Physical complications

• The following hormonal and biochemical changes may occur.

- reduction of sex and thyroid hormone secretion, secondary to hypothalamic and pituitary dysfunction

- increase of growth hormone and cortisol secretion

- increased insulin response to glucose loading

- low basal temperature and impaired temperature regulation

- low basal metabolic rate

- high serum cholesterol

- abnormal liver function tests

- low serum zinc.

• CT scan of the brain may show ventricular and sulcal enlargement. These changes are not immediately reversible with weight gain.

• Osteoporotic bones may develop in chronic cases.

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