Hypothalamo-pituitary-thyroid function in anorexia nervosa: influence of weight gain.

Leslie, R. D. G.; Isaacs, A J; Gomez, Joan; Raggatt, P R; Bayliss, Richard

doi:10.1136/bmj.2.6136.526

Cited by 81 publications

(38 citation statements)

References 17 publications

(4 reference statements)

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“…Since the T3 concentration is related to weight changes, it can be assumed that it is sensitive to energy balance rather than food intake per se. Serum T3 concentrations would thus decrease when energy intake is diminished and/or when expenditure is increased [15, 20]. Any analyses of serum T3 concentrations would thus have to be interpreted against the background of recent energy balance and interfering disease [19, 23].…”

Section: Discussionmentioning

confidence: 99%

“…Resting energy expenditure is decreased as a measure to preserve energy in times of shortage [11] and there are parallel changes of the concentrations of circulating thyroid hormones, most notably a decrease in serum T3 concentrations while serum thyroxine (T4) concentrations are less affected [11,12,13,14,15,16,17,18,19]. Upon refeeding and weight gain, resting energy expenditure increases and circulating thyroid hormones are normalized [14, 17, 19, 20].…”

Section: Introductionmentioning

confidence: 99%

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Triiodothyronine Is an Indicator of Nutritional Status in Adolescent Girls with Eating Disorders

Swenne

Stridsberg²,

Thurfjell

et al. 2009

Horm Res Paediatr

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Aim: Circulating thyroid hormone concentrations are influenced by nonthyroidal disease and changes in nutritional status. We studied thyroid hormones as possible indicators of nutrition in adolescent girls with eating disorders. Method: Blood samples for analyses of thyroid hormones were obtained at 360 assessments of 298 patients and biweekly during 42 treatment periods in 36 patients. Results: At assessment, when most of the girls were on a weight losing course, serum triiodothyronine (T3) concentrations were low. Great weight loss and rapid rate of weight loss were the most important predictors of low T3 concentrations. Serum free thyroxine concentrations were in the lower normal range. In premenarcheal girls, weight loss was the most important predictor of free thyroxine but this relationship was weaker in postmenarcheal girls. Serum TSH concentrations were within the normal range and only weakly related to weight changes. During treatment, T3 increased in parallel with weight but was also influenced by the short-term weight trend. Conclusion: Serum T3 concentration is an indicator of nutritional status in adolescent girls with eating disorders. It is sensitive to short-term weight changes and could be used to monitor progress throughout nutritional rehabilitation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Triiodothyronine Is an Indicator of Nutritional Status in Adolescent Girls with Eating Disorders

Swenne

Stridsberg²,

Thurfjell

et al. 2009

Horm Res Paediatr

View full text Add to dashboard Cite

show abstract

“…Malnutrition, starvation, acute and chronic illnesses, and weight loss (including in obese patients) are associated with a complex series of unfolding alterations in thyroid hormone and thyrotropin (TSH) levels (Bermudez, Surks, & Oppenheimer, 1975;Boyar, Hellman, Roffwarg, Katz, Zumoff, O'Connor, Bradlow, & Fukushima, 1977;Burman, Vigersky, Loriaux, Strum, Djuh, Wright, & Wartofsky, 1977;Carter, Eastman, Corcoran, & Lazarus, 1974;Chopra & Smith, 1975;Chopra, Williams, Orgiazzi, & Solomon, 1975;Croxson & Ibbertson, 1977;Hurd et al, 1977;Leslie, Isaacs, Gomez, Raggatt, & Bayliss, 1978;Miyai, Yamamoto, Azukiazwa, Idhibashi, & Kumahara, 1975;Moshang, Parks, Baker, Vaidga, Utiger, Bongiovanni, & Snyder, 1975;Moshang & Utiger, 1977;Nomura & Pittman, 1974;Portnay, O'Brian, Bush, Vagenakis, Azizi, Arky, Ingbar, & Braverman, 1974;Reichlin, Bolinger, Netad, & Sullivan, 1973;Spaulding, Chopra, Sherwin, & Lyall, 1976;Vagenakis, 1977;Wakeling, De Souza, Gore, Sabur, Kingstone, & Boss, 1979). These changes are progressive over time and depend on the length of the illness.…”

Section: The Hypothalamic-pituitary-thyroid (Hpt) Axis the Low Triiodmentioning

confidence: 99%

The Physiology of eating disorders

Weiner¹

1985

Int. J. Eat. Disord.

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This article summarizes current understanding of the pathophysiology of anorexia nervosa. Evidence is reviewed of alterations in hypothalamic‐pitui‐tary‐thyroid mechanisms, catecholamine metabolism, and endogenous opioid activity. It is concluded that once weight loss and starvation occur, the usual mechanisms for release and inhibition of various regulators of eating behavior change, and a new set of regulating mechanisms is instituted. Thus, despite an increased body of knowledge, understanding of the origins of anorexia nervosa still eludes us.

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“…A blunted and delayed TSH response to exogenously administered TRH has been reported in about 25 -50% of AN patients. Hence, there is evidence that AN is generally associated with hypothalamic -pituitary-thyroid dysfunction (82).…”

Section: Hypothalamic -Pituitary -Thyroid Axismentioning

confidence: 99%

Anorexia nervosa in female adolescents: endocrine and bone mineral density disturbances

Argente

2002

European Journal of Endocrinology

145

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Anorexia nervosa (AN) is a chronic childhood psychiatric illness that involves a reduction in caloric intake, loss of weight and amenorrhea, either primary or secondary. The diagnostic criteria for AN have been established by the American Psychiatric Association. The prevalence of this disease amongst adolescents and young adults is between 0.5 and 1% and the incidence of new cases per year is approximately 5-10/100 000 between 15 and 19 years of age. A number of endocrine and metabolic disturbances have been described in patients with AN including amenorrhea-oligomenorrhea, delayed puberty, hypothyroidism, hypercortisolism, IGF-I deficiency, electrolyte abnormalities, hypoglycemia and hypophosphatemia, among others. In addition to prolonged amenorrhea, osteopenia and osteoporosis are the most frequent complications leading to clinically relevant fractures and increased fracture risk throughout life. Patients exhibit an alteration in the hypothalamic -pituitary -gonadal axis, which is responsible for the menstrual disorders. The increase in gonadotropin secretion that can be observed after ponderal recuperation suggests that malnutrition could be the most important mechanism involved in the decrease in gonadotropin secretion. The loss of fat tissue as a consequence of nutrient restriction has been associated with hypoleptinemia and abnormal secretion of peptides implicated in food control (neuropeptide Y, melanocortins and corticotropin-releasing factor, among others). A review of the endocrine abnormalities, disturbances in neurotransmitters, as well as a detailed analysis of bone markers and bone mineral density in patients with AN is described.

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Hypothalamo-pituitary-thyroid function in anorexia nervosa: influence of weight gain.

Cited by 81 publications

References 17 publications

Triiodothyronine Is an Indicator of Nutritional Status in Adolescent Girls with Eating Disorders

Triiodothyronine Is an Indicator of Nutritional Status in Adolescent Girls with Eating Disorders

The Physiology of eating disorders

Anorexia nervosa in female adolescents: endocrine and bone mineral density disturbances

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