Call to Action on Hormone Testing for Veterans

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