Symptomatic hyponatremia is a common case of altered sensorium in elderly patients admitted to medical ward or intensive care units. Our patient was taking thyroid replacement since 18 months. He had clinical features of hypogonadism with recurrent hyponatremia necessitating multiple hospital admissions. Due to multiple hormonal deficiencies viz., Thyroid, Gonadotropin and ACTH, he was evaluated for pituitary disorders and was diagnosed to have a pituitary macro adenoma on MRI brain which was later excised through transphenoidal endoscopic approach resulting in full recovery and treated with hormone replacement.
