Pituitary hormone profile

Requires a medical indication

Pituitary hormone profile with IGF-1, TSH, free T4, FSH, LH, oestradiol, testosterone, prolactin, ACTH and cortisol. It covers the main pituitary axes and is designed for the investigation or monitoring of pituitary disease, surgery, cranial radiotherapy or another situation with a medical indication.

Requires a medical prescription

Results in 5-7 working days

Includes: IGF-1 · TSH · Free T4 · FSH · LH · Oestradiol · Total testosterone · Prolactin · ACTH · Cortisol. See what each one measures

A pituitary panel is not interpreted piece by piece, but as a whole and with the clinical picture in front of you: each hormone has to be read together with the hormone of the organ it controls. In addition, ACTH requires very strict sampling conditions. It only makes sense if a doctor is already investigating your case.

What it is for

It is used to assess whether the pituitary gland is sending adequate signals to the thyroid, the gonads, the adrenal glands and the growth hormone axis. It also shows whether prolactin is raised.

The hormones are interpreted in pairs. A "normal" TSH is not enough to rule out central hypothyroidism if free T4 is low, and FSH or LH within the range may be inappropriate if the sex hormones are also low. That combined reading is the reason the profile requires a medical indication.

When it is recommended

A known pituitary adenoma or other pituitary lesion
Follow-up after surgery or radiotherapy in the pituitary region
Medical suspicion of hypopituitarism or acromegaly
Several hormone axes abnormal at the same time
Severe head injury or postpartum haemorrhage with compatible symptoms afterwards

Clinical comment

The first limitation is interpretation. Population ranges are not enough: age, sex, the menstrual cycle, menopause and hormone treatments change what is expected of FSH, LH, oestradiol and testosterone.

The second is pre-analytical. ACTH is unstable and needs specific sampling and processing. The centre must know that the test request includes ACTH so it can prepare the sample correctly. Inadequate handling can lower the value and lead to a misleading reading.

IGF-1 is suitable for screening for growth hormone excess, but a normal value does not exclude every deficiency. When growth hormone deficiency is suspected, confirmation usually requires a stimulation test performed under supervision. In the same way, an indeterminate basal cortisol may need a functional test. This profile provides the first assessment of the axes; it does not replace those dynamic tests.

Dr. Antonio Mas

What is tested

IGF-1: Gives a stable reflection of growth hormone action and is used as the first test when excess is suspected.
TSH: The pituitary signal that regulates the thyroid.
Free T4: Interpreted together with TSH to identify central thyroid disorders.
FSH: Regulates part of ovarian or testicular function and must be interpreted according to sex, age and reproductive situation.
LH: Involved in ovulation and testosterone production.
Oestradiol: Assesses oestrogenic gonadal function and is interpreted according to the cycle or menopause.
Total testosterone: Assesses androgenic function, especially in men.
Prolactin: Can rise because of pituitary lesions, medicines, stress and other causes.
ACTH: The pituitary signal that stimulates cortisol production in the adrenal glands.
Cortisol: Interpreted together with ACTH and the time of sampling to assess the adrenal axis.

How to prepare

Have the sample taken between 8:00 and 9:00 in the morning, fasting. Say when you arrive that the test request includes ACTH, so the sample can be prepared and processed properly.

Arrive rested and in good time so you can rest for a few minutes. Report corticosteroids, contraceptives, hormone treatment and any medication that may affect the pituitary gland.

You can add

Without another needle. It is offered when you order, so you do not have to decide now.

General blood testA general blood test with full blood count, glucose, cholesterol and kidney and liver function: the basic parameters included in any general check-up.+€59.00
General + nutritional blood testEverything in the general blood test (anaemia, kidneys, liver, cholesterol and glucose) plus iron stores, vitamin D, vitamin B12 and folic acid. It is the broadest add-on: it covers the general and the nutritional in one go.+€129.00

Related blood tests

We have other profiles in Other tests with more or fewer tests:

The most comprehensive is not always the most useful. If you are not sure, the one we recommend to start with is High prolactin assessment.

What it is based on

Endocrine Society · J Clin Endocrinol Metab 101(11):3888-3921
Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline
This is the guideline that explains why this panel is read as a whole and not piece by piece. For the thyroid axis it asks for free T4 and TSH together, and states literally that TSH alone is not useful for diagnosing or monitoring central hypothyroidism; for the gonadal axis, FSH and LH together with testosterone or oestradiol; for the adrenal axis, cortisol drawn between 8:00 and 9:00 in the morning. It also recommends reviewing all the axes from six weeks after pituitary surgery and periodically thereafter, which is the situation this profile has been designed for. A point worth knowing: for the growth hormone axis the guideline asks for a stimulation test, and IGF-1 alone does not replace it.

Protocol designed by Dr. Antonio Mas, specialist in Endocrinology and Nutrition, Spanish medical licence no. 080846289, and reviewed in September 2026.

This blood test is a standardised protocol and does not replace a medical consultation. If you have symptoms, a known condition or a complex clinical situation, speak to your doctor.