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The '''pituitary gland''', or hypophysis, is a pea-sized gland of the [[endocrine system]], situated at the base of the brain. As part of the [[Hypothalamic-pituitary-adrenal axis|HPA axis]], it is regulated by the [[hypothalamus]] to produce, store, and secrete various [[hormone]]s, which target other endocrine glands. The pituitary gland is sometimes referred to as the “master gland” as it regulates the function of the other endocrine glands.<ref name="merck" /> == Structure and Function == [[File:Pituitary-gland-lobes.jpg|thumb|Anatomical diagram of the pituitary gland, depicting the pituitary stalk connection with the hypothalamus.<br> Image: Modified from Gray’s Anatomy by [https://openstax.org/books/biology-2e/pages/37-5-endocrine-glands OpenStax (2018)] with minor cropping and color changes/filters by MEpedia. License: CC-BY-4.0.<ref name="37-5-Endocrine Glands">{{Cite book |vauthors= Clark MA, Douglas M, Choi J|publisher= OpenStax | title = Biology 2e|url=https://openstax.org/books/biology-2e/pages/1-introduction|location=Houston, Texas |chapter=37.5 Endocrine Glands |chapter-url=https://openstax.org/books/biology-2e/pages/37-5-endocrine-glands | date = Mar 28, 2018}}</ref>]] The pituitary gland sits at the base of the brain, underneath the [[hypothalamus]]. It is surrounded by a protective bony cavity called the sella turcica. The pituitary is divided into three distinct lobes: posterior, anterior, and intermediate.<ref name="merck">{{Cite news | url=https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/pituitary-gland-disorders/overview-of-the-pituitary-gland | title = Overview of the Pituitary Gland - Hormonal and Metabolic Disorders|work=Merck Manuals Consumer Version|access-date=2018-10-25|language=en-US}}</ref> === Posterior === [[File:Pituitary-posterior.jpg|thumb|Anatomical diagram of the posterior pituitary.<br> Image: [https://openstax.org/books/anatomy-and-physiology/pages/17-3-the-pituitary-gland-and-hypothalamus The Pituitary Gland and Hypothalamus. Fig. 17.8 Posterior Pituitary]. License: CC-BY-4.0.<ref name="17-3-pituitary">{{Cite book | last=Betts | first = JG | authorlink = | last2 = Young | first2 = KA | authorlink2 = | last3 = Wise | first3 = JA | last4 = Johnson | first4 = E | last5 = Poe | first5 = B | last6 = Kruse | first6 = DH | last7 = Korol | first7 = O | last8 = Johnson | first8 = JE | last9 = Womble | first9 = M | last10 = DeSaix | first10 = P | date = Apr 25, 2013 | website = OpenStax|location=Houston, Texas|language=en|archive-url=|archive-date=|url-status= |chapter=17.3 The Pituitary Gland and Hypothalamus | title = Anatomy and Physiology | url=https://openstax.org/books/anatomy-and-physiology/pages/1-introduction |chapter-url=https://openstax.org/books/anatomy-and-physiology/pages/17-3-the-pituitary-gland-and-hypothalamus |access-date=2021-11-09}}</ref>]] The posterior pituitary develops as an extension of the [[hypothalamus]] (distinct from the anterior pituitary). The posterior pituitary is largely made up of the terminals of nerve cells of the hypothalamus, as neurons in the hypothalamus project directly to the posterior pituitary. Hormones produced by the hypothalamus are stored in the terminals of hypothalamic neurons in the posterior pituitary, and are released by nerve excitation. The two major hormones stored and secreted by the posterior pituitary include: * [[Antidiuretic hormone]] (ADH, also known as vasopressin) * [[Oxytocin]]<ref name="NBK27">{{Cite book | url =https://www.ncbi.nlm.nih.gov/books/NBK27/ | title = The pituitary gland | last = Nussey | first = Stephen | last2 = Whitehead | first2 = Saffron | date = 2001 |publisher=BIOS Scientific Publishers|language=en}}</ref> === Anterior === [[File:Pituitary-anterior.jpg|thumb|Anatomical diagram of the anterior pituitary.<br> Image: [https://openstax.org/books/anatomy-and-physiology/pages/17-3-the-pituitary-gland-and-hypothalamus The Pituitary Gland and Hypothalamus. Fig. 17.9 Anterior Pituitary]. License: CC-BY-4.0.<ref name="17-3-pituitary"/>]] The anterior pituitary is structurally distinct from the posterior pituitary. It makes up 80% of the pituitary gland, and is made up of different types of endocrine cells. These cells are classified by the hormones they synthesize and release, and are regulated by the hypothalamus via releasing and inhibiting hormones. The six major hormones of the anterior pituitary are: * [[Growth hormone]] (GH) * [[Adrenocorticotropic hormone]] (ACTH) * [[Thyroid-stimulating hormone]] (TSH) * [[Follicular-stimulating hormone]] (FSH) * [[Luteinizing hormone]] (LH) * Prolactin<ref name="NBK27"/><ref name="merck"/> === Intermediate === The intermediate lobe is present in many lower vertebrates, but is almost absent in humans. The intermediate pituitary synthesizes and secretes: * [[Melanocyte-stimulating hormone]] (MSH) == Function of Pituitary Hormones == {| class="wikitable" |'''Hormone''' |'''Target Organ''' |'''Role''' |- |[[Growth hormone]] (GH) |Muscular, skeletal, and fat tissue |Regulates growth and physical development by stimulating muscle growth and reducing fat tissue |- |[[Adrenocorticotropic hormone]] (ACTH) |Adrenal glands |Stimulates the adrenal glands to produce cortisol and other hormones |- |[[Thyroid-stimulating hormone]] (TSH) |Thyroid gland |Stimulates the thyroid to produce thyroid hormone |- |[[Follicular-stimulating hormone]] (FSH) |Ovaries or testes |Stimulates the ovaries to produce eggs/the testes to produce sperm, and the sex organs to produce sex hormones |- |[[Luteinizing hormone]] (LH) |Ovaries or testes |Stimulates the ovaries to produce eggs/the testes to produce sperm, and the sex organs to produce sex hormones |- |Prolactin |Mammary glands |Stimulates the mammary glands to produce milk |- |[[Antidiuretic hormone]] (ADH, also known as vasopressin) |Kidneys |Regulates amount of water absorbed and excreted by the kidneys |- |[[Oxytocin]] |Uterus and mammary glands |Causes uterus contraction during childbirth, stimulates contractions of the milk ducts in breast for breastfeeding |- |[[Melanocyte-stimulating hormone]] (MSH) |Skin and hair |Stimulates the production of melanin in skin and hair, suppresses appetite, contributes to sexual arousal.<ref name="merck"/> |} == Dysfunction and Disease == Dysfunction of the pituitary gland can result in overproduction or underproduction of pituitary hormones, thus having major consequences in bodily function. Conditions of pituitary malfunction include: * [[Acromegaly]] -- overproduction of GH * [[Cushing's disease]] -- overproduction of ACTH * [[GH deficiency]] -- underproduction of GH * Syndrome of inappropriate antidiuretic hormone -- overproduction of antidiuretic hormone * [[Diabetes insipidus]] -- underproduction of antidiuretic hormone * [[Sheehan syndrome]] -- underproduction of any pituitary hormone * [[Pickardt-Falhbusch Syndrome]] -- underproduction of any pituitary hormone aside from prolactin * [[Hyperpituitarism]] (usually pituitary adenoma) -- overproduction of any pituitary hormone * [[Hypopituitarism]] -- underproduction of any pituitary hormone * [[Hypophysitis]] -- inflammation of the pituitary gland * Autoimmune hypophysitis -- inflammation of the pituitary gland due to autoimmunity * [[Pituitary adenoma]] -- noncancerous tumor of the pituitary gland{{Citation needed | date = Nov 2021}} == ME/CFS == Dysfunction of the endocrine system, with a focus on [[hypothalamic-pituitary-adrenal axis]] (HPA axis) hypofunction, has been reported in individuals with ME/CFS.<ref>{{Cite journal | last = Nijhof | first = Sanne L. | last2 = Rutten | first2 = Juliette M. T.M. | last3 = Uiterwaal | first3 = Cuno S. P.M. | last4 = Bleijenberg | first4 = Gijs | last5 = Kimpen | first5 = Jan L.L. | last6 = Putte | first6 = Elise M. van de | date = Apr 2014 | title = The role of hypocortisolism in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/24636516|journal=Psychoneuroendocrinology|volume=42|pages=199–206|doi=10.1016/j.psyneuen.2014.01.017|issn=1873-3360|pmid=24636516}}</ref><ref>{{Cite journal | last = Papadopoulos | first = Andrew S. | last2 = Cleare | first2 = Anthony J. | date = 2011-09-27 | title = Hypothalamic-pituitary-adrenal axis dysfunction in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/21946893|journal=Nature Reviews. Endocrinology|volume=8|issue=1|pages=22–32|doi=10.1038/nrendo.2011.153|issn=1759-5037|pmid=21946893}}</ref><ref>{{Cite journal | last = Heim | first = Christine | last2 = Nater | first2 = Urs M. | last3 = Maloney | first3 = Elizabeth | last4 = Boneva | first4 = Roumiana | last5 = Jones | first5 = James F. | last6 = Reeves | first6 = William C. | date = Jan 2009 | title = Childhood trauma and risk for chronic fatigue syndrome: association with neuroendocrine dysfunction|url=https://www.ncbi.nlm.nih.gov/pubmed/19124690|journal=Archives of General Psychiatry|volume=66|issue=1 | pages = 72–80|doi=10.1001/archgenpsychiatry.2008.508|issn=1538-3636|pmid=19124690}}</ref><ref name="Morris">{{Cite journal | last = Morris | first = Gerwyn | last2 = Anderson | first2 = George | last3 = Maes | first3 = Michael | date = 2016-10-20 | title = Hypothalamic-Pituitary-Adrenal Hypofunction in Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) as a Consequence of Activated Immune-Inflammatory and Oxidative and Nitrosative Pathways|url=https://link.springer.com/article/10.1007/s12035-016-0170-2|journal=Molecular Neurobiology|language=en|volume=54|issue=9 | pages = 6806–6819|doi=10.1007/s12035-016-0170-2|issn=0893-7648}}</ref>. It has been suggested that HPA axis hypofunction in ME/CFS is caused by chronic activation of the inflammatory and oxidative and nitrosative stress pathways<ref name="Morris" />. However, this area of research continues to lack studies with direct measures of pituitary function. Some patients report that there seems to be a period of pituitary/HPA axis hyperfunction in the earlier stage of ME/CFS, whereas later in disease progression there's a switch to hypofunction. This could perhaps explain some of the wide variation across studies (e.g.,<ref>{{Cite journal | last = DEMITRACK | first = MARK A. | last2 = DALE | first2 = JANET K. | last3 = STRAUS | first3 = STEPHEN E. | last4 = LAUE | first4 = LOUISA | last5 = LISTWAK | first5 = SAM J. | last6 = KRUESI | first6 = MARKUS J.P. | last7 = CHROUSOS | first7 = GEORGE P. | last8 = GOLD | first8 = PHILIP W. | date = Dec 1991 | title = Evidence for Impaired Activation of the Hypothalamic-Pituitary-Adrenal Axis in Patients with Chronic Fatigue Syndrome|url=https://academic.oup.com/jcem/article-abstract/73/6/1224/2653522|journal=The Journal of Clinical Endocrinology & Metabolism|language=en|volume=73|issue=6|pages=1224–1234|doi=10.1210/jcem-73-6-1224|issn=0021-972X}}</ref><ref>{{Cite journal | last = Di Giorgio | first = Annabella | last2 = Hudson | first2 = Marina | last3 = Jerjes | first3 = Walid | last4 = Cleare | first4 = Anthony J. | date = May 2005 | title = 24-hour pituitary and adrenal hormone profiles in chronic fatigue syndrome|url=https://www.ncbi.nlm.nih.gov/pubmed/15911907|journal=Psychosomatic Medicine|volume=67|issue=3 | pages = 433–440|doi=10.1097/01.psy.0000161206.55324.8a|issn=1534-7796|pmid=15911907}}</ref><ref>{{Cite journal | date = 2004-07-01 | title = Basal circadian and pulsatile ACTH and cortisol secretion in patients with fibromyalgia and/or chronic fatigue syndrome|url=https://www.sciencedirect.com/science/article/pii/S0889159104000212|journal=Brain, Behavior, and Immunity|language=en|volume=18|issue=4|pages=314–325|doi=10.1016/j.bbi.2003.12.011|issn=0889-1591}}</ref>). Patients with ME have also reported other problems with the pituitary, such as [[empty sella syndrome]] and [[pituitary adenoma]]. These may be of note to guide future research.{{citation needed | date = Nov 2021}} ==See also == *[[Hypothalamus]] *[[Hypothalamic-pituitary-adrenal axis]] == Learn more == *[https://openstax.org/books/biology-2e/pages/37-5-endocrine-glands Endocrine Glands - OpenStax Biology 2e] *[https://openstax.org/books/anatomy-and-physiology/pages/17-3-the-pituitary-gland-and-hypothalamus The Pituitary Gland and Hypothalamus - OpenStax Anatomy and Physiology] *[https://www.sciencedirect.com/science/article/pii/S0889159104000212 The hypothalamus and pituitary gland] - Khan academy == References == {{Reflist}} [[Category:Endocrine system]] [[Category:Central nervous system]] [[Category:Neurology]] [[Category:Anatomy]]
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