Head trauma, including concussion, can lead to hormone deficiencies. This relationship between head trauma and hormonal deficiencies, though, is not well-recognized by physicians and healthcare professionals.
According to the CDC 1.7 million Americans sustain a traumatic brain injury each year. This number does not include individuals who sustain trauma, but don’t seek medical evaluation or treatment. Fifty-two thousand die from traumatic brain trauma while 275,000 are hospitalized. A vast majority, or 1.365 million are treated and released from the emergency room. That might sound like good news, but believe it or not a number of those individuals will either to continue to have symptoms or later develop symptoms related to the trauma.
Falls on the head account for 28% of the cases of head trauma, motor vehicle accidents account for 20%, getting struck by an object (sports and otherwise) account for 19%, and assaults account for 11%.
Hormone Physiology 101
To a large degree our endocrine system or hormonal system works on the principle of supply and demand. If there’s a need for a hormone the body will produce it. (This is important to recognize because you can intentionally create a demand for some hormones like testosterone, growth hormone, and insulin by the way you eat and exercise). Through a series of feedback loops the body regulates hormone levels so that supply meets demand – much like the thermostat in your house will automatically regulate temperature.
Our main hormones include estrogen, progesterone, testosterone, DHEA, cortisol, growth hormone, insulin, and thyroid. The production of these hormones is influenced by the production and release of other hormones found in the hypothalamus and pituitary, both of which are found in the brain. So obviously any trauma to the brain has the potential to disrupt hormone production.
Let’s use testosterone as an example. Testosterone is primarily (in males) produced in the testes in response to luteinizing (LH) hormone that is produced in the pituitary. LH in turn is produced in response to gonadotropin releasing hormone or GnRH that is produced in the hypothalamus. So trauma affecting either the hypothalamus or pituitary can lead to diminished testosterone production. The same can be said for estrogen, progesterone, growth hormone, thyroid hormone, and cortisol.
One study found that 35% to 40% of patients with traumatic brain injury developed hormone deficiencies. Another study found that 3 months after head trauma 56% of the patients were deficient in at least on hypothalamic/pituitary hormone with 32% being deficient in gonadotropin (stimulate production of sex hormones), 19% deficient in corticotropin that stimulates the production of cortisol, 8% deficient in somatotropin that stimulates production of growth hormone, and 8% deficient in thyrotropin that stimulates production of thyroid hormone.
After 12 months following the trauma 36% were still deficient in a least one hormone with a slight increase in those deficient in somatotropin to 10%.
Post-Concussion Syndrome and Hormone Deficiencies
There is quite a bit of overlap between symptoms of post-concussion syndrome and hormone deficiency and can include fatigue, insomnia, mood swings, loss of libido, being withdrawn, difficulty with mental focus and concentration, memory loss, anxiety, and depression to mention the more common ones. Might the symptoms of post-concussion syndrome be a manifestation of hormone deficiency? We don’t know yet, but existing treatments for post-concussion syndrome have focused on alleviating the symptoms, but don’t appear to address the underlying problem.
What to Do About Hormone Deficiencies?
Many times a hormonal assessment is not done following traumatic brain injury, mainly because the connection between the two is not considered. If you, or someone you know has suffered head trauma and have/has not fully recovered insist that the physician screen for hormone deficiencies and the patient be treated if a hormone deficiency exists.
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