POMC and hyperinsulinemic hypoglycemia, familial, 4: When the pituitary begins to fail, there is generally a specific sequential failure of pituitary hormones, starting with growth hormone (GH), continuing through luteinizing (LH) and follicle stimulating hormone (FSH) deficiency, and culminating in the loss of thyrotropin stimulating hormone (TSH) and adrenocorticotropic hormone (ACTH).