Neuroendocrine adaptations to starvation

• Published in: Psychoneuroendocrinology 2023-11, Vol.157, p.106365-106365, Article 106365
• Main Authors: Amorim, Tânia, Khiyami, Anamil, Latif, Tariq, Fazeli, Pouneh K.
• Format: Article
• Language: English
• Subjects: Amenorrhea; Anorexia Nervosa; Bone marrow adipose tissue; Growth hormone resistance; Human Growth Hormone; Humans; Hypogonadism; Malnutrition; Neurosecretory Systems
• ISSN: 0306-4530; 1873-3360; 1873-3360
• DOI: 10.1016/j.psyneuen.2023.106365

Famine and starvation have punctuated the evolutionary past of the human species. As such, we have developed hormonal responses to undernutrition that minimize energy expenditure on processes that are not critical for the survival of the individual, such as reproduction. In this review, we discuss neuroendocrine adaptations to starvation including hypogonadotropic hypogonadism, growth hormone resistance, hypercortisolemia, and the downregulation of the hypothalamic-pituitary-thyroid axis. We review the time-course of these adaptations by describing studies involving the short-term fasting of healthy individuals as well as studies describing the hormonal changes in states of chronic undernutrition, using individuals with anorexia nervosa as a model of chronic starvation. Lastly, we review representative clinical effects of chronic undernutrition. •Starvation is characterized by neuroendocrine responses to promote survival in the setting of insufficient caloric intake.•Hormonal responses to undernutrition include hypogonadotropic hypogonadism, growth hormone resistance and hypercortisolemia.•Hormonal adaptations to starvation contribute to the clinical effects of chronic undernutrition, including low bone mass.