Hormonal Havoc: Imbalance after Injury with Dr. Tamara Wexler, Neuroendocrinologist

Surprise! Our brains control our bodies! While it’s common knowledge that our brains control thoughts, movements, and perception; did you ever think about it controlling your hormones? Hormonal imbalance may sound abstract but could be behind many persistent and chronic brain injury symptoms. Fatigue, brain fog, mood changes, not feeling like yourself, menstrual irregularities, changes in libido, and weight gain, among many others could be signs of hormone imbalance related to your brain injury.  While hormone dysfunction may not be your answer; if it is, it is easily treatable and totally worth getting checked. Gain awareness and knowledge from our talk today with Dr. Tamara Wexler neuroendocrinologist.  Topics covered:NeuroendocrinologyA specific set of hormones overseen by parts in your brainIncludes: thyroid hormones, sex hormones (testosterone, estrogen, prolacin), growth hormones, and stress hormonesSystems in the brain involved are the pituitary gland and hypothalamus--they affect end organs like the adrenal glands, ovaries, testes, the liver, and the thyroidThe end organ glands are in a feedback loop with the brainThe hormones carry the messages between the brain and the end organsAwareness of hormone insufficiency post brain injuryThere is under awareness of hormonal issues in brain injuryIt is under diagnosed and under treatedYou need testing to determine if there is pituitary deficiency.  You can replace the deficient hormone and remove the symptoms associated with its insufficiencyPituitary insufficiency is most researched in post concussion/TBI.  There is some information about acquired brain injuries and hormonal deficiencies but the literature isn’t as broadCommon symptoms associated with hormonal insufficiency are vague and non-specific.  Not all of these symptoms are caused by hormonal changes but without looking you do not know if they are.  There is a higher rate of pituitary insufficiency after injury but it doesn’t mean every symptom is due to it.  Treatment may not lead to a complete return to pre-injury self. FatigueMental fogNot feeling like yourselfChanged menses and fertilityweight changesexercise intoleranceBody composition changesSlowed thinkingPoor tolerance of things you used to be able to handleMood changesSchool performanceBehaviorGrowth If you don’t look for insufficiency, you can’t tell if it existsHow do you test?Menstrual irregularities, absence of menses, or changes in libido that persist more than 3 months after a concussion can reflect a brain related hormonal change (pituitary damage)If you are having regular periods without being on oral contraceptives you don’t need to be testedEstradiol and FSH: if ovary insufficiency or menopause are causing the symptoms, the estrogen will be low and FSH will be high.  The pituitary sends FSH to signal the ovaries. FSH is high if the ovaries are the problem If the pituitary gland/brain is the problem the FSH will be normal or low.  It is trying to mount a response but it can’tYou have to look at multiple hormones as they rely on each other