Pituitary disorders

​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Hypoglycaemia in which adrenal insufficiency and/or growth hormone deficiency is suspected as the cause
  • New onset or suspected diabetes insipidus (anti-diuretic hormone deficiency or resistance), including unexplained hypernatraemia and dehydration
  • Suspected adrenal crisis or first diagnosis of adrenal insufficiency
  • Suspected pituitary mass with or without neurological symptoms and visual signs (e.g. headaches, visual field loss, blurred vision)
  • Vomiting or altered level of consciousness with known adrenal insufficiency

When public outpatient services are not routinely provided

  • ​Nil

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Suspected multiple pituitary hormone deficiencies
    Note: for optimum care, patient is to be seen within 1 week

​Category 2
Recommended to be seen within 90 calendar days.
  • Existing pituitary hormone deficiency or disorder
  • Hyperprolactinaemia due to suspected prolactinoma
  • Septo-optic dysplasia or optic nerve hypoplasia
  • Suspected Cushing's syndrome​

Category 3
Recommended to be seen within 365 calendar days.

  • Nil

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Examination findings, including Tanner staging and presence of hyperpigmentation
    • Height, weight and body mass index (BMI)
    • Blood pressure
    • Electrolyte, urea and creatinine (EUC)
    • Serum cortisol and adrenocorticotropic hormone (ACTH) (with specimen collected between 0800-0900) or earlier (if adrenal insufficiency suspected)
    • 24-hour urinary free cortisol, or midnight salivary cortisol test (if Cushing's syndrome suspected)
    • Thyroid stimulating hormone (TSH) and free thyroxine (fT4)
    • Insulin-like growth factor-1 (IGF-1)
    • Prolactin
    • Luteinising hormone (LH) (if aged > 9 years)
    • Follicle-stimulating hormone (FSH) (if aged > 9 years)
    • Oestradiol or testosterone (if aged > 9 years)
    • Staging of puberty (delayed, arrested, pre-pubertal)​

If available

  • Liver function test (LFT)
  • Cerebral magnetic resonance imaging (MRI) with pituitary view
  • X-ray: left hand for bone age​

​Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team. 

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing