Nutrients · 2 authors, 2 centres
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This narrative review describes endocrine alterations caused by semi-starvation in anorexia nervosa, including hypothalamic–pituitary axis changes and altered hunger/satiety regulation. The review found that most endocrine changes are adaptive and reversible with weight restoration, with transdermal oestrogen being a promising intervention for bone health.
The authors report that most endocrine alterations in anorexia nervosa are adaptive responses to semi-starvation and are reversible with weight restoration. They note that transdermal oestrogen and oral gestagen, alongside vitamin D and calcium supplementation, are advisable to prevent further bone loss. The review identifies fT3 and cortisol as important endocrine markers for distinguishing constitutional thinness from anorexia nervosa. The authors highlight that male individuals are underrepresented in existing studies and that many studies examining less commonly investigated hormones have been of limited statistical power.
