PLOD1 and hypopituitarism: Adrenocorticotropic hormone (ACTH) deficit comes in second with 6%, followed by LH/FSH deficiency with 5% and TSH deficiency with 1% (60).Notably, TBI severity assessed by the Glasgow Coma Scale (GCS) was poorly associated with the risk of hypopituitarism, suggesting that initial clinical symptoms are unreliable predictors of long-term endocrine sequelae (61).The pathophysiology of pituitary insufficiency after traumatic brain injury is thought to be multifaceted, ranging from primary mechanical injury to complex secondary insults.