Although a concussion (traumatic brain injury-TBI) is caused by a blow to your head, or sudden deceleration in speed (like a whip lash), what if the symptoms and failure of your brain to regenerate or heal has nothing to do with your brain?
In health care, we often have a problem looking outside of our own areas of expertise or training until it smacks us in the face. The other day, while working at our Sports Concussion Research Center, I was speaking with someone who had experienced a significant concussion, but wasn’t getting much better. In our discussion, she told me a number of things about her health, including the fact that she had a pituitary gland dysfunction before her brain injury.
What if that pituitary gland issue was somehow getting in the way of allowing her brain to heal?
After our consultation, I started digging into the research. Sure enough there was a body of science that has linked brain injury to damage to the pituitary gland, which causes a host of symptoms we often believe to be part of the concussion injury. A damaged pituitary gland is thought to cause hormonal changes that then impact neurological changes and poor recovery. These could include memory, concentration problems, anxiety, increase in pain and depression. It is estimated that from 25%-50% of those who experience a traumatic brain injury will experience a pituitary caused hormone dysfunction. The term for this injury is chronic hypopituitarism.
In another discovery, hormonal imbalances such as those caused by a damaged pituitary gland are also linked to tinnitus, which is often prevalent after a TBI. Researchers are beginning to investigate the benefits of providing those who experience a concussion with hormonal screening, followed by brief hormonal replacement therapy, which then allows other methods (Prescriptive Exercise-Cognitive Rehabilitation) to assist with neuro-regeneration (healing the brain).
For persons who fail to respond to the treatment of concussions, or for children and teens who have experienced a TBI, pituitary hormone tests may need to be ordered. These could include tests for growth hormone and IGF-1, prolactin, ACTH, LH and FSH. Starting with your family doctor is the first step. We have more work to do to better understand this process. I thank our research subjects for continuing to educate us at the Sport Concussion Research Center. We have to be open to ask those out of the box questions to help find answers. Will neurologists, psychologists and physicians consider Endocrinology as a profession to assist with the treatment of the brain? Starting to make perfect sense to me.