Glucocorticoid replacement in hypopituitarism

For patients with adrenal insufficiency secondary to hypopituitarism, the adrenal hormone cortisol is replaced, rather than the pituitary hormone, adrenocorticotrophic hormone (ACTH). Lifelong glucocorticoid replacement is needed for patients with ACTH deficiency.

The principles of glucocorticoid replacement in hypopituitarism are the same as for primary adrenal insufficiency, although patients with hypopituitarism often have a lower dose requirement. For detail about glucocorticoid replacement for adrenal insufficiency, see here.

Patients with adrenal insufficiency secondary to hypopituitarism do not require mineralocorticoid replacement because aldosterone secretion is principally controlled by the renin–angiotensin system, not by ACTH.