Hypothalamic dysfunction Health Article

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, incidence, and risk factors

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 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:

• Headaches
• Loss of vision

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:

• Dizziness
• Weakness

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:

• 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.

Expectations (prognosis)

Many causes of hypothalamic dysfunction are treatable. Most of the time missing hormones can be replaced.