Concussion and other forms of traumatic brain injury (TBI) have become well known triggers for later life neurological complications such as early onset dementia and personality changes, but what is less known, is that hormonal imbalance can occur in up to 40% of patients with a history of TBI or concussion, which can cause full-body symptoms and changes leading to reduced overall health and quality of life.
The term “not well since” in medicine captures a particular point in time that a patient can identify experiencing a change to their health. For patients with a history of concussion or TBI, we need to consider the impact of their injury on their current symptoms and future health risks.
The hormone regulating regions of the brain (hypothalamus and anterior pituitary) are innervated by very small, very fragile arteries and veins, that are highly susceptible to damage during trauma to the head. Research has followed patients with a history of TBI to discover that many of them have deficiencies in sex hormones (estrogen, progesterone, testosterone), or changes to their stress hormones (cortisol) as a result of their brain injury, and should be supported with hormonal therapies to address weight gain, urinary frequency, headaches, PMS or low testosterone to get to the root of their long-standing symptoms.
Our approach with TBI is to fully assess patients for pituitary hormone deficiency by looking at thyroid function, sex hormones, cortisol and adrenal reserve. Imbalances in these hormones can cause many symptoms that will continue to persist after the injury unless properly evaluated and treated.
Immediate support for TBI is preferred of course, with emerging support for the use of melatonin, creatine and specialized diets to support brain healing and recovery. Often by the time we see patients with a history of TBI they have struggled for years with their symptoms, without ever having their hormones assessed.
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