Hypopituitarism
Causes of anterior and posterior pituitary failure, how to test each axis (basal tests, when to do a synacthen, ITT, glucagon or copeptin test), and replacement in the right order with the interactions that catch people out.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Loss of one or more pituitary hormones. Pituitary adenomas and their treatment cause most adult cases.
- With an enlarging mass, hormones usually go in the order GH, LH and FSH, TSH, then ACTH. Prolactin is preserved or raised by stalk compression. The physiology is in Hypothalamic-pituitary anatomy and physiology.
- ACTH deficiency is the life-threatening one. Replace hydrocortisone before thyroxine.
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Sources
- Hormonal replacement in hypopituitarism in adults: an Endocrine Society clinical practice guidelineEndocrine Society (Fleseriu et al., J Clin Endocrinol Metab 2016;101:3888-921), 2016
- A copeptin-based approach in the diagnosis of diabetes insipidusN Engl J Med (Fenske et al., 2018;379:428-39), 2018
- Changing the name of diabetes insipidus: a position statement of the Working Group for Renaming Diabetes InsipidusJ Clin Endocrinol Metab (Arima et al., 2022), 2022
- Endocrinology (Therapeutic Guidelines)AU/NZTherapeutic Guidelines Ltd
- Adrenal insufficiency resources (sick day management plan and steroid card)AU/NZEndocrine Society of Australia
- Assessing fitness to drive for commercial and private vehicle driversAU/NZAustroads and National Transport Commission
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy