Case three in this paper is of potential relevance to a number here.
I am absolutely convinced that reduced pituitary function is far more common than is realised. In this case report the person seems to have been identified almost by luck. It makes a very obvious argument against relying on TSH only. Again, in this case, the cause was injury but let us not forget there are other possibilities.
Korean J Neurotrauma. 2015 Oct;11(2):139-143. Epub 2015 Oct 31.
Isolated Adrenocorticotropic Hormone or Thyrotropin Deficiency Following Mild Traumatic Brain Injury: Three Cases with Long-Term Follow-Up.
Baek CO1, Kim YJ2, Kim JH1, Park JH2.
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Presbyterian Medical Center, Jeonju, Korea.
2Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonbuk National University Medical School, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
Few studies have examined the clinical features and long-term outcomes of isolated pituitary hormone deficiencies after traumatic brain injury (TBI). Such deficiencies typically present at time intervals after TBI, especially after mild injuries such as concussions, which makes their diagnosis difficult without careful history taking. It is necessary to improve diagnosis and prevent life threatening or morbid conditions such as those that may occur in deficiencies of adrenocorticotropic hormone (ACTH) or thyroid-stimulating hormone (as known as thyrotropin, TSH), the two most important pituitary hormones in hypopituitarism treatment. Here, we report two cases of isolated ACTH deficiency and one case of isolated TSH deficiency. These patients presented at different time points after concussion and underwent long-term follow-ups.
Adrenocorticotropic hormone; Brain injuries; Hypopituitarism; Thyrotropin
PMID: 27169080 [PubMed - as supplied by publisher]
Thankfully, the full paper is available here: