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Jack Sisson's TBI Blog

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From the Grand Junction Free Press:

Traumatic brain injury (TBI) is well known to damage the brain tissue that controls thinking and movement as well as the part of the brain that controls hormone production. Some of the steroid hormones are known to vastly reduce damage to brain tissue after a TBI.

The incidence of hormonal problems after TBI is staggering. Recent attention is shedding more light on this common issue due to the large number of veterans returning from wars in Iraq and Afghanistan with head injuries from improvised explosive devices.

When you factor in the many others suffering from lingering brain injuries, the picture gets much bigger. Each year, approximately two million Americans suffer from some sort of brain injury, ranging from mild (such as concussions) to severe, due to childhood head injuries, car accidents, sports and even childbirth. A sudden impact to the head from external forces, or even sudden acceleration or forceful rotation, can cause an acute TBI with effects lasting anywhere from a few hours to becoming a life-long condition. 


Despite decades of laboratory research and clinical trials, a safe and effective treatment for traumatic brain injury has yet to reach clinical practice. This failure is due in part to past research targeting a single mechanism of injury and treatment. This fails to account for the fact that traumatic brain injury is a very complex disease caused by a cascade of systemic toxic events in the brain and throughout the body. 

Research is now turning to drugs that act on multiple genes, proteins, and metabolic pathways to improve structural and functional outcomes after brain injury. Of the agents now in clinical trials, the neurosteroid progesterone appears to hold considerable promise. Many still assume that progesterone is “just a female hormone” with limited, if any, neuroprotective properties, but this view is outdated.

Two clinical trials demonstrated the effectiveness of using progesterone to successfully treat patients with moderate-to-severe head injury, resulting in sparing the lives of about 50% of those treated. This revelation provides a ray of hope for both practitioners and patients with TBI.

Emerging data on vitamin D, itself a steroid hormone, has begun to provide evidence that, like progesterone, it too is neuroprotective, although some of its actions may involve different pathways. The combination of progesterone and vitamin D in pre-clinical and clinical studies is an exciting approach to TBI treatment.

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