Excess The most common disease of<unk>  excess is a pituitary tumor composed of somatotroph cells of the anterior pituitary. These somatotroph adenomas are benign and grow slowly, gradually producing more and more<unk> . For years, the principal clinical problems are those of<unk>  excess. Eventually, the adenoma may become large enough to cause headaches, impair vision by pressure on the optic nerves, or cause deficiency of other pituitary hormones by displacement. Prolonged<unk>  excess thickens the bones of the jaw, fingers and toes, resulting in heaviness of the jaw and increased size of digits, referred to as acromegaly. Accompanying problems can include sweating, pressure on nerves (e.g. carpal tunnel syndrome), muscle weakness, excess sex hormone-binding globulin (SHBG), insulin resistance or even a rare form of type 2 diabetes, and reduced sexual function.<unk> -secreting tumors are typically recognized in the fifth decade of life. It is extremely rare for such a tumor to occur in childhood, but, when it does, the excessive<unk>  can cause excessive<unk> , traditionally referred to as pituitary gigantism. Surgical removal is the usual treatment for<unk> -producing tumors. In some circumstances, focused radiation or a<unk>  antagonist such as pegvisomant may be employed to shrink the tumor or block function. Other drugs like octreotide (somatostatin agonist) and bromocriptine (dopamine agonist) can be used to block<unk>  secretion because both somatostatin and dopamine negatively inhibit<unk> RH-mediated<unk>  release from the anterior pituitary. Deficiency The effects of<unk>  <unk>  deficiency vary depending on the age at which they occur. Alterations in somatomedin can result in<unk>  deficiency with two known mechanisms; failure of tissues to respond to somatomedin, or failure of the liver to produce somatomedin. Major manifestations of<unk>  deficiency in children are<unk>  failure, the development of a short stature, and delayed sexual maturity. In adults, somatomedin alteration contributes to increased osteoclast activity, resulting in weaker bones that are more prone to pathologic fracture and osteoporosis. However, deficiency is rare in adults, with the most common cause being a pituitary adenoma. Other adult causes include a continuation of a childhood problem, other structural lesions or trauma, and very rarely idiopathic<unk> D. Adults with<unk> D "tend to have a relative increase in fat mass and a relative decrease in muscle mass and, in many instances, decreased energy and quality of life". Diagnosis of<unk>  deficiency involves a multiple-step diagnostic process, usually culminating in<unk>  stimulation tests to see if the patient's pituitary gland will release a pulse of<unk>  when provoked by various stimuli.
Growth hormone
Parathyroid hormone
Orexin
Adrenocorticotropic hormone 
Menotropin
Cortisol
Gonadotropin
Insulin-like growth factor