Pituitary Disorders

Questions discussed in this category

How do you manage microprolactinomas in women who are resistant to dopamine agonists, especially considering potential tumor growth during pregnancy?

2 Answers available

For non-functional pituitary macroadenomas, how effective has cabergoline been in reducing tumor size or preventing the need for surgery?

2 Answers available

How often and for how long do you monitor pituitary gland function in a patient with empty sella (radiologic finding only)?

2 Answers available

Would you recommend 11C-methionine PET/CT imaging for patients with persistent or recurrent Cushing’s disease after transsphenoidal surgery?

Furnica et al., PMID 39873396

1 Answer available

Do you recommend treating a macroprolactinoma that is acutely undergoing spontaneous apoplexy with dopaminergic agents?

1 Answer available

What degree of prolactin elevation is typically seen in patients with end stage kidney disease on hemodialysis?

1 Answer available

How do you evaluate remission in acromegaly when postoperative IGF-1 and GH levels are discordant?

2 Answers available

What are the advantages of oral octreotide acetate over its long acting injectable formulation for treatment of acromegaly?

1 Answer available

Does hyperprolactinemia always need to be treated if the patient has regular menses, no galactorrhea, no desire for fertility and MRI of the pituitary is normal?

2 Answers available

Would you evaluate for an ectopic source in a patient with persistently elevated IGF-1 level but no clinical features of acromegaly or evidence of pituitary abnormalities?

1 Answer available

Can the desmopressin stimulation test be used to assess for central adrenal insufficiency?

1 Answer available

In patients using NuvaRing for contraception, is the 1mg dexamethasone suppression test reliable to screen for cortisol excess?

1 Answer available

Do you pursue additional cardiac evaluation for patients diagnosed with Sheehan Syndrome, considering their elevated risk for atherosclerotic cardiovascular diseases?

Mohammad et al., PMID 40246232

1 Answer available

How would you manage new onset amenorrhea, diabetes insipidus and growth hormone deficiency without other pituitary deficiencies or excess in young females with MRI findings of pituitary mass and hypothalamic edema?

Is there any way to find out the diagnosis without a biopsy? Hypophysitis is in the differential, any role for high dose steroids?

1 Answer available

How often do you monitor pituitary adenomas once established as non-functioning?

2 Answers available

In patients with confirmed hypercortisolism with a high/normal unsuppressed ACTH who have both a pituitary adenoma and adrenal adenoma identified on imaging, can you reliably use DHEA-S to determine the source of cortisol production?

2 Answers available

Do you recommend increased screening for hypercortisolism in older patients given recent evidence that older patients do not commonly display hallmark symptoms of Cushing's Disease?

Nye, Endocrinology Advisor 2025

4 Answers available

What is the likelihood of recovery of the hypothalamic-pituitary-adrenal (HPA) axis in patients who develop immunotherapy induced adrenal insufficiency?

1 Answer available

Should we be considering transsphenoidal surgical resection as first-line therapy for prolactinomas?

Wu, PMID 38253861

1 Answer available

Should we be aiming for normalization of both late-night salivary cortisol and 24hr urinary free cortisol levels when monitoring response to Cushing's disease treatment?

2 Answers available

Do you have any specific recommendations to prevent large fluctuations in sodium levels during a colonoscopy prep in patients with central diabetes insipidus on DDAVP?

3 Answers available

Do you interpret failure to develop hypernatremia with prolonged water deprivation (such as for 12 hours) as evidence against diabetes insipidus even if the urine osmolality is just below normal?

For a patient whose sodium remains 142 despite water deprivation from 8 pm to 8 am, with urine osm of about 500, is further testing needed?

2 Answers available

When do you consider using setmelanotide for treatment of hypothalamic obesity?

2 Answers available

How do you approach mild prolactin elevations (20-80) in women with galactorrhea on nipple stimulation but regular menses and no plans for pregnancy?

1 Answer available

Would you consider treating empirically for AVP deficiency in a patient who had pituitary surgery 6 months earlier and complaints of polyuria/polydipsia with dilute urine (without performing water deprivation studies)?

2 Answers available

For patients with central hypothyroidism and a clear etiology (such as recent head irradiation), do you recommend brain imaging prior to starting thyroid hormone replacement therapy?

2 Answers available

Should dopamine agonist treatment stop in pregnant patients with recurrent prolactinoma despite prior surgery?

1 Answer available

What specific clinical factors would drive you to recommend surgical intervention for patients with small, nonfunctional pituitary adenomas who exhibit no neurological symptoms?

1 Answer available

When and how do you taper off cabergoline therapy for treatment of microprolactinoma?

1 Answer available

What is your approach to managing patients with new laboratory evidence of hypopituitarism (e.g. very low plasma ACTH level and low morning serum cortisol) and a remote history of trans-sphenoidal surgery for NFPA?

1 Answer available

Does growth hormone (GH) replacement therapy reduce the risk of fractures in patients with GH deficiency?

1 Answer available

Is Macrilen (macimorelin Dx) still available in the US for diagnosis of adult growth hormone deficiency (AGHD)?

1 Answer available

Should patients with non-functional pituitary macroadenomas with persistent, but tolerable, headaches be recommended for surgery?

1 Answer available

Given the new 2022 WHO classification of pituitary tumors, should we be regularly counseling our patients about the risk of malignancy for what we previously referred to as pituitary adenomas but now classified as pituitary neuroendocrine tumors (PitNETs)?

Asa et al., PMID 35291028

1 Answer available

What is your approach to differentiating diabetes insipidus from primary polydipsia in the outpatient setting?

1 Answer available

Does preoperative use of somatostatin receptor ligand improve remission rates after surgery for acromegaly?

1 Answer available

When do you check macroprolactin in the evaluation of hyperprolactinemia?

2 Answers available

Does norethindrone suppress FSH, LH completely?

If not, what can be possible causes for a postmenopausal woman to have FSH, LH < 0.3 with low E2, and being asymptomatic and doing well otherwise? ...

2 Answers available

Do patients with an elevated IGF-1 level and features of acromegaly need to have confirmatory growth hormone suppression testing with OGTT?

Can a diagnosis of acromegaly be made with just an elevated IGF-1 level in patients with features of acromegaly?

2 Answers available

Should oral combined contraceptives be held prior to overnight dexamethasone suppression test to rule out Cushings?

If so, how long should OCPs be held to reliably trust the dex suppression test results?

2 Answers available

Can combined oral contraceptive use cause falsely elevated 24-hour urine-free cortisol?

2 Answers available

What is your protocol to starting/stopping glucocorticoid replacement in Cushing disease patients after their transsphenoidal resection surgery?

1 Answer available

How often would you repeat testing in a patient suspected of Cyclic Cushing's?

And is there a preferred diagnostic test? Whenever cyclic hypercortisolemia is suspected, it is advised that evaluation should be repeated for months,...

2 Answers available

For a TSH producing microadenoma, would you recommend surgery vs methimazole if the patient is elderly and the tumor is relatively small?

The female patient is in her late 70s with cardiac disease (likely due to chronic hyperthyroidism that was missed due to non-suppressed TSH). I’...

1 Answer available

Should patients with asymptomatic GH deficiency be treated with GH replacement therapy if they have prior known severe CAD?

1 Answer available

Does caution have to be used in GH replacement therapy in any and all types of cancer history?

1 Answer available

Papers discussed in this category

The lancet. Diabetes & endocrinology, 2021 Oct 20

Consensus on diagnosis and management of Cushing's disease: a guideline update.

Pituitary, 2022 May 26

The NETting of pituitary adenoma: a gland illusion.

European journal of endocrinology, 2020 Feb

Use of late-night salivary cortisol to monitor response to medical treatment in Cushing's disease.

BMJ open, 2024 Jul 16

Study protocol for a prospective, multicentre study of hypercortisolism in patients with difficult-to-control type 2 diabetes (CATALYST): prevalence and treatment with mifepristone.

European journal of endocrinology, 2023 Jul 20

Natural history of non-functioning pituitary microadenomas: results from the UK non-functioning pituitary adenoma consortium.

The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2004 Sep

A comparative study on the effects of a contraceptive vaginal ring NuvaRing and an oral contraceptive on carbohydrate metabolism and adrenal and thyroid function.

Expert review of endocrinology & metabolism, 2024 Jun 06

Oral octreotide capsules for acromegaly treatment: application of clinical trial insights to real-world use.

The Journal of clinical endocrinology and metabolism, 2025 Sep 16

Diagnostic Value of 11C-Methionine PET-CT Imaging in Persistent or Recurrent Cushing Disease After Surgery.

Pituitary, 2022 Jun 06

Modern imaging in Cushing's disease.

Frontiers in endocrinology, 2022 Jun 23

A Multicenter Cohort Study in Patients With Primary Empty Sella: Hormonal and Neuroradiological Features Over a Long Follow-Up.

European journal of endocrinology, 2016-07

Treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists.

Archives of medical research, 2023 Nov 22

Pharmacological Treatment of Non-Functioning Pituitary Adenomas.

Pituitary, 2022 Jul 28

Treatment of non-functioning pituitary adenoma with cabergoline: a systematic review and meta-analysis.

Nature reviews. Endocrinology, 2023 Sep 05

Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement.

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