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Medications Used to Balance Pituitary Gland Function

cartoon brain with pill on top making it feel happy

The pituitary gland is a small endocrine gland located at the base of the brain. It secretes many important hormones. Please continue reading to learn about some of the endocrine disorders related to the pituitary gland and medications used to treat pituitary hormone imbalances.

What is the pituitary gland?

The pituitary gland is a pea-sized gland that weighs less than 1 gram. It is located at the base of the brain in a small chamber called the sella turcica, just below a part of the brain called the hypothalamus. 

The pituitary gland is an endocrine gland; it produces certain hormones and releases them into the bloodstream. These hormones coordinate different functions throughout the body. They also control hormone production by other endocrine glands in the body, such as the thyroid gland, adrenal glands, ovaries, and testes. 

You can think of the pituitary gland as an orchestra conductor that keeps the body functioning through hormones. Along with the hypothalamus, the pituitary gland forms the hypothalamus-pituitary complex. This is the brain’s command center that controls important bodily functions like blood pressure, heart rate, and breathing. 

Pituitary hormones have wide-ranging effects on growth and development, metabolism, temperature regulation, water and sodium balance, the body’s ability to respond to stress, the reproductive system (fertility, childbirth, and lactation), and the immune system

As a result, pituitary hormone imbalances can lead to a range of medical conditions originating in different organs.

What are some pituitary hormones?

Growth Hormone

Growth hormone stimulates growth in children, including bones and muscle mass. It also maintains healthy muscles and bones and regulates fat distribution in adults. Growth hormone deficiency can lead to dwarfism and excess can lead to gigantism and acromegaly (abnormally large bones).

Adrenocorticotropic Hormone (ACTH)

This pituitary gland hormone stimulates cortisol secretion from the adrenal glands. Cortisol (also called the stress hormone) regulates metabolism, blood pressure, blood glucose levels, and other important parameters in the body. Hormonal imbalances resulting in too much cortisol in the body can lead to a condition called Cushing’s syndrome. ACTH deficiency can cause symptoms such as low blood pressure, muscle weakness, weight loss, and loss of appetite.

Gonadotrophic Hormones

Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are called gonadotrophic hormones because they control the function of the gonads (ovaries and testes). Follicle-stimulating hormone stimulates sperm production in males. FSH also regulates the menstrual cycle and stimulates egg formation in the ovaries in females. Luteinizing hormone stimulates testosterone production in males and ovulation in females. In menopausal women, the pituitary gland produces more of these hormones, resulting in symptoms like hot flashes. 

Prolactin

Prolactin secretion stimulates lactation after childbirth. It also affects sexual function and fertility in adults. Prolactin deficiency can lead to a lack of breast milk production. 

Thyroid Stimulating Hormone (TSH)

A hormone called the thyrotropin-releasing hormone made by the hypothalamus stimulates the pituitary gland to make a thyroid-stimulating hormone (TSH). TSH, in turn, stimulates the thyroid gland to make thyroid hormones, which control metabolism, temperature regulation, and other bodily functions. Low thyroid hormone levels (hypothyroidism) can result in fatigue, weight gain, cold intolerance, and thinning of body hair. Excess thyroid hormone (hyperthyroidism) can result in weight loss, tremors, and a fast heartbeat.

Antidiuretic Hormone (ADH) or Vasopressin

This hormone controls water and sodium balance in the body. It is made by the hypothalamus and stored in the pituitary gland.

Oxytocin 

This hormone is also made by the hypothalamus and stored in the pituitary gland. For people who are female assigned at birth, oxytocin helps in the progression of labor during childbirth, the flow of breast milk after childbirth, the movement of sperm in males, and the bonding between a parent and child.

What medication helps the pituitary gland?

Various medications are used to treat pituitary gland problems. These conditions can be diagnosed with blood tests and imaging studies like magnetic resonance imaging (MRI scans). Some of the pituitary gland problems and medications used to treat them are briefly described below.

Pituitary tumors

Pituitary adenomas are slow-growing, noncancerous tumors of the pituitary gland. Some are functioning, i.e., there is hormone production by the tumor, while others are non-functioning. A common type of functioning pituitary tumor is a prolactinoma. This pituitary adenoma results in excess prolactin. It can be treated with medications like bromocriptine (Parlodel, Cycloset) and cabergoline (Dostinex), which decreases the production of the hormone prolactin and shrink the tumor.

Cushing’s Syndrome

A pituitary adenoma can result in excess ACTH secretion, which in turn can stimulate the adrenal glands to make more cortisol, resulting in a condition called Cushing’s syndrome. Treatment with medications like metyrapone (Metopirone), mitotane (Lysodren), and ketoconazole may be prescribed to people with Cushing’s syndrome to control excess cortisol secretion.

Growth Hormone Deficiency 

A synthetic version of the growth hormone called somatropin (Humatrope, Genotropin) may be given to people with low growth hormone production. 

Gigantism and Acromegaly

Somatostatin analogs like lanreotide (Somatuline Depot) and octreotide (Sandostatin) may be used in people with excess hormones (excess growth hormone or excess thyroid hormone). Pegvisomant (Somavert) is another medication that blocks the effects of excess growth hormone.

Central Diabetes Insipidus

A synthetic hormone called desmopressin (Nocdurna, DDAVP) is used to replace the antidiuretic hormone (ADH) in people with central diabetes insipidus. This is a condition in which the body cannot balance fluid levels due to a deficiency of ADH.

Central Hypogonadism

A healthcare provider may prescribe hormone replacement therapy with testosterone in males or estrogen and progesterone in females to treat hormonal imbalance caused by central hypogonadism (a deficiency of sex hormones FSH and LH).

Secondary Adrenal Insufficiency

Hormone replacement therapy with hydrocortisone (Cortef), methylprednisolone (Medrol), prednisone (Rayos), and fludrocortisone acetate may be prescribed to people with secondary adrenal insufficiency. In this condition, the pituitary gland does not make enough ACTH, leading to low cortisol secretion from the adrenal glands. 
 

References:

  1. https://my.clevelandclinic.org/health/body/21459-pituitary-gland
  2. https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/pituitary_center/pituitary-tumor/treatment/drug-therapy.html
  3. https://rarediseases.org/rare-diseases/acth-deficiency/?filter=ovr-ds-resources
  4. https://www.mayoclinic.org/diseases-conditions/prolactinoma/diagnosis-treatment/drc-20376962#
  5. https://www.mayoclinic.org/diseases-conditions/diabetes-insipidus/symptoms-causes/syc-20351269
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792781/
  7. https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293
  8. https://www.mayoclinic.org/diseases-conditions/cushing-syndrome/diagnosis-treatment/drc-20351314#