Why is pituitary dysfunction after a mild traumatic brain injury often overlooked or misdiagnosed?
Among various health conditions associated with mild traumatic brain injuries, neuroendocrine symptoms can overlap with other coexisting complications. From post-concussion syndrome, vagus nerve dysfunction, vision problems, post-traumatic stress disorder, or chronic neuroinflammation, conflicting issues could make it difficult for doctors to sort through, diagnose and treat.
Many patients can visit numerous health professionals chasing relief from their symptoms as their struggle to heal persists. Yet, of all the different health troubles one might face, the delayed onset of pituitary dysfunction after brain injury could be a significant cause for concern.
An article from Frontiers In Endocrinology cites, “Screening every patient with a TBI for PTHP is clearly not feasible. This approach does not meet the criteria for an appropriate screening tool due to the high cost and the complexity of testing, which often requires dynamic and sometimes repeat assessments.” The report continues to mention neuroendocrine decline as a common occurrence for patients with moderate to severe brain injuries.
Unfortunately, pituitary dysfunction after mild traumatic brain injury may be more widespread than reported. Although, recent studies quote, “Pituitary failure was previously thought to be rare, but recent literature reviews show the prevalence of hypopituitarism ranges from 15% to 90%.” and “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 afterward.
Patients discharged from emergency rooms might face the unknown potential for neuroendocrine dysfunction after TBI in the coming days and months. To improve long-term health outcomes, patients can self-monitor their symptoms, work closely with their doctor, and request a neuroendocrine screen for post mild TBI. A comprehensive 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 a proactive 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.