Opioid tonus and luteinizing hormone secretion in anorexia nervosa: priming effect with serotonin precursor L-5-hydroxytryptophan during pulsatile gonadotropin-releasing hormone administration.
In anorexia nervosa (AN) luteinizing hormone (LH) release is often impaired during opioid blockade. We investigated whether a restoration of the endogenous sex steroid milieu, together with a rise in central serotonergic tone, could increase LH responsiveness to Naloxone (NAL) in seven young women affected by AN. The spontaneous pulsatility of gonadotropins and their response to gonadotropin-releasing hormone (GnRH) and NAL challenges were tested before and after 13 days of pulsatile GnRH treatment and oral administration of L-5-hydroxytryptophan. Low and unpulsatile gonadotropin levels, responsive to GnRH, but not to NAL, were found before treatment. Pulsatile GnRH brought about a quasi-normal secretory pattern and 17 beta-estradiol increased to preovulatory levels in six of seven patients. On day 13 the lack of response to NAL administration was still present, however. A neuroendocrine disorder seems to be present in AN, which appears more complex than in other forms of hypothalamic amenorrhea.
Department of Endocrinology and Metabolism, University of Genoa School of Medicine, Italy.
S
S
Valenti
M
M
Giusti
R
R
Guido
D
D
Cavallero
G
G
Giordano
D006916:5-Hydroxytryptophan / Q000494:pharmacology*; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000378:metabolism*; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage*; D006801:Humans; D007986:Luteinizing Hormone / Q000378:metabolism*; D008597:Menstrual Cycle / Q000187:drug effects; D009270:Naloxone / Q000494:pharmacology*; D012701:Serotonin / Q000378:metabolism
D012701:Serotonin; D007987:Gonadotropin-Releasing Hormone; D009270:Naloxone; D007986:Luteinizing Hormone; D006916:5-Hydroxytryptophan