Here is a Q & A with Joanna Lane, author of ‘Mother of a Suicide: the Battle for the Truth behind a Mental Health Cover-Up’ There is no audio so I encourage you to read the Q & A
A British mother, Joanna Lane, describes a complication of brain injury which everyone needs to know about.
“Our son Chris took his own life when he was 31. Afterwards we discovered that he’d never managed a full sexual relationship with his girlfriend, even though they’d been together for four years. My sister was convinced that a serious head injury he’d had when he was seven might be to blame. She googled, and found a mass of academic papers demonstrating that yes – a serious head injury could give you a one in three chance of damage to your pituitary gland. This tiny fragile gland controls not only your sex drive and fertility, but many other things too – such as energy levels, weight and mood. Pituitary damage after head injury is known as post-traumatic hypopituitarism, or PTHP and among many other symptoms it can cause impotence.”
What are the other symptoms of PTHP?
“The pituitary gland produces several different hormones. Depending on which hormone is affected, PTHP can cause not only erectile dysfunction, but also infertility, fatigue, obesity, brain fog or depression, or any combination of these.”
How likely are you to get PTHP after a head injury?
“The research on severe head injury patients has repeatedly shown that between 20% and 30% of survivors suffer damage to at least one hormone. Concussion is well documented to cause it too, though there are no definite figures as yet. Even if the percentage of PTHP sufferers after concussion is extremely small, say 2%, this translates into a huge number, especially when you remember all the children who play football, and all the adult footballers, boxers and other athletes.”
Does it happen straightaway?
“Not necessarily. It can do, in fact the recommendation is to test for it six months after injury, but it can also be a long-delayed consequence. Some people are diagnosed decades after head injury. In the case of a child, sexual problems would of course not show until adulthood.”
Is it treatable?
“Yes! The missing hormones can be replaced regularly with synthetic hormones. For some people it’s a life-changer. For other people the results aren’t so dramatic, because head injury often causes other kinds of damage too, but certainly hormone replacement can restore your sex drive and make you able to conceive.”
I had never heard of PTHP. Why is it so under-diagnosed?
“Well yes, it is catastrophically under-diagnosed. A neurosurgeon on a BBC medical programme recently estimated that there are between 500,000 and a million undiagnosed sufferers in the UK, which is a huge, huge number. Part of the problem is that neither doctors nor patients know about it. When you have a head injury – in the UK at least – you’ll get a letter to take home which does not contain one word about this serious possible consequence. Another problem is that the symptoms, especially depression, fatigue and loss of sex drive, can be easily confused with the ‘normal’ aftermath of head injury. And yet another problem is that if PTHP shows itself years after injury, nobody is likely to make the connection or think of doing the tests.”
So what happens to the people who get missed?
“People who have been eventually diagnosed with PTHP write and tell me their stories, and a very common theme is that they have been told it is all in their minds. PTHP is invisible. So sufferers often get told they have Chronic Fatigue Syndrome or ME, and they have to really fight to get the right tests and the right diagnosis. “
Would you say PTHP increases the risk of suicide?
“Well, going by these same people who write to me, I’d say yes. About 20% of them have told me about suicidal feelings, or suicide attempts they’ve made. And there’s also the indisputable fact that head injury triples or quadruples your suicide risk. A population study of thousands of head injury patients in Denmark (Teasdale and Engberg) shows this – and interestingly, shows the high risk applies to people with concussion as well.”
Do you have any advice to people who think they may have PTHP?
“Doctors are unfortunately likely to fob you off. Do a lot of googling first, arm yourself with research from a respectable medical journal or reputable website, and then approach your doctor with immense tact. It’s sometimes wise to email the doctor beforehand – briefly, politely – quoting the relevant sentence from the research and saying what your symptoms are. Be clear about the blood tests you need – for example, the insulin stress test is the gold standard for growth hormone and ACTH deficiency, – and be patient and dogged until you get them. Good luck!”
The relevant research about PTHP is listed at the end of my book ‘Mother of a Suicide: the Battle for the Truth behind a Mental Health Cover-Up’ published by Accent Press, available from Amazon at $6.94 (paperback) and $3.67 (kindle). See also my website www.headinjuryhypo.org.uk