[mhr4]

Hey Group,


Well, after a much needed hiatus, I'm back. I still will only be able to post on a limited basis as my life is pretty busy at the moment. So, without further ado...

If you are 6 months post injury and you are still suffering from symptoms, I urge you to get your hormones tested. I have been doing a lot of research in this area and there is definitely a connection between brain injuries and hormone dysfunction. There are also some clinics out there who are specializing in hormone replacement therapy for tbi sufferers and they are seeing remarkable results from it. Below is a list of hormones you should get checked (in no particular order).

1. Cortisol

Cortisol is the only hormone in your body that you need to survive. Without it, you would die. It is also the bodies stress hormone that is responsible for keeping inflammation down when we become injured. That is why athletes get cortisol shots when they are injured and people who have serious infections get shots of prednisone. Your adrenal glands are responsible for producing cortisol and your pituitary gland is responsible for sending the signal to your adrenal gland to regulate cortisol production. In traumatic and/or chronic stressful situations, your adrenal glands are overworked and eventually shut down and stop producing cortisol. In many brain injuries, your pituitary gland is damaged and can't get an accurate signal to your adrenal glands. Too much cortisol production, which happens after a truamatic event, kill brain cells and too little, which happens after prolonged periods of stress, can cause inflamation in the brain. Cortisol is also responsible for escorting thyroid hormones into your cells. If your cortisol is low, you will have to go on physiologic doses of hydrocortisone until your adrenal gland can be restored.

2. Thyroid Hormone

Thyroid hormone is the "energy" hormone in our bodies. It is responsible for keeping our metabolism functioning properly by keeping our bodies at 98.6 degrees Fahrenheit. It receives its signal from the pituitary gland as well. Your thyroid gland is actually located on your throat, so whiplash injuries can damage this gland. You will need to get your TSH, FT3, FT4, RT3 checked with a blood test to ascertain thyroid function. A simple home test you can do is to take your temperature first thing in the morning. If it falls below 98.2 degrees Fahrenheit, you may have thyroid malfunctioning. The treatment for this is getting on T4 and T3 medication. Don't worry if these terms are foreign to you, your doctor will know what your are talking about. Thyroid hormone is also very important in brain functioning and plasticity.

3. Sex Hormones

Your ovaries and testicles also receive their signal hormones from the pituitary gland. So, if you damage your pituitary gland, your sex hormones will be off and will need to be supplemented. There really is no distinction between "female" and "male" hormones because both are needed in specific quantities in both sexes. The hormones to be tested are: testosterone, estrogen, DHEA, progesterone and pregnenalone. These hormones are all important in brain functioning.

4. Growth Hormone

Growth hormone is not just an important hormone for children. In terms of the nervous system, it is important in adults for brain plasticity and repair. This is made directly from the pituitary gland, so damage to this gland results in low growth hormone. The test to get for this is the IGF-1 blood test.

There is loads of information on the internet regarding this. Unfortunately, your GP and neurogist,and many endocrinologists, will not be knowledgeable in this area. So, you will probably have to find a bio identical hormone replacement specialist or anti aging doctor.

Good Luck!

[no_tbi]

Wow, thanks for the info! Unfortunately, I currently do not have health insurance and the various hormone tests would cost a lot.

[Mark in Idaho]

FYI,

The blood tests for most of the issues listed above cost about $1,000 or more. The analysis by a specialist adds about $500 to $1,000 to that. Insurance companies get big discounts but the uninsured or under-insured have a difficult time getting the providers to allow equivalent discounts.

Almost no insurance companies will pay for hormone replacement therapy (HRT) pharmaceutical costs. They limit coverage to post-menopausal HRT.

Many providers have contracts with Blue Cross/ Blue Shield and similar large insurance companies that limit their ability to discount to cash/under-insured customers. I have run into this problem here in Idaho with my prior health insurance company that only pays 'usual and customary' charges.

Usual and customary often means an average of what doctors will accept from their contracted insurance companies. The unpaid differential has been on my credit report for three years even after my insurance company paid substantially more than Blue Cross, Work Comp, Medicare, or Medicaid routinely pay.

It is unfortunate since HRT can be so helpful for many PCS subjects. The vitamin/supplement/nutritional regimens are much more affordable and do not necessitate a prescription to obtain the majority of the benefit.

So, until you can afford the hormone panels, the nutritional angle is a good start in the right direction.

[PCSLearner]

Some of us have been trying to figure out why teenage girls seem to suffer from PCS at higher rates than their male counterparts. Hormones seem like a likely culprit.

Most of the girls I've read about with PCS are the athletic, ultra driven types. I think we tend to blame their injuries on their activities. I'm starting to wonder if they might have different hormonal levels, less estrogren perhaps?, than their more calm or sedate counterparts before injury. So they are more prone to PCS because they have less of the protective estrogen? But if that was the case wouldn't boys get more PCS than girls?

Just a thought here by someone with zero medical training and little knowledge of the workings of hormones.

My daughter's blood work all came back normal, albeit results were read by a GP and I'm not positive she was tested according to the above protocol. Even if I found she did have a hormonal imbalance, I would be very hesitant to give a 16-year-old HRT. Is this something that can correct itself over time? Or with future hormonal changes (i.e. pregnancy, aging)?

This hormone theory also makes sense in terms of people who experience a dramatic improvement in symptoms after a lot of time has gone by. They may have experienced a hormonal change that reduced symptoms. Hmmm....

[mhr4]

PCSLearner,

Would you mind sharing with us your daughter's lab values? I am a member of a hormone yahoo group and I would be more than happy to run those by her to get their opinion on her values. One thing to keep in mind is that the current "normal range" for lab values, that was established by the FDA, is a statistical range that encompasses the normal range for every age group. In other words, they don't account for the different age groups when deciding what is normal and what isn't. Case in point, my Testosterone value came back at 345 with a normal range of 300-1100. Since I'm within the normal range, my GP dismissed it and told me it was fine. I then went to see a hormone specialist and he told me that my value was fine for someone in their 90's but at age 31, my value should be between 800-1100.

You are exactly right that hormones are the reason why teenage girls suffer more than teenage boys. This is actually a hot area of research right now. They are trying to figure out which hormones do what to the brain during normal functioning, injury and post injury. A guy actually noticed that women tended to recover better than men after a brain injury. This led him to discovering progesterone's protective effects on the brain.

As far as her hormones being corrected over time, it really depends on how badly (if at all) her pituitary gland was damaged (or if any other glands were damaged). If it wasn't and this is just her body processing the stressful event she encountered, then it probably will correct itself. If she did damage her pituitary gland (or other glands) beyond repair, then it probably won't be corrected and she'll need to go on replacement therapy for the rest of her life. However, the fact that she is still a teenager may throw a wrench in there. However, I'm not a doctor so I can't answer that question with certainty.

If you have the resources (insurance, money, time, etc.) then I would say that it is definitely worth further investigation. Contrary to someone's opinion on here, insurance will cover most of the testing and most of the hormone replacement therapy if your doctor diagnoses her with hypopituitary resulting from trauma (or something similar to that). I know a lot of people who have had their pituitary gland completely removed due to a tumor and their insurance companies pay for all of the testing and most of the hormone replacement therapy. The difference is that the cause can't just be from "old age," it has to be from a trauma or a tumor in order to get the insurance companies to pay for it.

Also, there is a clinic in California that specializes in hormone replacement therapy for people with brain injuries. The President of the company has even presented his case studies on national television. They are seeing great success from their patients after they begin their program. I don't think that you can consult with them over the phone; however, I do believe that your doctor can. For some reason, I can't post the link, but google this and you'll find it: tbimedlegal.

Good Luck!

[erica21]

Again- I am SO glad I joined this website. Not only is it great for moral support, but the amount of information I've learned has been extensive! This information on the pituitary gland and hormones is very interesting. Just from reading your post and others once I don't have the best understanding. What exactly would be the symptoms one would have if their pituitary gland had been damaged? My symptoms are fogginess, pressure in my head/headaches, dizziness and neck pain. I've never had any cognitive issues or memory problems, but I am now 7 months PCS.

Again- really interesting stuff, and thank you for posting the information!

[mhr4]

Erica21,

Not surprisingly, a lot of the PCS symptoms mimic the symptoms of low hormone production. Because of this, without blood tests, it is difficult to discern between the cause coming from tbi or low hormones. If you are interested in pursuing this, find a good hormone specialist in your area and consult with them. Otherwise, you can always run a google search on symptoms of hypopiutitarism and see if you have any of those.

[StuckinBoston]

Well I want to say that I guess I am one of the lucky ones and have been fully worked up in regards to endocrine issues. And I do have problems with cortisol and thyroid...well actually my pituitary is not releasing TSH & ACTH. From what I can get from the doctor is that this topic is becoming more and more known but still under diagnosed.

He also said that you need a endocrinologist that is very experience, as the lab numbers can be hard to fully understand. In my case my TSH, FT4, T4 all came in the low normal range. He said that is the first clue there is a problem.

Some doctors would say that they wouldn't put you on medicine because your TSH is low, which normally indicates hyperthyroidism - but when TSH,FT4, T4 all come in low or low normal you have what is called central hypothyroidism.

I am still learning about this issue so that is all I can give. If you can afford the testing I would highly recommend you getting it done. And even if your first set comes back normal...recheck in a year.

[BeccaP]

My neurologist ordered a full hormone and nutrient test for me also. My thyroid was low and I was borderline Vit D deficient. I took supplementation for the Vit D for a month to get the level up to normal (with a smaller maintenance dose) then started the thyroid meds (about 3 weeks ago). I still have a lot of typical PCS symptoms but my energy level is up and I feel better mentally/emotionally. Every little bit helps. The doctor called the panel the neuroscience panel-I think that is the name of the lab that did it. He said if my insurance didn't cover it the test would have cost ~$230. I don't know if that is a lot or a little but the panel covered all the hormones Mike mentioned plus some others. Hope this is useful to some of you.

[mhr4]

That is good to hear you are on the right path to recovery. My doctor said something that was extremely enlightening. He said that hormones won't heal your brain; rather, they will allow your brain to heal. So, you may continue to see benefits from your hormone replacement therapy as time goes on.