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Why is pituitary dysfunction often overlooked or misdiagnosed after a mild traumatic brain injury?

Neuroendocrine symptoms can overlap with other parallel complications among various health conditions associated with mild traumatic brain injuries. These include post-concussion syndrome, vision problems, post-traumatic stress disorder, vagus nerve dysfunction, or chronic neuroinflammation. These conflicting issues could make it difficult for doctors to diagnose and treat many people with such underlying issues.

Many patients visit several health professionals hoping to relieve their symptoms as their struggle for a cure persists. Yet, the delayed onset of pituitary dysfunction after brain injury could be a significant cause for concern of all the different health troubles that crop up after a TBI.  

An article from Frontiers In Endocrinology quotes, “Screening each patient with a TBI for PTHP is not feasible. This method does not meet the criteria for a proper screening tool due to the high cost and the complexity of testing, which often requires dynamic and sometimes repeat assessments.” 

According to the report, a neuroendocrine decline is common in patients suffering from mild or severe brain damage. Unfortunately, pituitary dysfunction after moderate traumatic brain injury may be more common than reported. 

Although recent studies quote, “Pituitary failure was formerly thought to be rare, but recent literature reviews show the prevalence of hypopituitarism ranges from 15% to 90%.” 

“Clinicians need to be aware of these post-TBI endocrinopathies and provide appropriate referral to an endocrinologist or internist for further testing and management.” Endocrine imbalance can occur right after an injury, or delayed symptoms could appear six to thirty-six months afterwards.

After sustaining TBI, patients who are discharged from the emergency room may face the unknown potential for neuroendocrine dysfunction in the days and months ahead. 

To improve long-term health effects, patients can self-monitor their symptoms, work closely with their doctor, and ask for a post-mild TBI neuroendocrine screen. A complete blood chemistry panel through a functional neurology specialist can also provide vital information on many health biomarkers imperative for brain injury recovery.

It could take years of data to support the implementation of a much-needed standardized protocol for the follow-up treatment of mild to moderate traumatic brain injuries. Patients and their families can take an active approach by mapping out a personalized health plan from the beginning to include physicians and specialists who are knowledgeable about post-TBI health conditions. Timing and finding the root cause are essential for recovery.

Few FDA-permitted tests are available for the early finding of traumatic brain injury. The brain injury blood tests can aid first responders. And emergency services know when patients have a concussion or minor bleed on the brain needing additional imaging. 

Early detection and a reduction in avoidable CT scans are certainly a move in the right direction. But what is happening to the current estimated 75% of patients who leave emergency rooms with mild to moderate concussions and clear CT scans?

 The unfamiliar impending health complications after a traumatic brain injury leave many patients with an escalating health crisis in the days, weeks, and months to come. 

Their lives can become engrossed in medical appointments. At the same time, they search for answers to their symptoms, often feeling discouraged and misunderstood by our conventional medical system.