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How much do you know about your pituitary gland? Is it healthy? Is it diseased? We often overlook this important gland in our bodies, but it is so important to know about in order to understand its connection to thyroid disease. Today, I want to dive into what your pituitary gland means for your overall health, and what you need to know about it.
Understanding the Endocrine System
If you could reach right behind your nose, right near the middle of your brain, you would find the pituitary gland. It is, more or less, the manager of the incorporation of your endocrine system. This means that your hypothalamus is the star of the show, but the pituitary gland plays the important role of managing your system and ensuring that everything is going according to plan.
The pituitary manages all of the other glands in your body, which includes:
- Your thyroid
- Your adrenals
- Your ovaries
- Your testicles
- Your pineal gland
The pituitary is critical because, if it is not doing its job, it has the opportunity to really compromise some of the most important systems in your body – it gives them a bit of an opportunity to “goof off.”
Let’s imagine that these aforementioned glands are all workers, and that the pituitary is their manager who helps to get them to work. Basically, the manager is instructed by the CEO (your hypothalamus, in this case) to work, which starts a chain reaction of people telling other people to get to work. So, while the CEO might direct the manager to motivate the workers, the manager is the one who has to go out there and do it.
Key Insight: The pituitary gland’s relationship to the rest of the body is known as a “positive feedback” – meaning that they only work when they are told, and the pituitary gland is in charge of making sure that they do the work they are told to complete. This is how the whole endocrine system works, essentially.
The problems begin when the upstream messages, those coming from the hypothalamus and the pituitary are wrong, it can cause disastrous results for our body and for our health. This would typically be corrected by this concept of positive feedback, where the upstream messages successfully correct inefficiencies in the system (whether it is too much, or not enough, hormone being released into the body).
Let’s quickly clear up any confusion about having hypothalamic disease. We know how important this is in our bodies, and you might be walking around wondering whether or not you have it. What I have to tell you is that if you are able to stand on both feet, you do not have hypothalamic disease – it is way more likely that you are currently being hospitalized.
Key Insight: Hypothalamic disease is not only rare, but it is incredibly severe. If you have it, you know about it, because your body is unable to regulate pretty much everything.
The important thing to know is that the pituitary can get diseased. By far the most common problem is known as a pituitary adenoma (1). This is where random cells grow on the pituitary, which mirrors the cells that the pituitary already has. This can result in exaggerated amounts of hormone release in the system. If the adenoma is squeezing the pituitary, which is a result of microscopic differences, it can block hormones from coming out and regulating your system.
In almost all cases, an adenoma is either going to be:
- Way too much, or
- Way too little
It is very rare, almost unheard of, to have a pituitary disease that is selective of one gland over another – it is a bit like an all or nothing proposition, in that regard. Another common problem that one might have with an adenoma is a prolactinoma (2) – where prolactin is being made unnecessarily, which can lead to lactation in both men and women. It can also:
- Block fertility, and
- Block menstrual cycles
There are also what are known as macroadenomas (3), which have the unfortunate ability to squeeze the optic nerves and impairing one’s vision. It can change your field of vision, but it can also trigger headaches or migraines which can be very problematic.
Bottom Line: Adenomas are the most common pituitary disease, and they usually involve exaggerated outputs of hormones (or, in rarer cases, lower outputs). When they do happen, though, they happen across the board – every single gland is affected.
The Most Common Pituitary Problem
What we will often see is this, there is a patient who has the following:
- A low level of TSH (4)
- Free hormones that are not high (and are maybe even a little low)
I have seen plenty of situations where a doctor might look at that status and think, “something is not right here.” The TSH is low, but the free hormones have remained unelevated – something does not seem right (5), and they might often default to thinking that it is a matter of the pituitary gland (that the gland is receiving the wrong signal).
While it might sound logical, this is not always the case. In almost all cases, we might be able to assume that all of the other pituitary hormones are completely normal (save for the thyroid). Everything else is coming out as it should, which runs counter to our previous understanding that pituitary problems cause changes across the board (across all hormones).
The problem, instead, is that the pituitary is performing a strategy of sorts. When you develop hyperthyroidism, because your gland is overproducing or you are taking more than you need, the first step that occurs is that your TSH lowers. This happens long before your free hormones activate because your free hormones are not a control mechanism for your body.
Bottom Line: Blaming this sort of state on your pituitary ignores one of the central tenets of pituitary disease: that it affects all of the hormones in your body. When your TSH is low, but your free hormones are high, it is more likely pointing to something else going on in your body.
Identifying Pituitary Problems
What we know about our pituitary gland is that it does a lot in order to manage the other glands in our body, it plays that manager role in a strategic way. This means that when we have thyroid issues, or adrenal issues, and they are unique to only that part of our body, it is typically our pituitary making strategic advances to try and manage what is going on – whether it be Addison’s disease, or something else.
What we need to be on the lookout for is when we see a combination of:
- Low ACTH
- Low cortisol
- Low TSH
- Low thyroid hormones
- Suppressed levels of IGF1 and growth hormone
- Unusually low levels of FSH or LH
These are typically signs that you have an adenoma, or a space lesion blocking your pituitary gland and impeding its ability to do its job. In those cases, medical imaging is appropriate to try and investigate what is going on with your pituitary. Overall, these are only a few hundred (or a few thousand) cases per year.
Bottom Line: A low TSH and low thyroid hormones is not often a pituitary problem, we know this and we need to be conscious of this if we are told that. While it might make sense logically, it discounts the widespread effect that your pituitary has on every gland that it oversees.
Understanding Your Pituitary and Your Thyroid
Today we talked a lot about your pituitary gland, and how it works to regulate your thyroid and other glands in your body. Do you feel like your thyroid might be acting up, or that it is not doing its job? Take the Thyroid Quiz (6) right now, and figure out what is really going on in your body. The results might surprise you, and they might also change your health for the better.
Dr. Alan Glen Christianson (Dr. C) is a Naturopathic Endocrinologist and the author of The NY Times bestselling Adrenal Reset Diet.
Dr. C’s gift for figuring out what really works has helped hundreds of thousands of people reverse thyroid disease, lose weight, and regain energy. Learn more about the surprising story that started his quest.