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Hypothalamic dysfunction

 

Hypothalamic dysfunction is a problem with part of the brain called the hypothalamus. The hypothalamus helps control the pituitary gland and regulates many body functions.

Causes

The hypothalamus helps control the pituitary gland. The pituitary is a small gland at the base of the brain. The pituitary, in turn, controls the:

  • Adrenal glands
  • Ovaries
  • Testes
  • Thyroid gland

The hypothalamus also helps regulate:

  • Body temperature
  • Childbirth
  • Emotions
  • Growth
  • Production of breast milk
  • Salt and water balance
  • Sleep
  • Weight and appetite

The most common causes of hypothalamic dysfunction are surgery, traumatic brain injury, tumors, and radiation.

Other causes include:

  • Anorexia nervosa or bulimia
  • Bleeding
  • Genetic disorders that cause iron buildup in the body
  • Head trauma
  • Infections and swelling (inflammation)
  • Malnutrition

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. In other children, puberty occurs too early or too late.

Tumor symptoms may include headache or loss of vision.

Hypothyroidism symptoms may include feeling cold all the time, constipation, fatigue, or weight gain, among others.

Low adrenal function symptoms may include dizziness or weakness.

Kallmann syndrome is a genetic type of hypothalamic dysfunction. Symptoms include:

  • Lowered function of sexual hormones (hypogonadism)
  • Inability to smell (in some people)

 

Exams and Tests

 

The doctor will perform a physical examination and ask about your symptoms.

Blood or urine tests may be ordered to determine levels of hormones such as:

  • Cortisol
  • Estrogen
  • Growth hormone
  • Pituitary hormones
  • Prolactin
  • Testosterone
  • Thyroid

Other possible tests include:

  • 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:

  • For tumors, surgery or radiation may be needed.
  • For hormonal deficiencies, missing hormones need to be replaced by taking medicine.

 

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
  • Problems controlling salt and water balance

HYPOTHYROIDISM

  • Heart problems
  • High cholesterol

ADRENAL INSUFFICIENCY

  • Inability to deal with stress (such as surgery or infection), which can be life-threatening by causing low blood pressure

GONADAL DEFICIENCY

  • Heart disease
  • Erection problems
  • Infertility
  • Thin bones (osteoporosis)
  • Problems breast feeding

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

 

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

Giustina A, Braunstein GD. Hypothalamic syndromes. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 10.

Molitch ME. Neuroendocrinology and the neuroendocrine system. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 223.

 
  • Central nervous system

    Central nervous system - illustration

    The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

    Central nervous system

    illustration

    • Central nervous system

      Central nervous system - illustration

      The central nervous system is comprised of the brain and spinal cord. The peripheral nervous system includes all peripheral nerves.

      Central nervous system

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

          Tests for Hypothalamic dysfunction

           

             

            Review Date: 10/28/2015

            Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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