# Traumatic Blast Injury(TBI) and Neuroendocrine Disorder(NED).



## Nemo888 (27 Aug 2013)

Why doesn't everyone know about TBI and NED? It should also be noted that NED can be caused by any concussive head injury. I have had great results after testing my baseline hormone levels and returning them to a normal physiological range. I should be adding IGF 1 lr3 to the cocktail shortly. 

Note how easily this could be misdiagnosed as an OSI or PTSD.

http://www.dcoe.health.mil/Content/Navigation/Documents/DCoE_TBI_NED_Training_Slides.pdf


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## Armymedic (27 Aug 2013)

The research backing hormonal changes due to pituitary gland injury secondary to TBI has only come out in the last year or so. It has been in the realm of civilian specialists in the US previously. Interestingly it has a pretty label and handouts for the syndrome now. 

Also, many of the Sx described are the same for depression (not PTSD). As part of the regular clinical guidelines for the diagnosis of depression, those hormone levels should be checked to ensure there is not an physiological cause to the depressive Sx. The is also the case for the medications to treat mental illness.

So to answer your question, medical professionals have known about checking hormone levels for some years, the link to TBI is relatively new.

And yes, some people who think they have PTSD don't.


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## Nemo888 (27 Aug 2013)

Rider Pride said:
			
		

> As part of the regular clinical guidelines for the diagnosis of depression, those hormone levels should be checked to ensure there is not an physiological cause to the depressive Sx. This is also the case for the medications to treat mental illness.
> 
> So to answer your question, medical professionals have known about checking hormone levels for some years, the link to TBI is relatively new.


I don't know of a single clinician actually testing hormone levels for psychological conditions. Even the OSI clinic and VAC are unaware of the aforementioned conditions and none of the hormones are covered. I  find Docs give great advice in private about hormone replacement and many have tried them. A few use them in the ICU on comatose patients. I only know a single one who screens and treats such conditions and he doesn't take OHIP.


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## Armymedic (27 Aug 2013)

Nemo888 said:
			
		

> I don't know of a single clinician actually testing hormone levels for psychological conditions.



See link.

http://emedicine.medscape.com/article/286759-workup#aw2aab6b5b3


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## Armymedic (27 Aug 2013)

Nemo888 said:
			
		

> Even the OSI clinic and VAC are unaware of the aforementioned conditions and none of the hormones are covered.



The OSI clinic is a self-licking ice cream cone, who's sole purpose is to help you deal with your condition. They (psychiatrist, psychologists, social workers etc) are not primary care providers, nor do they have time to deal with issues outside thier comfort zone.

VAC doesn't have a clue about the newest/latest medical advances. They are a benefit entity.

The condition your describe in your OP is something found by primary care providers, and the relevant specialties on investigation based upon you presenting complaints, signs and symptoms. You come to me complaining about fatigue, anxiety, poor memory, difficulty concentrating, sleep disturbances, sexual disfunction, wieght gain despite a lack of appetite,  and other complaints from your chart, you can GUARENTEE that any primary care provider will send you for some sort endocrine system testing.


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## Nudibranch (27 Aug 2013)

TSH is often a first-line test for people complaining of tiredless or unexplained weight gain. LH/FSH not so much - but the pamphlet doesn't explain that these are "middlemen" in a complex feedback system to the hypothalamus; the hormones tested would usually be at the end of the line, estrogen or testosterone, and if there was something abnormal further testing "upstream" could be indicated.


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## Nemo888 (27 Aug 2013)

The main hormones to supplement would be testosterone and possibly HGH. Finding a doc on civvie street willing to write a script for those is very rare. They don't even want to do the tests. Many are too lazy to even do a proper differential diagnosis. There is best practice and actual practice. You really need to go to a private care facility to get checked out if you suspect this is the problem.


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## medicineman (2 Sep 2013)

Nemo888 said:
			
		

> I don't know of a single clinician actually testing hormone levels for psychological conditions.



First thing told to me on the first day of my psychiatry rotation - "rule out organic causes before deciding on the more ethereal ones".  Also - "common things happen commonly".   The most common causes of depression I've found in the real world that weren't a neurotransmitter or situational issue are hypothyroidism, followed by menopause, followed by concussion and lastly low testosterone.  I'd be pretty hard pressed to order a lot of those tests without a really good reason - everyone thinks they are the good reason when in reality, many are grasping at straws or don't want a label.  Suffice to say this issue is out there and it does happen, but other things happen a lot more commonly.

MM


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## Nemo888 (3 Sep 2013)

Obviously I fell through the cracks. If outcomes of treatment means anything I weigh again what I did when I got hurt(almost 5 more pounds to go). I ballooned to a size 40 waist when my injury was at it's worst, now I am back in 31's. I lost over 30 pounds of fat since starting the program. My T was quite low. So I pumped it up to the 60th percentile of the normal range and felt normal again. I asked to get to the 75th percentile and my Doc agreed and increased my dose. I felt like I did before I was injured. 6 months later I look like I did before my injury.  The improvement in quality of life is dramatic. I went from a super fit guy in his 30's to an old man in a few months. Supplementing back to normal ranges reversed it in the same amount of time. I will add that this is not body builder style supplementation. It is bio-identical hormones within normal physiological ranges. Some bodybuilders use 100 times my dose.

It's not often you get to do a differential diagnosis so well you turn someone's whole life around. Something to keep in mind. Sleeping is still a bit of a mess sometimes. I wondered if low doses of HGH will remedy that. I was going to try that for 40 days and see what happens. If anyone is curious I can keep you informed of how well it works.


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## Nemo888 (4 Sep 2013)

The HGH had some effects I did not expect at all. It reduced what must have been a constant feeling of anxiousness and increased my cold tolerance. It both relaxes and boosts metabolism.  I hope it helps with my old joints as well but that should take a few weeks. I am in shock how well the doc nailed my condition. I got my life back. SSRI's would have masked the symptoms and sped up my physical decline.

 I now wonder if a resting heart rate of 50 may be a symptom as well.


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## Nemo888 (4 Oct 2013)

Just an update. My sleep is back to normal, anxiety is gone, almost back to my preinjury level of  fitness, joint pain disappearing, etc. I went off for three days.  My sleep problems and anxiety returned. I went back on the regimen and my sleep was back to normal that night.
7.5g top. Testosterone(Androgel) q.d.
20 µg Subq. IGF1 LR3 q.d.

Anything that might help with the lingering mild short term memory issues?


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## Nemo888 (10 Oct 2013)

The HGH greatly improved my sense of smell. I read this and found it rather interesting that smell was being used to diagnose neurodegenerative conditions. Peanut butter could become a diagnostic tool in the field. 

http://www.the-scientist.com/?articles.view/articleNo/37603/title/Smell-and-the-Degenerating-Brain/
http://www.the-scientist.com/?articles.view/articleNo/37842/title/Sniffing-out-Alzheimer-s/


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## Nemo888 (9 Nov 2013)

Another month down and I am becoming less of a dick. I had no idea the anxiety was so bad. Years of waking up at 3 am with a resting heart rate anywhere between 85 and 100 was also wearing on my psyche. I felt much better immediately but I did not expect the growth hormone to have an incrementally beneficial effect over time on top of that. So the borderline low T, elevated cortisol (12.03) and nonexistent hgh would indicate anterior pituitary injury IIRC. That is the most common. I was originally told to take SSRI's and benzos. Then get OSI counseling. I am glad I did not accept the diagnosis and went to get tests on my own. My meds helped me lose about 34 pounds of fat and gain WTF, 22.8 pounds lean body mass. I pulled out some Tanita body composition readouts. Holy shit, I have really put on lean body mass since last February. SSRI's do not have that as a side effect. You can see why sometimes I call it the super soldier formula. I would not have quit if I would have been treated in a timely fashion. Supplementation also helps the phsyio for my other injuries since I heal so much faster. Luckily I still had some pants that fit in an old box in the basement from before I got injured.





If the stats correlate between civvie and military cohorts about 5000 US soldiers are suffering from NED. In Canada that would mean hundreds of soldiers either misdiagnosed or undiagnosed. The meds are not covered by VAC. So I am trying to inform the chain and get some awareness of NED. 

Here are the links the DCOE gave me. Including a great app for mTBI's. Definitely something I would want on my phone if I was still a medic.
https://market.android.com/details?id=org.t2health.mtbi

http://www.dcoe.mil/content/Navigation/Documents/Mild%20Traumatic%20Brain%20Injury%20Pocket%20Guide.pdf

http://www.dcoe.mil/content/Navigation/Documents/DCoE_TBI_NED_Reference_Card.pdf

http://www.dcoe.mil/content/navigation/documents/dcoe_tbi_ned_clinical_recommendations.pdf

Hoping someone else doesn't have to go through the bullshit I did. 

Militi Succurrimus


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## Nemo888 (11 Dec 2013)

I brought my information to a Psychiatrist at the OSI clinic. After seeing my lab work he was very encouraged and told me that though he had heard about TBI and NED it was very political. He refused to elaborate. 

I have gone from IGF1 LR3 to Nutropin now that my medical insurance is satisfied I meet the diagnostic criteria for a pituitary injury. After some tweaking the dose is 1mg/day for now(roughly 0.0125mg/Kg qd) .  Hopefully that can be decreased in a few months, but currently that seems the most effective. It also seems to be healing things I thought would never heal. I found out why it was "political" when I saw how much it cost, 1300$ a month. Turns out that since since hgh has gone off patent the cost has increased every year. When Humanotrope was the only product available it was supposedly about half the cost.

So the good news is there is a safe product that can make me feel just like I did before my injury and even help heal my other injuries. The bad news is that is is completely unaffordable. No wonder this treatment is not being trialed.


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## Nemo888 (26 Dec 2013)

Starting some thymosin beta 4 at 2mg a day. I'll let you know how it goes. Tβ4 has regenerated brain, heart and corneas so far in clinical trials. 

 http://www.regenerx.com/wt/page/pr_1280346659


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## Pieman (26 Dec 2013)

Very interesting thread Nemo888, and congrats on your recovery progress. Good to see!

I read that OSI injuries can be considered to be physical brain injury caused by the overload of stress and chemicals present in a hyperactive Amygdala for long duration.  

Basically, some people treated with OSI through normal therapy will still have residual symptoms that are physical damage to the brain and won't go away. (Short/long term memory issues etc.)  OSI is not necessarily just a mental/emotional processing issue.

So, if my understanding is correct,  this information should be of interest as a potential treatment in all types of injuries that we are seeing.


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## BorisK (26 Dec 2013)

Interesting thread.  Keep us posted and good luck with your progress.  Amazing how much diet and excessive (both having effects on hormones) play a part in a healthy hominoid.  

Best wishes.


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## Nemo888 (25 Jan 2014)

The thymosin beta 4 was inconclusive. It burns a fair bit when injected, similar to vitamin B6 (pH 3 IIRC) but even stronger. I felt fatigued and had some mild headaches while taking it. The inflammation diminished in my joints. I thought it was doing very little and I was gaining weight. When I checked my body fat % had dropped 3% to 14% and I had gained about 6+ pounds of lean mass. I was denser, as no body measurements had increased. The dosage was low and I can't rule out the changes being from the growth hormone. When I plateau on the HGH I will get a larger dose and try again. 

On that front my resting heart rate has increased and my cold tolerance is back to normal, even without the 30+ pounds of fatty insulation. My resting heart rate before supplementation was around 50 and I could only stand the cold for short periods. Since supplementation it has only dropped below 60 when I forgot to take my shot. The second time I forgot I was curious and decided to see what would happen. I only slept till 2 am and awoke agitated. I forced myself to sleep but felt no more rested after 5 more hours. My resting heart rate was 96. I was bitchy and snapped at the wife and kids for no reason from the moment I got out of bed. The entire day my lowest heart rate was 92.  At 8 pm my wife confronted me and the experiment was over. I resumed my medications and 51 minutes later my resting heart rate was 64. 

My understanding is that HGH influences the conversion of stored FT4 into active FT3.  My TSH was 1.74 in a normal range of 0.30 to 5.60. Sorry but I did not think to test FT3 and FT4. I am lucky that I don't have to add another hormone as the thyroid symptoms were normalized with the HGH. It seems likely when I don't take the meds my body tries to maintain my metabolism by increasing cortisol and adrenalin. Regardless of cause it makes me feel both jacked up and exhausted at the same time. If anyone has more knowledge of endocrinology please chime in or PM me.

JAMA released a study correlating mTBIs with premature death particularly arrests for assault and suicide. This is interesting as it correlates with OSI/PTSD. 

http://media.jamanetwork.com/news-item/traumatic-brain-injury-linked-with-increased-risk-for-premature-death/

I really wish the JPSU would grab a bunch of soldiers, baseline them and throw the probable mTBI NED cases on supplementation. Some could probably avoid release and return to active duty. If I was this ripped and healed this quickly I never would have released. Though the implications of being on a 1300$+ month super soldier formula does raise some interesting questions.


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## Nemo888 (9 Feb 2014)

Thymosin β4 can have some strange side effects. I read that in some cases it made your grey hair turn dark again. I thought such a claim must be completely bogus, until today.


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## Tibbson (9 Feb 2014)

Nemo888 said:
			
		

> Thymosin β4 can have some strange side effects. I read that in some cases it made your grey hair turn dark again. I thought such a claim must be completely bogus, until today.



Do we want to know where you plucked those from?


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## Nemo888 (14 Feb 2014)

Found a good lab in the states that produces the thymosin beta 4 at about one third the Canadian price. Also looking at combining some FGL with the Tβ4 if I can get a deal somewhere. Short term memory problems are one of the last symptoms left. 

http://www.alzforum.org/news/research-news/peptide-sparks-synaptic-plasticity-improves-memory-rodents


> So far, FGL has been shown to enhance memory or protect neurons in animal models of chronic stress (see Borcel et al., 2008 and Bisaz et al., 2011), depression (see Aonurm-Helm et al., 2008), ischemia (see Skibo et al., 2005), and traumatic brain injury (see Pedersen et al., 2008). Other studies indicate that the peptide reduces neuroinflammation (see Downer et al., 2009 and Ojo et al., 2011). FGL has also been found to prevent age-related structural changes in synapses (see Ojo et al., 2011).


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## Nemo888 (27 Feb 2014)

I've been unable to find a lab who makes FGL and ships to Canada. It's very easy to make compared to things like IGF1 lr3 so it shouldn't be too expensive.  250 mcg per day for thirty days would be ideal. Tβ4 is easy to source in North America.

Please PM me.


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## Nemo888 (7 Mar 2014)

Interesting article on the hormone oxytocin.

http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=2786

_• There is preclinical and clinical support for implication of oxytocin in the pathophysiology of psychiatric disorders involving disturbed stress regulation as well as disrupted attachment and/or social deficits.
• Oxytocin may exert an effect on posttraumatic stress disorder (PTSD) through a dual mechanism, including a reduction of fear response and increase of social functioning.
• Oxytocin has a combination of pharmacologic effects that result in a “sense of safety” for the patient, which is a prerequisite to successful treatment of PTSD._

The second is about oxytocin, PTSD and links tummy and bowel problems to the dysregulation. Not as good as the first but an interesting read. _"A goal of this theorizing that posttraumatic oxytocin dysregulation (POD) is a mechanism of pelvic visceral dysregulation (PVD)"_ They are trying to find the mechanism by which PTSD moderates so many different physical morbidities.

I am tempted to get some oxytocin nasal spray and keep it in my pocket for things like going to the mall or a night out with the wife. Syntocinon would be the best choice.


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## Nemo888 (9 Aug 2014)

I am back to normal as long as I stay on the cocktail I am on. First round of TB4 was insufficient dose. Slowly ramped it to get good results and 1mg per day for 30 days produced the results I wanted. Ideal dose in mice for stroke is 2.7 mg/Kg in a single injection immediately after injury IIRC.

Seeing the latest research relating to PTSD and depression being neuroinflamatory conditions makes this treatment make sense.  Neuronal inflammations leads to loss of hippocampal mass. TB4 reduces local cytokines and enhances the ability of T cells to remove destructive proteins. It also causes neuronal regeneration.  

Seems to work pretty well in my human clinical trial of just one. After the last cycle part of my endogenous hormone regulation came back which was both gratifying and annoying. Started aromatizing the testosterone to estrogen for the first time. Been tweaking that since. I think this may be a very rewarding line of research eventually. The serotongeric model is not accurate, cytokine based causes look much more promising.

Oh, and on day 23 of the last TB4 cycle I started having dreams again. That was completely unexpected. That has remained and seems like a very useful safety valve for destressing. I didn't think it helped with slight memory deficits at first. Around two months after it did seem to improve. Perhaps it took months  for the neurons to mature or maybe placebo.

Talking to a former contractor who makes peptides now and he said to also try 1 to 16 grams of inositol a day for a few months. Stuff is cheap, mostly harmless and only about 10$ a pound online. Worked wonders for a friend of mine so it may be worth trying. He also liked CoQ10 and phosphatidylserine before bed.

Hope this helps.


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