Traumatic Brain Injury Blog

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Tagged with “growth hormone deficiency”

November 20, 2024

Systematic Review of the Literature Shows the Prevalence of Pituitary Dysfunction following TBI

Over the past decade this blog has featured several articles addressing the growing recognition that neuroendocrine issues are an often-overlooked consequence of TBIs of all levels of severity, leaving patients with unnecessary chronic symptoms. We have discussed evolving guidance on the best methods to assess these issues (including the importance of “stimulation testing.” ) Unfortunately, outside of major medical centers (and military hospitals) awareness of this issue is not consistent.

As we have discussed, one of the most common neuroendocrine deficiencies is “growth hormone” deficiency.  The symptoms of growth hormone deficiency are common following TBI; they include “quality of life” problems including low energy level, increased emotional lability and irritability, and increased social isolation. They also include physical symptoms such as increased fat mass and decreased muscle strength. The good news is that when the cause of these symptoms is injury to the pituitary gland (often the stalk of the pituitary gland, which is particularly vulnerable) treatment may lead to improvement in the symptoms.  Growth hormone deficiency may be addressed through regular growth hormone injections. Although this treatment can be expensive and is sometimes required on a permanent basis, the increasing understanding of this issue in the field of neuroendocrinology has made it easier for patients to get insurance coverage. Read More

March 27, 2020

Neuroendocrine issues, often overlooked following TBI, leave patients with unnecessary chronic symptoms

In prior posts I have discussed the growing evidence that traumatic brain injuries, even so-called “mild” traumatic brain injuries (mTBI), can lead to neuroendocrine dysfunction (NED) – most commonly growth hormone (GH) deficiency due to pituitary dysfunction. Although growth hormone deficiency often results in physical symptoms such as loss of lean muscle mass and strength, increased body fat around the waist, and dyslipidemia, other common GH deficiency symptoms overlap with the symptoms of “persistent post-concussion”- such as fatigue, poor memory, anxiety, depression, emotional lability, poor attention and poor concentration.

My earliest post on this issue discussed the August 2012 Department of Defense (DOD) clinical recommendations for screening for neuroendocrine dysfunction in “mild” traumatic brain injury (“mTBI”) cases – where indicative symptoms persist for more than three month or appear within three years. The guidelines contemplated a simple blood test, but subsequent studies, also discussed in this blog, showed that the only reliable means of detecting GH deficiency is provocative testing, which is expensive and takes several hours (the guidelines do suggest further assessment by an endocrinologist, even where the screening test is negative, if symptoms of NED persist.) Read More