Diseases of the pituitary are often very difficult to diagnose. The target glands of the pituitary—the thyroid, gonads and adrenals—are capable of producing their own hormones without the pituitary, but not very effectively. Because of this complex interrelationship between the pituitary and its target glands it is often difficult to determine whether a disease originates with the pituitary or with a secondary target gland.
Tests for the pituitary are also very difficult to perform. They require highly trained personnel and specialized laboratories. There is also a high degree of patient risk with these tests, since the laboratory measurement of the growth hormone is still being researched. Therefore, most present-day testing is conducted upon the hormone function of the target glands. Pituitary testing done on blood serum, plasma, urine or hair samples is considered safe. Hyperpituitarism: Because of the mystery surrounding the posterior lobe, when the terms hypo and hyper are used in connection with the pituitary gland, they usually refer to the anterior lobe. Hyperpituitarism of the anterior lobe is excess production of the growth hormone. If the hyperpituitarism occurs before the epiphyseal closure, giantism results; if it occurs after the epiphyseal closure, the result in adults is acromegaly, wherein the jaw, bones, hands and feet show overdevelopment and features become large.
The standard glucose tolerance test with blood samples can measure growth hormone production to determine if hyperpituitarism exists. Hypopituitarism-. With hypopituitarism growth of the body and sexual development are normally arrested. When hormone secretion from the anterior lobe is slow or completely halted, dwarfism results. Other related ailments are Simmond's disease, Sheehan's syndrome, acromicria, eunuchoidism and hypogonadism. Emaciation, muscular debility, loss of sexual function and general smallness of extremities may also occur.
An endocrine specialist should conduct any test to determine hypopituitarism. One procedure is to X-ray the skull to see if the sella turcica is depressed in the sphenoid bone of the skull where the pituitary gland rests. The x-ray also checks for possible erosion or enlargement. And a doctor should not overlook the possibility that a blow to the skull may have injured either the hypothalamus or pituitary.
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