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Hypothalamic-pituitary function in anorexia nervosa.

P E Garfinkel, G M Brown, H C Stancer

Archives of General Psychiatry

|June 1, 1975

Summary

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Anorexia nervosa patients show elevated growth hormone (GH) due to starvation, not an independent pituitary issue. Hormone levels often normalize after weight restoration, indicating a link between malnutrition and endocrine function.

Area of Science:

Endocrinology
Neuroscience
Nutritional Science

Background:

Anorexia nervosa is associated with complex hormonal disturbances.
The role of starvation versus intrinsic hypothalamic-pituitary dysfunction in these changes is debated.

Purpose of the Study:

To investigate endocrine profiles in patients with anorexia nervosa.
To differentiate the effects of starvation from independent hypothalamic-pituitary dysfunction.

Main Methods:

Assessed plasma growth hormone (GH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), cortisol, and testosterone levels.
Measured urinary 17-ketosteroid excretion.
Compared endocrine markers between undernourished and well-nourished anorexia nervosa patients, and after weight restoration.

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Main Results:

Undernourished patients exhibited significantly higher fasting GH and GH rebound post-glucose.
GH levels normalized in four patients after weight restoration.
Decreased FSH and LH were observed, with FSH correlating with illness duration.
Elevated cortisol and decreased testosterone/17-ketosteroids were noted in some patients.

Conclusions:

Elevated GH in anorexia nervosa appears secondary to starvation.
Hypothalamic-pituitary malfunction extends beyond GH, affecting multiple endocrine axes.