Brain Injury - Pituitary Injury
One of the discoveries in the past twenty years has been that a larger percentage of persons who suffer a severe brain injury, also injure the part of their brain known as the "pituitary gland." It can also be injured in mild to moderate TBI's. Pituitary is a small part of the brain in the center, well guarded by bone. However, it hangs down and is approximately the size of the uvula in the back of your throat. Therefore, in traumatic accidents, if just a tiny area the size of match head or less is damaged or has a reduced blood flow, major problems can result. The pituitary is the area of the brain, that along with the hypothalamus, controls all hormonal aspects of a human beings body.
This injury cannot generally be seen on MRI or any other imaging because of its small size. However, the effects of such an injury can be felt and a testing of hormonal levels can be undertaken. Generally, some or most of the pituitary functions will return within six to eight months of trauma in some patients. At one year post injury, the hormonal levels should be checked. Many of the ongoing symptoms of a brain injury survivor can be attributed to hormonal insufficiencies, especially if they are undiagnosed. What are they?
Growth hormone (GH) regulates the body's growth and has long term effects on a person's well being, bone development, and heart. This is the most common hormone to be effected by TBI. If there is a deficiency it needs to be replaced with daily injections and the costs of this over a lifetime can be more than a million dollars.
GH testing is tricky, a simple blood test will not be able to make this determination. If there are insufficiencies on the broad blood test, a more specific test needs to be ordered which takes several hours and involves a level of insulin uptake over time. Also, keep in mind that most endocrinologist (doctors who study hormones) do not have experience in TBI and pituitary dysfunction, nor do they know the proper tests to prescribe. A recent peer review medical article stated that up to 70% of doctors did not even know or consider this possible as a result of the TBI.
In a child who is still growing, a test for this hormone is essential, otherwise growth may cease. However, adults of all ages need the hormone as well.
This is the most overlooked part of brain injury, so be very diligent and careful in this area.
Thyroid Stimulating Hormone
Thyroid stimulating hormone (TSH) is involved in the function of the thyroid gland, a lack of stimulation in this gland can lead to hypothyroidism.
This hormone is also known as ACTH and stimulates the adrenal gland to produce a hormone similar to cortisone, called cortisol. A lost or deficiency of this hormone can lead to serious problems or death.
Gonadotropin (sex hormones)
A deficiency of this hormone can affect men or women. In women it can affect the fertility and a deficiency can lead to premature menopause. In a man it can result in muscle loss, fatigue and sexual dysfunction.
There are hormones that control water retention and urination, as well as the function of the kidneys. Deficiencies in this area can result in diabetes insipidus.
If you or a loved one has had a brain injury, it is often difficult to determine if there is involvement of the pituitary. Look for symptoms such as fatigue, sensitivity to cold, weight loss, abdominal pain, low pressure, visual disturbances or changes in sexual activities.