Neuroendocrinologist Francesca Galbiati, MD, Joins the California Center for Pituitary Disorders at UCSF
What led you to pursue a career in medicine and neuroendocrinology?
I grew up in Italy, where you enter a six-year medical program right after high school. I always knew I loved science, but I also knew I didn’t only want to work in a lab—I wanted a career that combined science with people. Medicine was the natural answer.
In my first-year anatomy class, I completely fell in love with the pituitary gland. I was fascinated that such a tiny structure could orchestrate the entire body. From that moment on, I knew I wanted to dedicate my career to pituitary endocrinology, and I never changed my mind.
Where did you train?
I earned my medical degree from the University of Milan–Bicocca. After graduating, I came to the United States and spent a year in the Neuroendocrine Unit at Massachusetts General Hospital, which helped me decide to pursue training here.
I completed my Internal Medicine residency at the University of Pittsburgh Medical Center, then returned to Boston for my Endocrinology, Diabetes & Metabolism fellowship at Brigham and Women’s Hospital and Massachusetts General Hospital.
What conditions do you treat?
I specialize in the full spectrum of hypothalamic and pituitary disorders, including:
Pituitary adenomas
Acromegaly
Cushing’s disease
Prolactin-secreting tumors
TSH-secreting tumors
Hypopituitarism
Arginine-vasopressin deficiency
Hypothalamic obesity and hyperphagia
Post-surgical and post-radiation hormonal deficiencies
What interests you most about pituitary medicine?
I’m drawn to the elegance of endocrine physiology. Hormones exist in incredibly small concentrations, yet they can completely change your life if they are too high or too low. There’s a mathematical balance to it—if something is low, we replace it; if it’s high, we suppress it.
I’m especially fascinated by vasopressin deficiency, not only because of its classic role in water balance but also because of its effects on appetite, metabolism, social behavior, and possibly mental health. We still don’t fully understand these relationships in humans, and that curiosity drives a lot of my work.
Similarly, most of my research work so far has focused on vasopressin’s “sister hormone,” oxytocin. Oxytocin is a “neglected” hypothalamic hormone that may be deficient in pituitary disease, and lack of oxytocin may affect our patients’ quality of life. I am excited by the growing interest in administering oxytocin, alongside other hormones, in patients with hypopituitarism, and look forward to seeing the results of ongoing clinical trials on oxytocin replacement.
What is your philosophy of patient care?
My approach is deeply collaborative. Managing pituitary disorders closely depends on patients understanding complex physiology and being active partners in their care.
For example, we don’t rely solely on lab values—we go by symptoms. That requires trust, communication, and shared decision-making. Patient education is essential. If someone doesn’t understand why they need to take ten different hormone replacements, they’re not going to be able to manage their condition confidently.
I also focus a lot on setting expectations around surgery. Pituitary surgery can feel routine to us, but for patients it’s still surgery. I want them to feel supported throughout the experience.
How would you describe the multidisciplinary environment at UCSF?
It has been wonderful. There is constant communication between endocrinology, neurosurgery, neuro-ophthalmology, ENT, and radiation oncology. And patients really benefit from that. Everyone—from attending surgeons to our clinic team—has been incredibly proactive about meeting, collaborating, and integrating me into the workflow.
What are your current research interests?
My research focuses on neuropeptides produced by the hypothalamus and posterior pituitary—oxytocin, vasopressin, and apelin—and how they affect appetite and metabolism, behavior and quality of life, and cognitive function in brain aging.
At MGH, I studied vasopressin’s role in appetite signaling and metabolic changes after bariatric surgery, and I participated in clinical trials of intranasal oxytocin in obesity and vasopressin deficiency.
At UCSF, I’m excited to explore how these hormones influence cognition and aging. I’m also interested in improving how we diagnose and treat aggressive pituitary adenomas, which can behave like malignant tumors.
What misconceptions do patients often have about pituitary disorders?
Many patients hear that they have a “mass near the brain” and immediately think brain tumor. It’s important to clarify that the pituitary is not fully part of the brain and that most lesions are benign. In fact, up to 20% of people have some kind of pituitary lesion if you scan everyone.
Helping patients understand this makes a huge difference in reducing fear and building trust.
How do you see your role in teaching and mentorship at UCSF?
Teaching has always been one of my favorite parts of medicine. I truly believe that I learn as much from teaching as students learn from me.
At UCSF, I hope to expand pituitary-focused education for endocrine fellows and work more closely with neurosurgery residents. I’d like trainees to be more involved in postoperative care for pituitary patients and to have exposure to the complexities of pituitary physiology. If I hadn’t had great teachers, I wouldn’t be here—so I want to create that same excitement for the next generation.
What do you enjoy outside of work?
I have two young children, so we are a very active family. We bike everywhere—usually on our cargo e-bike—and we love being outdoors, hiking, and exploring California. We travel as much as possible, especially to visit family.