The effect of weight gain on gonadotrophins and prolactin in anorexia nervosa

Abstract

Serum levels of gonadotrophins and prolactin and their response to luteinizing hormone/follicle stimulating hormone -releasing hormone (LRH) and thyrotrophin releasing hormone (TRH) were measured in 14 females with anorexia nervosa when at low body weight and again in 6 cases during, and 12 cases after weight gain. Mean serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were low initially and whereas FSH increased significantly with weight gain, LH levels remained subnormal in most patients. LH responses to LRH were grossly impaired or absent in patients whose weight was below 75% of the ideal, but increased dramatically above this weight overshadowing the more modest increase in FSH response. In three patients, however, impaired LH responses persisted as ideal weight was approached. Basal prolactin levels were well within the normal range in all patients. During weight gain there was no change in basal levels but the prolactin level 20 min after TRH was significantly increased.

The prolactin and growth hormone responses to arginine in anorexia nervosa

“…There is no support in our study for the presence of hyperprolactinemia in anorexia nervosa (Harrower, Tap, Nairn, Walton, Strons, & Craig, 1977;Travaglini, Beck-Peccoz, Ferrari, Ammoin, Parrachi, Spadu, & Faglia, 1976), and we agree with others who have found mostly normal basal prolactin levels (Mecklenburg et al, 1974;Skrabanek et al, 1981;Jeuniewic, Brown, Garfinkel, & Moldofsky, 1978;Isaacs, Leslie, Gomez, & Bayliss, 1980;Beaumont, Friesen, Gelder, & Kolakowska, 1974;Beaumont, George, Pimstone, & Vinik, 1976).…”

The Physiology of eating disorders

“…However, reduced responses of PRL (Isaacs et al, 1980), and a significant delay in the peak PRL response, to TRH have also been reported in some but not in other patients Macaron et al, 1978). Such a delay is strongly suggestive of hypothalamic dysfunction (Faglia et al, 1975;Hall et al, 1972).…”

“…Weight loss and loss of body fat may play a role (Frisch & McArthur, 1973). Urinary and basal serum levels of LH and FSH increase with weight recovery in some but not in all AN patients (Beumont et al, 1976;Danowski et al, 1972;Hurd et al, 1977;Isaacs et al, 1980;Jeuniewic, Brown, Garfinkel, & Moldofsky, 1978;Palmer, Crisp, MacKinnon, Franklin, Bonnar, & Wheller, 1975;Russell, 1965Russell, , 1972Sherman et al, 1975;Wakeling & DeSouza, 1983). The degree of weight recovery at which normal serum levels of LH and FSH are attained may have to be greater in AN patients who restrict their food intake than in those who alternate between restricting and bingeing (Wakeling & DeSouza, 1983).…”

“…In AN the levels of the gonadotropins-the luteinizing (LH) and follicle-stimulating hormone (FSH)-in urine and blood are uniformly low in girls and boys following puberty (Beumont et al, 1972(Beumont et al, , 1973Buvat, Lemaire, Buvat-Herbout, Lepretre, & Fourlinnie, 1983;Brown et al, 1977;Danowski et al, 1973;Emanuel, 1956;Isaacs, Leslie, Gomez, & Bayliss, 1980;Lemaire et al, 1983;Lundberg et al, 1971;Marshall & Fraser, 1971;Russell et al, 1965;Wakeling & DeSouza, 1983;Warren & Vande Wiele, 1973). The reduction in E, levels can be accounted for by depressed resting urinary or serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels (Mecklenburg, Loriaux, Thompson, Anderson, & Lipsett, 1974).…”

“…In anorexia nervosa resting PRL levels have uniformly been described as being normal (Beumont et al, 1976;Buvat et al, 1984;Burman et al, 1977;Isaacs et al, 1980;Macaron et al, 1978;Mecklenburg et al, 1974;Vigersky et al, 1976;Wakeling et al, 1979) and bear no relationship to the amount of weight loss (Wakeling et al, 1979). By contrast, some normal weight BN patients have elevated levels of PRL, including those women whose menses were irregular (Mitchell & Bantle, 1983).…”