Hormone Replacement Therapy (HRT) Overview
raumatic brain injuries (TBI) can have a profound impact on the endocrine system, which is responsible for regulating various physiological processes through the secretion of hormones. Hormonal dysregulation is a common yet overlooked issue for people in post-concussion care.
The endocrine system is composed of several glands, including the hypothalamus, pituitary gland, and pineal gland located inside the brain. These glands use chemical signals to regulate sleep cycles, metabolism, sexual arousal, reproductive processes, and other essential physiological functions.
The hypothalamus, pituitary gland, and pineal gland are particularly vulnerable to damage from TBI, and when injured, their functional output is significantly reduced. As a result, the brain has difficulty regulating the rest of the body’s functions.
Hormone Replacement Therapy (HRT) is a treatment option that can help reset the endocrine system by restoring hormone levels to normal. This therapy may help alleviate symptoms of hormonal dysregulation caused by TBI or concussion.
Hormonal Problems are Common in TBI Patients
Hormonal deficiencies and imbalances are common after traumatic brain injuries (TBI) and concussions. Despite their prevalence, they often go undiagnosed and untreated by healthcare providers, including concussion specialists. Several studies have demonstrated the prevalence of hormonal disturbances in TBI patients. For example, a study of 78 TBI patients and 38 healthy control subjects found hormonal disturbances in one-third of the TBI patients studied. Another study investigated pituitary dysfunction in 50 TBI patients over a five-year period and found that over half of the patients developed pituitary dysfunction within four or five years. The incidence of pituitary dysfunction was 38% in patients with mild TBI, 57% in those with moderate TBI, and 59% in people with severe TBI. These findings underscore the importance of monitoring and treating hormonal imbalances in individuals who have sustained a brain injury.
About half of all people with a major head injury will have some type of significant hormonal imbalance as a result.
A separate group of researchers pooled and analyzed data from 19 studies including 809 patients with TBI. The pituitary glands in nearly 28% of these TBI survivors were significantly under producing (or failing to produce) certain hormones. (See chart for details.)
Out of 809 TBI patients:
12.4% exhibited deficiencies in growth hormone
12.5% exhibited deficiencies in LH/FSH (gonadal…)
8.2% exhibited deficiencies in adrenocorticotropic (ACTH)
4.1% exhibited deficiencies in thyroid-stimulating hormone (TSH)
7.7% had multiple hormonal deficiencies
Hormone Replacement Therapy Can “Reset” Hormonal Balance
Traumatic brain injuries and concussions can cause significant hormonal dysregulation and imbalance, which can have adverse effects on various bodily functions. The endocrine system, composed of several hormone-secreting glands, regulates essential physiological processes such as sleep cycles, metabolism, sexual arousal, and reproductive processes.
In particular, the “master gland trio” – the hypothalamus, pituitary gland, and pineal gland – located inside the brain, are highly susceptible to damage caused by traumatic brain injury. When these glands are injured, they can significantly reduce functional output, leading to major difficulties in regulating bodily functions.
Studies show that hormonal deficiencies and imbalances are common in brain injury survivors, with nearly half of individuals experiencing some form of significant hormonal imbalance. Pituitary dysfunction is also prevalent in TBI patients, with over 50% of patients developing pituitary dysfunction within four or five years of injury.
Fortunately, targeted hormone replacement therapy (HRT) can help correct hormonal deficiencies and reset the endocrine system. To begin, a consultation with a hormone specialist or endocrinologist is necessary, followed by extensive blood work to determine hormonal levels. Supplementation can then be tailored to supplement missing hormones, with periodic blood work to monitor progress.
HRT can provide numerous benefits, such as improved cognitive function, physical performance, and quality of life. However, benefits and risks must be evaluated on an individual basis with a doctor, and HRT should never be undertaken without proper medical guidance.
Hormone Replacement Therapy – Example Benefits
I’m only going to share a few examples here, because any benefits and risks with HRT will be evaluated with your doctor. This isn’t medical advice, this is just hypothetical.
Hormone replacement therapy (HRT) can offer various benefits, depending on which hormones you are deficient in. For instance, some studies have shown that individuals with traumatic brain injuries (TBI) who have a deficiency in human growth hormone (HGH) may see improvements in mental speed, verbal memory, and cognition with HGH replacement therapy. Similarly, low levels of luteinizing hormone (LH) or follicle-stimulating hormone (FSH) may lead to sexual dysfunction, but supplementing these hormones can help alleviate these symptoms. It is essential to consult a doctor before beginning HRT, as the risks associated with HRT can vary depending on the type of supplement and how it is administered. Working with a trusted healthcare professional can help ensure the best possible outcome.
HRT – Functions of the Hypothalamus
The hypothalamus is a small but vital part of the brain that plays a crucial role in regulating many of the body’s hormonal functions. It helps to control important bodily processes such as body temperature, sleep, hunger, thirst, and response to stress. In addition, the hypothalamus also produces hormones that stimulate or inhibit the release of other hormones from the pituitary gland.
HRT – Functions of The Pituitary Gland
The pituitary gland, on the other hand, produces and secretes several different hormones that control the activity of other glands in the body. These include the thyroid, adrenal glands, and gonads (testes or ovaries), among others. The pituitary gland also produces melatonin, a hormone that helps to regulate reproductive hormones and sleep-wake cycles. Hormone replacement therapy can help to address deficiencies in these important hormones and restore balance to the endocrine system.
Blood Flow, Hormones & Concussion Recovery
More Information on Hormones & Concussion
HRT – Availability and Cost
Hormone replacement therapy (HRT) practitioners are becoming more prevalent, particularly in the United States, and there are numerous conferences and training programs for medical professionals interested in this field. Finding an HRT practitioner should be relatively easy, but it’s important to ensure that the practitioner has experience working with TBI-related cases.
The cost of HRT will depend on a variety of factors, including the type and extent of testing required, the specific hormones being replaced, and the practitioner’s fees. Typically, blood work and initial testing can cost between $300 to $500, with additional fees for ongoing monitoring and hormone replacement treatment. It’s essential to discuss all costs associated with HRT with your practitioner and ensure that you have a clear understanding of the financial commitment before beginning treatment.