Pituitary Disorders in Sharjah

What are pituitary disorders?

Pituitary disorders are problems with the pituitary gland, a pea-sized gland that sits in a small bony hollow behind the bridge of the nose, just below the nerves that carry sight from the eyes. The pituitary sends signals that run the thyroid, the adrenal glands, the ovaries and testes, growth and breast milk production, and it stores the hormone that tells the kidneys to hold on to water. At Dar Al Kamal Hospital, Sharjah, the endocrinology team investigates and treats pituitary disorders and coordinates care with eye, imaging and surgical teams.

Pituitary disorders fall into three groups:

• Prolactinoma, the most common hormone-releasing pituitary tumour. It produces excess prolactin, the milk hormone, and is usually treated with tablets that shrink it.
• Other pituitary tumours, which may release growth hormone (causing acromegaly), release a hormone that drives cortisol (causing Cushing's disease), or release no hormone at all and cause problems only through their size.
• Pituitary hormone deficiency, called hypopituitarism, where one or more pituitary hormones run low after a tumour, surgery, radiotherapy, head injury, severe bleeding at childbirth or inflammation.

Pituitary tumours are almost always benign adenomas, and the word "tumour" here describes a growth rather than cancer.

Who needs it

Pituitary assessment is usually arranged for:

• a raised prolactin level, with irregular or absent periods, breast milk leakage outside pregnancy and breastfeeding, reduced sex drive or difficulty conceiving
• a pituitary lump reported on a brain scan done for another reason
• gradual loss of vision at the outer edges, noticed as bumping into things or missing cars at the sides
• enlarging hands, feet, jaw or nose, with rings and shoes becoming tight, which can signal acromegaly
• features of cortisol excess, such as weight gain around the middle, purple stretch marks and easy bruising
• tiredness, low blood pressure, loss of body hair and reduced sex drive together, suggesting several hormones are low
• passing large amounts of dilute urine day and night with constant thirst, which can signal diabetes insipidus, a water-balance condition unrelated to blood-sugar diabetes

What happens

The endocrinology team takes a history, examines you and checks your visual fields at the bedside. Tests then look at the whole pituitary at once, because a problem with one hormone often travels with others:

| Test | Purpose |
|---|---|
| Pituitary hormone blood panel | checks the signals to the thyroid, adrenal glands, ovaries or testes, and growth |
| Serum prolactin | confirms raised prolactin, with a repeat sample if the first reading is mildly high |
| Early morning cortisol | checks the pituitary-adrenal link, which matters most for safety |
| Pituitary MRI scan | shows the size of any lump and its distance from the optic nerves |
| Formal visual field test | maps any loss of side vision, arranged with Ophthalmology |

Many medicines raise prolactin, including some for nausea, reflux and mental health, so the team reviews your medicine list before labelling a prolactinoma.

Treatment depends on the diagnosis:

1. Prolactinoma is usually treated with tablets that lower prolactin and shrink the tumour, with regular blood tests and a follow-up MRI.
2. Missing hormones are replaced, usually starting with cortisol and then thyroid hormone, followed by sex hormones and, where suitable, growth hormone.
3. Tumours releasing growth hormone or cortisol, and large non-functioning tumours pressing on the optic nerves, are considered for surgery, with the plan discussed with Neurosurgery.
4. Small non-functioning tumours are followed with scans and blood tests.

Preparing for it

Bring every medicine and supplement you take, previous hormone results, and the full report and images of any brain scan on a disc or link. Early morning blood tests are common, so ask for the timing when booking. For MRI, mention any metal implants, a pacemaker or a fear of enclosed spaces in advance.

Women should note the date of their last period and whether they are pregnant, breastfeeding or trying to conceive, since this changes both testing and treatment.

Afterwards

Pituitary disorders are followed over the long term with blood tests, scans and eye checks at intervals the endocrinology team sets. If you take cortisol replacement, learn the sick-day rules and carry a steroid emergency card. If you have diabetes insipidus, drink to your thirst, and plan fluids carefully in the Sharjah heat and around Ramadan fasting with the team beforehand.

Prolactinoma tablets often restore periods and fertility, so use contraception if pregnancy is unplanned and tell the team promptly if you become pregnant.

Contact the hospital if you notice any change in your vision, new persistent headaches, or growing thirst and urination. **Go to the emergency department straight away if you develop a sudden, severe headache with vomiting, double vision, drooping eyelid or sudden loss of vision, or collapse while taking cortisol replacement.**

Cost and insurance

UAE insurance plans usually cover endocrinology consultations, hormone blood tests and MRI when there is a clinical reason, and MRI usually needs pre-approval. Dynamic hormone tests, surgery and some hormone replacements, particularly growth hormone for adults, commonly need pre-approval or may be excluded. Dar Al Kamal Hospital, Sharjah can help you check your cover on 06 599 7777.