Hormone Replacement in Hypopituitarism Guideline Resources …

Posted: February 14, 2021 at 6:50 pm

Full Guideline: Hormonal Replacement in Hypopituitarism in AdultsJCEM | October 2016Maria Fleseriu (Chair), Ibrahim A. Hashim, Niki Karavitaki, Shlomo Melmed, M. Hassan Murad, Roberto Salvatori, and Mary H. Samuels

The 2016 guideline addresses:

The guideline addresses special circumstances that may affect the treatment of patients with hypopituitarism, including pregnancy care, post-surgical care following pituitary or other operations, treatment in combination with anti-epilepsy medication, and care following pituitary apoplexya serious condition that occurs when there is bleeding into the gland or blood flow to it is blocked.

Recommendations from the guideline include:

+ 1.0 Diagnosis of hypopituitarism

Central adrenal insufficiency

Central hypothyroidism

GH deficiency

Central hypogonadism in males

Central hypogonadism in females

Central diabetes insipidus

+ 2.0 Treatment

Hormonal replacement in panhypopituitarism

Glucocorticoid replacement

Adrenal crisis

Thyroid hormone replacement

Testosterone replacement

Estrogen replacement in premenopausal women

GH replacement therapy

Diabetes insipidus

Interactions between replacement hormones

Glucocorticoids and GH

Glucocorticoids and thyroid hormone

Glucocorticoids and estrogen

GH and thyroid hormones

Estrogen and thyroid hormones

GH and estrogen

Glucocorticoids and diabetes insipidus

Risk of hormonal over-replacement in hypopituitarism

Bone disease

Cardiovascular risks in patients with hypopituitarism on replacement therapy

Glucocorticoid over-replacement

Thyroid replacement

+ 3.0 Special circumstances

Cushings disease


GH replacement in cured acromegaly after surgery and/or radiation

Perioperative management of hypopituitarism

Pituitary surgery

Non-pituitary surgery

Management of hypopituitarism in pregnancy




Growth hormone

Management of hypopituitarism in pituitary apoplexy

Treatment of hypopituitarism in patients receiving antiepileptic medications

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Hormone Replacement in Hypopituitarism Guideline Resources ...

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