Causes, incidence, and risk factors: The hypothalamus helps control the pituitary gland, particularly in response to stress. The pituitary, in turn, controls the:
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 generally relate to the hormones that are missing. In children, there may be growth problems -- either too much growth or too little -- or puberty that occurs too early or too late.
Tumor symptoms:
Hypothyroidism symptoms:
- Breast enlargement
- Cold intolerance
- Fatigue
- Hair or skin changes
- Impotence
- Loss of body hair and muscle (in men)
- Menstrual disturbance
- Weight gain
Low adrenal function symptoms:
Other, less common symptoms may include:
- Body temperature disturbance
- Emotional abnormalities
- 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
Signs and tests: Blood or urine tests to determine levels of hormones such as:
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.
Expectations (prognosis): Many causes of hypothalamic dysfunction are treatable. Most of the time missing hormones can be replaced.
Complications: Complications of hypothalamic dysfunction depend on the cause.
Brain tumors:
- Permanent blindness
- Specific problems related to the brain area where the tumor occurs
- Vision disorders
Hypothyroidism:
Adrenal insufficiency:
- Inability to deal with stress (such as surgery or infection)
Gonadal deficiency:
Growth hormone deficiency:
Calling your health care provider: 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 strenuously 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. 11th ed. Philadelphia, PA: Saunders Elsevier; 2008:chap 7.
