Dear Visitors: 

Traumatic Brain Injury (TBI) causing hormonal dysfunction is not a myth nor a figment of ones imagination.  It is real and therefore, there are potential means of improving ones psychological, physical, and physiological functioning. So far, the Millennium Health Centers is the only organization that is aggressively pursuing and providing treatment protocols that address the dysfunction. Supporting our program is the science derived from over 7800 articles addressing the cause and effect of brain trauma on hormonal production. Every day more articles are added into the medical community with few being read.  Many of those articles discuss the benefits of hormone replenishment or the detrimental affect to your quality of life when they are diminished. There are over 100 key articles available on this site addressing all aspects of TBI. Please read and share with those who might benefit or help to share in this important information.   Thank You.  

Mark L. Gordon, M.D.

Medical Director
Millennium-TBI Network

2017-01-20 (up-dated)

1 - Patients with Severe Head Injury Should Have Hormone Assessment as Part of Routine Care according to the 86th Annual Meeting of the Endocrine Society.  June 21, 2004 -  Neuroendocrine abnormalities occur early and with high frequency in survivors of traumatic brain injury (TBI) and may have significant implications with respect to rehabilitation and recovery, according to the results of a prospective study presented at the 86th annual meeting of The Endocrine Society in New Orleans, Louisiana. "We have observed that some patients after head injury will present with symptoms that are similar to those that we observe in patients with hormone deficiency secondary to a pituitary gland under-function," lead author Amar Agha, MD, from the Department of Endocrinology at Beaumont Hospital in Dublin, Ireland, told Medscape. "There is strong evidence that this is a common and treatable problem...[and] very much under-diagnosed." To evaluate the presence of pituitary dysfunction in early-stage TBI, the investigators tested for hormone abnormalities 50 consecutive patients admitted to the neurosurgical unit with severe or moderate TBI as determined by the Glasgow Coma Scale (GCS). Results showed a high frequency of hormonal abnormalities. "This research gives us an insight into one of the potential causes of morbidity in patients with head injury, and in some of these patients that [involves] hormone deficiencies which might adversely affect their recovery and rehabilitation," said Dr. Agha. "We feel that all patients with significant head injury should undergo hormone assessment as part of routine clinical care, so that we can identify those patients with hormone deficiencies in whom treatment may influence their recovery and rehabilitation and improve their quality of life.

The Clinical Significance of Major Depression Following Mild Traumatic Brain Injury   Psychosomatics 44:31-37, February 2003. Mark J. Rapoport, M.D., F.R.C.P.C., Scott McCullagh, M.D., F.R.C.P.C., David Streiner, Ph.D., C.Psych., and Anthony Feinstein, Ph.D., F.R.C.P.C. Presented in part at the 13th annual meeting of the American Neuropsychiatric Association, La Jolla, Calif., March 10–12, 2002. from Sunnybrook and Women's College Health Sciences Centre, 2075 Bayview Ave., Toronto, Ont. M4N 3M5, Canada.
Abstract: The authors assessed the association of major depression with behavioral outcome following mild traumatic brain injury. RESULTS: Major depression was seen in 15.3% of the subjects after traumatic brain injury, and these individuals showed subjective and objective evidence of poorer outcome. CONCLUSIONS: Major depression is associated with poor outcome across multiple domains. This study highlights the need for the early diagnosis and prompt treatment of major depression following mild traumatic brain injury.

Early predictors of postconcussive syndrome in a population of trauma patients with mild traumatic brain injury(MTBI). J Trauma. 2009; 66(2):289-96;  296-7. National Study Center for Trauma and EMS, University of Maryland School of Medicine, Baltimore, Maryland, USA. PURPOSE: The purpose of this analysis was to determine which of the initial symptoms after mild traumatic brain injury (MTBI) can best predict the development of persistent postconcussive syndrome (PCS). METHODS: One hundred eighty (180) MTBI patients admitted to a level I trauma center were enrolled in a prospective study and 110 followed for 3 months. MTBI was defined as a Glasgow Coma Score of 13 to 15 with a transient loss of consciousness or report of being dazed or confused. Patients were screened at admission and at 3 days to 10 days and 3 months. Symptom checklists were administered to ascertain the presence of symptoms (cognitive, emotional, and physical) after concussion. RESULTS: The mean age of the subjects was 35 years, and 65% were men. Physical symptoms were the most prevalent in the 3 days to 10 days postinjury with most declining thereafter to baseline levels. Emotional and cognitive symptoms were less prevalent but more likely to remain elevated at 3 months; 41.8% of subjects reported PCS at 3 months. In multivariate regressions including age, gender, and early symptoms, only anxiety, NS and gender remained significant in the prediction of PCS. Interactions revealed that the effect of anxiety was seen primarily among women. CONCLUSIONS: The strongest individual symptoms that predicted long-term PCS included anxiety, noise sensitivity (NS), and trouble thinking; reported by 49%, 27%, and 31% of the subjects at 3 days to 10 days, respectively.
Prevalence of hypopituitarism and growth hormone deficiency in adults long-term after severe traumatic brain injury. Clin Endocrinol (Oxf) 2005 May;62(5):525-32/ Leal-Cerro A; et al.  Division of Endocrinology, Vorgem del Rocio University Hospital, Sevilla, Spain. OBJECTIVE: Traumatic brain injury (TBI) has been associated with hypopituitarism and GH deficiency. However, TBI-mediated hypopituitarism may be more frequent than previously thought. The present work, performed in patients with severe TBI at least 1 year before, had three aims: (i) to evaluate the prevalence of hypopituitarism, (ii) in particular to evaluate the prevalence of GH deficiency, and (iii) to compare three different tests of GH reserve in this cohort. DESIGN AND PATIENTS: From a group of 249 patients admitted for severe TBI over the last 5 years, 200 of them answered a questionnaire of symptoms of hypopituitarism. A total of 170 (99 men and 14 women), accepted to participate in the study; 57 had normal questionnaires and were not further studied, 14 discontinued the study, and 99 attended the hospital for dynamic tests of pituitary hormone deficiencies. From these, 44 subjects with IGF-I in the lower range were tested with GHRH+GHRP-6; ITT; and glucagon tests of GH reserve, on three different occasions. MEASUREMENTS: Pituitary hormones plus IGF-I and target gland hormones were analysed. RESULTS: With regard to the initial cohort of 170 subjects (100%), three (1.7%) showed diabetes insipidus; 10 (5.8%) TSH deficiency, 11 (6.4%) ACTH deficiency and 29 (17%) gonadotrophin deficiency. In 10 subjects (5.8%), GH deficiency was diagnosed by strict criteria. Finally, 15 (8.8%) showed combined deficit of several hormones. CONCLUSION: After severe head trauma, gonadotrophin deficiency was the most common pituitary deficit. GH deficiency showed a prevalence similar to ACTH and TSH deficits, i.e. near 6% of the cohort. Taken together, 24.7% of the subjects studied showed any type of pituitary hormone deficiency.
Growth hormone in the brain: characteristics of specific brain targets for the hormone and their functional significance. Front Neuroendocrinol 2000 Oct;21(4):330-48. Nyberg F  Dept of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden. During the past decade studies have shown that growth hormone (GH) exerts profound effects on the central nervous system (CNS). For instance, GH replacement therapy was found to improve the psychological capabilities in adult GH deficient (GHD) patients. Furthermore, beneficial effects of the hormone on certain functions, including memory, mental alertness, motivation, and working capacity, have been reported. Likewise, GH treatment of GHD children has been observed to produce significant improvement in many behavioral problems seen in these individuals. Studies also indicated that GH therapy affects the cerebrospinal fluid levels of various hormones and neurotransmitters. Further support that the CNS is a target for GH emerges from observations indicating that the hormone may cross the blood-brain barrier (BBB) and from studies confirming the presence of GH receptors in the brain.

Role of growth hormone in chronic heart failure: therapeutic implications. Ital Heart J.  2000; 1(11):732-8 Volterrani, Giustina, Manelli, Cicoira, et al;  Division of Cardiology, Salvatore Maugeri Foundation, Medical Center, Gussago, Italy. Abstract: Chronic heart failure is a multi-etiological cardiovascular disorder with high prevalence and poor prognosis. Medical treatment of dilated cardiomyopathy is aimed at alleviating heart failure symptoms. Diuretics, angiotensin-converting enzyme (ACE) inhibitors and very recently, beta-blockers have been shown to have favorable effects on symptoms, exercise capacity and mortality. Growth hormone (GH) and insulin-like growth factor (IGF)-1 are involved in several physiological processes such as the control of muscle mass and function, body composition and regulation of nutrient metabolism. The role of GH and IGF-1 as modulators of myocardial structure and function is well established. Receptors for both GH and IGF-1 are expressed by cardiac myocytes; therefore, GH may act directly on the heart or via the induction of local or systemic IGF-1, while IGF-1 may act by endocrine, paracrine or autocrine mechanisms. Impaired cardiac efficiency can be observed in patients with GH deficiency. Moreover, experimental studies suggest that GH and IGF-1 have stimulatory effects on myocardial contractility, possibly mediated by changes in intracellular calcium handling. Heart failure is due to ventricular dilation with inadequate wall thickening that leads to impaired cardiac performance; therefore, based on previous evidence we would expect beneficial effects from the use of GH in these patients. Several papers have highlighted the positive influence of GH in the regulation of heart development and performance. In patients with GH deficiency, GH administration dramatically improves cardiac function. In small open studies, acute and chronic GH treatment has demonstrated beneficial effects in patients with heart failure due to ischemic or idiopathic cardiomyopathy. Whether GH treatment will finally find a place in the treatment of heart failure, and with which modalities, remains to be established.

Role of the GH/IGF-1 axis in neurogenesis. 2009 Nov 24 Aberg D. Dept of Internal Medicine, Institute of Medicine, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden. The growth hormone/insulin-like growth factor 1 (GH/IGF-1) axis is not only involved in brain growth, development and myelination, but also in brain plasticity as indexed by neurogenesis. This may have links to various cognitive effects of GH and IGF-1. GH and IGF-1 affect the genesis of neurons, astrocytes, endothelial cells and oligodendrocytes. Specifically, IGF-1 increases progenitor cell proliferation and numbers of new neurons, oligodendrocytes, and blood vessels in the dentate gyrus of the hippocampus.    In the adult cerebral cortex IGF-1 only affects oligodendrogenesis. Recently, GH therapy has also been shown to induce cell genesis in the adult brain. The profile of effects by GH therapy may be somewhat different than that of IGF-1. In addition, GH secretagogues(GHS) also have neuroprotective and cell regenerative effects per se in the brain. Altogether, data suggest that both exogenous and endogenous GH and/or IGF-1 may be used as agents to enhance cell genesis and neurogenesis in the adult brain. Theoretically these substances could be used to enhance recovery after brain injuries. PMID: 19955757.   Consider Secretropin as your GH Secretagogue of choice.

Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit? International Journal of Impotence Research (2003). A T;Guay, J Jacobson, J B Perez, M B Hodge and Velasquez. Center for Sexual Function, Peabody, MA, USA. Section of Medical Biostatistics, Lahey Clinic Northshore, Peabody, MA, USA

Clomiphene citrate is safe and effective for long-term management of hypogonadism. BJU International (2012). Daniel J. Moskovic , Darren J. Katz , Ardavan Akhavan , Kelly Park and John P. Mulhall.  Sexual & Reproductive Medicine Program, Urology Service, Memorial Sloan Kettering Cancer Center, NYC, NY, USA

Three month and twelve month follow up of hormones after Traumatic Brain Injury.


Outside The Lines
January 21, 2007