Summary
Definition
History and exam
Other diagnostic factors
- decreased memory
- constipation
- muscle cramps
- weight gain
- depression
- dry, coarse skin
- oligomenorrhea/amenorrhea
- bradycardia
- reduced body and scalp hair
- delayed relaxation of deep tendon reflexes
- hearing impairment
- impassive facial expression
- diabetes insipidus (DI)
- headache
- diplopia
- decreased peripheral vision
- skin depigmentation
- atrophic breasts
- galactorrhea
Risk factors
- multiple endocrine neoplasia (MEN) type I
- age - between 5-14 years and older than 65 (craniopharyngiomas)
- age - second to fifth decades (prolactinomas)
- age - fourth to eighth decades (nonfunctioning pituitary adenomas)
- sarcoidosis
- head and neck irradiation
- traumatic brain injury (TBI)
- histiocytosis
- hemochromatosis
- pregnancy
- family history of central hypothyroidism
Diagnostic investigations
1st investigations to order
- serum free thyroxine (T4)
- serum thyroid-stimulating hormone (TSH)
Investigations to consider
- MRI of brain
- CT head
- prolactin (PRL)
- 9 a.m. serum cortisol
- serum testosterone
- serum gonadotropins
- genetic analyses
Treatment algorithm
Contributors
Authors
Consultant Endocrinologist
King's College Hospital NHS Foundation Trust
London
UK
Disclosures
JG declares that she has no competing interests.
Dr Jacqueline Gilbert would like to gratefully acknowledge Dr Rasa Zarnegar, a previous contributor to this topic.
Disclosures
RZ declares that he has no competing interests.
Peer reviewers
Assistant Professor
Department of Endocrine Surgery
Columbia University
New York
NY
Disclosures
JL declares that he has no competing interests.
Director of Clinical Endocrinology
Beth Israel Deaconess Medical Center
Boston
MA
Disclosures
JVH declares that he has no competing interests.
Sir Arthur Hall Professor of Medicine/Pro Vice Chancellor
University of Sheffield
Sheffield
UK
Disclosures
AW declares that he has no competing interests.
Use of this content is subject to our disclaimer