What are the referral criteria for a patient suspected of having hypopituitarism to an endocrinologist?

Referral criteria for suspected hypopituitarism to an endocrinologist:

• Refer patients who have persistent symptoms consistent with hypopituitarism after a head injury or who are not recovering as expected following discharge. Symptoms may include fatigue, weakness, weight loss, hypotension, hyponatraemia, hypoglycaemia, neuropsychiatric symptoms, sexual dysfunction, and others related to pituitary hormone deficiencies.
• Consider referral if there is suspicion of secondary hypothyroidism, which may indicate pituitary dysfunction.
• Refer urgently if adrenal insufficiency is suspected, especially if there are signs such as unexplained weight loss, salt craving, nausea, vomiting, hypotension, or biochemical abnormalities like hyponatraemia or hyperkalaemia, as adrenal insufficiency can be a component of hypopituitarism.
• Referral urgency depends on clinical judgement but should be prompt when multiple pituitary hormone deficiencies are suspected or when symptoms are severe or progressive.

These criteria ensure timely specialist assessment for diagnosis confirmation and management initiation.

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