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Hypothalamic dysfunction

Hypothalamic syndromes

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 keep the body's internal functions in balance. It helps regulate:

  • Appetite and weight
  • Body temperature
  • Childbirth
  • Emotions, behavior, memory
  • Growth
  • Production of breast milk
  • Salt and water balance
  • Sex drive
  • Sleep-wake cycle and the body clock

Another important function of the hypothalamus is to control the pituitary gland. The pituitary is a small gland at the base of the brain. It lies just below the hypothalamus. The pituitary, in turn, controls the:

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

Other causes include:

Symptoms

Symptoms are usually due to the hormones or brain signals 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 fatigue, weakness, poor appetite, weight loss, and lack of interest in activities.

Exams and Tests

The health care provider 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
  • Problems controlling salt and water balance

HYPOTHYROIDISM

ADRENAL INSUFFICIENCY

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

SEX GLAND DEFICIENCY

GROWTH HORMONE DEFICIENCY

  • High cholesterol
  • Osteoporosis
  • Short stature (in children)
  • Weakness

When to Contact a Medical Professional

Call your provider if you have:

  • Headaches
  • Symptoms of hormone excess or deficiency
  • Vision problems

Prevention

If you have symptoms of a hormonal deficiency, discuss replacement therapy with your 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 and peripheral nervous system

    Central nervous system and peripheral 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 and peripheral nervous system

    illustration

  • Hypothalamus

    Hypothalamus - illustration

    The hypothalamus is a highly complex structure in the brain that regulates many important brain chemicals. Malfunction of this area of the brain may give rise to cluster headaches.

    Hypothalamus

    illustration

    • Central nervous system and peripheral nervous system

      Central nervous system and peripheral 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 and peripheral nervous system

      illustration

    • Hypothalamus

      Hypothalamus - illustration

      The hypothalamus is a highly complex structure in the brain that regulates many important brain chemicals. Malfunction of this area of the brain may give rise to cluster headaches.

      Hypothalamus

      illustration


     

    Review Date: 5/7/2017

    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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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