Call to Action on Hormone Testing for Veterans

Tara Plybon — Wed, 02 Oct 2024 09:04:13 -0400

The high prevalence of traumatic brain injury (TBI) and poly trauma in the wounded, ill and injured veteran population results in an imbalance of hormones over time as the brain heals. Pain is one of the most common symptoms in TBI, many times treated with opioids, a medication that is directly associated with hormonal imbalance.

This will adversely create or exacerbate other health issues the veteran is already dealing with.

Hormone deficiencies in men and women cause sleep disturbance, depression and mood disorder, trouble regulating the heart and absorption problems with calcium and minerals. In addition, hormones influence libido and help regulate body temperature.

I witnessed the impact of the imbalance after my husband was 8 months post injury. He was exhibiting odd behaviors. I asked his Pain Management doctor if that was due to the medicine, and he said, “Everyone knows opioids can cause hormonal problems. Let’s do a blood draw and check.”

Sure enough, my then 35 year-old husband had the Testosterone level typically seen in older men. Within two weeks of receiving a hormonal replacement injection, the behavioral issues had disappeared. Fifteen years later, the low levels of testosterone have not been restored and he still needs to receive Testosterone injections.

As an advocate for caregivers and veterans, I have spoken with many peers over the past ten years and I noticed a trend. Many are unaware of the connection between TBI, opiates, and the potential imbalance and how it could impact a veteran. Inspired by this lack of education throughout the veteran caregiver community, I started doing some exploratory research.

I developed a survey that intended to collect information from veterans and their caregivers whether they received testing for hormones after suffering TBI. Out of 100 veterans and caregivers that answered the survey, only 3% responded receiving hormonal testing.

Three percent? Out of 100 warfighters? What happened to the others?

It is imperative that to address this critical issue, we improve blood hormone level testing.

The tests need to be administered at intervals of three months after injury, then at 6, 12, and 18 months to follow. It would help pinpoint when changes within the blood chemistry occur.

If a warfighter is identified as needing hormonal supplementation, it is necessary for males to have PSA (Prostate Specific Antigen) levels checked as hormone supplementation can cause an increase of the rate of Prostate Cancer.

This testing needs to be implemented at the initial admittance into a Warrior Transition Unit and continue at a VA facility as the patient is released home into the community.

This is a simple blood test that could greatly impact the overall health of the veteran. Tricare pays for this test.

If you look at the combination that TBI, Post-Traumatic Stress, and opiate use can create and the vestiges it presents insomnia, anxiety and mood disturbance it can be a deadly combination when you look at our sad statistics of veterans that are committing suicide at the rate of more than 22 deaths per day.

Research sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825904
https://onlinelibrary.wiley.com/doi/pdf/10.1002/ana.23958
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2265.1986.tb01691.x
https://www.research.va.gov/currents/summer2013/summer2013-1.cfm
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.971.6421&rep=rep1&type=pdf
https://www.mdedge.com/familymedicine/article/79596/pain/neuroendocrine-dysfunction-following-mild-tbi-when-screen-it

Chronic Hypopituitarism Associated with Increased Postconcussive Symptoms Is Prevalent after...

The most frequent injury sustained by US service members deployed to Iraq or Afghanistan is mild traumatic brain injuries (mTBI), or concussion, by far most often caused by blast waves from improvised explosive devices or other explosive ordnance. TBI ...

Response by Sgt Private RallyPoint Member made Oct 2 at 2024 12:23 PM

Sgt Private RallyPoint Member — Wed, 02 Oct 2024 12:23:33 -0400

Tara Plybon Excellent post! I was not aware of the connection between TBI, opioids, and hormone imbalance. I am happy to hear that Testosterone injections have helped your husband.

Response by SFC Marc W. made Oct 2 at 2024 10:15 PM

SFC Marc W. — Wed, 02 Oct 2024 22:15:26 -0400

I had to specifically ask for hormone testing. When they did, the results were about 20 points above the minimum ngdl. Since they were in the "normal range" (a spread of 800 points) they wouldn't do any hrt. Got out, saw a specialist and sure enough, my numbers were still at the bottom of normal, of which normal for the range would be for an 80 year old man, not a 30 something. Getting HRT and have felt 1000 times better since normalizing the levels.

Response by Bethina Lee made Oct 3 at 2024 2:01 AM

Bethina Lee — Thu, 03 Oct 2024 02:01:38 -0400

This is true...there are many different chemicals that affect your day to day bodily functions. Many will be surprised how detrimental it is to your brain and body when your adrenal glands stop producing.

Response by SN Thomas Burns made Oct 6 at 2024 3:58 AM

SN Thomas Burns — Sun, 06 Oct 2024 03:58:05 -0400

It’s heartbreaking to hear about the struggles veterans face after TBI, especially when something as simple as hormone testing could help. I can relate to how important it is to connect the dots between medications like opioids and hormone levels. My friend went through something similar after an injury; he experienced mood swings and fatigue that no one connected to his pain meds until he finally got tested. Once he started hormone therapy, it was a game changer. It's frustrating that so few veterans are getting tested.

Response by SGT Ruben Lozada made Oct 9 at 2024 2:52 PM

SGT Ruben Lozada — Wed, 09 Oct 2024 14:52:44 -0400

Good afternoon Tara Plybon. Excellent post. Thank you for sharing this.

Response by MAJ Donald Luce made Nov 9 at 2024 10:54 AM

MAJ Donald Luce — Sat, 09 Nov 2024 10:54:57 -0500

Outstanding information. I had four (TBI’s) concussions in 1970-71. I had some issues and a MRI done showing an inclusionary mass on my brain. I continue to have issues and suffer from chronic pain and others systolic problems. Should I be tested?

Response by SGM Private RallyPoint Member made Nov 15 at 2024 10:17 AM

SGM Private RallyPoint Member — Fri, 15 Nov 2024 10:17:50 -0500

Like everything in the federal government, MHS arbitrary regulations block effectiveness of the core mission. For example, there is a “mandatory minimum” tested testosterone level to write a TRT prescription. This doesn’t exist in the civilian world, as doctors prescribe TRT largely based on how a person feels. Healthy test levels in athletes should be in excess of 700, yet the MHS puts arbitrary parameters on TRT instead of how the Soldier feels. Troops are expected to perform like athletes, and the default should be higher T levels that support mental acuity, strength, and muscle growth.

Response by 1SG John Millan made Nov 23 at 2024 9:51 PM

1SG John Millan — Sat, 23 Nov 2024 21:51:42 -0500

Every vet should do a TBI screening.

Response by Tara Plybon made May 8 at 2025 10:47 AM

Tara Plybon — Thu, 08 May 2025 10:47:27 -0400

So, I heard from someone who keeps up with bio science and medical research and he claimed that the risk of getting prostate cancer has been lessened. It is definitely advised to annually check your PSA and ladies your estrogen/progresterone/testosterone.

I can say that after 16 years, his body doesn't still make enough on its own. The neuroendocrine disorder (NED), put a stop to that. He is feeling good, vital, with his weekly shot regimen. I monitor his cholesterol and other levels as the joys of TBI and NED can provide someone with a nice case of the 'betes.

Wishing all of you the best of health. Check out the topic of neuroplasticity and how it helps heal the brain, even with constant horrible exposures to war. It's a helpful tool, and it has helped my husband heal and find a new purpose.

Response by PFC Lisa McDonald made May 22 at 2025 11:20 AM

PFC Lisa McDonald — Thu, 22 May 2025 11:20:58 -0400

I think something missing from this conversation is how every chemical contaminating military bases are endocrine disruptors (mimic estrogen). Exposure to them can decrease testosterone levels. Males with lower testosterone levels have increased chances of getting breast cancer.
There is some research showing higher incidence of breast cancer in younger male veterans.
This isn't really just a Veteran issue either. How many families were exposed to these chemicals? What has exposure to the chemicals did to the children that were exposed to them while in fetal development and in early childhood?