While some physicians are shy about using testosterone and other hormones to treat patients with a traumatic brain injury, that hasn't stopped one southern California physician.
Studies have found testosterone hormone therapy can damage patients' brains, but Mark Gordon, Millennium Health Centers founder and medical director, has found a way to carefully increase this and other hormones in his patients.
For example, he has found clomiphene citrate, a drug commonly used for women trying to become pregnant, can increase the production of testosterone in men. If the patient does not respond to this, Gordon said he will use a low dose of testosterone, along with two other hormones that he claims will counteract testosterone's negative effects on the brain.
"This has been a battle I have been fighting for more than 15 years with my esteemed colleagues," Gordon said in an email. "In assessment of testosterone levels in a person with blast trauma, the traditional health care providers tend to do a very limited blood test."
Gordon said it’s more than just testosterone. He looks at the patient's levels of neurosteroids, the brain's hormones, and neuroactive steroids, which are produced by the body, and works to get those in balance.
"Using the science of neuroendocrinology, we assess the brain's hormones and those produced by the body as reflections of our brain's health since, after trauma, these can be greatly affected," he said about his Millennium-TBI Biomarker panel in a statement.
The Defense and Veterans Brain Injury Center, which tracks and studies TBI cases in the military, says mild TBI (mTBI) can cause temporary gaps in memory, irritability, depression, anxiety and trouble sleeping. Many physicians currently are treating mTBI in patients through cognitive and physical therapy, but Gordon says he has found success with hormone therapy.
Defense Department Health Affairs officials said March 12 they are not currently aware of Gordon’s work, but added they are researching neuroendocrine dysfunction (NED) in patients.
So far, the DoD recommends clinicians consider a NED diagnosis when symptoms like those Gordon has seen -- insomnia, impaired cognition and memory loss, as well as emotional and mood disturbance -- persist or appear after three months post-injury.
“Symptoms of NED are similar to the symptoms of other post mTBI medical diagnoses such as sleep disorder, memory difficulties, depression, PTSD and/or post concussive syndrome,” states the DoD NED guidance from 2012. “Considering NED may avoid a delay in diagnosis and improve prognosis.”
Gordon said his treatment regime has had great success, helping veterans, a Guinness World Record surfer and a New York City firefighter.
One patient is Green Beret veteran Andrew Marr, who went on to co-author a book with his brother, "Tales from the Blast Factory: A Brain Injured Special Forces Green Beret's Journey Back From the Brink."
Marr's story, along with a couple of other patients', are told in a newly released documentary called "Quiet Explosions: Healing The Brain." The film's next showing will be in Los Angeles on March 18.
-- Dorothy Mills-Gregg can be reached at firstname.lastname@example.org. Follow her on Twitter at @DMillsGregg.