Nearly half of veterans found with blast concussions might have hormone deficiencies

April 22, 2013, American Physiological Society

Up to 20 percent of veterans returning from Afghanistan and Iraq have experienced at least one blast concussion. New research suggests that nearly half these veterans may have a problem so under-recognized that even military physicians may fail to look for it. A new study conducted by Charles W. Wilkinson, Elizabeth A. Colasurdo, Kathleen F. Pagulayan, Jane. B. Shofer, and Elaine R. Peskind, all of the VA Puget Sound Health Care System and the University of Washington in Seattle, has found that about 42 percent of screened veterans with blast injuries have irregular hormone levels indicative of hypopituitarism.

Many conditions associated with hypopituitarism mimic other common problems that can suffer, including (PTSD) and depression, explains study leader Wilkinson. However, unlike those other conditions, those under the banner head of hypopituitarism can be can often be well-controlled by replacing the deficient hormones. "This could be a largely missed opportunity for successful treatment," Wilkinson says.

The team will discuss their study, entitled, "Prevalence of Chronic Hypopituitarism After Blast Concussion," at the 2013 meeting, being held April 20-24, 2013 at the Boston Convention and Exhibition Center, Boston, Mass. The poster presentation is sponsored by the (APS), a co-sponsor of the event. As the findings are being presented at a scientific conference, they should be considered preliminary, as they have not undergone the peer review process that is conducted prior to the data being published in a scientific journal.

A Simple Screen

Wilkinson explains that researchers have recently recognized that traumatic brain injuries (TBIs) can cause hypopituitarism—a decrease in the concentrations of at least one of eight hormones produced by the pituitary, a gland seated at the base of the brain. Studies in the last few years have suggested that between 25 and 50 percent of people who receive TBIs have low pituitary hormone levels. However, these early studies have focused on injuries that civilians are more likely to receive, such as an automobile accident.

As a research physiologist who works for the Department of Veterans Affairs, Wilkinson decided to investigate whether veterans returning from Afghanistan and Iraq who suffer show a similar frequency of hypopituitarism.

He and his colleagues collected blood samples from 35 veterans coming home from these wars and diagnosed with a blast concussion about a year prior—enough time for hormone changes to become evident. They then did a screen to compare blood concentrations of the eight hormones produced by the pituitary with the documented normal levels of these hormones.

Missed Opportunity for Treatment

The researchers found that about 42 percent of these veterans showed abnormally low levels of at least one of these hormones. The most common low hormone was human growth hormone, which can cause behavioral and cognitive symptoms similar to and depression, along with increases in blood lipids and changes in metabolism and blood pressure that can increase the risk of heart attack and stroke. The second most common problem was hypogonadism, changes in sexual hormones that can affect body composition and sexual function.

The researchers also saw that some veterans had abnormally low levels of vasopressin and oxytocin, hormones that have been linked to psychiatric problems and bonding. Problems with these hormone levels, in addition to growth hormone, could lead to personality changes that affect relationships with loved ones, Wilkinson explains.

He notes that the prevalence of hypopituitarism in the general population is estimated at 0.03 percent. The 42 percent prevalence that these results suggest is cause for further investigation, he says.

"We're not diagnosing definite disorders in this study—these individuals would still need a clinical evaluation," he explains. "But if even 10 percent of these veterans have hypopituitarism, it's a problem that physicians should be aware of."

Wilkinson adds that many veterans who suffer blast injuries may never see an endocrinologist—and a neurologist or a psychiatrist, whom they're more likely to see for post-concussion follow-up, is unlikely to screen for hormonal deficiencies. Because low can often be successfully treated, he says, it's a missed opportunity to help veterans. The work was supported by the Departments of Defense and Veterans Affairs.

Explore further: Brain injury and stress disorder strong indicators of vision problems for veterans

Related Stories

Brain injury and stress disorder strong indicators of vision problems for veterans

November 11, 2012
Many veterans of the United States armed forces who have traumatic brain injury or post-traumatic stress disorder also have undiagnosed, chronic vision problems, according to two studies presented today at the 116th Annual ...

Prevalence, risks for sexual dysfunction vary by veteran age

October 26, 2012
(HealthDay)—For Iraq/Afghanistan veterans, the prevalence and risk factors for sexual dysfunction (SD) vary with age, according to a study published online Oct. 22 in The Journal of Sexual Medicine.

Severely injured vets may need ongoing emotional care

April 11, 2013
(HealthDay)—U.S. veterans who suffered major limb injuries in combat showed little improvement with mental health problems such as depression, anxiety and post-traumatic stress disorder (PTSD) in the two years after receiving ...

High rates of substance abuse exist among veterans with mental illness

April 19, 2011
A new study published in The American Journal on Addictions reveals that Veterans who suffer from mental health disorders also have high rates of substance use disorders.

Recommended for you

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Flu may be spread just by breathing, new study shows; coughing and sneezing not required

January 18, 2018
It is easier to spread the influenza virus (flu) than previously thought, according to a new University of Maryland-led study released today. People commonly believe that they can catch the flu by exposure to droplets from ...

Certain flu virus mutations may compensate for fitness costs of other mutations

January 18, 2018
Seasonal flu viruses continually undergo mutations that help them evade the human immune system, but some of these mutations can reduce a virus's potency. According to new research published in PLOS Pathogens, certain mutations ...

Zika virus damages placenta, which may explain malformed babies

January 18, 2018
Though the Zika virus is widely known for a recent outbreak that caused children to be born with microencephaly, or having a small head, and other malformations, scientists have struggled to explain how the virus affects ...

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

Fresh approach to tuberculosis vaccine offers better protection

January 17, 2018
A unique platform that resulted in a promising HIV vaccine has also led to a new, highly effective vaccine against tuberculosis that is moving toward testing in humans.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.