Endocrinology and Kick-boxing

Here’s a link to a 2007 BBC article on a (then) new study on brain injuries from kick-boxing. The study found statistically significant hormone deficiencies in kick-boxers, and concluded that this resulted from damage to the pituitary gland.

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One response to “Endocrinology and Kick-boxing

  1. Thanks for posting that link Gill. People tend to overlook the fact that a “bump on the head” is an injury to the hardware that manages every single function of our bodies. In the case of the hypothalamus and pituitary gland, damage can wreak havoc across many systems, and the underlying causes are usually undiagnosed. The hypothalamus is situated directly above the pituitary gland, making damage to one an indication that damage to the other is probable. The pituitary sits in what is known as the Turkish Saddle (where’s Chopper when you need him..) which is a fragile bony cradle. A blow the back of the head will grate this area against the anterior floor of the skull; a blow from the front can cause swelling or shearing of the tissue. It’s possible for shearing forces from a percussive trauma to damage the connection between the two areas.

    The hypothalamus basically acts as the link between the endocrine and nervous systems. It’s unique in that it lacks an impermeable blood-brain barrier, so it’s one of the few brain regions that has direct contact with the blood stream. As a result, a strong blow to the head that concentrates force in this area can disrupt the exchange between the nervous and endocrine systems, potentially producing: metabolic problems (both have controlling/suppressive actions on the thyroid gland), disruption of hunger/feeding patterns, sleep patterns, sexual activity, thermal regulation, stress, olfactory function, the ability to learn (via production of Oxytocin, which basically enables the brain to overwrite old information with new), a decreased threshold for heat tolerance (heat tetany, usually a median sign of exposure to excessive heat, can occur at lower temperatures).

    People who are experiencing any of these symptoms following one or more significant head traumas need to see a neurologist; ER doctors are not generally good sources of helpful information following a closed head injury. The policy seems to be if you are walking and talking without assistance, out the door you go with a handout about warning signs (if you are lucky- some never even get this much). A neurologist suspecting hypothalamic damage will refer you to an endocrinologist, who will perform diagnostics of various thalamic-pituitary transmitters to see if the problem is in the hypothalamus, pituitary gland, or if the thyroid gland itself is the source of the problems. If this doesn’t turn up anything significant, neuropsychological evaluation may be the next step. Lesions to the hypothalamus and brain stem are difficult to see on MRI or CAT scans. It can take quite a while to sort these things out, and there isn’t much that one can do about it.

    One possible effect of percussive trauma to the thalamus/hypothalamus/pituitary/brainstem (referred to collectively as the diencephalon) is hyperthermia; this is the result of a malfunction in the hypothalamus’s role in mediating body temperature, which normally allows it to increase the internal temperature in response to microorganism infections in the blood (i.e. fever, but in this case, a permanent ‘resetting’ of the metabolic functions to a higher level), or possibly “diencephalic seizures,” an electrical disturbance of the thermal regulatory functions of this region. These sequelae may sound exotic, but they are actually more common than one would expect. In one study, autopsies of 47 TBI survivors revealed : Previously undiagnosed brainstem injury in 36 cases; hypothalamic injuries in 20; and combined hypothalamic and brainstem injuries were seen in 17. These symptoms are not generally addressed by ER or long-term care neurologists, but obviously are very common. This can leave patients in a very unpleasant limbo of experiencing persistent debilitating hyperthermic symptoms, yet receiving no medical acknowledgement or treatment for the causes. (link to abstract: http://cat.inist.fr/?aModele=afficheN&cpsidt=19029689).

    In the short term, an increase in internal temperatures can actually worsen the damage that occurs in affected brain tissue following a head injury- intracranial swelling and chemical cell death cascades occur 24-48 after the injury, which means that much of the long-term damage from a TBI happens in this period, not necessarily upon impact. Another head injury within this time frame is likely to have disastrous results. (Remember that when Keith Richards sustained a TBI a few years back, doctors drilled into his skull to lessen this pressure and hopefully lessen the aftermath). If you are knocked out or receive a concussion, avoid the activity that caused it for at least a month. This can mean the difference between relatively manageable symptoms and severe permanent dysfunction.

    For more information, check out:

    Post Head Injury Autonomic Complications: Overview
    http://emedicine.medscape.com/article/325994-overview

    Post TBI Endocrine Complications
    http://emedicine.medscape.com/article/326123-overview

    Components and mechanisms of thermal hyperpnea
    http://jap.physiology.org/cgi/content/full/101/2/655

    (note: these comments are in no way intended to be a substitute for consultation with a qualified physician)

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