A hormone deficiency in women with the eating disorder anorexia nervosa is associated with increased severity of anxiety and depression, according to a new study being presented Sunday, June 3, at The Endocrine Society’s 89th Annual Meeting in Toronto.

Anorexia nervosa is a serious psychiatric disorder in which patients severely restrict their food intake because of a distorted body image. It affects 1 to 2 percent of college-aged women, according to the presenter, Dr. Karen Miller, an endocrinologist at Massachusetts General Hospital and an assistant professor at Harvard Medical School. Up to 70 percent of women with anorexia nervosa have anxiety disorders, and up to 80 percent also have depression, she said.

Women with anorexia nervosa tend to have low levels of testosterone. Generally considered a male hormone, testosterone is normally present in women at about one-tenth the levels in men. Although data in men suggest that low testosterone levels are associated with depression, researchers do not know whether these findings apply to women with anorexia nervosa.

In this study, Miller and her co-workers measured symptoms of anxiety, depression and eating disorder behaviors, as well as testosterone levels in the blood, in 43 women with anorexia nervosa. Generally, the lower the testosterone levels, the more likely women were to have more severe anxiety and depression. They also were likely to have more severe thoughts and behaviors associated with eating disorders, specifically feelings of ineffectiveness, perfectionism, distrust of others and insecurity in social situations. These findings could not be explained by weight and also held true in a subset of 21 anorexic women who were not receiving psychotropic medications, including antidepressants and anti-anxiety medications.

The study, which was funded by the National Institutes of Health, did not address whether low-dose testosterone replacement would help treat psychiatric symptoms in women with anorexia nervosa. However, Miller said, “This study is important, because it lays the basis for studies to determine whether a new therapy might be effective to treat a disorder that has few effective treatments.”

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