During NFL season, millions of people dey watch monster tackles. Many sabi say those hits fit cause brain damage wey dem dey call chronic traumatic encephalopathy, or CTE. But wetin less people know be say big concussions and small repeated hits to head fit also damage pituitary, a pea-size gland for base of brain wey dey control hormones including testosterone.
In some men, pituitary damage fit cause fatigue, mood changes, sexual problems and other symptoms long after injury look like e don heal. A 2019 survey of nearly 3,500 former NFL players inside JAMA Neurology show say 18.3% don collect medication for low testosterone, and 22.7% report same for erectile dysfunction, one common symptom of testosterone deficiency. Players wey get most concussion symptoms during their career get more than twice odds of reporting low testosterone pass those wey get fewest symptoms.
Hone Health examine how head injuries from contact sports like football fit make men get decreased levels of testosterone years later. The concern no stop only for professional football. About one million American teens dey play high school football every year, and hormone problems related to head trauma fit no show until years later. Researchers never know how often football-related concussions or repeated smaller hits dey cause lasting pituitary problems, but endocrinologist Dr. Steven Wise believe say probably 20% of men wey e see for him practice, especially men for their 30s and 40s with low hormone levels, get some kind of injury to pituitary or hypothalamus during high school or even earlier.
By time dem come, Wise talk say low testosterone symptoms like fatigue, brain fog, low libido and mood changes fit look like ordinary aging instead of old head injury. Testosterone production start for brain. The hypothalamus dey signal pituitary gland, wey dey release luteinizing hormone, and that one dey tell testes to produce testosterone. Damage anywhere along that signaling pathway fit make testosterone levels fall.
Pituitary gland dey especially vulnerable to sports-related head injuries because of im position for base of brain. When you look at pituitary gland, you get one gooey small gland sitting on thin stalk with fragile blood supply down inside bony hole with sharp edges, Wise talk. When skull stop moving, brain dey continue forward until e no fit again. The thin stalk attached to pituitary gland fit stretch as brain lurch forward. That fit damage stalk, pituitary gland, or both.
Head trauma fit also disrupt blood flow and trigger inflammation wey reduce pituitary ability to secrete hormones, neuroendocrinologist Dr. Maria Fleseriu add. The hormonal disruptions wey result fit resemble symptoms of concussion recovery. After concussion, people fit still get fatigue and trouble concentrating. Dem no fit sleep. Dem get mood changes and low energy, Fleseriu talk. All these symptoms fit come from hormonal deficiency, so which one be cause, that one or concussion?
Researchers no fit give exact risk for football players or for person wey experience routine sports concussion. But studies on traumatic brain injury, or TBI, suggest say roughly 28% to 32% of people with head trauma dey develop some form of pituitary dysfunction. More severe injuries generally carry greater risk. One meta-analysis find hormone disruption for more than 35% of severe TBI cases, compared with around 11% of moderate cases and 17% of mild cases.
Not every concussion go cause hormonal problems, especially mild ones, Fleseriu talk. But if e be significant one, we suppose check. Wise believe say smaller, repeated head injuries fit get similar effect. If you pull kickboxers, football players, people with repeated trauma to their head for random sampling, you go find subtle changes in pituitary function, e talk. The more injuries you get on top of other injuries, the more trouble you go get.
Although some of the damage fit resolve on im own, often within one year, that fit be long hormone disruption for teens wey dey go through puberty. If young athlete take significant hit and puberty or growth look like e stall, Fleseriu recommend evaluation with endocrinologist around six months after injury. Hormone disruptions from head injury fit take years to surface, and dem no always follow predictable pattern. Some people take couple of years to develop problems, Wise talk. Others develop problems right away and then heal over few years.
If you play contact sport and now you dey experience fatigue, low motivation, brain fog, mood changes, or weight gain, Wise recommend say make you tell your doctor about any head injury history. These symptoms get many possible causes, but old injury fit be relevant part of picture. I can’t tell you how many people I don see wey tired or lose motivation or dey moody, irritable, fatigued, get brain fog or weight gain, and doctors dey dismissive, saying, Yeah, welcome to being 50, e talk.
Blood tests no fit prove say injury from years ago cause low testosterone, but dem fit show whether pituitary signaling dey impaired. A hormone test dey look at markers like free testosterone, total testosterone, and LH. If testing suggest low testosterone or hormone imbalance, physician go determine whether treatment with testosterone replacement therapy dey appropriate. You can give people low dose of hormone wey you think dem dey miss, as long as you dey keep them in normal range, and see if dem get better, Wise talk.
