Can a traumatic brain injury affect your hormones?

Traumatic brain injuries are far more common than most people realize. Among U.S. service members alone, more than 530,000 have been diagnosed with a first traumatic brain injury since 2000, most of them mild.¹ Add the car accidents, falls and sports concussions in civilian life, and finding safe, effective ways to help people recover matters more than ever. Our understanding of brain injuries, once lumped together as “shell shock,” keeps growing.

This topic is personal for me. After I was rear-ended in 2018, I went through my own recovery from a head injury, which Dr. Paul Anderson, NMD and I talk about on episode 42 of The Dr. Madeira Show.

Why a head injury can affect your hormones

Two of the most important parts of your endocrine (hormone) system, the hypothalamus and the pituitary gland, sit at the base of your brain. Together they direct your thyroid, adrenal glands, sex hormones and growth hormone. A blow to the head can injure these structures or their blood supply and disrupt the signals they send.

This is more common than you might expect. A 2024 review of 52 studies with 7,367 people found that about 1 in 3 had problems with at least one pituitary hormone after a traumatic brain injury. The most common were low growth hormone (about 18%), low sex hormones such as testosterone (about 16%), low cortisol signaling (about 10%) and low thyroid signaling (about 6%).²

It doesn’t always show up right away. A review focused on people tested a year or more after their injury still found pituitary problems in about a third of them, though the rate was lower after mild injuries than after moderate or severe ones.³ For some people, symptoms appear months or even years later.

Symptoms that can point to a hormone problem

Many of these overlap with the symptoms of the brain injury itself, which is one reason hormone problems get missed:

• Fatigue that doesn’t lift, or poor exercise tolerance
• Brain fog, slower thinking or trouble with memory
• Low mood, irritability or anxiety
• Low sex drive, erectile problems or changes in menstrual cycles
• Weight gain or loss of muscle
• Feeling cold, dizziness on standing, or low blood pressure
• Excessive thirst and urination (a rare but important sign that needs prompt care)

Some hormone problems after a head injury, such as very low cortisol or severe sodium changes, can be serious. Seek urgent care for severe weakness, vomiting, confusion or fainting.

Testing comes first

Because every brain injury is different, no two recoveries look the same. If you’ve had a head injury and still don’t feel like yourself, ask your doctor whether hormone testing makes sense. Some hormone problems are temporary and improve on their own; others need long-term treatment, usually guided by an endocrinologist.

When a deficiency is confirmed, treating it can help. For example, a review of 12 studies with 264 patients found that growth hormone treatment for people with brain-injury–related deficiency was linked to better processing speed, memory, mood and quality of life, though the authors called for larger controlled trials.⁴

Looking at the whole picture

Hormones are one piece of brain injury recovery. Sleep, nutrition, inflammation, blood sugar and the nervous system all matter too. That’s the approach I take for brain fog and concussion recovery: find the drivers, protect the foundations and coordinate with neurology, endocrinology and rehabilitation specialists when they’re needed.

If you’re a veteran, the VA and the Military Health System have dedicated brain injury programs, and it’s worth asking about hormone testing there too.

This article is general education, not medical advice, and does not create a doctor–patient relationship. Talk with your own doctor before changing your diet, supplements or medications.

Sources

1. Military Health System, Traumatic Brain Injury Center of Excellence: DOD TBI Worldwide Numbers
2. Aljboor et al. (Neurosurgical Review, 2024): Acute and chronic hypopituitarism following traumatic brain injury: a systematic review and meta-analysis (52 studies, 7,367 participants)
3. Emelifeonwu et al. (Journal of Neurotrauma, 2019): Prevalence of anterior pituitary dysfunction twelve months or more following traumatic brain injury in adults: a systematic review and meta-analysis (29 studies, 2,756 participants)
4. Szarka et al. (Journal of Neurotrauma, 2021): Effect of growth hormone on neuropsychological outcomes and quality of life of patients with traumatic brain injury: a systematic review (12 studies, 264 patients)

More articles by Dr. Madeira →