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Hormone Deficiencies Common in Concussion Patients

by U.S. Medicine

July 5, 2016

SEATTLE—Hormonal changes related to explosive blast-related concussions often cause military veterans to suffer sleep disturbance, fatigue, depression and poor quality of life, according to a new study.

The research evaluating hormone levels in 41 male veterans who had been deployed to Iraq or Afghanistan was presented at the Endocrine Society’s 98th annual meeting in Boston.1

“Some of these hormone deficiencies, which mimic some symptoms of post-traumatic stress disorder, may be treated successfully with hormone replacement, if correctly diagnosed,” suggested senior researcher Charles Wilkinson, PhD, of the Veterans Affairs (VA) Puget Sound Health Care System.

Concussion, also called mild traumatic brain injury (TBI), represents 80% of head injuries among U.S. military servicemembers, according to government estimates in 2010.

“Although studies in civilians indicate a 25 to 50% prevalence of hormonal deficiencies resulting from brain injuries, surprisingly there are limited data on their prevalence and symptoms in military veterans,” Wilkinson said.

For the study, researchers took blood samples from 27 veterans with one or more blast concussions sustained at least one year earlier and from 14 previously deployed veterans with no history of blast exposure, measuring 11 hormones in the blood related to the pituitary system.

Basal morning levels of IGF-I, LH, FSH, prolactin, free and total testosterone, TSH, thyroxine, ACTH and cortisol were measured. Growth hormone deficiency and secondary adrenal insufficiency were identified by provocative testing with the glucagon stimulation test (GST). Body composition was determined with bioimpedance spectroscopy.

In addition, behavioral questionnaires were administered, addressing number of blast exposures, length of deployments, sleep quality, fatigue, cognitive function, depression and symptoms of post-traumatic stress disorder (PTSD).

The most common hormone abnormality found was growth hormone deficiency (GHD) which was exhibited by for veterans and is associated with significant negative effects on cognition, mood, sleep and metabolism. Adrenal insufficiency and hypogonadism were each seen in two of eight veterans with hypopituitarism, either as a single deficiency or in concert with GHD. Finally, thyroid hormone deficiency was detected in one of eight veterans with hypopituitarism.

“In conclusion, veterans who sustained mTBI have a high prevalence of pituitary hormone deficiencies,” study authors noted. “There is evidence that supplementing deficient hormones can have a positive impact, and our results support screening for hypopituitarism after blast-related mTBI when indicated by relevant symptoms. Accurately diagnosing and treating hypopituitarism in mTBI patients, particularly in returning servicemembers, may alleviate physiological and psychiatric symptoms and significantly improve quality of life.”

1 Coasurdo EA, Pagulayan KF, Burges DE, Meichi SP, et. al. (2016, April)

Chronic Hypopituitarism Is Prevalent after Blast Concussion in Deployed Military Personnel. Poster session presented at the Endocrine Society’s 98th annual meeting, Boston, MA.


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