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Hypopituitarism — SCE Endocrinology MCQ

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ModeratePituitaryHypopituitarismSCE Endocrinology

A 40-year-old man has fatigue, loss of libido and headaches. Testosterone is low with low LH and FSH. Morning cortisol is 140 nmol/L and free T4 is low with normal TSH. What is the most appropriate next investigation?

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Correct answer: C — Pituitary MRI with full pituitary hormone profile

Multiple anterior pituitary hormone deficiencies suggest hypopituitarism from pituitary or hypothalamic disease. Cortisol reserve should be assessed and protected before thyroid or testosterone replacement. Testicular imaging alone misses central pathology.

Reference: Society for Endocrinology Pituitary Guidance