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Hypothalamic dysfunction
Definition
Hypothalamic dysfunction is a problem with the region of the brain called the hypothalamus, which helps control the pituitary gland and regulate many body functions.
Causes
The hypothalamus helps control the pituitary gland, particularly in response to stress. The pituitary, in turn, controls the:
- Adrenal glands
- Ovaries
- Testes
- Thyroid gland
The hypothalamus also helps regulate:
- Body temperature
- Childbirth
- Emotions
- Growth
- Milk production
- Salt and water balance
- Sleep
- Weight and appetite
Causes of hypothalamic dysfunction include:
- Anorexia
- Bleeding
- Bulimia
- Genetic disorders
- Growths (tumors)
- Head trauma
- Infections and swelling (inflammation)
- Malnutrition
- Radiation
- Surgery
- Too much iron
The most common tumors in the area are craniopharyngiomas in children.
Symptoms
Symptoms are usually due to the hormones that are missing. In children, there may be growth problems -- either too much or too little growth -- or puberty that occurs too early or too late.
Tumor symptoms:
- Headaches
- Loss of vision
Hypothyroidism symptoms:
- Cold intolerance
- Constipation
- Depressed mood
- Fatigue
- Hair or skin changes
- Hoarseness
- Impotence
- Loss of body hair and muscle (in men)
- Mental slowing
- Menstrual cycle changes
- Weight gain
Low adrenal function symptoms:
- Dizziness
- Weakness
Other, less common symptoms may include:
- Body temperature problems
- Emotional problems
- Excess thirst
- Obesity
- Uncontrolled urination
Kallmann's syndrome (a type of hypothalamic dysfunction that occurs in men) symptoms:
- Lowered function of sexual hormones (hypogonadism)
- Inability to smell
Exams and Tests
Blood or urine tests to determine levels of hormones such as:
- Cortisol
- Estrogen
- Growth hormone
- Pituitary hormones
- Prolactin
- Testosterone
- Thyroid
Other possible tests:
- Hormone injections followed by timed blood samples
- MRI or CT scans of the brain
- Visual field eye exam (if there is a tumor)
Treatment
Treatment depends on the cause of the hypothalamic dysfunction.
- Tumors -- surgery or radiation
- Hormonal deficiencies -- replace missing hormones
Specific treatments may be available for bleeding, infection, and other causes.
Outlook (Prognosis)
Many causes of hypothalamic dysfunction are treatable. Most of the time missing hormones can be replaced.
Possible Complications
Complications of hypothalamic dysfunction depend on the cause.
Brain tumors:
- Permanent blindness
- Problems related to the brain area where the tumor occurs
- Vision disorders
Hypothyroidism:
- Heart problems
- High cholesterol
Adrenal insufficiency:
- Inability to deal with stress (such as surgery or infection), which can be life threatening
Gonadal deficiency:
- Heart disease
- Impotence (in men)
- Infertility
- Thin bones (osteoporosis)
Growth hormone deficiency:
- High cholesterol
- Osteoporosis
- Short stature (in children)
- Weakness
When to Contact a Medical Professional
Call your doctor if you have:
- Headaches
- Symptoms of hormone excess or deficiency
- Vision problems
Prevention
Maintain a healthy diet and don't exercise too hard or lose weight too quickly. If you believe you have an eating disorder such as anorexia or bulimia, get medical attention: these conditions can be life threatening.
If you have symptoms of a hormonal deficiency, discuss replacement therapy with your health care provider.
References
Low MJ. Neuroendocrinology. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 7.
Reviewed By: Nancy J. Rennert, MD, Chief of Endocrinology & Diabetes, Norwalk Hospital, Associate Clinical Professor of Medicine, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
