There are hundreds of thousands of people diagnosed with Post Traumatic Stress Disorder (PTSD) that are being treated with psychiatric medication and are not getting any better. They are dealing with insomnia, depression, anxiety, fatigue, decreased sex drive and substance abuse. Many of these patients that I have treated in my office are on multiple medications and are shells of their former selves. Their relationships are falling apart, they are having a difficult time holding a job and it feels like there is no hope in site. What is exciting about taking care of these patients is that in the majority of these cases no one has addressed the hormonal imbalances that accompany traumatic brain injury (TBI). The goal of this blog is to help patients and family members understand that when someone suffers a TBI, even small or what refer to as micro TBI’s (mTBI), that the brain loses its ability to manufacture and regulate hormones. As a results of reductions in human growth hormone, thyroid, DHEA, cortisol, testosterone and estradiol patients manifest all of the above symptoms. When these hormonal imbalances are corrected that start to heal the brain and many of their symptoms resolve very quickly.
- What hormones are effected by Traumatic Brain Injury?
When the brain is traumatized as a result of an accident, sports concussions, blasts and even repetitive gun fire some predictable injuries occur in the brain. The neurons are actually sheared, blood vessels are torn and over time the brain becomes inflamed. There is an area of the brain called the hypothalamus and pituitary which regulate hormone production in the body. They are responsible for generating testosterone, growth hormone, thyroid, cortisol, estradiol, progesterone, oxytocin, vasopressin, prolactin and DHEA. All of these hormones have profound effects on the brain and a reduction in any of them can result in numerous signs and symptoms that mimic PTSD (depression, anxiety, fatigue, insomnia, erectile dysfunction, memory difficulties etc). One of the things we see in patients with PTSD as a result of a TBI is that their testosterone levels are on the bottom end of the normal range if not deficient. Low testosterone is associated with fatigue, irritability, low sex drive, erectile dysfunction, weight gain, depression and numerous other symptoms that are confused with psychiatric illness. When you give these patients testosterone their symptoms resolve. Here is a great article in Life Extension magazine about treating traumatic brain injury and PTSD with bioidentical
2. What should you do if you have PTSD as a result of a TBI or concussion and not getting better (or even if you are doing great)?
The first step you need to take is speak with Dr. Breen (an expert in treating the hormonal imbalances associated with TBI) so you can get the correct blood tests ordered. He will check total and free testosterone, estradiol, estrone, free T4, free T3, TSH, rT3, DHEA-S, IGF-1, IGF-BP3, cortisol, insulin, DHT, progesterone and pregnenolone levels. Once you have these levels tested you need to have Dr. Sean Breen interpret them which you can do in person or over the phone. Traditional, doctors look at hormone levels as either in the range or out of the range and if you are anywhere in the “normal” range they tell you that you do not need to take the hormone. What the research shows that if you treat hormone levels to the upper 25% of the normal range, or the optimal range, that patients feel much better and are able to reduce their need for medications. For example, I see men in my practice all the time with testosterone levels in the 350-400 range (normal 348-1197) who have all the symptoms of low testosterone (erectile dysfunction, low sex drive, weight gain, fatigue, memory issues, loss of muscle etc) and when you bring their levels into the 900-1200 range they feel incredible within weeks. Once you realize the profound effects that all these hormones have on brain health and get all your levels optimized your life is going to change forever. I have seen 11 Soldiers and Marines in the past 4 months all diagnosed with PTSD as a result of IED explosions in Iraq and Afghanistan in my office. All of them were on 8 or more medications and their lives were falling apart. In every case we have been able to wean them off all their medications after optimizing their hormone levels. Listen to Dr. Mark Gordon discuss the effects of TBI on hormone production in the brain with Joe Rogan. https://www.youtube.com/watch?v=aJeGeclGDpQ
3. What else can you do to improve symptoms of PTSD as a result of TBI?
Step one, again, is to optimize and balance your testosterone, growth hormone, thyroid, DHEA and pregnenolone levels. Step 2 is to make sure you are taking the supplements that have been proven to help the brain recover from TBI. The two best supplements for patients with TBI and PTSD are omega-3 fish oils and N-Acetyl Cysteine (NAC). Both have been shown in the literature to reduce inflammation and create a neuropermissive environment. In addition, it is extremely important that you work on getting a full 8 hours of sleep. In many patients we start out with sustained release melatonin, theanine, valerian root and other natural sleep remedies. Some patients, require a more pharmaceutical approach to help them sleep well and trazodone is one that works very well. Sleep is critical for getting the body to produce normal amounts of cortisol and growth hormones, both of which have profound effects on the brain. Lastly, nutrition is obviously very important to healing the brain. Avoiding refined sugars, processed carbs and anything else that drives inflammation in the body is essential to feeling better.
The bottom line is that right now there are thousands of patients with PTSD as a result of a TBI that are being treated by psychiatrists with medications and are not feeling better. It is not until these patients have their hormones levels checked and optimized that they will start getting their life back. Growth hormone, testosterone, thyroid, DHEA, pregnenolone and cortisol are the major hormones effected by traumatic brain injury. I encourage anyone who has suffered a TBI and is being treated for PTSD to have their hormone levels checked. Dr. Sean Breen is an expert in treating hormonal imbalances as a result of traumatic brain injury. If you would like to schedule an appointment with Dr. Sean Breen simply pick up the phone and give our office a call. Visit us on the web at www.DoctorBreen.com