Part of “CHAPTER 17 – HYPOPITUITARISM“

The syndrome of hypopituitarism frequently includes nonspe-cific symptoms, such as weakness and fatigue. Because such symptoms are frequently psychogenic or, if organic, may be secondary to a variety of diseases, it is not cost-effective to screen specifically for hypopituitarism unless there are additional clues.

Two specific syndromes may superficially mimic hypopituitarism. Anorexia nervosa (see Chap. 128) is a form of deliberate chronic starvation, most commonly seen in young women and likely to have a psychiatric cause.40 The presence of amenorrhea with low gonadotropin levels and borderline low thyroid function test results suggests pituitary disease, but these are compensatory hormonal changes seen in any form of starvation. A patient with anorexia nervosa appears obviously emaciated, an unexpected component of hypopituitarism.