Diagnosis of Generalized Hypopituitarism MRI or CT Pituitary hormone levels: TSH, prolactin, LH, FSH, Target organ hormone levels: Free thyroxine (T4), testosterone (in men) or estradiol (in women), and cortisol levels plus provocative testing of pituitary-adrenal axis Sometimes other provocative testing Clinical features are often nonspecific, and the diagnosis must be established with certainty before committing the patient to a lifetime of hormone replacement therapy.