Last month was ‘Pituitary Awareness’ month. It got me thinking that we just don’t put enough focus on exploring this gland when discussing the endocrine system. When I lecture on the endocrine system our time is spent discussing thyroid conditions and Type 2 Diabetes as these are health issues which are widely recognised within the healthcare system as commonly occurring.
Pituitary disorders such as pituitary tumours are considered rare. It is estimated that there are around 70,000 pituitary patients in the United Kingdom.
However, as misdiagnosis is a common problem, some reports suggest that many more people could have undiagnosed pituitary issues. And for this reason it is important to understand the ‘MASTER GLAND’.
Your pituitary gland is about the size of a pea and is situated in a bony hollow, just behind the bridge of your nose. It is attached to the base of your brain by a thin stalk. The pituitary gland is often called the master gland because it controls several other hormone glands in your body, including the thyroid and adrenals, the ovaries and testicles.
Pituitary hormones include:
Prolactin
This hormone stimulates breast milk production after childbirth. When prolactin is high, it affects the hormones that control the ovaries in women and testes in men. As a result, high prolactin can affect menstrual periods, sexual function and fertility.
Growth Hormone
This hormone stimulates growth in childhood and plays a role in maintaining healthy muscles and bone and well-being in adults. It also affects fat distribution in the body
Adrenocorticotrophin (ACTH)
This hormone stimulates the production of cortisol by the adrenal glands—small glands that sit on top of the kidneys. Cortisol, a "stress hormone," is needed for our survival. It helps maintain blood pressure and blood glucose (sugar) levels, and is produced in larger amounts when we’re under stress, especially during illness, surgery, or after injury.
Thyroid Stimulating Hormone
This hormones stimulates the thyroid gland to produce thyroid hormones, which regulate the body's metabolism, energy balance, growth, and nervous system activity. Too much TSH is rare and will cause hyperthyroidism (too much thyroid hormone). Lack of TSH results in hypothyroidism (not enough thyroid hormone).
Luteinising Hormone
This hormone stimulates testosterone production in men and egg release (ovulation) in women
Follicle Stimulating Hormone
This hormone promotes sperm production in men and stimulates the ovaries to produce estrogen and develop eggs in women. LH and FSH work together to enable normal function of the ovaries and testes. Problems with these hormones affects menstrual periods in women and fertility and sexual function in both women and men.
Anti-diuretic Hormone (ADH)
This hormone is also called vasopressin, it regulates water balance in the body and sodium levels in the blood. It conserves body water by reducing the amount of water lost in urine.
Oxytocin
This hormone causes milk to flow from the breasts in breastfeeding women, and may also help labor to progress. Oxytocin may also play an important role in human behavior and social interaction and may promote bonding between a mother and her child.
Melanocyte-Stimulating Hormone
MSH is a collective name for a group of peptide hormones produced by the pituitary gland, the hypothalamus, and the skin. This hormone is an anti-inflammatory hormone that gets its name because of its effect on melanocytes, skin cells that contain the black pigment, melanin. Melanocytes are responsible for moles, freckles, and suntans. Melanin helps protect our cells from DNA damage from sunlight.
Symptoms:
Due to this vital role in orchestrating the endocrine system, when the pituitary gland is not functioning appropriately symptoms are diverse and varied dependent on whether hormones are being under or over-secreted. Some examples below:
•Unexplained weight gain (ACTH) Adrenocorticotropic hormone stimulates the adrenal glands to produce cortisol. If it is over produced this may result in weight gain.
•Loss of libido and fertility issues (Low Luteinizing hormone and Follicle Stimulating Hormone)
•Feeling dizzy and nauseous (Low ACTH)
•Muscle wasting (Low ACTH)
•Coarsening of facial features (High growth hormone)
•Enlarged hands and feet (as above)
•Excessive sweating and oily skin (overexpression of GH and insulin-like growth factor 1)
•Moon face (with reddened skin on face) (high ACTH)
•Lactation (High Prolactin)
•High LDL cholesterol (Low Thyroid Stimulating Hormone)
•High urination (low anti diuretic hormone)
•Erectile dysfunction (LSH & FSH stimulate the gonads)
•Dark skin patches (MSH)
This final point here is one we may not immediately identify with the pituitary. Hyperpigmentation or abnormal darkening of the skin can occur when the adrenal glands do not produce enough cortisol, the hypothalamus stimulates the pituitary gland to release more adrenocorticotropic hormone to try and stimulate the adrenal glands to produce more cortisol. Adrenocorticotropic hormone can be broken down to produce melanocyte-stimulating hormone, leading to hyperpigmentation of the skin.
Symptoms of a pituitary tumour may also include headaches or vision issues. These are associated with the location of the tumour which may be pushing against the optic nerve or other structures.
Pituitary Tumour and Health Implications:
Depending on the type of pituitary condition, there are many medical avenues such as surgery, medication or radiotherapy which can alleviate the issues and lead to some resolution of symptoms.
For some, on-going stress and anxiety following diagnosis/ and or treatment can be an issue. Not for all. But considering that the pituitary gland plays a vital role in the stress response then pituitary patients may need some support at managing stress.
There are many different health angles we could consider. I am going to focus on stress in this blog post.
In a healthy endocrine situation, if a situation is judged as being stressful, the hypothalamus (at the base of the brain) is activated.
The hypothalamus in the brain is in charge of the stress response. When a stress response is triggered, it sends signals to two other structures: the pituitary gland, and the adrenal medulla.
The ‘normal’ Hypothalamic Pituitary-Adrenal (HPA) System
1.The stressor activates the Hypothalamic Pituitary Axis
2.The hypothalamus stimulates the pituitary gland
3.The pituitary gland secretes adrenocorticotropic hormone (ACTH)
4.ACTH stimulates the adrenal glands to produce the hormone corticosteroid
5.Cortisol enables the body to maintain steady supplies of blood sugar
6.Adequate and steady blood sugar levels help a person to cope with prolonged stressor, and helps the body to return to normal
Imagine how this process can become problematic when the pituitary is not communicating with the adrenal glands. If this is the case (NOT in all pituitary cases, remember each one is unique), if cortisol remains low then dizziness, stress intolerance, cravings and low energy may follow.
Important to manage the diet well alongside working on stress management with one or a collection of the following:
Box Breathing - practice this to use in stressful situations. For my favourite Box Breathing Video follw this link Guided Breathing Meditation: Box Breathing - YouTube
Spending time in nature.
Using a meditation app such as Headspace or Calm
Avoiding caffeine which fuels the stress response
Aromatherapy roller balls - keep handy for stressful moments
Join a group such as the Pituitary Foundation in order to feel that sense of solidarity which is so reassuring
Use a supplement such as Ashwaganda
Classified as an adaptogen, meaning that it can help your body manage stress. Ashwagandha also provides numerous other benefits for your body and brain. For example, it can boost brain function, lower blood sugar and cortisol levels, and help fight symptoms of anxiety and depression. It is important to note that supplements often interact with medications so its wise to seek the support of a nutritionist before starting on a supplement programme.
Looking after the gut and the bones are vital too when taking long term medications. Again, it is best to seek support from an experienced nutritionist as there is no ‘one size fits all’ when it comes to health.
As for diet, keep lots of colour in your food plan, avoid processed foods, high sugar snacks which lead to blood sugar highs and lows and keep well hydrated. Aim for that rainbow. And, as with any health diagnosis, embrace the change, learn about your condition and take the reigns of your health journey as much as you are able.
