Expert Evaluation & Treatment in Bronxville, Serving Westchester & New York State
The pituitary gland, often referred to as the “master gland,” is a pea-sized structure at the base of the brain that orchestrates nearly every major hormonal pathway in the body. From growth and metabolism to reproduction, thyroid activity, adrenal stress response, and water balance, the pituitary’s signals influence virtually every organ system.
When pituitary function is disrupted — by tumors, inflammation, autoimmune disease, trauma, or genetic conditions — the consequences can be profound. Patients may experience fatigue, infertility, abnormal growth, vision changes, mood disturbances, or dangerous hormonal imbalances. Many of these disorders are rare and require nuanced diagnosis.
At Sequoia Medical 360, Dr. Tony Mathews provides precision evaluation and highly individualized care for both common and complex pituitary conditions. With advanced training in Endocrinology, Diabetes & Metabolism, as well as Preventive Cardiology, Dr. Mathews bridges hormone science with holistic health optimization — ensuring that no subtlety in diagnosis or treatment is overlooked.
Pituitary Tumors & Growths
Pituitary Adenomas
Pituitary adenomas are benign tumors that develop within the gland. While most are noncancerous, their impact depends on whether they secrete hormones (“functioning adenomas”) or simply cause pressure on surrounding structures.
Evaluation: MRI imaging, detailed hormone panels, and ophthalmologic exams when visual pathways are affected.
Treatment: Small, non-secreting adenomas may be monitored; hormone-secreting adenomas often require medication, surgery, or radiation.
Prolactinoma & Hyperprolactinemia
The most common pituitary tumor, a prolactinoma produces excessive prolactin.
In women: Irregular periods, infertility, galactorrhea (milk production without pregnancy).
In men: Low testosterone, erectile dysfunction, gynecomastia.
Treatment: Usually with dopamine agonist medications (cabergoline or bromocriptine), which both lower prolactin and shrink tumors.
Craniopharyngiomas
Rare, benign tumors near the pituitary, often affecting children and young adults. They can cause vision problems, headaches, and hormone deficiencies.
Management: Requires careful coordination between endocrinology, neurosurgery, and oncology teams.
Pituitary Apoplexy
A medical emergency caused by sudden bleeding or swelling in the pituitary, often within an adenoma.
A medical emergency caused by sudden bleeding or swelling in the pituitary, often within an adenoma.
Treatment: Immediate hospitalization, hormone replacement, and sometimes urgent neurosurgery.
Hormone Excess Disorders
Cushing’s Disease (ACTH Excess)
When a pituitary adenoma produces too much ACTH, the adrenal glands release excess cortisol.
Symptoms: Rapid central weight gain, round face, muscle weakness, thin skin, bruising, high blood pressure, diabetes, and mood swings.
Treatment: Often surgical removal of the tumor, with medications or radiation as second-line options. Long-term monitoring is essential, as recurrence can occur.
Acromegaly & Gigantism (Growth Hormone Excess)
Excess growth hormone (GH) leads to:
Acromegaly in adults: Enlarged hands, feet, jaw, and soft tissues; joint pain; sleep apnea; heart disease risk.
Gigantism in children: Excessive height and rapid growth.
Management: MRI to identify adenoma, surgery when feasible, medications to reduce GH, or targeted radiation.
TSH-Secreting Adenomas (TSHomas)
Rare tumors that produce excess thyroid-stimulating hormone, causing hyperthyroidism.
Treatment: GH replacement therapy under close supervision, with regular monitoring for metabolic and cardiovascular effects.
Central Adrenal Insufficiency (Low ACTH)
When the pituitary fails to produce ACTH, cortisol levels fall dangerously low.
Symptoms: Fatigue, weight loss, low blood pressure, dizziness, salt craving.
Risks: Can be life-threatening during stress or illness.
Treatment: Lifelong cortisol replacement therapy, with careful stress-dose education.
Central Hypothyroidism (Low TSH)
Inadequate TSH from the pituitary means the thyroid underproduces hormones.
Symptoms: Fatigue, weight gain, cold intolerance, dry skin, hair loss.
Diagnosis: Requires measuring free T4, not just TSH, to avoid missed diagnoses.
Treatment: Tailored thyroid hormone replacement.
Central Hypogonadism (Low LH & FSH)
Failure of the pituitary to produce reproductive hormones disrupts estrogen and testosterone production.
In women: Irregular periods, infertility, low bone density.
In men: Low libido, erectile dysfunction, loss of muscle mass, infertility.
Treatment: Hormone replacement therapy and fertility-specific interventions when desired.
Panhypopituitarism
A rare but serious condition in which most or all pituitary hormones are deficient.
Causes: Large tumors, Sheehan’s syndrome (postpartum pituitary damage), trauma, or apoplexy.
Management: Lifelong multi-hormone replacement (thyroid, cortisol, sex hormones, sometimes GH) with meticulous ongoing monitoring.
Water Balance Disorders
Diabetes Insipidus (ADH Deficiency or Resistance)
When the pituitary fails to make enough antidiuretic hormone (ADH), or the kidneys fail to respond:
Symptoms: Excessive urination, constant thirst, risk of dehydration and electrolyte imbalance.
Diagnosis: Water deprivation testing, urine studies, and MRI.
Treatment: Synthetic ADH (desmopressin) and close hydration management.
Empty Sella Syndrome
In some cases, imaging reveals that the pituitary space (“sella turcica”) appears filled with fluid rather than tissue. While many patients remain asymptomatic, some develop pituitary hormone deficiencies.
Management: Regular hormone testing and replacement when necessary.
Special Situations
Sheehan’s Syndrome
Severe bleeding during childbirth can damage the pituitary, leading to multiple hormone deficiencies.
Treatment: Lifelong hormone replacement, with emphasis on adrenal and thyroid function.
Rare Genetic & Hormone Resistance Syndromes
Some individuals inherit conditions where hormones are produced but the body cannot use them properly, such as thyroid hormone resistance or certain forms of GH/ACTH resistance. These require highly specialized evaluation and individualized treatment.
Our Diagnostic Approach
At Sequoia Medical 360, evaluation of pituitary disorders is thorough and precise:
Dynamic testing (stimulation and suppression tests) for subtle deficiencies or excesses.
High-resolution MRI imaging for adenomas and structural abnormalities.
Body composition analysis (InBody 770) to measure the impact of hormonal imbalance on muscle, bone, and fat.
Collaborative assessments with ophthalmology, neurosurgery, and oncology as needed.
Personalized Treatment Strategies
Medical therapy: Targeted drugs to suppress hormone excess or replace deficiencies.
Surgical referrals: For pituitary tumors, coordinated with expert neurosurgeons.
Radiation or biologics: For resistant adenomas.
Lifelong endocrine optimization: Regular monitoring and proactive adjustments to minimize long-term risks.
Concierge-level care: Expedited appointments, direct messaging, extended consultations, and telehealth across New York State.
The Sequoia Medical 360 Advantage for Pituitary Health
Quadruple board-certified care with dual fellowship expertise in endocrinology and preventive cardiology.
Integration of care: Linking pituitary management with thyroid, adrenal, bone, and reproductive health.
Advanced diagnostics: Full lab panels, imaging, and functional testing in a private, concierge setting.
Direct Physician Counsel: Ample, scheduled exam time and streamlined communication to review results with the depth your physiology requires.
Take the Next Step
Pituitary disorders are among the most complex endocrine conditions, often requiring careful detective work and long-term follow-up. At Sequoia Medical 360, we provide the clarity, precision, and continuity you need to restore balance and protect your long-term health.
