Adult Growth Hormone Deficiency After Mild Traumatic Brain Injury

Document Type

Conference Proceeding

Publication Date

10-2025

Publication Title

Journal of the Endocrine Society

Abstract

Adult Growth Hormone Deficiency (AGHDA) is a debilitating but treatable condition, historically observed when children with congenital hypopituitarism transition to adulthood. AGHDA can also be acquired de novo in adulthood, caused by brain tumors, surgery, and radiation affecting the pituitary gland. Perhaps the largest, and most overlooked cause of AGHDA is Traumatic Brain Injury (TBI). Head trauma can damage the hypothalamic-pituitary axis, causing various hormonal deficits, some of which resolve spontaneously, but often result in chronic neuroendocrine derangement. The most common single hormone deficit associated with head trauma is Growth Hormone Deficiency (GHD). Per incident, mild Traumatic Brain Injuries (mTBIs), or ‘concussions’ are less likely to cause AGHD than moderate or severe TBI; however, owing to the much higher incidence of mTBIs, mTBIs are the most common cause of AGHD. In a retrospective analysis of 371 patients who reported to a TBI clinician with chronic (>1 year) symptoms of brain injury, 263 had symptoms (e.g., weight gain, fatigue, sleep disturbance, social withdrawal, etc.), met screening criteria for growth hormone deficiency, and underwent bioassay via the insulin tolerance test (ITT). 136 (37%) patients met criterion for deficiency (peak < 5ng/ml). Of the 263 ITT tests, no patient had a serious adverse reaction to the test. This indicates that in chronic mTBI patients, the risk of ITT testing is far outweighed by the benefit of diagnosing and reversing the effects of a debilitating condition. While the ITT is resource intensive, the cost/benefit profile can be enhanced with symptom-based prescreening tools designed specifically for TBI patients. The authors present piloting results of the Quality of Life Scale-99 (QoLS-99) which was designed to identify AGHD amid comorbid TBI symptoms. The results highlight telltale symptoms and were used to create a multivariate predictive model that correctly identified 85% of AGHD cases with a 35% false positive rate. These findings should encourage TBI clinicians to screen for GHD and to refer for bioassay when indicated.

Volume

9

Issue

Suppl 1

First Page

A724

Last Page

A725

Comments

ENDO 2025 Endocrine Society Annual Meeting, July 12-15, 2025, San Francisco, CA

DOI

10.1210/jendso/bvaf149.1373

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