Anorexia nervosa and the secretion of prolactin

Update on endocrine disturbances in anorexia nervosa

The marked endocrine changes that occur in anorexia nervosa have aroused a great deal of interest, and over the last decade much research has been conducted in this field. The endocrine disturbances are not specific to this disorder, as they also occur in starvation states secondary to other causes, and they return to normal upon weight restoration. However, emaciation may have profound effects on psychological processes, establishing an intricate circular interaction whereby somatic and psychological manifestations of starvation may continue to act. The purpose of this paper is to provide an overview of the large body of literature concerning endocrine aspects of anorexia nervosa with the main focus on the latest results, which provide leads for potential etiological theories.

Continuous infusion of luteinizing hormone releasing hormone (LHRH) in patients with anorexia nervosa

LHRH was administered by continuous 4-hour intravenous infusion to 14 anorexia nervosa patients on a refeeding programme. Infusions were repeated in 7 patients following weight gain and in 4 after a course of bromocriptine. Five healthy female volunteers in the early or mid-follicular phase of the menstrual cycle served as controls. The LH response was diminished in patients at 65% standard weight, but was of progressively increasing magnitude in patients at 80% and 95% standard weight. The pattern of LH response to the 4-hour infusion was suggestive of a deficient stimulation by endogenous LHRH in patients at extremely low weights, and of an impaired oestrogen feedback mechanism in patients at intermediate weights. Bromocriptine enhanced the LH response on one occasion in patient with moderately elevated plasma HPR values, but failed to produce a similar effect when given to 3 patients with normal HPR levels. The mean FSH response did not differ significantly between patients in different weight categories, although those at 65% standard weight had a markedly greater variance of response. Plasma oestradiol values were lower in patients at 65% standard weight than in those at higher weights.

Anorexia nervosa and 'Turner syndrome': cause or coincidence?

We report the eleventh documented case of the concurrence of anorexia nervosa and 'Turner syndrome'. Although some authors have suggested that the 2 syndromes occur together more often than by chance, and 5% of anorexia nervosa patients karyotyped to data have 'Turner syndrome', recent evidence in fact suggests that the 2 conditions do not occur together more often than one would expect by chance.