Pituitary Disorders Specialist | Naas Endocrinology Clinic
Pituitary · Naas, Co. Kildare

Pituitary Disorders & Hormonal Conditions

Specialist assessment and management of pituitary tumours and hormonal conditions, including prolactinoma, Cushing's disease, growth hormone deficiency, and hypopituitarism.

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About the Pituitary Gland

The Master Gland

The pituitary gland is a small, pea-sized gland at the base of the brain, sitting in a bony cavity called the sella turcica. Despite its tiny size, it is often called the "master gland" because it regulates the output of most other endocrine glands in the body — controlling thyroid hormone production, adrenal function, growth, reproduction, and water balance.

Pituitary disorders arise when tumours, inflammation, or damage disrupt this regulatory function — either causing excess hormone secretion (functioning tumours) or impairing hormone production (hypopituitarism). Some conditions affect adjacent structures, causing headaches or visual disturbance. Many pituitary abnormalities are discovered incidentally on brain imaging performed for other reasons — a finding known as a pituitary incidentaloma.

This page is for educational purposes only. It does not constitute medical advice. Always consult a qualified healthcare professional for assessment of pituitary conditions.
Conditions We Manage

Pituitary Conditions

  • Prolactinoma
  • Non-functioning pituitary adenoma
  • Cushing's disease
  • Acromegaly
  • Growth hormone deficiency
  • Hypopituitarism
  • Pituitary incidentaloma
  • Diabetes insipidus
  • Craniopharyngioma (follow-up)
  • Post-surgical pituitary care

Many of these conditions require coordination with neurosurgery, neuro-ophthalmology, and clinical oncology. We provide specialist endocrine input as part of a multidisciplinary approach.

Specialist Services

How We Can Help

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Prolactinoma

Assessment and management of prolactin-secreting pituitary adenomas, including medical treatment with dopamine agonists, monitoring for tumour response, and assessment of hypogonadism and fertility implications.

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Cushing's Disease

Evaluation of ACTH-dependent hypercortisolism caused by a pituitary corticotroph adenoma. Collaboration with neurosurgery where pituitary surgery is indicated, and post-treatment surveillance.

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Growth Hormone Deficiency

Assessment of adult growth hormone deficiency in patients with pituitary disease or history of cranial irradiation, including dynamic testing and, where appropriate, growth hormone replacement therapy.

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Pituitary Incidentaloma

Structured evaluation of incidentally discovered pituitary lesions, including hormonal assessment for secretory activity, assessment for hypopituitarism, and surveillance imaging planning.

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Hypopituitarism

Management of partial or complete pituitary hormone deficiency, including thyroxine, hydrocortisone, testosterone or oestrogen, and growth hormone replacement where indicated, with careful monitoring.

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Post-Surgical Follow-up

Endocrine surveillance following transsphenoidal pituitary surgery, including assessment for remission or recurrence, management of new pituitary hormone deficiencies, and long-term surveillance planning.

Investigations

Pituitary Investigations

Assessment of pituitary disorders combines hormonal blood tests with imaging. Hormonal evaluation typically includes prolactin, IGF-1 (as a marker of growth hormone excess), morning cortisol, ACTH, gonadotrophins (LH, FSH), thyroid function, and sex hormones. Interpretation requires careful attention to pre-analytical factors — many pituitary hormones fluctuate significantly.

Dynamic tests — including insulin tolerance testing, synacthen stimulation testing, and oral glucose tolerance testing for acromegaly — are used when basal tests are inconclusive. MRI pituitary with gadolinium contrast is the gold-standard imaging modality for identifying and characterising pituitary lesions.

All pituitary consultations are led by Dr Syed Kashif Hussain Kazmi, Consultant Endocrinologist (IMC: 213626), with comprehensive pituitary assessment and close collaboration with neurosurgical and neuro-radiology services when required.

Patient Questions

Frequently Asked Questions

The pituitary gland is a small gland (approximately 1 cm in size) located at the base of the brain, connected to the hypothalamus by a stalk. It produces and regulates multiple hormones including growth hormone, ACTH (adrenocorticotrophic hormone, which controls cortisol), TSH (which controls thyroid hormones), LH and FSH (which control reproductive hormones), prolactin (which regulates breast milk production), and ADH (antidiuretic hormone, which controls water balance). Because it controls so many other hormone systems, damage or tumour formation in the pituitary can have wide-ranging effects on metabolism, growth, reproduction, and stress response.
A prolactinoma is the most common type of pituitary tumour. It is a benign (non-cancerous) adenoma of the pituitary gland that secretes excess prolactin. Elevated prolactin can cause menstrual irregularity and reduced fertility in women, and hypogonadism (low testosterone), reduced libido, and erectile dysfunction in men. In women, it may also cause galactorrhoea (inappropriate breast milk production). Prolactinomas are classified as microprolactinomas (less than 10mm) or macroprolactinomas (10mm or larger). Most prolactinomas respond excellently to medical treatment with dopamine agonist medications (cabergoline or bromocriptine), which lower prolactin levels and often shrink the tumour. Surgery is rarely required.
Cushing's disease specifically refers to excess cortisol caused by an ACTH-secreting pituitary adenoma. It is distinct from Cushing's syndrome, which is the general term for excess cortisol from any cause (including adrenal tumours, ectopic ACTH secretion, or long-term corticosteroid medication). Cushing's disease causes a characteristic clinical syndrome including central weight gain, a rounded "moon face," a "buffalo hump" of fat between the shoulders, skin thinning and bruising, purple stretch marks, high blood pressure, diabetes, osteoporosis, muscle weakness, and mood disturbance. Diagnosis requires careful biochemical testing followed by imaging. First-line treatment is usually pituitary surgery.
A pituitary incidentaloma is a pituitary lesion discovered unexpectedly on brain imaging (typically MRI or CT) performed for unrelated reasons, such as headache investigation or following head trauma. They are increasingly common as brain imaging becomes more widely used. The majority are benign pituitary adenomas, and most are non-functioning (do not secrete excess hormones). However, all require specialist evaluation to assess for hormonal activity (both secretory excess and deficiency), to determine the risk to adjacent structures such as the optic chiasm, and to plan appropriate surveillance. Management ranges from observation with periodic imaging to medical or surgical treatment, depending on the characteristics of the lesion.
Pituitary investigation combines blood tests with imaging. Hormone blood tests typically include prolactin, IGF-1 (growth hormone marker), morning cortisol and ACTH, LH, FSH, testosterone or oestradiol, TSH and free T4, and sodium (to screen for diabetes insipidus). Some conditions require dynamic tests performed under supervised clinical conditions — for example, the insulin tolerance test assesses growth hormone reserve and cortisol reserve; the oral glucose tolerance test is used to diagnose acromegaly; the low-dose dexamethasone suppression test screens for Cushing's syndrome. MRI of the pituitary with gadolinium contrast is the imaging of choice for pituitary lesion characterisation. Visual field testing (Goldman or Humphrey perimetry) is used when a lesion is near the optic chiasm.

Specialist Care for Pituitary Conditions

Book a private pituitary consultation with Dr Kazmi, Consultant Endocrinologist. Thorough assessment with access to specialist investigation and multidisciplinary input.

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