Pituitary Disorders

Lab Tests for Pituitary Disorders and health information

Do you endure headaches, fatigue, or other symptoms that limit your activities? 

Our lab tests can detect irregularities in the levels of hormones produced by pituitary gland disorders that result in headaches, fatigue, or other symptoms that limit your activities? 

If so, you may be suffering from one of the many pituitary gland disorders. These conditions can cause problems with hormone production in the body and lead to serious health issues if left untreated. We offer comprehensive lab testing for pituitary gland disorders to help determine what is causing these symptoms in your body. 

Comprehensive lab testing can determine the presence of too much or too little hormones. These tests can also pinpoint specific pituitary gland disorders, their severity, and what type of treatment is best for the individual. With cases of inherited conditions, the risk of a pituitary disorder is seen across all ages and demands constant checkups.

It’s recommended to seek scheduled testing to compare hormonal measurements at different ages. This can help diagnose fluctuations in TSH (thyroid-stimulating hormone) along with additional hormones produced by the endocrine system such as Thyroxine (Thyroid Gland Hormone T4).

Tests can assess the following hormones:

Regular test results may include:

  • Constant TSH Levels
  • Varying Cortisol Levels
  • Cyclical LH and FSH Levels (Menstrual Cycle Only)
  • Increased Prolactin Production (During Breastfeeding for Women or Periods of Stress)

These variations in each test necessitate regular testing to pinpoint specific trends in the hormonal levels. This can help determine whether a person has excess or deficient hormones. It can also account for medicine-related suppression or production.

Click here to read more about testing for Pituitary Gland Disorders and the lab tests that can help you.


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Cortisol is increased in Cushing's disease and decreased in Addison's disease (adrenal insufficiency).

Cortisol is increased in Cushing's disease and decreased in Addison's disease (adrenal insufficiency).

Cortisol is increased in Cushing's disease and decreased in Addison's disease (adrenal insufficiency). This test requires 5 individual serum blood specimens to be drawn; 30 minutes apart. Patient should plan for 3 hours at the patient service center.


Cortisol is increased in Cushing's disease and decreased in Addison's disease (adrenal insufficiency).


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Cortisol is increased in Cushing's Disease and decreased in Addison's Disease (adrenal insufficiency). Patient needs to have the specimen collected between 7 a.m.-9 a.m.


Urinary Free Cortisol is useful in the detection of patients with Cushing's syndrome for whom Free Cortisol concentrations are elevated.

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Cortisol is increased in Cushing's Disease and decreased in Addison's Disease (adrenal insufficiency). Patient needs to have the specimen collected between 3 p.m - 5 p.m.


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Cortisol is increased in Cushing's Disease and decreased in Addison's Disease (adrenal insufficiency).

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Description: Estradiol is a blood test that is used to measure the levels of Estradiol in the blood's serum. Estradiol is one of the Estrogen hormones in the body.  Estradiol, Ultrasensitive LC/MS/MS #30289 is a more appropriate test for children that have not yet started a menstrual cycle.

Also Known As: E2 Test, Estrogen 2 Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is this test ordered?

Tests for estradiol for women and young girls may be ordered if:

  • The development of a girl's sex organs might occur sooner or later than predicted.
  • After menopause, a woman may experience symptoms such as abnormal vaginal bleeding or irregular or absent menstrual cycles.
  • When a woman is unable to conceive, a series of estradiol readings taken over the course of her menstrual cycle may be used to track follicle development before using in vitro fertilization procedures
  • A woman is experiencing menopause symptoms such as hot flashes, night sweats, sleeplessness, and/or irregular or absent menstrual cycles.
  • If a menopausal woman is on hormone replacement therapy, her doctor may order estrone levels on a regular basis to check her progress.

Men and young boys may be subjected to estradiol testing if:

  • A boy's puberty is delayed, as evidenced by slow or delayed growth of testicles and penis, as well as a lack of deepening of voice or growth of body hair.
  • Signs of feminization, such as larger breasts, can be seen in a guy.

What is being tested?
Estradiol, or E2, is a component of Estrogen that is present in the blood. For women, Estradiol is something that should be produced naturally, and the body produces larger amounts of Estradiol during puberty and it fluctuates throughout the menstrual cycle. Estradiol is most prominent in women of reproductive age. Low levels are common in girls who have not yet had their first menstrual cycle and in women after their reproductive age.

Related Tests and Panels:

  • Estrogen
  • Estriol
  • Estrone
  • Estradiol, Ultrasensitive
  • Testosterone Free and Total
  • Sex Hormone Binding Globulin
  • FSH
  • LH
  • Progesterone

Related Conditions:

  • Infertility
  • Menopause
  • Polycystic Ovarian Syndrome
  • Hormone Imbalance
  • Premature, delayed, or abnormal development of sex organs

Commonly Asked Questions:

How is the Estradiol test used by my health care provider?

Estrogen tests are used to detect a deficit or excess of estrogen in a woman, as well as to aid in the diagnosis of a range of illnesses linked to this imbalance. They may also be ordered to monitor the health of the growing fetus and placenta during pregnancy, as well as to help predict the timing of a woman's ovulation. Estrogen testing can be used to detect a hormone excess and its origin in men.

In the case of girls and women

Estradiol testing may be requested for the following reasons:

  • Diagnose early-onset puberty, which occurs when a girl develops secondary sex traits much earlier than anticipated, or late puberty, which occurs when a female develops secondary sex characteristics or begins menstruation later than predicted.
  • Examine menstrual irregularities such as the absence of menstrual periods, infertility, and unusual vaginal bleeding.
  • Evaluate ovary function and look for signs of ovarian failure.
  • Serial measurements of estradiol can be used to track follicle development in the ovary in the days leading up to in vitro fertilization.
  • Keep track of any hormone replacement therapy you're getting to help with your fertility.
  • Keep track of menopausal hormone replacement medication, which is used to treat symptoms caused by estrogen insufficiency.
  • Identify cancers that produce estrogen.
  • As with breast cancer, keep an eye on anti-estrogen therapy.

Boys and men may be subjected to estradiol testing in order to:

  • Assist in the diagnosis of delayed puberty
  • Assist in determining the cause of larger breasts or other feminization indications.
  • Detect an excess of relative estrogen due to a testosterone or androgen deficit.
  • Identify cancers that produce estrogen.

What do my Estradiol test results mean?

Estradiol is one of the three Estrogens that have a large impact on the women's body throughout the menstrual cycle. When these hormones are too high or too low, it could cause irregular bleeding, infertility, complications with menopause, and delayed or premature puberty. Out of range levels can also be indicative of an ovarian condition such as PCOS. It is important to note that these values will fluctuate throughout a woman's cycle. The Estrogen hormones work together and if one is out of range, the others may also be out of range. It is recommended to follow up with a licensed healthcare professional to determine the best treatment if need.

We advise having your results reviewed by a licensed medical physician for proper interpretation of your results.

IMPORTANT - Note this Estradiol test is not for children that have yet to start their menstrual cycle.  If this test is ordered for a child that has yet to begin their menstrual cycle Quest Diagnostics labs will substitute in Estradiol, Ultrasensitive LC/MS/MS - #30289 at an additional charge of $34


Much of Estradiol is bound to proteins. The unbound portion and Estradiol bound to proteins with low affinity reflect the Free concentration. The Free Estradiol may better correlate with medical conditions than the Total Estradiol concentrations.



Estrogens are a group of steroids that regulate the menstrual cycle and function as the main female sex hormones. The most common forms of estrogens tested are estrone (E1), estradiol (E2), and estriol (E3). Estrogens are responsible for the development of female sex organs and secondary sex characteristics and are tied to the menstrual cycle and pregnancy. They are considered the main sex hormones in women and are present in small quantities in men. E1 and E2 are the two main estrogens in non-pregnant females.Estrone (E1) is derived from metabolites from the adrenal gland and is often made in adipose tissue (fat). Estrone can be converted into estrdiol or estriol when needed. Estrone is present in small amounts in children prior to puberty and then increases slightly at puberty for both males and females. While levels remain constant in adult males, it will increase and fluctuate for females during the menstrual cycle. After menopause, it becomes the major estrogen, with E2 and E3 levels diminishing greatly.Estradiol (E2) is the predominant form and is produced primarily in the ovaries with additional amounts produced by the adrenal glands in women and in the testes and adrenal glands in men. In menstruating women, levels vary throughout the month, rising and falling in concert with FSH (follicle-stimulating hormone), LH (luteinizing hormone), and progesterone as follicles are stimulated in the ovaries, an egg is released, and the uterus prepares for a potential pregnancy. The level is lowest at the beginning of the menstrual cycle and rise to their highest level just before the release of an egg from the ovary (ovulation). Normal levels of estradiol provide for proper ovulation, fertilization of the egg (conception), and pregnancy, in addition to promoting healthy bone structure and regulating cholesterol levels.


Estrogens are secreted by the gonads, adrenal glands, and placenta. Total estrogens provide an overall picture of estrogen status for men and women.

This test is useful in the differential diagnosis of pituitary and gonadal insufficiency and in children with precocious puberty.

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FSH and LH are secreted by the anterior pituitary in response to gonadotropin-releasing hormone (GNRH) secreted by the hypothalamus. In both males and females, FSH and LH secretion is regulated by a balance of positive and negative feedback mechanisms involving the hypothalamic-pituitary axis, the reproductive organs, and the pituitary and sex steroid hormones. FSH and LH play a critical role in maintaining the normal function of the male and female reproductive systems. Abnormal FSH levels with corresponding increased or decreased levels of LH, estrogens, progesterone, and testosterone are associated with a number of pathological conditions. Increased FSH levels are associated with menopause and primary ovarian hypofunction in females and primary hypogonadism in males. Decreased levels of FSH are associated with primary ovarian hyper-function in females and primary hypergonadism in males. Normal or decreased levels of FSH are associated with polycystic ovary disease in females. In males, LH is also called interstitial cell-stimulating hormone (ICSH). Abnormal LH levels with corresponding increased or decreased levels of FSH, estrogens, progesterone, and testosterone are associated with a number of pathological conditions. Increased LH levels are associated with menopause, primary ovarian hypofunction, and polycystic ovary disease in females and primary hypo-gonadism in males. Decreased LH levels are associated with primary ovarian hyperfunction in females and primary hyper-gonadism in males.

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Serum glucose levels may be abnormally high (hyperglycemia) or abnormally low (hypoglycemia). Glucose measurements are used in the diagnosis and treatment of carbohydrate metabolic disorders including diabetes mellitus, idiopathic hypoglycemia, and pancreatic islet cell neoplasm.

This test is used for the routine diagnosis of diabetes in children and the non-pregnant adult. For pregnant females see test "Glucose Tolerance Test, Gestational, 4 Specimens (100 g)". For appropriate interpretation of this test, the patient must fast overnight and ingest a 75 g load of glucose, immediately after, a fasting specimen is obtained. For children, the glucose load is 1.75 g/Kg of ideal body weight, up to 75 g glucose. The diagnosis of diabetes is made if the fasting glucose is ?126 mg/dL or if the 2-hour specimen is ?200 mg/dL.

This test is used for the routine diagnosis of diabetes in children and the non-pregnant adult. For pregnant females see test "Glucose Tolerance Test, Gestational, 4 Specimens (100 g)". For appropriate interpretation of this test, the patient must fast overnight and ingest a 75 g load of glucose. Immediately after, a fasting specimen is obtained. For children, the glucose load is 1.75 g/Kg of body weight, up to 75. The diagnosis of diabetes is made if the fasting glucose is ?126 mg/dL or if the 2-hour specimen is ?200 mg/dL.

For appropriate interpretation of this test, the patient must fast overnight and ingest a 75 g load of glucose, immediately after a fasting specimen is obtained. (for children, the glucose load is 1.75 g/kg of body weight, up to 75). The diagnosis of diabetes is made if glucose exceeds 200 mg/dL in the 2 hour specimen and in any preceding specimen

For appropriate interpretation of this test, the patient must fast overnight and ingest a 75 g load of glucose, immediately after a fasting specimen is obtained. (for children, the glucose load is 1.75 g/Kg of body weight, up to 75). The diagnosis of diabetes is made if glucose exceeds 200 mg/dL in the 2 hour specimen and in any preceding specimen.

This test is used for the routine diagnosis of diabetes in children and the non- pregnant adult. For pregnant females use test code 6745. For appropriate interpretation of this test, the patient must fast overnight and ingest a 75 g load of glucose, immediately after a fasting specimen is obtained. (for children, the glucose load is 1.75 g/kg of body weight, up to 75). The diagnosis of diabetes is made if glucose exceeds 200 mg/dL in the 2 hour specimen and in any preceding specimen.

For appropriate interpretation of this test, the patient must fast overnight and ingest a 75 g load of glucose immediately after a fasting specimen is obtained. (for children, the glucose load is 1.75 g/kg of body weight, up to 75). The diagnosis of diabetes is made if glucose exceeds 200 mg/dL in the 2 hour specimen and in any preceding specimen.

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Measurement of GH is primarily of interest in the diagnosis and treatment of various forms of inappropriate growth hormone secretion. Growth hormone measurements in children are used in the evaluation of short stature and help differentiate low GH production from other sources of growth failure. Stimulation and suppression tests are often more meaningful than random measurements.

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Insulin-like growth factor I (IGF-I, or somatomedin C), a protein involved in stimulating somatic growth, is regulated principally by growth hormone (GH) and nutritional intake. IGF-I is transported in serum by several proteins; this helps maintain relatively high IGF-I plasma levels and minimizes fluctuations in serum IGF-I concentrations. Measuring IGF-I is useful in several growth-related disorders. Dwarfism caused by deficiency of growth hormone (hypopituitarism) results in decreased serum levels of IGF-I, while acromegaly (growth hormone excess) results in elevated levels of IGF-I. IGF-I measurements are also helpful in assessing nutritional status; levels are reduced in undernutrition and restored with a proper diet.


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This test is useful in the differential diagnosis of pituitary and gonadal insufficiency and in children with precocious puberty.


The pituitary gland is responsible for regulating hormonal production in the human body. When the gland begins to secrete too much or too little, it often leads to a set of symptoms associated with pituitary disorders. In some cases, the condition involves the presence of a pituitary tumor, which presses against nearby tissues.

The endocrine system is composed of multiple functional and well-integrated parts, including the pituitary gland. Several glands within the human body are interlinked via the endocrine system. These glands produce a variety of hormones to help balance and regulate the body’s natural processes.

This gland is located at the bottom of the brain and behind the sinus cavity. It also sits below the hypothalamus, which is responsible for sending important messages to other parts of the nervous system while regulating the body’s processes. This includes sending hormones designed to start and/or stop the pituitary gland. Once initiated, the pituitary gland begins to release its hormones to other glands, which increases the production of other hormones throughout the endocrine system.

In its basic layout, the pituitary is composed of two parts – the front (anterior) and the back (posterior). Both parts are responsible for different hormones.

  • Anterior (Front): With the anterior pituitary, it’s responsible for secreting GH (growth hormone), TSH (thyroid-stimulating hormone), ACTH (Adrenocorticotrophic hormone), FSH (follicle-stimulating hormone), Prolactin, and LH (luteinizing hormone). These hormones offer a long list of organic benefits, including increased muscle mass, stress regulation, blood sugar levels, bone growth, metabolic rate, sexual characteristics, and fertility. This includes targeting specific tissues in the human body, such as the ovaries for women, testicles for men, thyroid glands, and adrenal glands.
  • Posterior (Back): With the posterior pituitary, it’s responsible for storing ADH (antidiuretic hormone) and oxytocin from the hypothalamus. The antidiuretic hormone helps regulate the kidney’s water output to ensure the body’s water levels remain balanced while oxytocin is responsible for regulating the uterus and its contractions during the birthing process for women while also playing a role during breastfeeding (releasing milk).

It’s important to note that pituitary disorders encompass several different hormones leading to a unique set of symptoms for everyone.

Causes of Pituitary Disorders

When a tumor begins to grow in the area, this can bring along with several medical concerns. The average tumor is diagnosed as a pituitary adenoma (benign), but this can still lead to significant hormonal production by the pituitary gland when it’s active. As a result, this hampers other glands in the endocrine system while restricting blood flow to the surrounding tissues. Optic nerves and/or blood vessels near the tumor can become compromised due to their positioning. Once the tumor begins to press against the surrounding tissues, it will lead to symptoms such as vision problems (loss of vision), headaches, weakness, seizures, fatigue, and other relevant symptoms associated with hormone production.

Additional causes can include:

  • Head Trauma
  • Genetic Conditions (From Birth)
  • Genetic Mutations
  • A Malignant Tumor
  • Reduced Blood Supply to the Pituitary Gland
  • Radiation Treatment
  • Excess Iron (i.e., Blood Transfusions/Hemochromatosis)
  • Unknown Health Condition

Examples of Pituitary Disorders

Pituitary Tumors

This type of tumor can cause a variety of symptoms, including too much or too little hormone production. In most cases, the tumor will be benign but can cause symptoms such as headaches, visual problems, and other similar problems as it grows. Due to the added growth, this gland can press against surrounding tissues leading to increased hormone production in some areas and reduced hormone production in others.

Growth Hormone Deficiency

This is seen in children and can lead to issues involving delayed growth. For adults, the symptoms can include general fatigue, muscular weakness, obesity, and/or reduced bone mass.

Hypopituitarism

This can include trauma, tumors, infections, sarcoidosis, autoimmune concerns, decreased pituitary blood supply, radiation, side effects of pituitary surgery, or the removal of a pituitary gland. Due to these reasons, the body doesn’t gain access to enough pituitary hormone production to stay healthy.

Hyperprolactinemia

In this case, the pituitary tumor begins to release prolactin and/or suppresses the secretion of prolactin. This can lead to symptoms involving a lack of breast milk for feeding mothers, too much breast milk (outside pregnancy), low libido, lack of menstrual periods, and erectile dysfunction.

Empty Sella Syndrome

This involves the sella, which is a small part of the skull (hollow) where the pituitary is situated. It includes a specialized membrane called the sellae located on top of the pituitary as protection. If something causes this membrane to burst or open, it can lead to a unique MRI scan where the socket appears empty through imaging. Therefore, the condition is called Empty Sella Syndrome by medical experts and can often be associated with radiation therapy or tumors.

Craniopharyngioma

This is often seen in young children and teenagers but can also show up in adults over the age of 50. In general, the condition is benign but can press against the pituitary leading to headaches, delayed growth, hypopituitarism, and vision issues.

Rare Pituitary Disorders

Acromegaly and Gigantism

This is when the growth hormone production skyrockets because of adenoma (benign tumor). The condition usually occurs in childhood and is linked with gigantism (excessive bone growth), causing children to grow taller than the average adult. This is known as acromegaly as the bone thickens, leading to larger hands, coarsened facial features, headaches, larger feet, sleep apnea, fatigue, sweating, hypertension, colon cancer, and/or diabetes mellitus.

Adrenal Insufficiency

This is a rare disorder triggered by pituitary dysfunction. When the hormone ACTH (adrenocorticotropic hormone) depletes, it can often be a sign of adrenal insufficiency. ACTH is responsible for acting as a pituitary messenger. This includes sending messages to the adrenal cortex for it to release cortisol. When the ACTH level drops, it can often be linked to pituitary damage or a pituitary tumor. This leads to a drop in cortisol production, which reduces the amount of aldosterone and cortisone in the body. These hormones are responsible for regulating the body’s blood pressure and metabolism.

Cushing Disease

This disorder encompasses specific symptoms associated with excess ACTH caused by the pituitary tumor. When there’s excess ACTH, this leads to hyperactive adrenal glands releasing too much cortisol. Due to the additional cortisol, it can lead to a long list of symptoms including a larger face, obesity (torso), thinner arms, thinner legs, muscular weaknesses, high blood sugar, pink streaks (Abdomen), osteoporosis, and high blood pressure.

Diabetes insipidus

This includes a reduction in ADH production via the hypothalamus. The kidneys don’t retain enough water causing the individual to feel thirsty while having to frequent the bathroom often (dilute urination).

Nelson Syndrome

This disorder occurs when the adrenal glands have been removed from the human body as a treatment option. The tumor begins to actively produce ACTH while hampering the pituitary hormones. This can lead to symptoms involving skin darkening as the MSH (melanocyte-stimulating hormone) levels rise.

Multiple Endocrine Neoplasia Type 1 (MEN1)

This genetic mutation can increase the likelihood of developing tumors close to the pituitary and other similar endocrine glands.

Kallman Syndrome

This is a genetic condition due to a deficiency in GnRH (gonadotropin-releasing hormone). This can create a reduction in LH and FSH production while halting a child’s puberty and hampering their ability to smell.

Pituitary Infarction

This is often cited as a leading cause of bleeding near a benign pituitary tumor. It occurs once the surrounding tissues have been damaged (hypopituitarism).

Sheehan Syndrome

This is a rare condition that occurs after childbirth. It takes place due to excessive bleeding during birth, causing the pituitary gland to lose function. This is noted as a pituitary infarction.

Tests

Comprehensive lab testing can determine the presence of too much or too little hormones. These tests can also pinpoint specific pituitary disorders, their severity, and what type of treatment is best for the individual. With cases of inherited conditions, the risk of a pituitary disorder is seen across all ages and demands constant checkups.

It’s recommended to seek scheduled testing to compare hormonal measurements at different ages. This can help diagnose fluctuations in TSH (thyroid-stimulating hormone) along with additional hormones produced by the endocrine system such as Thyroxine (Thyroid Gland Hormone T4).

Tests can assess the following hormones:

LH and FSH

Prolactin Cortisol and ACTH

Free T4 (Thyroxine) and TSH IGF-1 and GH

Regular test results may include:

  • Constant TSH Levels
  • Varying Cortisol Levels
  • Cyclical LH and FSH Levels (Menstrual Cycle Only)
  • Increased Prolactin Production (During Breastfeeding for Women or Periods of Stress)

These variations in each test necessitate regular testing to pinpoint specific trends in the hormonal levels. This can help determine whether a person has excess or deficient hormones. It can also account for medicine-related suppression or production.