From the Research
Hormonal imbalances involving LH, FSH, and prolactin significantly impact individuals with eating disorders, particularly those with anorexia nervosa, by disrupting the hypothalamic-pituitary-gonadal axis, leading to decreased LH and FSH levels, amenorrhea, and potential long-term consequences such as bone density loss and infertility issues. In these conditions, severe caloric restriction and low body weight conserve energy by suppressing reproductive functions when nutritional intake is inadequate. Prolactin levels may be elevated in some eating disorder patients, further contributing to menstrual irregularities and reduced libido. The primary treatment approach involves nutritional rehabilitation and weight restoration, which often normalizes hormone levels without specific medication intervention, as supported by a study from 1. However, in cases where hormonal imbalances persist despite weight recovery, endocrinological consultation may be necessary. Monitoring these hormone levels during eating disorder treatment provides valuable information about physiological recovery and helps guide appropriate interventions. Some studies, such as 2 and 3, have investigated the effects of weight gain on gonadotrophins and prolactin in anorexia nervosa, finding that LH and FSH levels increase with weight gain, but LH responses to LRH may remain impaired in some patients. Additionally, a study from 4 found that anorexia nervosa patients had delayed pituitary hormone responses to LRF and TRF, indicating hypothalamic dysfunction. Overall, the most recent and highest quality study, 1, suggests that the endocrine manifestations of anorexia nervosa are complex and multifaceted, and that treatment should focus on nutritional rehabilitation and weight restoration to normalize hormone levels and prevent long-term consequences. Key points to consider in the treatment of eating disorders include:
- Nutritional rehabilitation and weight restoration as the primary treatment approach
- Monitoring of hormone levels, including LH, FSH, and prolactin, to guide treatment and assess physiological recovery
- Potential for endocrinological consultation in cases where hormonal imbalances persist despite weight recovery
- Awareness of the potential long-term consequences of hormonal disruptions, including bone density loss and infertility issues.