The hormones of the hypothalamic pituitary system include. The device and purpose of the hypothalamic-pituitary system

So is the endocrine.

The hypothalamic-pituitary system consists of the pituitary stalk, which begins in the ventromedial region of the hypothalamus, and three lobes of the pituitary gland: the adenohypophysis (anterior lobe), the neurohypophysis (posterior lobe), and the intercalary lobe of the pituitary gland. The work of all three lobes is controlled by the hypothalamus with the help of special neurosecretory cells. These cells secrete special hormones - releasing hormones, as well as "posterior lobe" hormones - oxytocin and vasopressin.

Structure

Hormones of the hypothalamic-pituitary system

Under the influence of one or another type of exposure to the hypothalamus, the lobes of the pituitary gland secrete various hormones that control the work of almost the entire human endocrine system. The exception is the pancreas and the adrenal medulla. They have their own regulation system.

Anterior pituitary hormones

Somatotropin

It has an anabolic effect, therefore, like any anabolic, CT enhances synthesis processes (especially protein synthesis). Therefore, growth hormone is often called somatotropin.

In violation of somatotropin secretion, three types of pathologies occur.

• With a decrease in the concentration of somatotropin, a person develops normally, but his growth does not exceed 120 cm - "pituitary nanism". Such people (hormonal dwarfs) are capable of childbearing and their hormonal background is not greatly disturbed.
• With an increase in the concentration of somatotropin, a person also develops normally, but his height exceeds 195 cm. This pathology is called "gigantism" girls, whose hormonal surge, unlike boys, is smooth and its decline is quite fast.) muscle mass increases greatly, hence the number of capillaries increases. The heart is not capable of such rapid growth. Because of this discrepancy, pathologies arise.
• After 20 years, the production of somatotropin decreases, therefore, the formation of cartilage tissue (as one of the aspects of growth) slows down and decreases. Therefore, the bone tissue slowly "eats" the cartilaginous tissue, therefore, the bones have nowhere to grow, except in diameter. If the production of somatotropin does not stop after 20, then the bones begin to grow in diameter. Due to this thickening of the bones, for example, fingers thicken, and because of this thickening, they almost lose their mobility. At the same time, somatotropin also stimulates the production of connective tissue, as a result of which lips, nose, auricles, tongue, etc. increase. This pathology is called " acromegaly".

Thyrotropin

The target of thyrotropin is the thyroid gland. It regulates growth thyroid gland and the production of its main hormone - thyroxine. An example of the action of a releasing factor: Thyroxine is necessary to increase the efficiency of oxygen respiration, thyroxine needs thyrotropin, and thyrotropin needs thyroliberin, which is a thyrotropin releasing factor.

Gonadotropins

The name gonadotropins (GT) stands for two different hormones - follicle-stimulating hormone and luteinizing hormone. They regulate the activity of the sex glands - gonads. Like other tropic hormones, gonadotropins primarily affect the endocrine cells of the gonads, regulating the production of sex hormones. In addition, they have an impact on the maturation of gametes, the menstrual cycle and related physiological processes.

Corticotropic hormones

The target of CT is the adrenal cortex. It should be noted that the parathyroid gland regulates mineral metabolism (with the help of parathormone), like the adrenal cortex, so that regulation can only be put on the adrenal cortex, and parathyroid gland will automatically work in accordance with the adrenal cortex.

The hypothalamic-pituitary system is a morphological and functional combination of the structures of the hypothalamus and pituitary gland, which are involved in the regulation of the main autonomic functions of the body. Various releasing hormones produced by the hypothalamus have a direct stimulating or inhibitory effect on the secretion of pituitary hormones. At the same time, feedbacks exist between the hypothalamus and the pituitary gland, with the help of which the synthesis and secretion of their hormones are regulated. Principle feedback here it is expressed in the fact that with an increase in the production of endocrine glands of their hormones, the secretion of hormones of the hypothalamus decreases. The release of pituitary hormones leads to a change in the function of the endocrine glands; the products of their activity with the blood flow enter the hypothalamus and, in turn, affect its functions.

The main structural and functional components of the hypothalamic-pituitary system are two types of nerve cells - neurosecretory, producing peptide hormones vasopressin and oxytocin, and cells, the main product of which are monoamines (monoaminergic neurons). Peptidergic cells form large nuclei - supraoptic, paraventricular and posterior. The neurosecret produced inside these cells, with the current of the neuroplasm, enters the nerve endings of the nerve processes. Most of the substances enter the posterior lobe of the pituitary gland, where nerve endings axons of neurosecretory cells are in close contact with the capillaries, and passes into the blood. In the mediabasal part of the hypothalamus, there is a group of indistinctly formed nuclei, the cells of which are capable of producing hypothalamic neurohormones. The secretion of these hormones is regulated by the ratio of the concentrations of norepinephrine, acetylcholine and serotonin in the hypothalamus and reflects the functional state of the visceral organs and internal environment organism. According to many researchers, it is advisable to distinguish the hypothalamic-adenohypophyseal and hypothalamic-neurohypophyseal systems as part of the hypothalamic-pituitary system. In the first, the synthesis of hypothalamic neurohormones (releasing hormones), which inhibit or stimulate the secretion of many pituitary hormones, is carried out, in the second - the synthesis of vasopressin ( antidiuretic hormone) and oxytocin. Both of these hormones, although synthesized in the hypothalamus, accumulate in the neurohypophysis. In addition to the antidiuretic effect, vasopressin stimulates the synthesis of pituitary adrenocorticotropic hormone (ACTH) and the secretion of 17-ketosteroids. Oxytocin affects the activity of the smooth muscles of the uterus, enhances labor activity, and is involved in the regulation of lactation. A number of hormones of the anterior pituitary gland are called tropic. These are thyroid-stimulating hormone, ACTH, somatotropic hormone, or growth hormone, follicle-stimulating hormone, etc. Melanocyte-stimulating hormone is synthesized in the intermediate lobe of the pituitary gland. Vasopressin and oxytocin accumulate in the posterior lobe.

In the 70s. it was found that in the tissues of the pituitary gland, a number of biologically active substances of a peptide nature are synthesized, which were later attributed to the group of regulatory peptides. It turned out that many of these substances, in particular endorphins, enkephalins, lipotropic hormone and even ACTH, have one common precursor - the high molecular weight protein proopiomelanocortin. The physiological effects of the action of regulatory peptides are diverse. On the one hand, they have an independent influence on many functions of the body (for example, on learning, memory, behavioral reactions), on the other hand, they are actively involved in the regulation of the activity of the hypothalamus itself. pituitary system, affecting the hypothalamus, and through the adenohypophysis - on many aspects of the autonomic activity of the body (relieve pain, cause or reduce hunger or thirst, affect intestinal motility, etc.). Finally, these substances have a certain effect on metabolic processes (water-salt, carbohydrate, fat). Thus, the pituitary gland, having an independent spectrum of action and closely interacting with the hypothalamus, is involved in uniting the entire endocrine system and regulating the processes of maintaining the constancy of the internal environment of the body at all levels of its vital activity - from metabolic to behavioral. The importance of the hypothalamus-pituitary complex for the life of the body is especially pronounced when the pathological process is differentiated within the hypothalamic-pituitary system, for example, as a result of complete or partial destruction of the structures of the anterior pituitary gland, as well as damage to the centers of the hypothalamus that secrete releasing hormones, symptoms of adenohypophysis insufficiency develop, characterized by reduced secretion of growth hormone, prolactin, and other hormones. Clinically, this can be expressed in pituitary dwarfism, hypothalamic-pituitary cachexia, anorexia nervosa, etc. (see Hypothalamo-pituitary insufficiency). Lack of synthesis or secretion of vasopressin may be accompanied by the onset of the syndrome not diabetes, the main cause of which is damage to the hypothalamic-pituitary tract, the posterior pituitary gland, or the supraoptic and paraventricular nuclei of the hypothalamus. Similar manifestations accompany the hypothalamic syndrome.

Classification of the mechanisms of regulation of the activity of the heart

The mechanisms of regulation of the activity of the heart are divided into extracardiac and intracardiac (see Fig. 1).

MECHANISMS OF REGULATION OF HEART ACTIVITY:

INTRACARDIAC

EXTRA-CARDIAC

Extracardiac mechanisms are represented by neuroreflex and humoral, and intracardiac mechanisms are neuroconduction and myogenic.

Neuro-reflex regulation of the activity of the heart

Neuroreflex mechanisms are divided into congenital (unconditional) and acquired (conditional). Any reflex arc consists of five main elements: receptors, afferent nerve, nerve center, efferent nerve and executive organ.

Receptors and reflexogenic zones of cardiac reflexes

The main receptors involved in the implementation of cardiac receptors are receptors that control blood pressure (baroreceptors) and receptors that control the volume of blood circulating through the vessels (volume receptors). Baroreceptors are located in the walls of arteries and are mainly grouped in the paired carotid sinus zone (a zone of branching of the common carotid artery on the external and internal carotid arteries), the aortic zone (aortic arch), the pulmonary artery. Volumoreceptors are localized mainly in the right parts of the heart.

Afferent links of cardiac reflexes

From the steam carotid sinus zone, afferent information is transferred to the central nervous system by branches of the IX pair of cranial nerves (n. glossopharingeus), called n. caroticus or Hering's nerves. From the aortic reflexogenic zone, afferentation in the central nervous system is supplied by branches of the vagus nerve (n. vagus) Zion-Ludwig nerves or buffer nerves (n. depressor). From pulmonary artery and the right parts of the heart afferent in the central nervous system comes through the afferent branches of the vagus nerve (n. vagus).

Nerve centers of cardiac reflexes

We traditionally consider the concept of the nerve center in two versions: narrow and wide. In a narrow sense, by the heart center we mean the totality of neurons in the medulla oblongata, which ensure the implementation of cardiac reflexes. The nerve center of the medulla oblongata is heterogeneous. Firstly, it includes the effector nuclei of the vagus nerve, which innervates the heart. Secondly, it includes neurons located among the cells of the pressor section of the vasomotor center of the medulla oblongata. They direct their axons to the upper segments of the spinal cord, where neurons are located in the lateral horns. sympathetic department autonomous nervous system that innervate the heart.

With a broad interpretation of the concept of "cardiac nerve center", it includes the nerve centers of the hypothalamic region (the posterior nuclei represent the sympathetic division, and the anterior nuclei represent the parasympathetic division of the autonomic nervous system), the nerve centers of the cerebral cortex.

Efferent links of cardiac reflexes: the role of sympathetic and parasympathetic nerves in the regulation of heart activity

The heart has sympathetic and parasympathetic innervation. Parasympathetic innervation is represented by two vagus nerves (n. vagus) - left and right. The first neuron of the parasympathetic nerve is located in the motor nucleus of the vagus nerve in the medulla oblongata, the second neuron is located intramurally, in the heart. The vagus nerves innervate the conduction system of the heart: right nervus vagus innervates the sino-atrial node, the left - atrio-ventricular node. Since healthy person the pacemaker is the sinoatrial ganglion, the leading parasympathetic nerve that regulates the activity of the heart is the right vagus nerve. The left vagus nerve to a greater extent affects the conduction of the conduction system of the heart.

Sympathetic innervation is represented by the nerves of the autonomic nervous system, the first neurons of which are localized in the lateral horns of the upper thoracic segments of the spinal cord. The second neurons are located in the upper, middle and lower cervical ganglia. Sympathetic nerves innervate the heart diffusely, covering all its departments.

The sympathetic and parasympathetic divisions of the autonomic nervous system have different effects on the heart. If you cut the right vagus nerve and then irritate its peripheral part with an electric current, you can detect a decrease in heart rate (negative chronotropic effect), a decrease in the strength of heart contractions (negative inotropic effect), a decrease in excitability (negative bathmotropic effect), a decrease in conductivity (negative dromotropic effect ). These effects are due to the fact that acetylcholine acts as a mediator in the postganglionic synapses of the vagus nerve, and muscarinic-sensitive cholinergic formations act as receptors for subsynaptic membranes. As a result of the formation of mediator-receptor complexes in the postsynaptic membranes of these synapses, the permeability of potassium channels increases. In this regard, hyperpolarization occurs, the consequence of which is a decrease in excitability, conductivity, an increase in the time of one excitation cycle, and, consequently, a decrease in the frequency of generated action potentials per unit of time. In addition, in this situation, there is a decrease in the permeability of biological membranes to calcium ions, which leads to a decrease in the strength of myocardial contractions.

With irritation of the peripheral branches of the sympathetic nerves, opposite effects are noted: an increase in heart rate (positive chronotropic effect), an increase in the strength of heart contractions (positive inotropic effect), an increase in excitability (positive bathmotropic effect), an increase in conductivity (positive dromotropic effect). These effects are due to the fact that norepinephrine, which acts as a mediator, is released in the postganglionic synapses of sympathetic nerves. In the role of receptors of subsynaptic membranes, mainly b1-adrenergic receptors act. Activation of b1 leads to an increase in the permeability of postsynaptic membranes of myocardial cells in relation to sodium and calcium ions. This causes depolarization, which leads to an increase in excitability, conduction, a decrease in the duration of one excitation cycle, and hence to an increase in the frequency of generation of action potentials by the pacemaker cells. An increase in the permeability of membranes with respect to calcium ions leads to an increase in the strength of contractions, since calcium ions affect the processes of interaction between actin and myosin, which are part of myofilaments.

Humoral regulation of the activity of the heart

Humoral regulation of the activity of the heart is provided by a number of chemical compounds: biologically active substances, incl. hormones, soluble salts (electrolytes) and metabolites. The first group includes adrenaline, thyroid hormones. The second group includes compounds of calcium, potassium and some others. The third group should include organic acids (lactic, pyruvic, carbonic), their derivatives, ATP cleavage products, etc.

Intracardiac mechanisms of regulation of the activity of the heart

Myogenic mechanisms of self-regulation of the activity of the heart are divided into heterometric (with a change in the length of myocardial muscle fibers) and homeometric (without a change in the length of myocardial muscle fibers).

The heterometric mechanism of self-regulation of the activity of the heart is reflected in the "law of the heart" by O. Frank - E. Starling. This law states that the strength of myocardial fiber contractions depends on the degree of their initial stretch: the more the muscle fiber is stretched, the greater strength it is shrinking.

Homeometric mechanisms of self-regulation of the activity of the heart are reflected in the phenomena of Anrep and the Bowditch ladder.

The Anrep phenomenon is reflected in the fact that if there is an increase in resistance to blood flow in the main vessels (aorta or pulmonary artery), then the strength of myocardial fiber contractions increases without any extracardiac effects.

The phenomenon of the Bowditch ladder is that with a stepwise increase in heart rate, the strength of heart contractions increases (rhythmoinotropic dependence).

The neuroconduction mechanisms of regulation of the activity of the heart are associated with the presence of microganglia in the walls of the heart, containing neurons that are different in functional respects - efferent, afferent and associative. These neurons are combined into single structural and functional complexes with myocardial fibers. In essence, these structural-functional complexes allow reflex-like reactions to occur without the participation of the central nervous system.

The hypothalamic-pituitary system connects the endocrine system with the nervous system.

It regulates the synthesis of hormones in the body, which are necessary for the correct functioning of organs.

Violation of the functions of the hypothalamic-pituitary system leads to pathologies in the internal organs and can even cause death.

Why is the hypothalamic-pituitary system needed?

The proper functioning of the whole organism is impossible without correct operation nervous and endocrine systems. The nervous system is formed directly by neurons (cells nervous tissue), neuroglia (auxiliary cells that make up about 40% of the volume of the nervous system) and connective tissue, permeates the entire body. neurons conduct nerve impulses. Neuroglia surrounds nerve cells, protecting them and providing conditions for the transmission and formation of impulses, and also performs part of the metabolic processes of nerve cells. Connective tissue is essential for connecting parts of the nervous system. The central nervous system (CNS) is made up of the brain and spinal cord, and peripheral - the nerves and nerve nodes lying outside them.

Even primitive animals, such as coral polyps, have a nervous system.

The endocrine system regulates the functioning of internal organs using hormones. Endocrine cells are present in most body tissues. Proper functioning of the endocrine glands gives the body the ability to adapt to conditions environment, while maintaining the coordinated work of the organs of the body itself.

The well-coordinated interaction of the nervous and endocrine systems is provided by the hypothalamic-pituitary system, formed by the pituitary gland and the hypothalamic stalk. responsible for the production of hormones that regulate metabolism, tissue growth, reproductive function. This is a small area, weighing less than a gram, located at the base of the brain and consisting of three lobes. The hypothalamus is located in diencephalon and is associated with almost all departments of the central nervous system. The list of its features is extensive:

• thermoregulation of the body;
• formation of an emotional response;
• formation of behavioral features.

The hypothalamus connects the nervous system with the endocrine system through the pituitary gland. The hypothalamic-pituitary system is formed early, even in the first weeks prenatal development. Then the synthesis of hormones is also launched.

Working mechanism

The hypothalamus contains special neurosecretory cells - a cross between endocrine cells and . They combine the functions of both types of cells, perceiving signals coming from different areas of the nervous system and releasing neurosecretions into the blood, which occupy an intermediate position between hormones and neurotransmitters. They are called releasing hormones.

Releasing hormones are divided into releasing (liberins) and stopping (statins). The first contribute to the secretion of the pituitary gland, and under the action of the second, it, accordingly, stops.

Under the influence of releasing hormones, the pituitary gland secretes hormones that control the functioning of the secretory glands. If some glands secrete too much or, conversely, too little of certain hormones, the hypothalamus fixes a deviation from the norm of their concentration in the blood and inhibits or stimulates the activity of the pituitary gland, thus regulating the activity of the glands.

In other words, the entire system operates on a negative feedback mechanism. An increase (or decrease) in the level of a hormone endocrine gland causes a suspension (or increase) of the synthesis of the corresponding hormone in the pituitary gland and inhibition (or stimulation) of the production of the hormone by a certain gland. For example, with an increase in the concentration of thyroxine associated with the thyroid gland in the body, the synthesis of thyrotropin in the pituitary gland is inhibited, which causes inhibition of the hormone-forming function of the thyroid gland itself. Such functional disorders during their prolonged course cause morphological changes in endocrine system. A prolonged excess of the hormone causes atrophy of the gland, and a deficiency causes its pathological growth.

The hypothalamic-pituitary system is also affected by signals from CNS neurons. Information from the senses (visual, auditory, olfactory, tactile, etc.) enters the central nervous system, which sends it to the hypothalamus. There it is converted into a regulatory signal and the pituitary gland receives a “command” to activate or inhibit the synthesis of substances.

What are substances responsible for?

Each releasing hormone has its own "zone of responsibility". Gonadoliberins (folliberin and luliberin) regulate the production of gonadotropins - luteinizing and follicle-stimulating hormone. Normal levels of estrogen, progesterone and testosterone depend on them. Somatoliberin and somatostatin are responsible for the synthesis of growth hormone. Prolactoliberin and prolactostatin control the synthesis of prolactin. Thyroliberin affects the blood levels of thyroxine and triiodothyronine. Corticoliberin promotes the production of adrenocorticotropins.

Somatotropin is produced in the anterior pituitary gland. Growth hormones promote tissue growth. The formation of somatotropin depends on many factors, including exercise, other substances, intake medicines. Together with other particles, it adapts the body to a shortage of food, using free fatty acids from body fat as an energy source.

Adrenocorticotropin promotes the production and secretion of hormones of the adrenal cortex. The anterior and intermediate lobes of the pituitary gland and some CNS neurons are responsible for the synthesis. Its secretion is stimulated by any stress, from emotional experiences to surgical interventions.

Thyrotropin is necessary for the synthesis and secretion of iodine-containing thyroid hormones. Synthesis of thyrotropin is carried out in the anterior pituitary gland.

Gonadotropins are represented by follicle-stimulating and luteinizing hormones, as well as chorionic gonadotropin of the placenta. In men, the follicle-stimulating substance controls spermatogenesis, in women it is necessary for the growth of ovarian follicles.

The luteinizing substance in men promotes the synthesis of testosterone in the testicles, in women - the synthesis of estrogens and progesterone in the ovaries. It also stimulates ovulation. Chorionic gonadotropin during pregnancy is involved in the formation of progesterone.

Prolactin during puberty accelerates breast development in girls. In adult pregnant women and women who have given birth, it stimulates the formation of milk. Prolactin is produced in the anterior pituitary gland. During pregnancy, its volume doubles due to an increase in the number and increase in the size of lactotrophs, cells that produce prolactin.

Melanotropins are responsible for the pigmentation of the skin and mucous membranes.

Also, the hormones oxytocin and vasopressin are involved in the formation of the hypothalamic-pituitary relationship. They are produced in the hypothalamus and accumulate in the posterior pituitary gland. Oxytocin is necessary during breastfeeding - it promotes the release of milk produced with the help of prolactin. It is also important for uterine contractions during childbirth. Oxytocin affects the psyche, causing a feeling of trust in a partner, calmness and satisfaction, as well as reducing fear. Vasopressin regulates aggression and may be related to memory mechanisms. In addition, vasopressin works as an antidiuretic.

Releasing hormones, in addition to regulating the work of the pituitary gland, have a psychotropic effect. So, corticoliberin provokes feelings of anxiety. Thyreoliberin has an anticonvulsant effect. Gonadoliberin regulates sex drive and improves mood. But some of the substances secreted by the pituitary gland, for example, follicle-stimulating and luteotropic, can only affect the endocrine glands.

Structure pathologies

Organic brain damage inflammatory processes, tumors, traumas, hemorrhages, thromboses cerebral vessels lead to damage to the system and, as a result, the development of severe endocrine disorders. Impaired synthesis in the hypothalamus of a certain liberin or statin causes problems with the production of the hormone associated with it. Also, the hypothalamic-pituitary system may not be directly affected, but in case of disruption of the endocrine glands.

The most common cause damage - vascular disorders.

Thus, diabetes mellitus is often accompanied by atherosclerotic damage to the pancreas.

Among the common pathologies of activity are deviations in the synthesis of somatotropin. Insufficient or excessive synthesis of substances contributes to the development of dwarfism or gigantism, respectively. Gigantism is not uncommon, it occurs in 1-3 people out of 1000. Symptoms of the disease appear with the onset of puberty. An excess of somatotropin in an already formed, adult organism leads to acromegaly. With this pathology are observed:

• bone expansion;
• an increase in the diameter of the fingers;
• connective tissue grows.

As a result, fingers thicken and lose mobility, ears, lips, nose increase. Acromegaly develops slowly, changes in the body last for years. It leads to deterioration mental abilities, fatigue, headaches, nerve compression, deforming arthrosis. Among the celebrities who suffered from acromegaly are the French wrestler Maurice Tiye, who became the prototype of the cartoon character Shrek, and the Russian boxer Nikolai Valuev.

Throughout life, the manifestation of dwarfism, gigantism, and acromegaly is possible - this was the case with the Austrian Adam Rainer. Until the age of 26, the man's height was 122 cm, but due to a pituitary tumor, he grew by almost a meter in a few years. Even the removal of the tumor did not help to cope with the problem. Rainer died at the age of 51, by which time his height had reached 238 cm.

Excessive production of adrenocorticotropic hormone causes the proliferation of the adrenal cortex, while the lack leads to endocrine insufficiency of the adrenal glands. Excessive work of the thyroid gland provokes the development of thyrotoxicosis, which causes weight loss, vascular problems, diarrhea, disorders of the central nervous system and heart function. Lack of hormones leads to hypothyroidism, which is accompanied by hair loss, swelling, dry skin, and drowsiness. In advanced form, hypothyroidism leads to a coma, which, in the absence of emergency care, ends in death in 80% of cases. An increase in the production of gonadotropins leads to too early puberty, a lack of damage to the gonads and infertility.

To correct the functionality, drugs are used that reduce the synthesis of either replacement therapy. Brain tumors are subject to removal if possible.

16-02-2012, 11:31

Description

Since many hypothalamic-pituitary diseases in which ocular symptoms are observed are due to tumors of the pituitary gland, we will consider this issue at the beginning of this chapter.

pituitary tumors

The main form of pathology of the pituitary gland are tumors. These are predominantly adenomas of the anterior or glandular lobe (adenohypophysis). There are three groups of adenomas: eosinophilic, basophilic and chromophobic. Endocrine disorders with adenomas, they make it possible to distinguish lesions of the chiasm caused by these tumors from lesions of its other origin.

endocrine disorders with tumors of the pituitary gland are very diverse, but are not always observed, sometimes they are absent in chromophobic adenomas. A pituitary adenoma without endocrine disorders is isolated into a special category. clinical form and call it the "ophthalmic form". Its leading manifestation, in addition to the destruction of the Turkish saddle, are eye symptoms [Tron E. Zh., 1966].

Tumors of the pituitary gland in varying degrees destroy the Turkish saddle, which is revealed by X-ray examination of the skull; however, with very small tumors, they are not detected radiographically.

Due to excess production growth hormone anterior pituitary gland develops a clinical picture acromegaly. Most early manifestation acromegaly are sexual disorders, headaches.

In connection with disproportionate bone growth the shape of the skull, predominantly facial, changes greatly, the lower jaw is especially noticeably enlarged. cartilage grows and soft tissues, auricles; the nose becomes thick, the tongue enlarges, the lips thicken, and the eyelids swell. Hands, feet, etc. are greatly enlarged.

Due to the disorder of various endocrine functions pituitary function is impaired and other endocrine glands(diabetes mellitus, thyroid disease, diabetes insipidus).

Very often seen eye symptoms combined with endocrine disorders in tumors such as craniopharyngiomas. Craniopharyngioma is usually located suprasellar (sometimes intersellar) and is a cyst with cholesterol crystals, has a tendency to calcify. The tumor compresses the third ventricle or blocks the foramen of Monroe, resulting in increased intracranial pressure. The growth of craniopharyngioma is accompanied by pressure on the Turkish saddle, chiasm and hypothalamic region.

Of the endocrine disorders, it should be noted decreased function of the pituitary and hypothalamus; this is manifested in children by growth retardation, underdevelopment of the genital organs, secondary sexual characteristics, deposition of fat on the chest, abdomen, drowsiness and the development of diabetes insipidus. At a young age, there is a disorder of sexual function.

Timely diagnosis of these tumors and appropriate treatment ( radiation therapy, surgical removal) are of paramount importance for prevent blindness, and often to save the life of the patient, so the role of the ophthalmologist in the examination of such patients can hardly be overestimated.

Adiposogenital dystrophy (Pechkarants-Babinski-Frölich syndrome)

Adiposogenital dystrophy occurs in connection with a tumor (more often chromophobic adenoma or craniopharyngioma), dropsy of the third ventricle, vascular thrombosis, hemorrhages, birth trauma. This disease can also develop as a result of damage to the hypothalamus in various acute (influenza, typhoid fever etc.) and chronic (tuberculosis, syphilis) infectious diseases and intrauterine infection(toxoplasmosis).

Sick with this disease complain on the fatigue, drowsiness, decreased performance, weight gain, etc. The disease manifests itself in obesity and hypogenitalism. In boys, there is a deposition of fat according to the female type, the absence of secondary sexual characteristics, underdevelopment of the genital organs, cryptorchidism. Girls aged 14-15 do not have menstruation, there is an underdevelopment of the uterus and its appendages.

Eye symptoms in adiposogenital dystrophy are caused by the pathological processes mentioned above, depending on the localization of which characteristic changes occur. With a tumor of the third ventricle, the most common eye symptom is congestive optic discs. Congestive discs can be combined with symptoms of chiasm damage associated with pressure on it from the bottom of the dilated third ventricle.

Of violations oculomotor apparatus with tumors of the third ventricle, paralysis and paresis of the external eye muscles, paralysis and paresis of the gaze, nystagmus occur.

Gigantism

Pituitary gigantism and acromegaly are considered as age variants of the same pathology. Based on this view, the disease that began before puberty manifests itself as gigantism, and in adulthood as acromegaly.

Gigantism - rare disease, more common in men; it usually appears during puberty and is due to increased secretion growth hormone in connection with hyperplasia of eosinophilic cells of the anterior pituitary gland, eosinophilic adenoma or malignant tumor. Pituitary gigantism is characterized tall(for men above 200 cm, for women above 190 cm). The length of the limbs prevails over the length of the body, the dimensions of the skull do not correspond to growth (relatively small). Often there is a violation of the function of the gonads. Often there is an increase in the thyroid gland with symptoms of hyperthyroidism, sometimes with exophthalmos. Since in childhood eosinophilic adenoma is small, usually there are no disorders of the organ of vision; the changes characteristic of it develop in a later period.

diabetes insipidus

Distinguish hypothalamic and renal forms diabetes insipidus. Hypothalamic diabetes insipidus is caused by a lack of production of antidiuretic hormone. He can be independent disease or one of the manifestations of certain endocrine and non-endocrine diseases; often occurs between the ages of 18 and 25.

Renal diabetes insipidus seen only in males. The disease is genetically determined, inherited in a recessive, sex-related type.

Diabetes insipidus is most commonly caused by neurotropic viral infections (influenza, etc.) "may be associated with other acute and chronic diseases(whooping cough, scarlet fever, typhoid fever, relapsing fever, sepsis, tuberculosis, syphilis), as well as with traumatic brain injury, tumors of the pituitary gland and hypothalamus. This disease can be combined with other endocrine pathology(adiposogenital dystrophy, acromegaly and gigantism, pituitary dwarfism, Simmonds syndrome, Itsenko-Cushing's disease).

Deficiency of antidiuretic hormone can be absolute, with damage to the supraoptic and paraventricular nucleus of the hypothalamus, as well as the hypothalamic-pituitary tract, through the fibers of which neurosecretion enters the posterior lobe of the pituitary gland, and relative, due to the excess of its destruction on the periphery.

Diabetes insipidus can also develop with congenital pathology renal tubular receptors.

Deficiency of antidiuretic hormone causes decreased water reabsorption renal tubules and increased diuresis. Dehydration of the body occurs, which is accompanied by irritation of the corresponding center of the hypothalamus, resulting in a strong thirst.

Diabetes insipidus most often occurs suddenly, rarely develops gradually. Patients complain on the constant thirst and frequent copious excretion urine, loss of appetite, headache, weakness, etc.

There may be an expansion of the stomach due to the intake a large number fluids, as well as the omission of it; sometimes develops gastritis, colitis.

In women, in some cases, there is a violation of the menstrual cycle up to amenorrhea, a tendency to spontaneous abortions. In men, there is a decrease in libido and impotence. In children, there is a delay in growth and sexual development, bedwetting.

Changes in the organ of vision in diabetes insipidus, they are mainly observed in cases where this disease develops as a result of damage to the hypothalamic-pituitary region by a tumor, an inflammatory process. If there is compression by a tumor or other formation of the area of ​​the optic chiasm, then chiasmal syndrome, and if there is an increase in intracranial pressure, then there is congestive optic disc. Possible increase intraocular pressure.

In diabetes insipidus are described and other changes in the organ of vision. Sometimes there are complaints of "dry" eyes, fatigue when reading. A significant decrease in the sensitivity of the cornea, lethargy of pupillary reactions was noted.

Hyperhydropexic syndrome (Parchon's syndrome)

This disease, which occurs predominantly in men, is caused by excessive production of antidiuretic hormone, while fluid is periodically retained in the body, water intoxication occurs, oliguria with high relative density urine (1.020-1.030).

Sick with hyperhydropectic syndrome complain headache, reduced urine output. Patients have dry and pale skin of the body, uniform obesity, edema often occurs on various
areas of the body. Women may develop amenorrhea, men have a decrease in sexual function, impotence.

It is believed that in the occurrence Parkhon's syndrome have known value mental trauma, toxic-infectious effects and allergic factors.

Of the eye symptoms noted narrowing of the arteries of the retina, which is associated with the vasopressor action of angiodiuretic hormone. However, the total arterial pressure in patients with this syndrome is not increased, which has a certain diagnostic value.

Laurence-Moon-Barde-Biedl syndrome

This disease, like adiposogenital dystrophy, is associated with damage to the hypothalamic-pituitary system.

Clinical manifestations Laurence-Moon-Barde-Biedl syndromes are very similar to those in adipose-genital dystrophy: obesity, hypoplasia of the genital organs, decreased sexual function, poor development of secondary sexual characteristics.

In addition to these symptoms, there is a violation growth process, skull deformity, polydactyly, mental retardation. characteristic muscle weakness, drowsiness, increased appetite and thirst.

An important place in the clinic of the disease is occupied by eye symptoms: strabismus, nystagmus, myopia, retinitis pigmentosa.

Patients with retinitis pigmentosa complain of a decrease in vision and difficulty in orientation at dusk. An ophthalmoscopic examination of the fundus reveals characteristic pigmented foci on its periphery, resembling bone bodies in shape (Fig. 42).

Rice. 42. Pigmentary dystrophy retina.

Gradually, their number increases, they spread to the center, the vessels of the retina narrow. Other areas of the fundus are discolored, sometimes so much that it actually shines through choroid. The optic disc becomes yellowish-white, atrophic.

central vision remains high for a long time. The field of view narrows concentrically, and at the extreme periphery (within 10 °) it is preserved. As the process progresses, there is a further narrowing of the field of view, up to a tubular one. In the advanced stage, complications are sometimes observed: cataract, glaucoma. There may be changes in the area yellow spot.

Hypothalamic-pituitary cachexia (Simmonds syndrome) and postpartum hypopituarism (Shien's syndrome)

Hypothalamic-pituitary cachexia(Simmonds syndrome) develops as a result of destructive changes in the anterior pituitary gland and in the hypothalamus. This leads to insufficiency of the adenohypophysis and progressive exhaustion. The disease most often affects women aged 30-40 years and is caused by damage to the hypothalamic-pituitary region by tumors, as well as acute or chronic infectious disease(influenza, typhoid, tuberculosis, syphilis, etc.), as well as trauma to the skull, accompanied by hemorrhage in the anterior pituitary gland. Simmonds' sypdrome can also occur after surgery - gyiophysectomy.

In connection with these lesions, the function of the triple hormones of the adenohypophysis drops out and, as a result, the function of the peripheral endocrine glands, mainly the thyroid gland, the sex glands and the adrenal cortex, decreases.

Patients complain weakness, loss of appetite, headache, drowsiness, chilliness, constipation alternating with diarrhea, decreased libido, menstrual irregularities.

Characteristic signs premature aging, severe exhaustion, weak expression of the subcutaneous fat layer, pallor and atrophy of the skin, hair loss, atrophy of the lower jaw, dental caries and their loss. There are bradycardia, hypotension, atony and ptosis of the intestine, impaired liver function. There are pronounced changes in the neuropsychic sphere: lethargy, depression, memory loss, etc. As the process progresses, the symptoms observed in schizophrenia develop.

In Simmonds syndrome, there are various symptoms and on the part of the organ of vision. Patients sometimes complain of decreased vision, fatigue when reading. In some cases, there is hair loss in the eyebrow area, eyelash swelling of the eyelids, narrowing palpebral fissures, atrophy of the subcutaneous and orbital tissue, muscles, retraction of the eyeballs. Sometimes there is swelling of the conjunctiva of the eyelids and eyeball, decreased sensitivity of the cornea, sluggish pupillary reactions, development of cataracts.

Changes in the organ of vision due to mainly damage to the adenohypophysis by a tumor or other pathological processes. Most often there is a chiasmal syndrome (bitemporal hemianopsia or bitemporal narrowing of the visual field), later primary atrophy of the optic disc develops. If the growth of the tumor is accompanied by an increase in intracranial pressure, a congestive optic disc may develop. Naturally, all these changes are accompanied by a decrease in vision.

postpartum hypopituarism(Shien's syndrome) in its clinical picture is similar to Simmonds' syndrome, but less pronounced. The disease develops slowly chronic course; no sharp depletion is observed. Often there are symptoms of thyroid insufficiency, accompanied by its pasty, sometimes swelling of the face, lower extremities.

Mental changes in Shien's syndrome are mild and are associated with hypothyroidism.

Think that postpartum hypopituarism due to spasm of the vessels of the adenohypophysis, which occurs during birth bleeding.

Changes in the organ of vision in Shien's syndrome are similar to those in Simmonds' syndrome, but are less pronounced.

Syndrome of persistent lactation and amenorrhea (Chiari-Fromel)

Chiari-Fromel syndrome occurs in women and girls as a result of damage to the hypothalamus with the subsequent development of endocrine disorders. Often the cause of the disease is a chromophobe pituitary adenoma, a tumor of the hypothalamus. In this regard, prolactin-releasing, an inhibitory factor, ceases to have an inhibitory effect on the production of prolactin, which leads to incessant lactation.

Sick with this syndrome complain for headache, menstrual irregularities, milk secretion from the mammary glands, and this is not associated with pregnancy and breastfeeding. In some cases, there is exhaustion, in others, on the contrary, excessive deposition of fat. There is hypertrichosis.

Eye symptoms are due mostly pituitary tumor a, which puts pressure on the optic chiasm. This causes bitemporal narrowing of the visual field, bitemporal hemianopia. Further develops descending atrophy optic nerves.

Changes in the organ of vision are not observed in all cases, in a number of patients the process does not progress for a long time and the Chiari-Fromel syndrome is manifested only by persistent lactation and menstrual irregularities, amenorrhea.

Itsenko-Cushing's disease and syndrome

In 1932, N. Cushing described in detail clinical picture disease associated with basophilic pituitary adenoma. But as early as 1924, N. M. Itsenko reported a similar picture of the disease, in which changes were established in the interstitial brain. In this regard, it was proposed to call what is described by these authors pathological condition Itsenko-Cushing's disease.

Based contemporary ideas about unified system hypothalamus-pituitary-adrenal cortex, many authors call Itsenko-Cushing's disease a pathological process in which the hypothalamus is primarily affected and other parts of the central nervous system that regulates the function of the hypothalamus, the pituitary gland (pituitary adenoma), and Itsenko-Cushing's syndrome is a pathological process in which the adrenal glands are primarily affected [Gncherman E. 3., 1971; Vaskzhova E. A. et al., 1975, etc.].

Itsenko-Cushing's syndrome may also be due to ectopic tumors producing ACTH-like substances, and hypercortisolism associated with the treatment of various diseases with corticosteroids.

Hypercortisolism is the main manifestation of both Itsenko-Cushing's disease and Itsenko-Cushing's syndrome. AT clinical manifestations Itsenko-Cushing's disease and Itsenko-Cushing's syndrome have many common symptoms.

Cushing's disease and syndrome in women is observed 5 times more often than in men. The disease affects people aged 20 to 40 years. Already in the early period patients complain weakness, which is probably due to increased catabolism due to increased production of cortisol, as well as hypokalemia. Complaints of headache, pain in the region of the heart, palpitations are quite frequent, and pain in the region of the spine and ribs is not uncommon. Women are concerned about menstrual irregularities, infertility, men - the weakening of sexual desire and sexual function.

Complaints about change appearance (obesity, skin coloration) are presented with an already developed process. It is generally accepted that such manifestations of the disease as osteoporosis, steroid diabetes, hypokalemia, muscle atrophy, characteristic obesity, matronism, and trophic changes in the skin are caused by hypercortisolism. Headache, dizziness, visual and hearing disorders, drowsiness, insomnia, impaired vestibular functions, nighttime hunger, mental depression are considered as hypothalamic and cerebral symptoms.

Naturally, this division is arbitrary, for example, arterial hypertension may be of central origin and may be associated with hypercortisolism, as well as secondary renal dysfunction.

With Itsenko-Cushing's disease and syndrome patients have characteristic appearance : the face becomes round, moon-shaped. There is obesity of the neck, supraclavicular areas, mammary glands, abdomen, back (in the region of the upper thoracic vertebrae). There are no signs of obesity in the extremities. The skin of the face becomes purple-cyanotic, a marble pattern appears on the skin of the shoulders, shins, thighs, striae are very characteristic. Often there are acne, boils. In women, there is excessive hair growth.

Often celebrated atrophy muscle tissue caused by a violation of protein metabolism (due to the catabolic effect of glucocorticoids, inhibition of protein synthesis). Osteoporosis is very common, often leading to bone fractures. Osteoporosis, which usually occurs in the late period of the disease, is due to the catabolic effect of glucocorticoids on bone tissue.

The earliest and most frequent sign of the disease and Itsenko-Cushing's syndrome is arterial hypertension(Fig. 43).

Rice. 43. Hypertonic fundus changes in a patient with Itsenko-Cushing's syndrome.

Arterial pressure can reach high level(systolic 250 mm Hg, diastolic 150 mm Hg). The more severe the form of the disease, the more pronounced arterial hypertension. In this case, the phenomena of cardiovascular insufficiency may develop.

There are also characteristic of arterial hypertension changes in kidney function. In the pathogenesis of hypertensive syndrome, along with a violation of the central mechanisms of regulation of vascular tone, hypersecretion of mineralocorticoid hormones - aldosterone, corticosterone is important. Electrolyte disorders leading to hypokalemia and hypernatremia may contribute to the appearance of edema.

One of early signs disease and Itsenko-Cushing's syndrome is dysfunction of the sex glands. In women, this manifests itself in violation of the menstrual cycle, up to amenorrhea, violation reproductive function, hypertrichosis, hirsutism.

With Itsenko-Cushing's disease and syndrome, often impaired glucose tolerance and latent or overt diabetes develops. Features mild or moderate diabetes mellitus in these diseases are a rarity of ketoacidosis, frequent glucosuria with low glycemia (a discrepancy between the level of glycemia and glucosuria)

With Itsenko-Cushing's disease, approximately 10% of patients have skin hyperpigmentation on the neck, elbows, abdomen, due to increased secretion of adrenocorticotropic and melanocyte-stimulating hormones. With Itsenko-Cushing's syndrome, skin hyperpigmentation is absent.

Thus, Itsenko-Cushing's disease can be attributed to neuroendocrine forms hypothalamic syndrome, the so-called youthful hypercorticism can also be attributed to them. The latter is different from typical disease Itsenko-Cushing by the fact that in adolescents with this lesion, growth is higher than in their peers, which is due to excessive production of somatotropic hormone along with adrenocorticotropic hormone.

Except typical shape Itsenko-Cushing's disease, there is a so-called erased form of the disease when, against the background of a Cushingoid change in the patient's appearance, there are no symptoms characteristic of Itsenko-Cushing's disease: osteoporosis, arterial hypertension, a clear violation of carbohydrate metabolism [Vasyukova E. A. et al., 1975].

Itsenko-Cushing syndrome caused by tumors of extra-adrenal localization (bronchi, pancreas, mediastinum, etc.) is marked by rapid progression and significant severity of all symptoms of the disease.

Currently significantly improved diagnostic methods Itsenko-Cushing's disease and Itsenko-Cushing's syndrome, which provides the possibility of differential diagnosis between them. These methods include determining the rate of secretion and the study of the content of corticosteroids in the blood and urine. With Itsenko-Cushing's disease, the secretion of cortisol is significantly increased with a relatively slight increase in the secretion of other corticosteroids; at benign tumors adrenal cortex, the production of corticosteroids and their content in the blood and urine differ little from the corresponding indicators in Itsenko-Cushing's disease, and in malignant tumors the adrenal cortex there is a significant increase in the secretion of 11-deoxycortisol and corticosterone.

Functional tests are of known importance for the differential diagnosis of Itsenko-Cushing's disease and Itsenko-Cushing's syndrome. Widely spread tests with metapyrine and dexamethaeon.

In the diagnosis of Itsenko-Cushing's disease and syndrome x-ray examination plays a minor role. Basophilic pituitary adenomas, which can cause Itsenko-Cushing's disease, are small in size and are not detected radiographically (therefore, there are no eye symptoms characteristic of pituitary tumors). Tumors of the adrenal cortex, causing the syndrome Itsenko-Cushing, radiographically detected only when they reach large sizes, and in most cases they are not detected.

With Itsenko-Cushing's disease and syndrome, there are various eye symptoms. In connection with arterial hypertension most often angiopathy of the retina is detected, which disappears with normalization blood pressure; rarely develops hypertensive angiosclerosis of the retina and even more rarely hypertensive retinopathy. The predominant occurrence of small changes in the retina (angiopathy), apparently, is due to the fact that both the disease and Itsenko-Cushing's syndrome develop at a young age, when intraocular vascular system has a high resistance to damaging factors [Margolis M. G., 1973].

In the case of Itsenko-Cushing's disease and syndrome, dysregulation of intraocular pressure, usually in the form of transient symptomatic hypertension. An increase in ophthalmotonus can also be persistent, with the development of symptoms of glaucoma. There are studies indicating that primary glaucoma may be due to hypercortisolism.

With Itsenko-Cushing's disease, it can sometimes develop exophthalmos, which is associated with increased hormonal function of the anterior pituitary gland, from which a special exophthalmic factor has been isolated.

With Itsenko-Cushing's disease, there may be symptoms caused by a lesion basal-diencephalic regions of the brain: feeling of bulging of the eyeballs, pain in the area superciliary arches and behind the eyeballs. In inflammatory processes on the basis of the brain, changes can develop in optic nerves; sometimes ptosis occurs upper eyelid, anisocorpya, paralysis of gaze up, which, apparently, is due to damage to the quadrigemina and nuclei oculomotor nerves[Gincherman E. 3., et al., 1969].

Disturbances in the regulation of intraocular pressure in hypothalamic-pituitary lesions

The issue of impaired regulation of intraocular pressure in hypothalamic-pituitary disorders is very relevant.

Numerous researchers have found that with this pathology very often there are various violations regulation of intraocular pressure, often resembling primary glaucoma th, so a number of authors proposed the term " diencephalic glaucoma". Later, they began to call the condition in which there is an increase in intraocular pressure, symptomatic hypertension of the eye. This term to a greater extent reflects the essence of the occurring changes in the specified state.

Dysregulation of intraocular pressure is expressed not only in an increase in intraocular pressure, but also in high diurnal curves intraocular pressure. Very important differential diagnosis between primary glaucoma and ocular hypertension caused by hypothalamic-pituitary disorders, since the nature of therapeutic effects depends on this. Symptomatic ocular hypertension is characterized by some features that make it possible to reject the diagnosis. primary glaucoma. With hypothalamic-pituitary disorders, intraocular pressure is very labile, it can change to a large extent during the day, but it can also be quite stable for a long time. An increase in intraocular pressure is accompanied in some cases by a deterioration general condition, appears headache palpitations, possible vomiting. Provocative tests(dark, caffeinated, water loaded) do not cause an increase in ophthalmotonus. The use of miotic agents (pilocarpine, ezerin, prozerin, tosmilen, phosphakol, etc.) does not reduce intraocular pressure.

For symptomatic ocular hypertension not noted dystrophic changes anterior part of the eyeball, as well as changes in the fundus characteristic of glaucoma (shift of the vascular bundle to the nasal side, marginal excavation of the optic nerve head).

Tonographic studies make it possible to establish that with symptomatic eye hypertension, increased secretion of intraocular fluid at a normal outflow rate. The boundaries of the visual field usually remain normal, visual acuity does not decrease.

Confirmation Symptomatic ocular hypertension, and not glaucoma, is also the fact that treatment for hypothalamic-pituitary disorders has a normalizing effect on intraocular pressure. However, it should be borne in mind that with symptomatic ocular hypertension, noted for a long time, there may be secondary lesion drainage system of the eye and develop glaucoma.

Toxic lesions of the hypothalamus (chronic poisoning tetraethyl lead) can also cause symptomatic eye hypertension [Skripnichenko 3.I., 1965]. Under influence toxic substance on the area of ​​the hypothalamus, the regulation of intraocular pressure and the hydrodynamics of the eye are disturbed. Upon termination of the action of the toxic substance, intraocular pressure and hydrodynamics of the eye are normalized.

symptomatic ocular hypertension may occur and in case of poisoning with pesticides [Glazko I. V., 1969], as well as in traumatic brain injury [Kalfa S. F., 1970].

The occurrence of symptomatic eye hypertension in cervical osteochondrosis is associated with compression of the vertebral artery, and this leads, in particular, to a deterioration in the blood supply to the hypothalamus [Zolotareva M. M., 1970].

We do not dwell on the issue of dysregulation of intraocular pressure due to changes in the hypothalamus-pituitary-thyroid gland system, as well as in the hypothalamus-pituitary-adrenal system and in the hypothalamus-pituitary-gonadal system. This issue is covered in the relevant sections of this chapter.

It should be concluded that in patients with hypothalamic-pituitary disorders, it is necessary to carry out careful ophthalmic examination (tonometry, elastotonometry, tonography, biomicroscopy, microgonioscopy, ophthalmoscopy, perimetry, etc.) in order to establish the correct diagnosis in a timely manner.

Article from the book: .

The regulation of the work of internal organs depends on the production of hormones. main role in production essential substances played by the human pituitary gland.

On the different stages development of the human body, you need an unequal amount of hormones. So, during pregnancy, growth or sexual intercourse, it is required to speed up the work of the pituitary gland, and then stabilize the pituitary gland.

For this purpose, the neuroendocrine complex, consisting of the pituitary gland and the hypothalamus, serves. The hypothalamic-pituitary system is a morphofunctional association responsible for the regulation of the autonomic functions of the human body.

What are hypothalamic-pituitary functions

System structure

Each of the parts of the hypothalamic-pituitary complex has its own special structure.

The structure and functions of the hypothalamic-pituitary system are interconnected. The hypothalamus produces both stimulating and depressing hormones. As a result close cooperation between the part of the brain and its appendage, it is possible, if necessary, to stimulate the accelerated release of prolactin and other substances necessary in the process of growing up, the regulation of female menstrual cycles, as well as affecting human sexual activity.

System functions

• Hypothalamus - supports the work of internal organs, regulates body temperature, endocrine and reproductive systems, thyroid and pancreas, adrenal glands and the pituitary gland itself.
• The pituitary gland produces tropic hormones that regulate the activity of the peripheral endocrine glands. The pituitary gland stimulates the synthesis of testosterone, provokes the production of spermatozoa, growth hormones, and contributes to the normal functioning of the thyroid gland.

In a normal state, the necessary amount of hormones is produced for the coordinated work of the body. Insufficiency or hyperactivity of the function leads to serious malfunctions in the work of the human body.

Physiology of the system

Due to the development of tumor formations: cysts or adenomas, metabolic disorders, the patient has hypothalamic-pituitary dysfunction.

As a result of failures, disturbances in the functioning of the sexual, endocrine, genitourinary and other human systems are observed. Often, patients with problems of the hypothalamic-pituitary complex suffer from sexual dysfunction, infertility, reduced immunity. Treatment of dysfunction is associated with the elimination of the causes of pathological changes.

System value

Reduced secretion is the cause of reduced immunity, the development of diabetes insipidus and other abnormalities.

How to restore the functions of the pituitary and hypothalamus

Treatment of hypothalamic-pituitary insufficiency is carried out only after diagnosing the causes that caused the system to malfunction. To do this, the patient undergoes a complete examination of the body, which includes the following procedures:

1. Taking clinical tests and testing for hormones.