Interesting Article on TBI and The Pituitary Gland

Traumatic Brain Injury and Pituitary Hormones

JUNE 18TH, 2009 | CATEGORIES: TBI ADULTS | 16 COMMENTS | PRINT THIS POST

Pituitary Deficiency and Brain Injury

By Flora Hammond, M.D. and Rhona Shapiro, R.N., M.S.N.

Traumatic brain injury and the pituitary

Pituitary hormone deficiency may result from head trauma or subarachnoid hemorrhage. Two recent studies show that one or more pituitary hormones may be affected by traumatic brain injury or subarachnoid hemorrhage.1,2

Symptoms of hormone deficiency can mimic other effects of a traumatic brain injury, which can prevent suspicion of this disorder. A deficiency of one or more of the hormones regulated by the pituitary gland may have physical and/or psychological effects such as:

• reduced muscle mass
• weakness
• decreased exercise capacity
• fatigue
• irritability
• depression
• impaired memory
• reduced sex drive.

Most patients do not even realize that they have the hormone deficiency until specific laboratory tests for this disorder are performed. However, individuals with a history of a moderate to severe brain injury are more likely to have a pituitary deficiency than those with a mild brain injury.

The likelihood of pituitary damage exists even if the injury occurred years ago and a good rehabilitative outcome has been achieved. The pituitary gland, hypothalamus, and surrounding structures, including their blood supply, may have been injured.

Damage to the pituitary gland causes a condition called hypopituitarism: a loss or reduction in the normal activity of the pituitary gland. Hypopituitarism means that any pituitary hormone can be deficient.

The pituitary is a pea-sized gland at the base of the brain. Pituitary hormones are important because they regulate other hormones from the thyroid, gonads (ovaries and testes), and adrenals (cortisone). Prolactin, oxytocin, and ADH (antidiuretic hormone) may also be effected by brain injury, but the incidence is less common. These hormones are chemical messengers that target vital organs that control vital functions.

Listed below are the hormones produced by the pituitary along with the symptoms commonly seen with a deficiency of each. Diagnostic testing for pituitary hormone deficiency involves blood and urine testing. Hormonal replacement requires monitoring by a physician.

Thyroid stimulating hormone deficiency may cause…

• reduced memory
• slowed metabolism
• reduced energy
• altered mood
• failure to thrive
• slowed growth
• lethargy
• muscle aches
• cold intolerance
• decreased appetite
• dry hair or skin
• numbness or tingling in extremities

Adrenocortical stimulating hormone deficiency may cause…

• weakness
• fatigue
• altered mood
• electrolyte abnormalities
• weight loss
• low or fluctuating blood pressure
• increased body fat
• decreased bone mass
• reduced exercise capacity

Sex hormone deficiency may cause…

• decreased energy
• decreased muscle mass

in males, it may cause…

• decreased sex drive
• shrunken testes
• loss of beard growth
• decreased sperm production

in females, it may cause…

• infertility
• amenorrhea (lack of menstruation)
• loss of female characteristics

Growth hormone deficiency may cause:

• decreased lean body and muscle mass, particularly in the shouldersincreased fat mass, especially around the waist and trunk
• high “bad” cholesterol levels (higher ldl and lower hdl) which may increase risk of stroke and heart diseasedecreased bone density, which may cause osteoporosis
• fatigue, regardless of the amount of sleep.decreased interest in socialization
• a sense of isolation and depression