Newer Dopaminergic Agents Cause Minimal Endocrine Effects in Idiopathic Parkinson's Disease

Abstract

OBJECTIVEWe studied the prevalence of endocrine dysfunction in subjects with idiopathic Parkinson’s disease (IPD) on newer dopaminergic agents (DA). DA are also used in endocrine hypersecretory states in small doses and we hypothesized that endocrine dysfunction was likely in IPD where DA were used in comparatively much higher dosage.PATIENTS AND METHODSTwenty-five subjects with IPD, established on DA, were recruited to this cross-sectional study. We measured insulin-like growth factor-1, prolactin, luteinizing hormone, follicle stimulating hormone, thyroid function, oestradiol or testosterone and cortisol levels following a short synacthen test.RESULTSWe studied 18 males and 7 females, whose median age was 72 years, and whose median time from diagnosis, and duration of treatment was 27 months (interquartile range 17–45 and 13–39 months, respectively). (1) Endocrine tests were normal in 19 of 25 subjects at recruitment. Minor abnormalities reverted to normal on repeat testing in three of six with initial abnormalities; two had persistent abnormalities and the third subject could not be further investigated. Therefore, 22 of 24 (92%) with IPD on DA therapy had normal endocrine profiles. (2) The cortisol response to ACTH was normal in 24 of 25 subjects (96%). (3) Eleven subjects (44%) had isolated PRL suppression. There were no differences between the suppressed PRL and “normal” PRL groups. However, a higher number of them were on non-ergoline-derived DA (83% vs 31%; P < 0.05).CONCLUSIONSWe have demonstrated that newer non-ergoline DA therapy caused only minimal endocrine perturbations in subjects with IPD. Their clinical significance can only be speculative currently. The cortisol response to ACTH was normal in almost all but a significant minority had suppressed prolactin levels.

Metabolic treatment of syndrome linked with Parkinson's disease and hypothalamus pituitary gonadal hormones by turmeric curcumin in Bisphenol-A induced neuro-testicular dysfunction of wistar rat

“…Idiopathic Parkinson's disease and uncontrollable hike of dopaminergic metabolizing enzymes could influence hypothalamus pituitary hormone secretion [21] . The anterior pituitary endocrine dysfunction had also been documented in patients with Parkinson's disease [22] . Sub-acute exposure to 50 mg/kg BPA (endocrine disrupting chemical) significantly inhibited the luteinizing hormone-releasing hormone (LHRH), follicle stimulating -releasing hormone (FSRH) and serum testosterone.…”

“…Investigation has recognized that idiopathic Parkinson's disease and uncontrollable hike of dopaminergic metabolizing enzymes could influence hypothalamus pituitary hormone secretion [21] . As the anterior pituitary endocrine dysfunction had also been documented in patients with Parkinson's disease [22] …”

Role of orexin in pathogenesis of neurodegenerative parkinsonisms

“…Currently, there are few prospective publications on long-term treatment with dopamine agonists and its effect on hormonal balance [4][5][6][7]. Based on the literature, in untreated patients diagnosed with Parkinson's disease, there are no significant disorders in the basal secretion of anterior pituitary hormones-prolactin [8], thyroid-stimulating hormone [8], luteinsing hormone [9], and follicle-stimulating hormone [9].…”