The hypothalamic regulatory
hormones used for clinical studies are TRH,
Gn-RH and
somatostatin. In addition, as
dopamine appears to be a physiological PIF, the
dopamine agonists such as
bromocriptine, could be considered as functional analogues of PIF.
Gn-RH can be used to study the hypothalamic-pituitary gonadal relationship and to test the secretory reserve capacity of the gonadotrophs in disease states. Unfortunately
Gn-RH testing discrimulates between pituitary and
hypothalamic diseases only poorly. However gonadotrophin deficient men or women may be successfully treated with long-term
Gn-RH with induction of puberty, potency, spermatogenesis and ovulation.
Somatostatin has multiple actions in inhibiting endocrine and exocrine secretion but its actions are still being explored in diabetes.
Bromocriptine, a long acting
dopamine agonist (a functional analogue of PIF), suppresses
prolactin and is highly effective in treating many hypogonadal states since
hyperprolactinaemia is common. It also lowers
growth hormone in
acromegaly. TRH has provided a major, accurate, sensitive and safe test of thyroid function.