PTSD and TBI have
physical symptoms that can be evaluated and treated if we ask our care teams
about the newly emerging treatments that can help manage some of the
symptoms. Most of the time, the VA will
guide a service member or veteran to CBT (Cognitive Behavior Therapy) or PET
(Prolonged Exposure Therapy) as their first standard of care. Yet, if you look at many of the symptoms of
TBI and PTSD, these conditions may have resulted in reduced levels of important
hormones. These invisible injuries have
a “neuro-endocrine” component; hence the psychological elements, but also the
physical one. Considering hormone replacement therapy is a complementary therapy option.
Physical injury to the brain with these
(often) precipitous drop in hormonal levels, may contribute to many
psychological and physical symptoms such as anger outbursts, depression,
anxiety, mood swings, memory loss, concentration issues, learning disabilities
and sleep deprivation. Many vets also experience high blood pressure, diabetes,
loss of sexual drive, obesity, muscle weakness, and in women, menstrual
changes.
Hormones are powerful in our bodies, and may strongly
impact quality of life for the veteran and their families. It’s never fast enough for us, but studies
are ongoing with hormone therapy to address the specific areas of reduced
hormone production. These hormonal
deficits cover hormones regulating the thyroid, pituitary and adrenal glands, growth
hormone, and the sex hormones, estrogen and testosterone.
Researchers at the VA Puget Sound and the
University of Washington found that up to 42% of veterans with blast injuries
could suffer from low levels of pituitary hormones, causing some of the most
troubling and lingering effects of mild TBI, such as fatigue, insomnia,
lessened cognition, memory loss, sexual problems, depression, concentration and
mood disturbances. The primary
investigating physician on the study said this:
“If PTSD does not resolve, it’s very possibly due to hormonal
deficiencies”.
How many of you have heard the term “NED”? DCoE for Psychological and Brain Health
recommends screening for NED, or Neuro-Endocrine-Dysfunction in veterans with a
history of TBI and symptoms lasting longer than 3 months, or which present
within 3 years of injury. One example is with low levels of testosterone. In the past,
testosterone was delivered via injections, which caused spikes in blood levels,
translating to the comments made by caregivers in two categories: “too much sex drive, low energy, mood change” or “too little sex drive, aggressive, mood change”. Newer administration is through pellet delivery
(small as grains of rice) through a shallow incision in the buttocks or
elsewhere for roughly 3-4 months in women and 5-6 months in men. This delivers the bio-identical hormone in a
steady fashion to the body; a blood test can determine if the levels have been
optimized for each of the hormones (thyroid, adrenal gland, pituitary and gonads). Sometimes, hormones are administered through
oral supplements to complement the therapy an individual will require.
This isn’t only about sex drive; it’s about
quality of life with energy, mood, concentration, focus, and the potential to
feel more like before deployment. Note: this may be used as a complementary or alternative therapy, and no single therapy works for 100% for all taking it. Research hormone therapy as a possibility with your primary care physician, since studies are showing real promise for improved quality of life. More information is available through an
Internet search or at the www.USMedicine.com
website and search for “hormone replacement”.
Linda Kreter & the
VeteranCaregiver Team
