What is the role thyroid function testing in the diagnosis of hypopituitarism (panhypopituitarism)?

Updated: Jun 09, 2020
  • Author: Bernard Corenblum, MD, FRCPC; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Assessment of thyroid function is important in the evaluation of ACTH deficiency. In a hypothyroid state, cortisol clearance decreases, causing an increase in the serum cortisol level. If thyroid replacement is initiated, the cortisol level may be inappropriate to the new state, initiating an adrenocortical crisis.

In suspected TSH deficiency, measure serum TSH and thyroxine. A normal level of total free T4 rules out hypothyroidism. A low thyroxine and low/normal serum TSH and a small, soft thyroid gland confirm the diagnosis of TSH deficiency.

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