Ask most people where the heart, lungs or kidneys are, and they can probably point them out.
But mention the pituitary gland and most would probably look puzzled.
Despite being only about the size of a pea, the pituitary gland plays a crucial role in a child’s growth, development, metabolism and overall health.
In fact, it is the “master gland” because it produces hormones that control vital organs and functions throughout the body.
The pituitary gland sits at the base of the brain, tucked safely behind the bridge of the nose.
It acts like a command centre, sending hormonal messages through the bloodstream to tell different parts of the body what to do and when to do it.
The hormone conductor
Imagine an orchestra.
Every musician may be skilled, but without a conductor, the music can quickly become chaotic.
The pituitary gland functions much like that conductor.
It coordinates different hormones so that growth, energy levels, stress responses, puberty and many other bodily functions remain in harmony.
Let us look at some of the key hormones it controls:
This is perhaps the hormone most parents would have heard about.
As per its name, GH stimulates the growth of bones, muscles and other tissues.
During childhood, it is essential for the child to gain normal height.
Children who do not produce enough GH may grow much more slowly than their peers.
One child I saw was a cheerful five-year-old boy whose parents noticed that his clothes seemed to last forever.
While his friends were outgrowing their uniforms every year, he hardly needed larger sizes.
Clinical investigations eventually showed he had GH deficiency.
With appropriate GH treatment, his growth rate improved significantly and he gradually caught up with his peers.
TSH tells the thyroid gland in the neck to produce thyroid hormones.
Thyroid hormones influence metabolism, body temperature, energy levels, growth and brain development.
In children, it is especially important for normal growth and learning.
If the pituitary gland does not produce enough TSH, a child may experience tiredness, poor growth, constipation, dry skin and difficulty concentrating.
ACTH signals the adrenal glands, which are located above the kidneys, to produce cortisol.
Cortisol is sometimes called the “stress hormone”, but its job goes far beyond stress.
It helps maintain blood pressure, blood sugar levels, and the body’s ability to cope with illness and infection.
Children with severe ACTH deficiency may become unusually sleepy, develop low blood sugar, experience vomiting, or become seriously unwell during infections if the condition is not recognised.
These hormones become particularly important during puberty.
LH and FSH signal the ovaries and testes to produce sex hormones.
These sex hormones drive the physical changes of puberty, including breast development in girls, testicular enlargement in boys, growth spurts and fertility later in life.
When these hormones are lacking, puberty may be delayed or fail to start altogether.
The pituitary gland also releases ADH, which helps the kidneys regulate the body’s water balance.
Children with insufficient ADH may develop excessive thirst and pass large amounts of urine – a condition known as diabetes insipidus.
Varying symptoms
Pituitary disorders may be present from birth (congenital) or develop later in life (acquired).
Some children are born with an underdeveloped pituitary gland or genetic conditions affecting hormone production.
Others may develop pituitary problems because of tumours, infections, trauma, surgery or radiation affecting the brain.
The symptoms vary depending on which hormones are affected.
Some children may have only one hormone deficiency, while others have multiple hormone deficiencies, a condition known as hypopituitarism or panhypopituitarism.
Consider a newborn baby boy who was admitted shortly after birth because he appeared unusually sleepy and had episodes of low blood sugar.
Further evaluation revealed that he was not producing sufficient ACTH, TSH and GH.
Without these hormones, maintaining normal blood sugar and adapting to life outside the womb became difficult.
Some babies with multiple pituitary hormone deficiencies may also have feeding difficulties, prolonged jaundice, problems with salt and water balance, or developmental concerns.
Fortunately, once the diagnosis was made, hormone replacement treatment could be started.
With close monitoring and ongoing specialist care, many children like him can grow and develop well.
Not all pituitary disorders present during infancy, however.
A 15-year-old boy may come to the clinic because he is still waiting for puberty while his classmates have already experienced voice changes and growth spurts.
Investigations sometimes reveal deficiencies of LH and FSH.
With appropriate hormone replacement, puberty can often be induced and progress normally.
Detective work
Diagnosing pituitary disorders often requires careful detective work.
Doctors start by listening closely to the child’s and/or parents’ stories, and examining growth patterns, pubertal development and overall health.
Blood tests help measure hormone levels, while specialised stimulation tests may sometimes be required.
Magnetic resonance imaging (MRI) of the brain can provide detailed pictures of the pituitary gland and surrounding structures.
Because symptoms may develop gradually, diagnosis can occasionally be delayed.
This is why regular growth monitoring remains so important.
A child’s growth chart often provides some of the earliest clues that something may not be right.
Although pituitary disorders can sound frightening and complex, many are highly treatable depending on the underlying cause and hormone deficiencies.
Today, we have effective hormone replacement therapies that can replace the hormones the body is unable to produce.
Depending on the condition, treatment may include GH injections, thyroid hormone tablets, hydrocortisone, puberty-inducing hormones or medications to regulate water balance.
With timely diagnosis and appropriate treatment, many children with pituitary disorders can enjoy healthy, active and fulfilling lives.
An influential gland
The pituitary gland may be small enough to fit on the tip of a finger, but its influence reaches into nearly every corner of the body.
From helping a newborn maintain blood sugar to supporting a child’s growth and triggering puberty in adolescence, this tiny gland quietly works behind the scenes every day.
So, let us give this remarkable little gland the recognition it deserves this Pituitary Awareness Month (October 2026).
Remember, some of the most important things in life come in very small packages.
Dr Jeanne Wong Sze Lyn is a consultant paediatrician and paediatric endocrinologist. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
