Pituitary & Adrenal
Pituitary Disorders & Acromegaly
The pituitary governs every other endocrine gland, so its disorders present in unexpected ways. Acromegaly, prolactinoma, Cushing's disease and hypopituitarism are core areas of Dr Ghosh's training and published work.
Symptoms that bring people in
- Headaches, or loss of side vision
- Hands, feet or facial features enlarging; rings and footwear no longer fitting
- Deepening voice, or increasing gaps between the teeth
- Milk discharge from the breasts, or absent periods
- Loss of libido or erectile dysfunction
- Profound tiredness, low blood pressure, salt craving
- Passing very large volumes of urine with intense thirst
Having one of these does not mean you have this condition — several overlap with far more common problems. It means the question is worth asking properly.
The pituitary is a small gland beneath the brain that directs the thyroid, the adrenals, the gonads, growth and water balance. A tumour there — almost always benign — may over-produce one hormone, under-produce others by pressure, or press on the optic nerves. Because the presenting complaint is often something apparently unrelated, these conditions are frequently diagnosed years late.
Acromegaly
Caused by excess growth hormone, usually from a pituitary adenoma. The changes are so gradual that patients and families rarely notice them; old photographs are often the most revealing investigation in the room. Enlarging hands and feet, coarsening facial features, increased spacing of the teeth, snoring, joint pain, sweating, hypertension and diabetes are typical. Untreated, it shortens life. Diagnosis uses IGF-1 and a growth hormone suppression test with MRI of the pituitary; treatment may be surgery, somatostatin analogues such as long-acting octreotide, or radiotherapy. Dr Ghosh has presented and published on the efficacy of long-acting octreotide in acromegaly at a tertiary centre in eastern India.
Prolactinoma and raised prolactin
Presents with absent or irregular periods, milk discharge, infertility, or loss of libido and erectile dysfunction in men. Medication is usually highly effective and surgery is often unnecessary. Drug causes and hypothyroidism are excluded first, since both commonly raise prolactin.
Hypopituitarism
Under-production of one or several pituitary hormones, following a tumour, surgery, radiotherapy, head injury, infiltrative disease, or postpartum haemorrhage. Replacement must be given in the correct order — cortisol before thyroid hormone, always — and patients on steroid replacement need clear sick-day rules and a means of identifying their condition in an emergency. Adrenal crisis is preventable and is fatal when it is missed.
Cushing's disease and diabetes insipidus
Cortisol excess from a pituitary source, and disorders of water balance causing large-volume urine output, are both investigated with dynamic testing — protocols Dr Ghosh co-authored for the Department of Endocrinology at IPGMER.
This page is general information. Doses and treatment choices in endocrinology are individual, and are decided at a consultation with your reports in front of us. Please do not start, stop or change a medicine based on this page.
Common questions
Before your first visit
How do I book an appointment?
Use the appointment form on this website and the clinic will telephone you to confirm a time, usually within one working day. For a same-day or urgent request, please ring the number in the page header instead — a phone call is always faster than a form.
Hospital OPDs at CMRI and Narayana Memorial are booked through the hospital's own reception. For district chambers, it is worth calling the chamber number listed on its page before travelling.
Which chamber should I choose?
Whichever is easiest for you to reach and return to. Endocrine conditions need review over months and years rather than a single visit, so the chamber you can get to comfortably every few months is nearly always the better choice than the one that seems most impressive.
That said: if your problem needs same-day tests, an ultrasound, or admission, a hospital OPD is the better setting. The Chambers page lists every location with its days and timings, and the weekly timetable shows them all side by side.
Do chamber timings ever change?
Yes — and this is worth taking seriously if you are travelling any distance. Several district visits run on a monthly rotation, such as the 1st and 3rd Saturday, and a hospital OPD can be rescheduled at short notice. Timings shown on this website are kept up to date and any known cancellation appears on the chamber's page, but please telephone ahead before a long journey.
What should I bring to the first consultation?
Bring everything you have, even if it seems old or irrelevant:
- all previous prescriptions, including from other doctors
- every blood report and scan you hold, in date order if possible
- the actual strips or boxes of the medicines you take, or a written list with doses
- your home blood sugar or blood pressure diary, if you keep one
- for a child, the growth chart and immunisation record
Old reports are genuinely useful. A five-year-old thyroid result or an earlier scan often changes the plan, because what matters in endocrinology is frequently the trend rather than today's number.
Consultation
Request an appointment
Tell us which chamber suits you and when. We will confirm your slot by phone.