Treatment of Sheehan Syndrome in Central Adrenal Insufficiency Due to ACTH Deficiency

This protocol covers Sheehan syndrome occurring in the context of central adrenal insufficiency due to ACTH deficiency — a state in which inadequate cortisol secretion arises from insufficient pituitary ACTH output rather than from primary adrenal failure.

Central adrenal insufficiency represents inadequate cortisol secretion due to ACTH deficiency. Because the deficit originates at the pituitary level, treatment must address the downstream cortisol gap with appropriate replacement.

The cornerstone of management is glucocorticoid replacement with hydrocortisone (HC), individually tailored to the patient. The complete protocol specifies the recommended dosing strategy, scheduling approach, and the criteria under which alternative longer-acting glucocorticoids may be considered instead.

Full regimen details — including dose, schedule structure, and agent selection criteria — are available in the structured protocol below.