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Body Shop: Head trauma’s lingering effects felt in the bedroom

The lingering effects of invisible injuries are sometimes difficult to pinpoint and can severely affect your quality of life. Whether you hit your head falling off a bike as a kid, were on the receiving end of a high school football tackle or survived a blast downrange, additional symptoms can appear months, weeks or years after a traumatic brain injury.

TBI can cause lasting injury to the pituitary gland, a chickpea-sized gland behind the bridge of the nose responsible for monitoring hormone levels in the body, according to Charlene Chaloner, a registered nurse and research coordinator at the John Wayne Cancer Institute.

A damaged pituitary gland can lead to low levels of testosterone and growth hormone in the blood, and can compromise thyroid and adrenal gland function.

Red flags

Symptoms, some of which also fall under post-traumatic stress disorder, are depression, fatigue, anxiety, poor concentration, decreased libido and reduced energy levels. Other long-term effects include loss of lean muscle, reduced bone density and increased fat mass.

“Testosterone and GH levels decrease normally as we age,” Chaloner said. “But our research shows pituitary gland injuries may result in these levels falling precipitously. In patients with low GH levels, hormone replacement therapy has proven effective in restoring quality of life.”

Chaloner organizes research studies for neurosurgeon Dr. Daniel Kelly, who began studying the correlation between head injury and pituitary failure in the 1990s.

“When I started to suspect a connection between pituitary failure and TBI, there was a smattering of case reports, but nothing definite,” Kelly said. “After receiving funding from an NIH grant, we focused our first study on patients with moderate or severe head injuries.”

Kelly is currently conducting research on the pituitary function of retired pro football players to determine whether a connection exists between mild TBI, better known as a concussion, and loss of hormonal function.

Tom Baugh, a former center for the NFL’s Kansas City Chiefs and Cleveland Browns, is taking part in the studies.

“I never thought I would be one to have issues, but it’s imperative that people with head injuries, and their loved ones, become aware of potential symptoms,” Baugh said. “Everyone needs to know that small changes in chemical and electrical impulse can cause dramatic changes in our brains.”

Diagnosis and treatment

Chaloner stressed that one mild brain injury doesn’t mean a lifetime of aftereffects. In fact, pituitary function usually returns to normal in the weeks following TBI. But the evidence in moderate and severe TBI cases shows that 18 percent to 20 percent of patients demonstrated signs of reduced testosterone or GH.

“If no other diagnosis has been put on a patient’s symptoms, and there is a history of concussions, the patient should ask for a full pituitary blood panel,” Kelly said. “It’s a simple blood test that can be administered by your primary care physician.”

If low testosterone is confirmed, testosterone replacement therapy is regularly administered via a topical cream, injections, patches, pellets, lozenges or pills.

“The more awareness and discussion around this topic, the better,” Chaloner said. “Many people don’t realize how significantly hormone function contributes to quality of life.”

Baugh agreed. “Men are often trained to endure hardship for the sake of self-preservation. But in this case, the important thing is to recognize when things aren’t quite right and get some help.”