Post-mTBI Hypopituitarism or Other Post-Traumatic Hormonal Abnormalities? Results of a 12-Month Follow-Up Study in Emergency Department Patients After Mild Traumatic Brain Injury (mTBI)

Background: Over the last two decades, there has been a substantial change in the understanding of post-traumatic hypopituitarism which is no longer regarded as a marginal phenomenon. Clinical manifestations of pituitary hormone deficiency are frequently nonspecific, with fatigue and cognitive dysfunction predominating. Given that head injuries currently constitute a global burden for healthcare systems, the aim of the present study was to determine whether self-reported post-mTBI symptoms that may indicate hypopituitarism reflect true pituitary insufficiency or are attributable to other hormonal aberrations. Objective: Assessment of the relationship between self-reported symptoms of post-traumatic hypopituitarism and hormonal test results following mild Traumatic Brain Injury (mTBI). Setting: Patients were recruited from a tertiary trauma center emergency department (ED) in northern Poland from January 2023 to October 2025. Participants: Adult (18>y.o.) individuals with mTBI meeting the inclusion criteria. Design: Prospective cohort study. During their post-head injury admission to the ED patients had a blood sample taken. The procedure was repeated consecutively after 3,6 and 12 months. After 6 and 12 months, patients were asked to complete a questionnaire. Method: Pituitary and thyroid hormones were measured using Chemiluminescence Immunoassay method (CLIA) and Heterogenous immunochemiluminescence method (CMIA). The questionnaire used was designed for the purposes of this study Questionnaire for the Assessment of Symptoms of Anterior Pituitary Insufficiency in Patients After Mild Traumatic Brain Injury (mTBI) Hospitalized in the Emergency Department. Results: Self-reported symptoms suggestive of anterior pituitary dysfunction following mTBI were not confirmed by laboratory assessment of pituitary hormones. However, after 6 months, a statistically significant correlation was found between the number of reported symptoms and prolactin levels (ρ = 0.730; p = 0.0013), whereas after 12 months a downward trend in fT3 levels was observed compared with baseline. Conclusion: Persistent symptoms observed in patients after mTBI at 6 and 12 months, particularly those related to increased fatigue and impaired concentration, appear to be associated primarily with prolactin levels (6-month observation) and with a decrease in fT3 levels (12-month observation) rather than true post-traumatic hypopituitarism (PTHP).