The human hypothalamus in metabolic and episodic disorders

The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.

Short-term regulation of food intake primarily involves neural signals from the gastrointestinal (GI) tract, blood nutrient levels, and GI tract hormones. Communication between the gut and brain via vagal nerve fibers plays a significant role in evaluating the contents of the gut. Clinical studies have shown that protein ingestion produces a more prolonged response in these nerve fibers compared to an equivalent amount of glucose. Additionally, the activation of stretch receptors caused by GI...

The hypothalamus is a small yet highly complex and essential brain region that plays a crucial role in regulating various bodily functions. Anatomically, it is located at the base of the brain, just above the brainstem and below the thalamus, forming part of the limbic system.
The hypothalamus interacts with other brain regions, including the pituitary gland, through a direct physical connection called the hypothalamic-pituitary axis. The hypothalamus receives somatic and visceral inputs and...

Hormones, the biochemical messengers produced by endocrine glands, are pivotal in regulating bodily functions and maintaining homeostasis. Each hormone's balance is crucial; imbalances can lead to significant physiological disruptions. Major hormones include oxytocin, cortisol, epinephrine, estrogen, testosterone, thyroxine, growth hormone, insulin, and glucagon.
Oxytocin, produced in the hypothalamus and released by the pituitary gland, plays a role in social bonding, childbirth, and lactation.

Hunger and thirst are fundamental physiological drives crucial for maintaining homeostasis and ensuring the survival of both humans and animals. These drives are regulated through complex interactions between the brain, hormones, and sensory receptors.
Hunger arises when the brain detects changes in the body's nutrient levels, including glucose, lipids, amino acids, and hormones such as ghrelin and leptin. The hypothalamus plays a central role in hunger regulation. The lateral hypothalamus acts...

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...