When hypothalamic hormones are over or under secreted, it is usually a result of either a tumor or a disconnection of some kind between the pituitary and the hypothalamus. Since most of the hormones secreted from the hypothalamus act on the pituitary gland to secrete something else, the treatments for alterations in hypothalamic function usually act as a hormone replacement or adjustment for that the pituitary gland would have secreted, had the hypothalamus given it the direction to secrete it. If the reason for the hypothalamic dysfunction is due to a tumor, radiation or surgery would be implemented to attempt correcting the problem.
Specific hormone dysfunctions related to the hypothalamus:
- If the hypothalamus sends the signal to the pituitary to release more ADH than required on a regular basis, more water gets retained than necessary resulting in an excess retention of water and hyponatremia. Treatment for this chronically includes a fluid restrictive diet, vasopressin-2 receptor antagonists, or, if those do not work, increasing the intake of solutes. Inhibition of this hormone’s release is usually caused by an intake of alcohol or caffeine and will correct itself with time and a higher intake of water.
- If CRH gets released in excess from the hypothalamus, ACTH will also get over released, causing an increase in cortisol levels. In the vast majority of cases, though, an increase in cortisol levels is due to a disruption in the negative feedback loop of CRH, ACTH, and cortisol, so a dysfunction in any of those could result in an over or under secretion of CRH, exacerbating the problem. To correct the over secretion of cortisol, drugs are under investigation to either decrease CRH or ACTH levels, but they are reported to not be the most effective. The most common reason for elevated cortisol levels (Cushing’s syndrome) are pituitary tumors, so removal of those will correct the CRH-ACTH-cortisol mechanism.
- Alterations in GHRH levels can either lead to an under or oversecretion of growth hormone from the pituitary gland. If not enough GHRH gets created, then not enough growth hormone will get released. Thus, the treatment for that would be growth hormone therapy. If too much GHRH or growth hormone gets released (usually due to a tumor), either surgery to remove a tumor occurs or Sandostatin/Somatuline Depot can be given as synthetic somatostatin, which is growth hormone inhibiting hormone from the hypothalamus.
- An underproduction of oxytocin can be treated with synthetic oxytocin medications such as carbetocin, syntocinon and pitocin. An overproduction of oxytocin is more linked to prostatic issues in men, and a way to treat this is to manipulate the levels of oxytocin.
- An underproduction of TRH is due to a tumor or an injury in the brain, so removing or shrinking the tumor would be the priority treatment for this patient. Additionally, treating with thyroid stimulating medications like levothyroxine can help simulate thyroid hormone in the body. A case of an overproduction of TRH is not known.
THE HYPOTHALAMUS IS THE MASTER GLAND. Many may argue that the pituitary gland is very important. Although that is true, there's a higher control, which is the hypothalamus. The hypothalamus controls the pituitary gland, which then regulates the activity of the endocrine glands. The hypothalamus contains many small nuclei that controls a variety of functions. This gland plays an vital role in the endocrine, as well as the nervous system. The hypothalamus controls body temperature, release of eight major hormones, food and water intake, sexual behavior, reproduction, circadian rhythm, and mediation of emotional responses.
“Acromegaly.” (2013, February 5). Retrieved November 22, 2015, from http://www.mayoclinic.org/diseases-conditions/acromegaly/basics/treatment/con-20019216
A.D.A.M. (2011, December 11). Hypothalamic Dysfunction - Symptoms, Diagnosis, Treatment of Hypothalamic Dysfunction - NY Times Health Information. Retrieved from http://www.nytimes.com/health/guides/disease/hypothalamic-dysfunction/overview.html
“Brainy Hormones.” (2015). Retrieved November 22, 2015, from http://www.hormone.org/hormones-and-health/brainy-hormones
DeAngelis, T. (2002). A Genetic Link to Anorexia. American Psychological Association, Vol. 33. Retrieved from http://www.apa.org/monitor/mar02/genetic.aspx
Dougherty, P. (n.d.). Hypothalamus: Structural Organization. Retrieved November 22, 2015, from http://neuroscience.uth.tmc.edu/s4/chapter01.html
Hall, J. (1998). Insights into hypothalamic-pituitary dysfunction in polycystic ovary syndrome. - PubMed - NCBI. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9856414
"Hereditary hemochromatosis.” (2015). Hereditary hemochromatosis. Genetics Home Reference. Retrieved from http://ghr.nlm.nih.gov/condition/hereditary-hemochromatosis
Hyperactive hypothalamus, motivated and non-distractible chronic overeating in ADAR2 transgenic mice. - PubMed - NCBI. (2013, April 12). Retrieved November 14, 2015, from http://www.ncbi.nlm.nih.gov/pubmed/23323881
Hypothalamus. (2015, March 2). Retrieved November 22, 2015, from http://www.healthline.com/human-body-maps/hypothalamus
Lee, J. R., & Hopkins, V. (n.d.). What Your Dr. May Not Tell You about PCOS. Retrieved from http://www.virginiahopkinstestkits.com/pcos.html
Lustig, R.H. (2013). Hypothalamic Obesity. PituitaryNetworkAssociation. Retrieved from https://pituitary.org/medical-resources/pavilions/pediatric-health/pediatric-health-archive/hypothalamic-obesity
Nature Care Family Health. (2013, August 2). Depression and Your Hypothalamus | Dr. Lauren Deville, Naturopathic Doctor - Tucson, AZDr Lauren Deville. Retrieved November 14, 2015, from http://www.drlaurendeville.com/articles/depression-hypothalamus/
“Oxytocin.” (2015, March 31). Retrieved November 22, 2015, from http://www.yourhormones.info/hormones/oxytocin.aspx
Shaikh, M.G. (2011). Hypothalamic dysfunction (hypothalamic syndromes). Oxford Textbook of Endrocrinology and Diabetes, 2 ed. Retrieved from http://oxfordmedicine.com/view/10.1093/med/9780199235292.001.1/med-9780199235292-chapter-241
Wisse, B. (2013). Hypothalamic dysfunction. MedlinePlus. Retrieved from https://www.nlm.nih.gov/medlineplus/ency/article/001202.htm