Pituitary Gland Dysfunction: What to Watch For

The pituitary is a pea-sized gland at the base of your brain that controls many hormones. When it stops working right, you can feel tired, gain or lose weight, lose your sex drive, or have trouble growing. Some people have subtle symptoms for years; others get sudden, serious problems. Knowing the common signs helps you ask the right questions and get help faster.

Common Symptoms to Spot

Symptoms depend on which hormones are affected. Low ACTH or cortisol often causes strong fatigue, dizziness when standing, and low blood pressure. Low TSH leads to cold intolerance, slow thinking, and weight gain. Growth hormone issues can cause short stature in kids and low energy in adults. Low LH or FSH shows as missed periods, low libido, or infertility. High prolactin may cause unexpected milk production or sexual problems. If the pituitary tumor presses on nearby nerves, you might notice headaches or vision loss, especially difficulty seeing to the side.

Diagnosis and Treatment

If you suspect a pituitary problem, start with a primary care visit. The doctor will likely order blood tests for hormone levels and an MRI of the pituitary. Sometimes they use stimulation tests to see if glands respond properly. An eye test to check fields of vision is common when a tumor is possible. Early referral to an endocrinologist is useful because managing hormones can be complex.

Treatment varies by cause. Small prolactin-secreting tumors often respond well to dopamine agonists like cabergoline. Larger tumors that press on the optic nerves may need surgery, usually done through the nose by a neurosurgeon. Radiation is an option when surgery and meds don’t fully control a tumor. For hormone loss, treatment means replacing what’s missing: cortisol pills for adrenal insufficiency, levothyroxine for low thyroid, sex hormones for low gonadal function, and desmopressin for diabetes insipidus. Growth hormone replacement is sometimes used in adults with proven deficiency.

One critical point: adrenal insufficiency can be life threatening. People with low cortisol should carry a steroid card and know how to increase doses during illness or stress. Regular follow up is essential—hormone doses change over time and need monitoring. Also, if you plan pregnancy or surgery, tell your endocrinologist so doses can be adjusted safely.

You don’t have to memorize every detail, but know this: persistent fatigue, changes in weight, reproductive changes, or visual problems deserve a check. Pituitary problems are treatable, and timely care makes a big difference in quality of life.

Practical tips: keep a printed list of your hormone tests and medications, and carry a steroid emergency card if you take cortisol. Ask your doctor about bone density checks if you have long-term hormone loss. Bring prior MRI or surgery notes to appointments. Before any scheduled surgery or dental work, tell the team you have pituitary disease so steroid doses can be adjusted. Learn signs of low cortisol and have an emergency plan with family. Small daily habits—regular sleep, balanced meals, and light exercise—help recovery.