What is the recommended follow-up protocol for patients diagnosed with hypopituitarism after initiating hormone replacement therapy?

There is no direct, specific UK guideline excerpt provided in the context explicitly detailing the follow-up protocol for patients diagnosed with hypopituitarism after initiating hormone replacement therapy. However, based on the management principles of hormone deficiencies and adrenal insufficiency (a common component of hypopituitarism), the recommended follow-up protocol includes:

• Regular clinical reviews with an appropriate specialist team to monitor clinical response and adjust hormone replacement doses accordingly.
• Monitoring for signs and symptoms of under- or over-replacement of hormones, such as glucocorticoids, thyroid hormones, and others depending on the deficient axes.
• Individualised frequency of reviews based on clinical needs, with more frequent reviews around diagnosis, during periods of changing clinical status, or if concerns about adherence or self-management arise.
• Specific monitoring tests may include blood pressure, electrolytes, HbA1c, bone density, and relevant hormone levels depending on the replaced hormones.
• Patient education on sick-day rules, emergency management (e.g., injectable hydrocortisone for adrenal crisis), and self-management is essential.

In primary care, the role is to support ongoing monitoring, identify clinical features of over- or under-replacement, and liaise with endocrinology specialists for dose adjustments and management of complications.

These recommendations are extrapolated primarily from the guidance on adrenal insufficiency management and hormone replacement monitoring, which are key components of hypopituitarism management ³.