Hypothalamic–pituitary–somatotropic axis with growth hormone deficiency or Laron syndrome ( insensitivity) show symptoms like short stature, dwarfism and obesity, but are also protected from some forms of cancer. Conversely, acromegaly and gigantism are conditions of GH and IGF-1 excess usually due to a pituitary tumor, and are characterized by overgrowth and tall stature. Hypothalamic–pituitary–somatotropic axis The hypothalamic–pituitary–somatotropic axis (HPS axis), or hypothalamic–pituitary–somatic axis, also known as the hypothalamic–pituitary–growth axis, is a hypothalamic–pituitary axis which includes the secretion of growth hormone (GH; somatotropin) from the somatotropes of the pituitary gland into the circulation and the subsequent stimulation of insulin-like growth factor 1 (IGF-1;
Pituitary apoplexy replacement; in this case, blood levels of cortisol are determined at 9:00 AM (as cortisol levels vary over the day). A level below 550 nmol/l indicates a need for replacement. The decision on whether to surgically decompress the pituitary gland is complex and mainly dependent on the severity of visual loss and visual field defects. If visual acuity is severely reduced, there are large or worsening visual field defects, or the level of consciousness falls consistently, professional guidelines recommend that surgery is performed. Most commonly, operations on the pituitary gland are performed through transsphenoidal surgery. In this procedure, surgical instruments