Dr.

Farrukh Majeed
Department of Physiology
Hypothalamus and Pituitary
gland
 Learning objectives
At the end of this lecture student should be able
to:
• Discuss role of hypothalamic releasing and
inhibiting hormones on anterior pituitary
hormone secretion.
• Understand the hypothalamic-hypophysial
portal blood vessels of the anterior pituitary
gland
 Case scenario: hypothyroidism
• History: A 50 year old housewife complains of progressive weight
gain of 20 pounds in 1 year, fatigue, postural dizziness, loss of
memory, slow speech, deepening of her voice, dry skin,
constipation, and cold intolerance.
• Physical examination: Vital signs include a temperature 96.8 oF,
pulse 58/minute and regular, BP 110/60. She is moderately obese
and speaks slowly and has a puffy face, with pale, cool, dry, and
thick skin. The thyroid gland is not palpable. The deep tendon
reflex time is delayed.
• Laboratory studies: CBC and differential WBC are normal. The
serum T4 concentration is low, the serum TSH is low TRH is also
low., and the serum cholesterol is 255 mg/dl (N<200).
 Hypothalamus: connection with pituitary
gland
• Anterior pituitary
hypothalamic
releasing and
inhibitory hormones
(or factors)
• Posterior pituitary
signals that
originate in the
hypothalamus.
Hypothalamus: Anterior pituitary gland
• Hypothalamic releasing and inhibiting
hormones help regulate anterior pituitary
hormone secretion.
Hypothalamic–Hypophyseal Portal System
 Role of the Hypothalamic–Hypophyseal Portal
System
• The hypothalamic–hypophyseal portal
system provides a critical link between the
brain endocrine system.
• This system provides a “private” route of
connection through which hypothalamic
hormones immediately and directly
delivered to the anterior pituitary
• Via this system relatively high concentrations
of hormone is carried to anterior pituitary,
bypassing the general circulation.
 Hypothalamic releasing and inhibiting
hormones
• Tropic hormones: are hormones
that have other endocrine glands as
their target.
• Hypothalamic releasing and
inhibiting hormones help regulate
anterior pituitary hormone
secretions.
• Release of each anterior pituitary
hormone is largely controlled by still
other hormones produced by the
hypothalamus.
• The secretion of these hypothalamic regulatory
neurohormones, in turn, is controlled by a variety of
neural and hormonal inputs to the hypothalamic
neurosecretory cells.
 Specific Areas in the Hypothalamus Control Secretion of
Hypothalamic Releasing and Inhibitory Hormones

• The specific loci of the neuronal

cell bodies that form the different
hypothalamic releasing or
inhibitory hormones are still
poorly known.
• Hypothalamic hormones are
secreted at nerve endings in the
median eminence transported
to the anterior pituitary gland.
• Electrical stimulation excites
nerve endings release the
hypothalamic hormones.
Three hormone
sequence:
Hypothalamus
 Anterior pituitary
 peripheral target
endocrine gland.
Hypothalamic –
pituitary… axis.
Hypothalamic releasing and inhibiting
hormones functions
 Hypothalamic disease
•  Damaged to hypothalamus resulting from:
– malnutrition, including anorexia and bulimia 
– genetic disorders,
– radiation,
– surgery, head trauma, lesion, tumour or other
physical injury to the hypothalamus.
• Examples of hypothalamic diseases:
– Tertiary hypothyroidism:
– Tertiary Adrenal Insufficiency
T3 T4↓ T3 T4↓ T3 T4↓
TSH ↑ TSH ↓ TSH ↓
TRH ↑ TRH ↑ TRH ↓
Case scenario: hypothyroidism???
• History: A 50 year old housewife complains of progressive weight gain
of 20 pounds in 1 year, fatigue, postural dizziness, loss of memory, slow
speech, deepening of her voice, dry skin, constipation, and cold
intolerance.
• Physical examination: Vital signs include a temperature 96.8 oF, pulse
58/minute and regular, BP 110/60. She is moderately obese and speaks
slowly and has a puffy face, with pale, cool, dry, and thick skin. The
thyroid gland is not palpable. The deep tendon reflex time is delayed.
• Laboratory studies: CBC and differential WBC are normal. The serum T4
concentration is low, the serum TSH is low and TRH is also low., and
the serum cholesterol is 255 mg/dl (N<200).
• Diagnosis: Tertiary hypothyroidism
 Lack of Gonadotropin-releasing
hormone (GnRH)- Kallman’s syndrome
• Kallmann syndrome (KS) may be inherited in
an X-linked recessive, autosomal dominant,
or autosomal recessive manner depending on
the responsible gene.
• features are delayed or absent signs of
puberty, and absent or diminished sense of
smell (anosmia or hyposmia, respectively).
• Hypothalamus problems also appear with genetic
link (chromosomes 15) in Prader-Willi Syndrome.
This is a condition leads to short stature and
hypothalamic dysfunction.
 Reading material
• Guyton 11th edition chapter 75, page 919-