| Condition | Primary ‣ | Primary ‣ | Secondary ‣ | ‣
(Criteria: 2/3) | ‣ | ‣ (sex hormone) | ‣ | ‣ | ‣ | Hypoprolactinemia | ‣, ‣ | ‣ | Low LSH, FH ‣ |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| Physiology | High TH | Low TH | Low TH | High Cortisol | High Aldosterone | High Sex Hormone | High Epi, NE | Low Cortisol | High prolactin | Low prolactin | High GH | Low GH | Low LSH, FH, sex hormones |
| Measuring Test | - TSH low
- T3,T4 high | - TSH high
- T3, T4 low | - TSH low
- T3, T4 low | 1. 24h urine cortisol high
- Midnight salivary cortisol high | - Aldosterone high
- Renin low | - DHEAS | urine metanephrine, normetanephrine, catecholamine | 8 AM cortisol | Prolactin | Prolactin | IGF-1 | IGF-1 | LSH, FH, estradiol, BA testosterone |
| Suppression or Stimulation Test | N/A, | N/A | TRH Stimulation Test | 3. Dexamethasone Suppression Test Abnormal | Salt-loading test | N/A | N/A | ACTH Stimulation test (primary); Insulin Stimulation Test (secondary) | N/A | TRH Stimulation Test | Oral glucose suppression test | Insulin Stimulation Test | GnRH Stimulation Test |
| Management | Overproduction: beta-blocker, thiouracil; leaky thyroid: beta-blocker | L-thyroxine | L-thyroxine | Surgery for unilateral adenoma + 6 m tapering dose of cortisol | Na C Blocker, MRB, surgery for unilateral adenoma | Surgery | Alpha blocker, + beta blocker (HR), Surgery | Normal: PO Hydrocortisone, Fludrocortisone; Crisis: IV high dose Hydrocortisone | Dopamine agonist, surgery | N/A (investigate ‣) | Surgery, Med: somatostatin, dopamine agonist, GHR antagonist | Synthetic GN | Synthetic estrogen, progesterone, testosterone |