Hormones to Assess in Traumatic Brain Injury (TBI)

Growth Hormone is likely the most common hormone deficiency in those suffering from brain trauma. Growth hormone is important in adults for maintaining lean muscle mass, stamina, mood, energy, temperature regulation, sexual interest and function.

IGF-1 is a hormone that has an important anabolic effect on the body and has a growth promoting effect on almost every cell in the body. It is stimulated by growth hormone and produced primarily by the liver. Levels of IGF-1 are a reflection of growth hormone levels.

Testosterone is an androgenic hormone with importance for both men and women. DHT is an active form of testosterone that is key for muscle and bone development, sexual/reproductive development and brain health. Too much DHT can cause thinning scalp hair and oily skin.

Thyroid hormones drive the metabolic machinery of every cell. TSH is the signal the brain sends to the thyroid to regulate free thyroid hormone levels and may be impacted by head trauma.

FSH and LH are reproductive hormones and when low can indicate a problem with the pituitary gland in the brain. This may impact the menstrual cycle and the production other hormones. Neurons and glial cells in the brain have been shown to produce LH which regulates pregnenolone synthesis.

Pregnenolone is often called the “mother of all hormones” and sits at the pinnacle of two important hormone cascades. In one direction it becomes progesterone and in the other DHEA. Pregnenolone supports GABA, memory and is anti-inflammatory.

Prolactin contributes to many functions in the body including the production of breast milk. Prolactin levels can help us understand the health of the hypothalamus and pituitary gland in the brain.

Progesterone has important functions in the central nervous system to regulate cognition, mood, inflammation, mitochondrial function and recovery from brain injury.

Estradiol is a type of estrogen and a hormone with many non-reproductive functions such as bone and mineral metabolism, cardiac and vascular function, cognition and mood.

DHEA and DHEA-sulfate are produced in the adrenal glands, the brain and central nervous system. DHEA is important for energy, lean muscle mass, blood sugar, cardiac function and cognition and is protective of the brain and nervous system.

SHBG is the carrier protein for the sex hormones such as estrogen, testosterone. When it is elevated it binds to the hormones, reducing their bioavailability.

Cortisol is a hormone athat can be elevated by acute and chronic stress. Eventually chronic stress will cause adrenal “fatigue” as the adrenals cannot/do not keep up with the high levels of cortisol demanded by the brain.

Insulin is a hormone that helps regulates blood glucose and when high is suggestive of metabolic syndrome.

Vitamin D is a hormone and it regulates gene expression as all hormones do. It affects the ability of other hormones to function optimally, supports immune function, brain health, mood and hair growth.