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By Amir Khan


Veterans returning from Afghanistan or Iraq have often experienced blast concussions in combat, and many exhibit symptoms indicative of post-traumatic stress disorder. According to preliminary new research presented at the Experimental Biology 2013 meeting in Boston, there may be a hormonal explanation for the the PTSD symptoms.


Nearly half of veterans with blast injuries in the new study had low levels of pituitary hormones, which have been associated with symptoms similar to PTSD, but are simpler to treat.




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Researchers already knew that traumatic brain injuries, such as the kind caused by blast injuries, can cause hypopituitarism - a type of hormone deficiency in the pituitary gland, which is located at the base of the brain, researchers said. Post-injury hypopituitarism affects approximately 40 percent of people who suffer a traumatic brain injury, according to a 2005 study in the European Journal of Endocrinology.


The pituitary gland produces six different hormones, which helps regulate growth, blood pressure, metabolism, temperature, pain, sex organ function and some aspects of pregnancy and childbirth. People with hypopituitarism are typically deficient in three or more hormones.


In the small study presented at the Experimental Biology meeting, researchers at the VA Puget Sound Health Care System in Washington state looked at 35 veterans coming home from active duty who had been diagnosed with a blast concussion in the year prior. They found that 42 percent had hormone levels indicative of hypopituitarism.


"This could be a largely missed opportunity for successful treatment," Charles W. Wilkinson, PhD, lead researcher and associate professor of psychiatry at the VA Puget Sound, said in a statement.


The most common pituitary hormone deficiency was in human growth hormone, a lack of which can cause anxiety, depression, fatigue and a feeling of isolation -- symptoms reminiscent of the ones seen in people with PTSD, researchers said.


"We're not diagnosing definite disorders in this study -- these individuals would still need a clinical evaluation," Wilkinson said in a statement. "But if even 10 percent of these veterans have hypopituitarism, it's a problem that physicians should be aware of."


The findings are promising, said Rachel Yehuda, PhD, director of the traumatic stress studies division at the Icahn School of Medicine at Mount Sinai in New York City, but she cautioned that they are also very preliminary, as the study only looked at 35 veterans and has not yet been peer-reviewed. If the researchers are correct, she said, it may mean that a simple blood test could help thousands of veterans live a a more normal life upon returning home.


"This is very important research because the more we can learn about the nature of blast injury, the better we can treat it," Dr. Yehuda said. "The good news is that it's a lot easier to fix a hormone problem than a brain problem." Hypopituitarism can be treated with corticosteroid medication, and in some cases, the problems may even resolve in their own, she said.


"There's evidence that hypopituitarism can reverse itself, especially when it's associated with blast injury," Yehuda said.


She urged researchers to conducted larger studies.


"There are many important findings that start in a small group," she noted. "It will be very important to replicate and extend the findings."


"This is a very positive piece of research that offers a lot of hope for our veterans," she added.


"PTSD or Hormone Disorder? New Findings Could Mean New Diagnosis for Vets" originally appeared on Everyday Health.


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