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Tbi And Hypopituitarism ( Pituitary Gland And Hormone Dysfunction )


militarynurse

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  • The most common hormonal deficiencies associated with TBI include:

    Pituitary deficiencies (TSH/FSH/GH/IGF-1)

    Gonadotropin deficiencies (LH/FSH/testosterone/estradiol) Adrenocorticotropic hormone, thyroid deficiency and prolactin deficiencies are also seen among patients with neuroendocrine involvement following TBI

  • Hypogonadotropic hypogonadism (acquired): pituitary-hypothalamic injury from trauma. These men have low testosterone serum concentrations but have gonadotropins in the normal or low range. Suggest Neuroendocrine Dysfunction Screening ( NED ) for FSH,

See links at: http://www.ncbi.nlm.nih.gov/pubmed/15879352

http://www.brainline.org/content/2011/07/hypopituitarism-after-brain-injury.html

http://www.ncbi.nlm.nih.gov/pubmed/18780593

http://cdn.intechopen.com/pdfs/30501/InTech-The_case_of_hypopituitarism_in_traumatic_brain_injury.pdf

http://www.ncbi.nlm.nih.gov/pubmed/20731261

http://www.noticeandcomment.com/An89-Proposed-Rule-Secondary-Service-Connection-for-Diagnosable-Illnesses-Associated-With-Traumatic-Brain-fn-3325.aspx

https://www.federalregister.gov/articles/2012/12/10/2012-29709/secondary-service-connection-for-diagnosable-illnesses-associated-with-traumatic-brain-injury

https://priorservice.wordpress.com/2013/04/30/ptsd-or-hypopituitarism-nearly-half-of-veterans-found-with-blast-concussions-might-have-hormone-deficiencies/

http://www.va.gov/vetapp09/files2/0910774.txt

http://www.va.gov/vetapp07/files3/0726237.txt

http://www.dcoe.mil/content/Navigation/Documents/DCoE_TBI_NED_Training_Slides.pdf

http://www.dtic.mil/dtic/tr/fulltext/u2/a568011.pdf

http://neuro.psychiatryonline.org/article.aspx?articleID=103172

A good read:

Gulf War and Health: Volume 7: Long-Term Consequences of Traumatic Brain Injury

By Committee on Gulf War and Health: Brain Injury in Veterans and Long-Term Health Outcomes, Board on Population Health and Public Health Practice, Institute of Medicine

Edited by militarynurse
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Thank you, militarynurse! 

It's another possible line of questioning for me.  I snapped my neck while in service, and have a cervical nonunion.  I'm lucky because I'm still walking.  Since the injury, I stopped sweating in the face/head, my urination frequency is far too frequent, and my constipation went off the charts (as well as almost constant headaches, vertigo incidents, and tinnitus).  I've checked TSH, but several of the endocrine issues listed in one of the articles have not been checked and are worth a look. 

The constipation appears to be some sort of intestinal sluggishness.  I've tried every recommendation by the gastroenterologist, but it doesn't seem to be anything simple. I drink water constantly because I also urinate about every 2 hours.

In trying to nail down the vertigo issues, I recently had a brain MRI with contrast that revealed a small lesion on the brain that the private neurologist and private psychiatrist think is related to the broken neck. It's near my sinuses in the left temporal lobe, so it may be why the vertigo bothers me.  Bluntly, there's probably almost no way to get that brain injury service connected because it would be as a TBI and that's almost impossible to do.  Especially 30+ years after the fact. 

But since there is that brain lesion, and we know at least two of my cranial nerves are partially paralyzed dating back to the military accident, it's possible that there may be pituitary involvement. There's no good answer to the no sweating in the face or the constant urination issues.  I do need to find an answer.  My gastroenterologist wants to do surgery to deal with the ongoing worsening rectal tone due to constant constipation events. But, surgery for repair when the underlying issue is still unknown may just end up with less options in the future.

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