Pituitary Dysfunction Related to Blast TBI

by U.S. Medicine

January 5, 2015

CHICAGO – Pituitary dysfunction after blast injury may be an important, under-recognized, and potentially treatable source of symptoms in servicemembers who survive traumatic brain injury (TBI) from blast exposure, according to a new study.

The research was presented recently at the joint meeting of the International Society of Endocrinology and the Endocrine Society meeting in Chicago.1

“Our study suggests that deficiencies in the pituitary’s growth hormone and testosterone are commonly seen after blast traumatic brain injury, especially in patients who are overweight. Because multiple symptoms common with blast traumatic brain injury are also seen with growth hormone and testosterone deficiencies, perhaps treating these hormone deficiencies will help improve the symptom burden and quality of life for these veterans,” said lead author Jeffrey S. Taylor, MD, endocrinology fellow at Virginia Commonwealth University Medical Center in Richmond, VA.

Warfighters returning from Iraq and Afghanistan have suffered higher rates of blast traumatic brain injury (bTBI). Researchers report that a common consequence of the condition is pituitary hormone dysfunction, which can occur even without mechanical head trauma.

That dysfunction can interfere with recovery, long-term health, and overall well-being, yet depression, post-traumatic stress disorder (PTSD), and certain medications may complicate diagnosis, so possible pituitary dysfunction often goes unrecognized and untreated, study authors noted.

For the industry-supported research on the incidence of pituitary dysfunction with bTBI, Taylor and his colleagues looked at 37 male veterans who had been exposed to combat-related blasts. Study subjects were evaluated for bTBI and tested for hormonal dysfunction while screening for and minimizing their use of medications that might interfere with their lab tests.

Of the veterans, 23 had mild and two had moderate TBI. Overall, 27% were obese and almost all the men had PTSD. Their exposure to the blast ranged from two to 113 months prior to the time their blood samples were taken.

The most common finding involved growth hormone deficiency and hypogonadism associated with low testosterone, especially in their overweight patients, suggesting that these hormone deficiencies occur frequently after bTBI and that treating them may improve their symptoms.

“One challenge in diagnosis is that certain medications commonly used for these patients can interfere with needed laboratory testing,” Taylor pointed out. “Another is that, although our data suggest that growth hormone deficiency and hypogonadism occur frequently after bTBI, these conditions also appear to be strongly associated with obesity. PTSD and depression may also affect pituitary function.”

  1. Taylor JS, Anderson AD, McNamee S, Adler RA. (2014, June). Anterior Pituitary Dysfunction in Male Military Veterans with Blast Traumatic Brain Injury. Poster presented at the joint meeting of the International Society of Endocrinology and the Endocrine Society meeting. Chicago, IL.

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