzyme made by the placenta destroys ADH in the mother.

What are the symptoms of diabetes insipidus?

Common symptoms may include:

  • Being very thirsty
  • Making too much urine
  • Dehydration

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is diabetes insipidus diagnosed?

Your provider will take your health history and give you a physical exam. You may also need the following tests:

  • Urine tests
  • Blood tests to see how your pituitary and kidneys react to dehydration (called a formal water deprivation test)

How is diabetes insipidus treated?

Your healthcare provider will figure out the best treatment for you based on:

  • Your age, overall health, and medical history
  • How sick you are
  • How well you handle certain medicines, treatments, or therapies
  • If your condition is expected to get worse
  • Your opinion or preference

Treatment for diabetes insipidus depends on what is causing it:

  • For central and gestational types, treatment may include taking modified ADH medicines or medicines to stimulate ADH production.
  • In nephrogenic diabetes insipidus, other medicines are used.
  • For all types, specific fluid intake is needed.
  • There is no known treatment for dipsogenic diabetes insipidus.

What are the complications of diabetes insipidus?

If you don’t drink enough fluids, you can get dehydrated. You can also have an electrolyte imbalance. This means not having the right balance of minerals in your body.

Dehydration can cause:

  • Dry skin
  • Dry mouth, nose, and sinuses
  • Fever
  • Rapid heart rate
  • Eyes can appear sunken
  • Weight loss

Electrolyte imbalance can cause:

  • Tiredness
  • Headache
  • Muscle pains
  • Feeling very tired
  • Being grouchy (irritable)
  • Irregular heartbeat

Living with diabetes insipidus

It’s important to follow your healthcare provider’s advice on medicines and fluid intake to prevent problems.

When should I call my healthcare provider?

If your symptoms get worse or you have new symptoms, call your healthcare provider right away.

Key points

  • Diabetes insipidus occurs when your body doesn’t make enough antidiuretic hormone (ADH). It is a rare disease that causes you to urinate often.
  • It is not related to the more common type of diabetes (diabetes mellitus).
  • Symptoms may include extreme thirst and urine production, and dehydration.
  • You may need to have blood tests and urine tests.
  • Treatment depends on what is causing the disease. It includes replacing ADH with medicines.

What is empty sella syndrome?

Empty sella syndrome (ESS) may occur if you have an enlarged sella turcica. This is a bony structure where the pituitary gland sits at the base of the brain. During an imaging test of the area, the pituitary gland may first look like it is missing. 

There are 2 types of ESS: primary and secondary.

  • Primary ESS. The pituitary gland is usually flattened. This type is more common in women who are obese and have high blood pressure. It has also been linked to fluid buildup in the brain. 
  • Secondary ESS. The pituitary gland may be small because of a genetic change (mutation), injury, radiation therapy, or surgery.

What causes empty sella syndrome?

Health experts don’t know what causes primary ESS. Secondary ESS may be caused by injury, radiation therapy, or surgery. ESS is not a life-threatening illness.

What are the symptoms of empty sella syndrome?

You may not have any symptoms. If symptoms occur, they may include:

  • Impotence in men
  • Less desire for sex
  • Irregular menstrual periods in women

Symptoms vary from person to person. They also depend on your age and what caused the syndrome. Symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is empty sella syndrome diagnosed?

Your healthcare provider will ask about your medical history and do a physical exam. You may also need these tests:

  • CT scan. This test uses X-rays and a computer to make images of your body. It helps find any problems.
  • MRI. This test creates 2-D views of an internal organ or structures, especially the brain or spinal cord.

How is empty sella syndrome treated?

Your healthcare provider will figure out the best treatment for you based on:

  • How old you are
  • Your overall health and past health
  • How sick you are
  • How well you can handle specific medicines, procedures, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

You may not need treatment if you do not have any symptoms, and if your pituitary gland is not enlarged. Your healthcare provider will treat any hormone problems with hormone replacement.

When should I call my healthcare provider?

Call your healthcare provider if your symptoms get worse or you have new ones.

Key points

  • ESS may happen if you have an enlarged sella turcica. This is a bony structure where the pituitary gland sits at the base of the brain.
  • Health experts don’t know what causes primary ESS. Secondary ESS may be caused by injury, radiation therapy, or surgery.
  • It is not a life-threatening condition.
  • You may not have any symptoms. If symptoms occur, they may include impotence, less desire for sex, and irregular menstrual periods.
  • You may not need treatment if you do not have symptoms, and if your pituitary gland is not enlarged.

What is hypopituitarism?

Hypopituitarism happens when your pituitary gland is not active enough. As a result the gland does not make enough pituitary hormones.

The pituitary is a small gland at the base of your brain. It is one of several glands that make hormones. Hormones are chemicals that send information and instructions from one set of cells to another. The pituitary gland makes many types of hormones. These hormones affect many things, including bone and tissue growth, your thyroid gland, and sexual development and reproduction.

What causes hypopituitarism?

Causes can directly affect the pituitary gland. Or they can indirectly affect the gland through changes in the hypothalamus. This is a part of the brain that is just above the pituitary gland.

Direct causes include:

  • Pituitary tumors
  • Poor blood supply to the pituitary gland
  • Infections or inflammatory diseases
  • Radiation treatment
  • Surgery to remove pituitary tissue
  • Autoimmune diseases
  • Head injury
  • Genetic diseases
  • Rare diseases, such as sarcoidosis and amyloidosis

Indirect causes include:

  • Hypothalamus tumors
  • Inflammatory disease or a disease that spreads to the pituitary, such as cancer 
  • Head injuries
  • Surgical damage to the hypothalamus or blood vessels or nerves leading to it

What are the symptoms of hypopituitarism?

Symptoms are different for each person. They may happen over time or right away. They depend on which hormones the pituitary gland is not making enough of. These hormone deficiencies, and the symptoms they cause, include:

  • Not enough gonadotropins (luteinizing hormone and follicle-stimulating hormone). This affects women who have not gone through menopause. They may not have a menstrual period. They may have problems with fertility, vaginal dryness, and loss of some female traits. Men may have problems with fertility, sexual function, and loss of some male traits. Children will not go through
  • Not enough growth hormone. Adults with this problem may lose bone and muscle mass. In children it can lead to stunted growth and dwarfism.
  • Not enough thyroid-stimulating hormone. This often leads to an underactive thyroid. It may cause lack of energy (fatigue), confusion, inability to handle the cold, weight gain, constipation, and dry skin.
  • Not enough ACTH (adrenocorticotropin hormone). This is rare. It leads to an underactive adrenal gland. You may have low blood pressure, low blood sugar, feel tired, and be easily stressed.
  • Not enough prolactin. This is rare. Women who lack this hormone may not be able to make breastmilk after childbirth.

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is hypopituitarism diagnosed?

Your healthcare provider will ask about your medical history. You will also need an exam. Other tests you may need include:

  • CT scan. This test uses X-rays and computer technology to make images of your body.
  • MRI. This test makes 2-dimensional views of your organs or body structures.
  • Blood and urine tests. These tests measure hormone levels in your body.

How is hypopituitarism treated?

Your healthcare provider will figure out the best treatment for you based on:

  • How old you are
  • Your overall health and past health
  • How sick you are
  • How well you can handle certain medicines, treatments, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

Treatment depends on what is causing the condition. The treatment goal is to have the pituitary gland work as it should. Treatment may include:

  • Hormone replacement therapy
  • Surgery to remove a tumor
  • Radiation therapy

When should I call my healthcare provider?

Tell your healthcare provider if your symptoms get worse or you have new symptoms.

Key points about hypopituitarism

  • Hypopituitarism happens when the pituitary gland is not active enough. It does not make enough hormones.
  • It can be caused by things that directly affect the pituitary gland. Or it can be caused by things that indirectly affect the gland through changes in the hypothalamus.
  • Symptoms depend on which hormones the pituitary gland is not making enough of.
  • The treatment goal is to return the pituitary gland to normal function. Treatment may include hormone replacement therapy, surgery to remove a tumor, or radiation therapy.

What are pituitary tumors?

A pituitary tumor is an abnormal growth in the pituitary gland. The pituitary is a small gland in the brain. It is located behind the back of the nose. It makes hormones that affect many other glands and many functions in your body. Most pituitary tumors are not cancerous (benign). They don’t spread to other parts of your body. But they can cause the pituitary to make too few or too many hormones, causing problems in the body.

Pituitary tumors that make too many hormones will cause other glands to make more hormones. That will cause symptoms related to each of the specific hormones. Many pituitary tumors will also press against the nearby optic nerves. This can cause vision problems. 

Most pituitary tumors don’t cause symptoms. As a result, they are not diagnosed. Or they are found only during a routine brain imaging test. About 25% of people may have small pituitary tumors without knowing it.

Below are the main types of pituitary tumors.

Nonfunctional adenomas (null cell adenomas)

These tumors are the most common type. They don’t make extra hormone. You may not have any symptoms until the tumor is a certain size. When the tumor is big enough, it may cause headaches and vision problems. Large pituitary tumors can crush normal pituitary cells. This leads to symptoms caused by decreased hormone production.

Prolactin-producing tumors (prolactinomas)

These benign tumors are also common. They make too much prolactin. If you are a woman, high prolactin levels can make your menstrual period irregular, or even stop your period. These tumors can also cause you to make breastmilk, even if you are not pregnant or nursing. If you are a man, you may have erectile dysfunction or a lack of interest in sex. You may also have enlarged breasts, a low sperm count, or less body hair. In time, you may have headaches and vision problems.

ACTH-producing tumors

ACTH (adrenocorticotropic hormone) stimulates the adrenal gland to make steroids that affect metabolism. These are called glucocorticoids. They reduce redness and swelling (inflammation) all over the body. They also slow down your immune system. Too much ACTH can cause Cushing's disease. This disease causes fat buildup in your face, neck, back, belly (abdomen), and chest. Also your arms and legs tend to become thin. You may also have purple stretch marks and high blood pressure. These tumors can also weaken your bones.

Growth hormone-producing tumors

These tumors make too much growth hormone. In children, too much growth hormone stimulates the growth of almost all the bones in the body. When that occurs, the result is called gigantism. Gigantism can include increased height (over 7 feet), very quick growth, joint pain, and heavy sweating. In adults, too much growth hormone causes a condition called acromegaly. It may include:

  • Extra growth in the skull, hands, and feet
  • Deepened voice
  • A change in the facial appearance because of extra growth in the facial bones
  • A wide spacing of teeth because of the growth of facial bones
  • Joint pain
  • Snoring or sleep apnea
  • Diabetes or impaired glucose tolerance

What causes pituitary tumors?

Experts don't know what causes these tumors. But a condition called multiple endocrine neoplasia type I (MEN 1) may raise your risk. This condition is passed down through families.

What are the symptoms of pituitary tumors?

Symptoms depend on the type of tumor and the affected area of the pituitary gland. These tumors can lead to symptoms caused by too much or too little of the pituitary hormones. Each person’s symptoms may vary. The symptoms may also look like other health problems. Always see your healthcare provider for a diagnosis.

How are pituitary tumors diagnosed?

Your healthcare provider will ask about your medical history and do a physical exam. You may also need one of these tests:

  • Blood and urine tests. These tests will check hormone levels in your blood and urine.
  • CT scan. This test uses X-rays and a computer to make images of your body.
  • MRI. This test uses large magnets, radio waves, and a computer to make detailed images of organs and structures in your body.
  • Biopsy. During this test, the provider removes a tissue sample with a needle or during surgery. It is then checked under a microscope. A biopsy can tell if cancer or other abnormal cells are present.

How are pituitary tumors treated?

Your health care provider will figure out the best treatment for you based on:

  • How old you are
  • Your overall health and medical history
  • How sick you are
  • How well you can handle certain medicines, treatments, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

Treatment may include:

  • Surgery to remove the tumor. Surgery is often a better option for smaller tumors.
  • External radiation (external beam therapy). This treatment sends high levels of radiation right to the cancer cells. Special shields may be used to protect the tissue around the treatment area. These treatments are painless and usually last a few minutes.
  • Radiosurgery (stereotactic radiosurgery) or gamma knife treatment. This uses 1 high dose of radiation sent right into the cancerous tissue. It causes less damage to nearby tissues. It is not actually surgery. But like surgery, it is a 1-session treatment that removes the tumor.
  • Medicine. Different types of medicine may be used to control how much growth hormone is made by the tumor.

When should I call my healthcare provider?

Call your healthcare provider if your symptoms return or you have new symptoms.

Key points

  • A pituitary tumor is an abnormal growth in the pituitary gland. Most pituitary tumors are not cancer (benign).
  • The pituitary is a small gland in the brain. It makes hormones that affect many other glands and many functions in your body.
  • Symptoms vary depending on the type of tumor and the affected area of the pituitary gland.
  • Your healthcare provider may order blood and urine tests, a CT scan, MRI, or biopsy to diagnose the tumor.
  • Treatment may include surgery, radiation therapy, or medicine.