Pituitary and Adrenal Function in Undernutrition with Mental Illness

Abstract

Urinary excretion of adrenal metabolites, especially neutral 17-ketosteroids, is often low in patients with anorexia nervosa (Escamilla, 1949; Bliss and Branch, 1960). This has been taken (Emanuel, 1956; Greenblatt et al., 1951) to provide evidence of adreno-cortical insufficiency secondary to defective pituitary function (Sheldon, 1939; Perloff et al., 1954). According to Perloff et al. (1954) “prolonged starvation may result in functional hypopituitarism, whose differentiation from the syndrome of hypopituitary cachexia due to structural impairment of the anterior pituitary gland is at times extremely difficult, even when the accepted tests for endocrine adequacy are performed”.