Screening for and treating hypopituitarism after traumatic brain injury
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Some of the long-term negative outcomes associated with TBI are related to hypopituitarism, a condition that can occur when the pituitary gland, a pea-sized region of the brain, sustains direct or indirect damage. Because the pituitary gland plays a critical role in regulating the body’s hormones, disruptions to the gland’s functioning can cause chronic cognitive, physical, and behavioral decline. An estimated 27.5 percent of individuals with TBI will experience hypopituitarism, so there is significant need for treatments and interventions designed to reduce the symptoms associated with hormone dysfunction in TBI patients.
The most common symptoms of hypopituitarism in adults are fatigue, weakness, mood disorders, memory deficits, reduced bone and muscle mass, and reproductive problems. Unfortunately, because these symptoms are also commonly caused by other TBI-related conditions, hypopituitarism is significantly underdiagnosed in patients with TBI. A group of researchers in Florida recommend ongoing evaluations for pituitary functioning among TBI patients, even for those with mild injuries. Individuals who are successfully diagnosed with hypopituitarism may be eligible for hormone replacement, which can significantly reduce the often debilitating outcomes associated with pituitary dysfunction (such as lethargy, poor sleep, anxiety, depression, and insomnia).
Because the negative outcomes associated with hypopituitarism can persist for months or years following TBI, physicians are advised to screen all TBI patients for pituitary dysfunction. Individuals who screen positive for hypopituitarism should be referred to an endocrinologist, who can ensure that patients receive optimal treatment for the condition. With timely intervention, many individuals with hypopituitarism can return to a fuller quality of life after TBI.
Gray S, Bilski T, Dieudonne B, & Saeed S. Hypopituitarism after traumatic brain injury. Cureus. (March 2019).