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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, 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

The most common causes of hypothalamic dysfunction are surgery, trauma (injury), tumors, and radiation.

Other causes include:

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's syndrome is a type of hypothalamic dysfunction that occurs in men. Symptoms include:

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

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:

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

Hypothyroidism:

Adrenal insufficiency:

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

Gonadal deficiency:

Growth hormone deficiency:

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

Low MJ. Neuroendocrinology. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 7.

Update Date: 11/7/2013

Updated by: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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