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Dopamine agonists (bromocriptine and cabergoline) C a s e s of raised plasma prolactin Physiological should be requested to rule stress (taking a blood sample y p oints low thyroid a stressful experience and may result in modest elevation of C a s e s tsh should raise the suspicion of secondary hypothyroidism individuals with secondary hypothyroidism should be antagonists (metoclopramide) neuroleptics (such as chlorpromazine haloperidol) antidepressants opiates antiretroviral hormonal tests clinical features of trh stimulates prolactin secretion) metabolic renal failure (decreased excretion of (gh deciency) amenorrhoea in women (fsh and lh deciency) and large pituitary tumour causing stalk deciency) weight loss and tiredness (acth deciency) symptoms of hypothyroidism (tsh deciency) failure of lactation surgery is usually the best treatment for most pituitary tumours the posterior pituitary is involved in the pathological process individuals with pituitary failure should be to dopamine agonists successful treatment the condition including Pituitary or parapituitary tumours pituitary infarction inltrative disease (histiocytosis haemachromatosis sarcoidosis) previous radiotherapy trauma (following head injury) management of pituitary failure requires e s mri of the pituitary shows a large pituitary adenoma measuring 1. 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