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PITUITARY SOCIETY
Dr. Edward H. Oldfield, Professor of Neurosurgery and Medicine, University of Virginia for the past 10 years, passed away on September 1, 2017. He was truly a “giant’ in his field regarding scientific research and advancements, development of surgical techniques and in-patient care. I was fortunate to work with him in our Pituitaryclinic
THE PITUITARY SOCIETY The following are a series of educational booklets, downloadable in PDF format, on a variety of pituitary-related diseases. The Pituitary Society gratefully acknowledges Chiasma for its support of these patient education booklets. WHAT IS THE PITUITARY GLAND? The pituitary is an endocrine (hormone-producing) gland that sits just beneath the base of the brain, behind the bridge of the nose. It is very small – only about the size of a pea. The pituitary gland is very important as it takes messages from the brain (via a gland called the hypothalamus) and uses these messages to produce hormones that HYPOPITUITARISM TESTING & WHAT'S NECESSARY The tests needed to make a diagnosis depend on the patient’s symptoms, the type of pituitary problem and the type of treatment received ( surgery, radiation).In general, a patient with a large pituitary adenoma is more likely to have a hormone deficiency than a patient with a small adenoma. A single blood test to determine the pituitary and target organ hormone levels may be all that is needed. WHEN LIFE-LONG TREATMENT FOR HYPOPITUITARISM IS NEEDED Proper hormone replacement usually requires life-long treatment for hypopituitarism, if the pituitary gland is permanently damaged. The optimal dose is then considered the “maintenance” dose, and it should become a regular part of daily life.PROLACTINOMAS
PATIENT INFORMATION PROLACTINOMAS 2 3 A prolactinoma is an abnormal growth, or tumor, on the pituitary gland. The tumor causes the pituitary to produce too much prolactin leading to TESTING TO DIAGNOSE CUSHING’S DISEASE By comparing the levels of ACTH produced close to the pituitary gland in response to the medication with those produced by other parts of the body, a diagnosis can be made. There are other tests used for the diagnosis of Cushing’s disease such as the dexamethasone suppression and corticotropin-releasing hormone ( CRH ) stimulation tests. IS FERTILITY POSSIBLE WITH HYPOPITUITARISM? Fertility is never certain for anyone, even adults with a normal pituitary gland (10% of all “normal” couples are infertile). Infertility related to hypopituitarism is the result of LH and FSH deficiency. Sometimes PRL levels are high, which results in reduced LH and FSH levels. In such a situation, fertility may be restored by lowering PRL levels with medication such as bromocriptine or WHAT ARE CUSHING’S SYNDROME AND CUSHING’S DISEASE? Cushing’s syndrome is a rare condition that is the result of too much of the hormone cortisol in the body. Cortisol is a hormone normally made by the adrenal glands and it is necessary for life. It allows people to respond to stressful situations such as illness, and has effects on almost all body tissues. It is produced in bursts, mostin
WHAT IS A PROLACTINOMA? There are a few conditions other than prolactinomas that may be associated with hyperprolactinemia.As prolactin is regulated by dopamine, medications that interfere with this substance in the brain can cause elevated prolactin levels.Drugs prescribed for psychiatric and gastrointestinal disorders may raise prolactin levels to greaterthan 200 ng/ ml.
PITUITARY SOCIETY
Dr. Edward H. Oldfield, Professor of Neurosurgery and Medicine, University of Virginia for the past 10 years, passed away on September 1, 2017. He was truly a “giant’ in his field regarding scientific research and advancements, development of surgical techniques and in-patient care. I was fortunate to work with him in our Pituitaryclinic
THE PITUITARY SOCIETY The following are a series of educational booklets, downloadable in PDF format, on a variety of pituitary-related diseases. The Pituitary Society gratefully acknowledges Chiasma for its support of these patient education booklets. WHAT IS THE PITUITARY GLAND? The pituitary is an endocrine (hormone-producing) gland that sits just beneath the base of the brain, behind the bridge of the nose. It is very small – only about the size of a pea. The pituitary gland is very important as it takes messages from the brain (via a gland called the hypothalamus) and uses these messages to produce hormones that HYPOPITUITARISM TESTING & WHAT'S NECESSARY The tests needed to make a diagnosis depend on the patient’s symptoms, the type of pituitary problem and the type of treatment received ( surgery, radiation).In general, a patient with a large pituitary adenoma is more likely to have a hormone deficiency than a patient with a small adenoma. A single blood test to determine the pituitary and target organ hormone levels may be all that is needed. WHEN LIFE-LONG TREATMENT FOR HYPOPITUITARISM IS NEEDED Proper hormone replacement usually requires life-long treatment for hypopituitarism, if the pituitary gland is permanently damaged. The optimal dose is then considered the “maintenance” dose, and it should become a regular part of daily life.PROLACTINOMAS
PATIENT INFORMATION PROLACTINOMAS 2 3 A prolactinoma is an abnormal growth, or tumor, on the pituitary gland. The tumor causes the pituitary to produce too much prolactin leading to TESTING TO DIAGNOSE CUSHING’S DISEASE By comparing the levels of ACTH produced close to the pituitary gland in response to the medication with those produced by other parts of the body, a diagnosis can be made. There are other tests used for the diagnosis of Cushing’s disease such as the dexamethasone suppression and corticotropin-releasing hormone ( CRH ) stimulation tests. IS FERTILITY POSSIBLE WITH HYPOPITUITARISM? Fertility is never certain for anyone, even adults with a normal pituitary gland (10% of all “normal” couples are infertile). Infertility related to hypopituitarism is the result of LH and FSH deficiency. Sometimes PRL levels are high, which results in reduced LH and FSH levels. In such a situation, fertility may be restored by lowering PRL levels with medication such as bromocriptine or WHAT ARE CUSHING’S SYNDROME AND CUSHING’S DISEASE? Cushing’s syndrome is a rare condition that is the result of too much of the hormone cortisol in the body. Cortisol is a hormone normally made by the adrenal glands and it is necessary for life. It allows people to respond to stressful situations such as illness, and has effects on almost all body tissues. It is produced in bursts, mostin
WHAT IS A PROLACTINOMA? There are a few conditions other than prolactinomas that may be associated with hyperprolactinemia.As prolactin is regulated by dopamine, medications that interfere with this substance in the brain can cause elevated prolactin levels.Drugs prescribed for psychiatric and gastrointestinal disorders may raise prolactin levels to greaterthan 200 ng/ ml.
WHAT IS ADULT GROWTH HORMONE DEFICIENCY? Adult Growth Hormone Deficiency also known as GH or AGHD is a protein hormone made by the pituitary, a hormone producing gland located at the base of the skull and is THE SYMPTOMS OF HYPOPITUITARISM Symptoms depend on which hormone or hormones are missing. ACTH deficiency causing cortisol deficiency: Symptoms include weakness, fatigue, weight loss, abdominal pain, low blood pressure and low serum sodium levels. During a period of severe stress such as infection or surgery, cortisol deficiency may potentially result in coma and death. HOW HYPOPITUITARISM IS TREATED Hormone deficiency is treated by replacing the deficient hormones. The goals of treatment are to improve symptoms (see Table 2) and to replace the deficient hormone or hormones at a level that is as close to physiologically correct (“mother nature”) as possible. However, one rule of hormone replacement is that no one dose will suit every patient. . Thus, when hormone replacement therapy is HYPOPITUITARISM TESTING & WHAT'S NECESSARY The tests needed to make a diagnosis depend on the patient’s symptoms, the type of pituitary problem and the type of treatment received ( surgery, radiation).In general, a patient with a large pituitary adenoma is more likely to have a hormone deficiency than a patient with a small adenoma. A single blood test to determine the pituitary and target organ hormone levels may be all that is needed. THE SYMPTOMS OF CUSHING’S SYNDROME The most common symptoms in adults are weight gain (especially in the trunk, and often not accompanied by weight gain in the arms and legs), high blood pressure (hypertension), and changes in memory, mood and concentration. Additional problems such as muscle weakness arise because of loss of protein in body tissues. Table 1. WHAT ARE CUSHING’S SYNDROME AND CUSHING’S DISEASE? Cushing’s syndrome is a rare condition that is the result of too much of the hormone cortisol in the body. Cortisol is a hormone normally made by the adrenal glands and it is necessary for life. It allows people to respond to stressful situations such as illness, and has effects on almost all body tissues. It is produced in bursts, mostin
NON-FUNCTIONING TUMORS Pituitary tumors are commonly divided into "functioning" tumors (those that secrete pituitary hormones and cause clinical syndromes) and "nonfunctioning" tumors (those that do not secrete a pituitary hormone that leads to a clinical syndrome). The functioning tumors make growth hormone and cause gigantism (in children) or acromegaly (in adults), make adrenocorticotropic hormone (ACTH) and WHAT IS HYPOPITUITARISM? There are numerous causes of hypopituitarism (see Table 1). The most common cause of hypopituitarism is a pituitary tumor (also known as a pituitary adenoma ). Pituitary adenomas are almost invariably benign (not cancerous). However, the pituitary adenoma itself may put pressure on the remaining normal part of the pituitary gland and limitor
NON-FUNCTIONING TUMORS Non-functioning tumors - Clinical Presentation. Patients with non functioning pituitary tumors present with symptoms due to the size and location of the tumor, symptoms due to deficiency of pituitary hormones, or a combination of these two effects: Symptoms due to the size and location of the tumor. Any pituitary tumor (or any othertumor or
HOW YOU MIGHT FEEL AFTER CUSHING'S DISEASE TREATMENT Most people feel relief from their symptoms following treatment for cushing's disease. Read more about how the body will gradually adjust to lower cortisol levels.PITUITARY SOCIETY
Dr. Edward H. Oldfield, Professor of Neurosurgery and Medicine, University of Virginia for the past 10 years, passed away on September 1, 2017. He was truly a “giant’ in his field regarding scientific research and advancements, development of surgical techniques and in-patient care. I was fortunate to work with him in our Pituitaryclinic
WHAT IS THE PITUITARY GLAND? The pituitary is an endocrine (hormone-producing) gland that sits just beneath the base of the brain, behind the bridge of the nose. It is very small – only about the size of a pea. The pituitary gland is very important as it takes messages from the brain (via a gland called the hypothalamus) and uses these messages to produce hormones that THE SYMPTOMS OF CUSHING’S SYNDROME The most common symptoms in adults are weight gain (especially in the trunk, and often not accompanied by weight gain in the arms and legs), high blood pressure (hypertension), and changes in memory, mood and concentration. Additional problems such as muscle weakness arise because of loss of protein in body tissues. Table 1. HYPOPITUITARISM TESTING & WHAT'S NECESSARY The tests needed to make a diagnosis depend on the patient’s symptoms, the type of pituitary problem and the type of treatment received ( surgery, radiation).In general, a patient with a large pituitary adenoma is more likely to have a hormone deficiency than a patient with a small adenoma. A single blood test to determine the pituitary and target organ hormone levels may be all that is needed. WHAT IS ADULT GROWTH HORMONE DEFICIENCY? Adult Growth Hormone Deficiency also known as GH or AGHD is a protein hormone made by the pituitary, a hormone producing gland located at the base of the skull and is HOW CUSHING’S SYNDROME IS DIAGNOSED How is Cushing’s Syndrome Diagnosed? Because not all people with Cushing’s syndrome have all signs and symptoms, and because many of the features of Cushing’s syndrome, such as weight gain and high blood pressure, are common in the general population, it can be difficult to make the diagnosis of Cushing’s syndrome based on thesymptoms alone.
TESTING TO DIAGNOSE CUSHING’S DISEASE By comparing the levels of ACTH produced close to the pituitary gland in response to the medication with those produced by other parts of the body, a diagnosis can be made. There are other tests used for the diagnosis of Cushing’s disease such as the dexamethasone suppression and corticotropin-releasing hormone ( CRH ) stimulation tests.PROLACTINOMAS
PATIENT INFORMATION PROLACTINOMAS 2 3 A prolactinoma is an abnormal growth, or tumor, on the pituitary gland. The tumor causes the pituitary to produce too much prolactin leading to WHAT IS A PROLACTINOMA? A. A. A. Hyperprolactinemia is suspected in women who have absent or irregular menstrual periods, abnormal breast discharge, or fertility issues. In men, an elevated prolactin level is suspected in the presence of erectile dysfunction, infertility, headaches, or vision problems. The first step in the evaluation is to draw a blood sampleto
WHAT IS A PROLACTINOMA? There are a few conditions other than prolactinomas that may be associated with hyperprolactinemia.As prolactin is regulated by dopamine, medications that interfere with this substance in the brain can cause elevated prolactin levels.Drugs prescribed for psychiatric and gastrointestinal disorders may raise prolactin levels to greaterthan 200 ng/ ml.
PITUITARY SOCIETY
Dr. Edward H. Oldfield, Professor of Neurosurgery and Medicine, University of Virginia for the past 10 years, passed away on September 1, 2017. He was truly a “giant’ in his field regarding scientific research and advancements, development of surgical techniques and in-patient care. I was fortunate to work with him in our Pituitaryclinic
WHAT IS THE PITUITARY GLAND? The pituitary is an endocrine (hormone-producing) gland that sits just beneath the base of the brain, behind the bridge of the nose. It is very small – only about the size of a pea. The pituitary gland is very important as it takes messages from the brain (via a gland called the hypothalamus) and uses these messages to produce hormones that THE SYMPTOMS OF CUSHING’S SYNDROME The most common symptoms in adults are weight gain (especially in the trunk, and often not accompanied by weight gain in the arms and legs), high blood pressure (hypertension), and changes in memory, mood and concentration. Additional problems such as muscle weakness arise because of loss of protein in body tissues. Table 1. HYPOPITUITARISM TESTING & WHAT'S NECESSARY The tests needed to make a diagnosis depend on the patient’s symptoms, the type of pituitary problem and the type of treatment received ( surgery, radiation).In general, a patient with a large pituitary adenoma is more likely to have a hormone deficiency than a patient with a small adenoma. A single blood test to determine the pituitary and target organ hormone levels may be all that is needed. WHAT IS ADULT GROWTH HORMONE DEFICIENCY? Adult Growth Hormone Deficiency also known as GH or AGHD is a protein hormone made by the pituitary, a hormone producing gland located at the base of the skull and is HOW CUSHING’S SYNDROME IS DIAGNOSED How is Cushing’s Syndrome Diagnosed? Because not all people with Cushing’s syndrome have all signs and symptoms, and because many of the features of Cushing’s syndrome, such as weight gain and high blood pressure, are common in the general population, it can be difficult to make the diagnosis of Cushing’s syndrome based on thesymptoms alone.
TESTING TO DIAGNOSE CUSHING’S DISEASE By comparing the levels of ACTH produced close to the pituitary gland in response to the medication with those produced by other parts of the body, a diagnosis can be made. There are other tests used for the diagnosis of Cushing’s disease such as the dexamethasone suppression and corticotropin-releasing hormone ( CRH ) stimulation tests.PROLACTINOMAS
PATIENT INFORMATION PROLACTINOMAS 2 3 A prolactinoma is an abnormal growth, or tumor, on the pituitary gland. The tumor causes the pituitary to produce too much prolactin leading to WHAT IS A PROLACTINOMA? A. A. A. Hyperprolactinemia is suspected in women who have absent or irregular menstrual periods, abnormal breast discharge, or fertility issues. In men, an elevated prolactin level is suspected in the presence of erectile dysfunction, infertility, headaches, or vision problems. The first step in the evaluation is to draw a blood sampleto
WHAT IS A PROLACTINOMA? There are a few conditions other than prolactinomas that may be associated with hyperprolactinemia.As prolactin is regulated by dopamine, medications that interfere with this substance in the brain can cause elevated prolactin levels.Drugs prescribed for psychiatric and gastrointestinal disorders may raise prolactin levels to greaterthan 200 ng/ ml.
THE PITUITARY SOCIETY The following are a series of educational booklets, downloadable in PDF format, on a variety of pituitary-related diseases. The Pituitary Society gratefully acknowledges Chiasma for its support of these patient education booklets. WHAT IS ADULT GROWTH HORMONE DEFICIENCY? Adult Growth Hormone Deficiency also known as GH or AGHD is a protein hormone made by the pituitary, a hormone producing gland located at the base of the skull and is THE SYMPTOMS OF HYPOPITUITARISM Symptoms depend on which hormone or hormones are missing. ACTH deficiency causing cortisol deficiency: Symptoms include weakness, fatigue, weight loss, abdominal pain, low blood pressure and low serum sodium levels. During a period of severe stress such as infection or surgery, cortisol deficiency may potentially result in coma and death. HOW HYPOPITUITARISM IS TREATED Hormone deficiency is treated by replacing the deficient hormones. The goals of treatment are to improve symptoms (see Table 2) and to replace the deficient hormone or hormones at a level that is as close to physiologically correct (“mother nature”) as possible. However, one rule of hormone replacement is that no one dose will suit every patient. . Thus, when hormone replacement therapy is IS FERTILITY POSSIBLE WITH HYPOPITUITARISM? Fertility is never certain for anyone, even adults with a normal pituitary gland (10% of all “normal” couples are infertile). Infertility related to hypopituitarism is the result of LH and FSH deficiency. Sometimes PRL levels are high, which results in reduced LH and FSH levels. In such a situation, fertility may be restored by lowering PRL levels with medication such as bromocriptine or NON-FUNCTIONING TUMORS Non-functioning tumors - Clinical Presentation. Patients with non functioning pituitary tumors present with symptoms due to the size and location of the tumor, symptoms due to deficiency of pituitary hormones, or a combination of these two effects: Symptoms due to the size and location of the tumor. Any pituitary tumor (or any othertumor or
WHEN LIFE-LONG TREATMENT FOR HYPOPITUITARISM IS NEEDED Proper hormone replacement usually requires life-long treatment for hypopituitarism, if the pituitary gland is permanently damaged. The optimal dose is then considered the “maintenance” dose, and it should become a regular part of daily life. HOW YOU MIGHT FEEL AFTER CUSHING'S DISEASE TREATMENT Most people feel relief from their symptoms following treatment for cushing's disease. Read more about how the body will gradually adjust to lower cortisol levels. FREQUENTLY ASKED QUESTIONS ABOUT CUSHING’S DISEASE Frequently Asked Questions (FAQ) I have been told I might have Cushing’s syndrome and have been referred to an endocrinologist. Why is this? An endocrinologist is a physician who specializes in hormone disorders. Cushing’s syndrome and disease are fairly rare and often quite complex and the best results can be expected when these are treated by a specialist endocrinologist, often togetherACROMEGALIA
INFORMACION PARA EL PACIENTE • ACROMEGALIA 1 Supported by an unrestricted educational grant from Eli Lilly and Company. La financiación ha sido proporcionada por el Grupo Ipsen, Novo Nordisk,Inc. y
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Advancing the GLOBAL EDUCATION and TREATMENT of PITUITARY DISEASE Find A Specialist Near YouCountry
ArgentinaAustraliaAustriaBelgiumBrazilCanadaChinaColombiaCosta RicaFranceGermanyIsraelIndiaItalyJapanLebanonMexicoMoroccoNetherlandsNew ZealandPakistanPanamaPeruPolandRomaniaSaudi ArabiaSingaporeSouth AfricaSpainTaiwanTurkeyUnited Arab EmiratesUnited KingdomUnited StatesUruguayVenezuelaYemen State --AlabamaArizonaCaliforniaColoradoDelawareDistrict Of ColumbiaFloridaGeorgiaIllinoisIowaKansasKentuckyLouisianaMarylandMassachusettsMichiganMinnesotaMississippiMissouriNebraskaNew JerseyNew MexicoNew YorkNorth CarolinaOhioOklahomaOregonPennsylvaniaSouth CarolinaTexasUtahVirgin IslandsVirginiaWashingtonWest VirginiaWisconsin WELCOME TO PITUITARY SOCIETY - EDUCATIONAL SOURCE FOR PITUITARY DISEASES & DISORDERS IN MEMORIAM: EDWARD H. OLDFIELD, MD, FACS Dr. Edward H. Oldfield, Professor of Neurosurgery and Medicine, University of Virginia for the past 10 years, passed away on September 1, 2017. He was truly a “giant’ in his field regarding scientific research and advancements, development of surgical techniques and in-patient care. I was fortunate to work with him in our Pituitary clinic – his clinical judgment, surgical expertise and knowledge were superior. He was an excellent teacher (Neurosurgery fellows and residents, Endocrine fellows, Neurology residents and medical students, and to me). More importantly, he was such a polite, kind and considerate man who was the classical description of a “Kentuckygentleman”.
His passing is our loss. Mary Lee Vance, M.D. Read the Journal of Neurosurgery Tribute No front page content has been created yet. 2015 Pituitary Society. All Rights Reserved. E&OE. user agreement and terms of use|
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