NeuroEndocrinology

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What is NeuroEndocrinology?

Neuro means the study of the brain and nervous system. Endocrinology means the study of hormones. So therefore, Neuroendocrinology is the study of the interactions between hormones and the brain (which amounts to basically how hormones affect behaviors). This also includes the biological features of the cells involved and how they communicate.

Hormones are basically chemical messengers that transport signals from one cell to another within the body. When hormone levels are abnormal or off, signs of abnormal behavior and illness will develop (for example: mood or behavior changes, weight gain, seizures, and/or depression).

Neuroendocrinology includes the other things that the brain regulates, such as the autonomic nervous system, and even the immune system – or immune system hormones anyway.

What does Neuroendocrinology include?

Neuroendocrinology combines elements from different fields, including OB/GYN, psychiatry, endocrinology and behavioral neurology. Doctors in these specialties often refer cases to a Neuroendocrinologist to help sort out hormonal issues.

What Is Neuroendocrine Integration?

The nervous and endocrine systems often act together in a process called neuroendocrine integration, to regulate the physiological processes of the human body. Neuroendocrinology arose from the recognition that the brain, especially the hypothalamus, controls secretion of pituitary gland hormones, and has subsequently expanded to investigate numerous interconnections of the endocrine and nervous systems.

The neuroendocrine system is the mechanism by which the hypothalamus maintains homeostasis, regulating reproduction, metabolism, eating and drinking behaviour, energy utilization, osmolarity and blood pressure.

Endocrine glands are glands of the endocrine system that secrete their products, hormones, directly into the blood rather than through a duct. The major glands of the endocrine system include the pineal gland, pituitary gland, pancreas, ovaries, testes, thyroid gland, parathyroid gland, hypothalamus and adrenal glands. The hypothalamus and pituitary gland are neuroendocrine organs.

How are Neuroendocrinology and Traumatic Brain Injury (TBI) Linked?

The greatest challenge associated with endocrine complications in individuals with traumatic brain injury (TBI) is early recognition of these subtle problems. Often times emergency room personnel are focused on life threatening areas of the body including the airway, breathing, and maintaining adequate circulation, and stabilizing life threatening issues.  The primary thought at this time does not include a protocol for running laboratory tests for Endocrine issues/changes due to potential brain injuries in any form.

Endocrine complications can produce significant impact on the progress and outcome of TBI rehabilitation, they can even enhance the duration of TBI symptoms in recovery. Prompt diagnosis and treatment of endocrine complications following TBI facilitate the rehabilitation process of patients with TBI.

Anterior pituitary hormones (eg, growth hormone [GH],thyrotropin, corticotropin, gonadotropins) are released by the neuropeptide-releasing hormones from the hypothalamus. The posterior pituitary hormones (eg, vasopressin, oxytocin) are produced by the hypothalamus and are carried by long axonal projections into the posterior pituitary; they are released later. The posterior lobe vascular supply is not affected by pituitary stalk trauma, because it is supplied by the inferior hypophyseal arteries, which arise from the internal carotid artery below the level of the diaphragma sella.

The most common endocrine complication after a TBI is syndrome of inappropriate antidiuretic hormone (SIADH). SIADH causes a dilutional hyponatremia secondary to inappropriate renal water conservation. Relatively less common post-TBI endocrinopathies include anterior hypopituitarism (AH), DI, cerebral salt wasting (CSW), and primary adrenal insufficiency (PAI).

The most common endocrinopathies associated with hypopituitarism, in descending order, include hypogonadism, hypothyroidism, adrenal insufficiency, hyperprolactinemia, DI, and GH deficiency. CSW and PAI are peripheral causes of hyponatremia after a TBI. SIADH, AH, and DI have central endocrine etiologies.

A retrospective study demonstrated that 4% of patients with TBI sustained an associated neuroendocrine disorder of the hypothalamic-pituitary axis. This condition is underdiagnosed, as demonstrated by evidence that 40-63% of fatal cases of TBI reveal postmortem pathologic findings of the hypothalamus/anterior pituitary.

CLINICAL NEUROENDOCRINOLOGISTS WHO PROVIDE PATIENT CARE

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34 thoughts on “NeuroEndocrinology

  1. I wish there is a specialist near Lexington, KY!! I feel like it is exactly what I need with my seizures that are related to hormones. There don’t seem to be any near. Would you think I should try a neuroendocrinologist or endocrinologist in this case. I have seen neurologists and they ignore the hormone relationship

    Liked by 1 person

    • Ashley, thanks for taking the time to read the article. A lot of us who have experienced a brain injury, have also experienced neuroendocrine changes. We also have had similar experiences, where some of the specialists, providers, and neurologists we see have no training, concept, or experience dealing with what we are going through. This can make our attempts to recover, improve our health, and be taken seriously even more challenging.

      I am unable to give personal medical advice, and cannot recommend you see any particular specialist as a means of solving your questions.

      However, I will say that I have benefited for advocating for myself and many others have benefited from getting answers similar to your by getting more than one opinion (sometimes several opinions in fact before one that actually helps).

      Clinical Neuroendocrinologists are in short supply in the United States. I would love to see more becoming Board Certified and more brain research as it is associated with the Endocrine system. Have you seen our list of NeuroEndocrinologists that we are aware of?

      (the list is always changing and evolving )

      Like

  2. Hi! This post couldn’t be written any better! Reading this post reminds me of my old room mate! He always kept chatting about this. I will forward this post to him. Fairly certain he will have a good read. Many thanks for sharing!

    Liked by 1 person

  3. Howdy I am so delighted I found your weblog, I really found you by accident, while I was browsing on Bing for something else, Anyways I am here now and would just like to say thanks for a fantastic post and a all round interesting blog (I also love the theme/design), I don’t have time to read through it all at the minute but I have book-marked it and also added your RSS feeds, so when I have time I will be back to read much more, Please do keep up the excellent work.

    Liked by 1 person

  4. Hope, I am still recovering from a bad accident I was in on 1 march 2020. As a result among other things I had a severe TBI. I am looking for a neuroendocrinologist in Florida. Do you know if one exists in or close to Florida? Please let me know when you finish the list you are working on. Thank you for what you are doing?

    Liked by 1 person

  5. With everything that seems to be developing throughout this particular subject matter, all your viewpoints are generally fairly radical. However, I appologize, because I can not subscribe to your whole idea, all be it refreshing none the less. It looks to us that your comments are generally not entirely justified and in actuality you are yourself not even wholly confident of your argument. In any event I did enjoy looking at it.

    Like

  6. I am looking forward to your compiled list of neuroendocrinologists; I have GH deficiency post mTBI and am getting injections prescribed from an endocrinologist (near Boston MA) who specializes in pituitary tumors, but would like a full evaluation by someone with mTBI-related experience to help get me to the next level of healing.
    Thanks in advance!

    Liked by 1 person

  7. I see you are located in Grand Rapids, MI. Do you know of a Neuroendocrinologist that is practicing in our area? I moved here 6yrs ago. I’ve had multiple head injuries with subsequent issues that may be the result. Thank you.

    Liked by 1 person

    • There are no Clinically practicing NeuroEndorcrinologists in Michigan that I am aware of. Most Neuroendocrinology Departments (like at UofM) only have Endocrinologists or Neurologists. Mostly those providers in that Department work with folks that have Diabetes, Pituitary tumors, etc. There used to be a Neuroendocrinologist there years ago, but he retired. I am putting together a list of Clinically practicing Neuroendocrinologists and will be providing this as soon as it is completed. Neuroendocrinology is a unique subspecialty of Endorcrinology. I know this is not the answer you are looking for, yet there is still hope on the horizon.

      Like

  8. Hi,

    Thank you for this page and the info. Is there any chance you know of any specialists on the east coast, specifically Pennslyvania.

    Thanks

    Liked by 1 person

    • Collin, I am putting together a list of Clinically practicing Neuroendocrinologists and will be providing this as soon as it is completed. I will let you know if I learn of one in PA. Come back often as we will be adding more to our website this Summer.

      Like

  9. I am looking for names of Neuroendocrinologists near the Richmond VA area – any would be much appreciated! My husband was in a car accident when he was 15 – massive TBI – he is 48 now and experiencing worsening symptoms. Thank you!

    Liked by 1 person

  10. I have damage from using Amphetamines for weight loss which caused damage to my brain and is affecting my systemic system diabetes.
    I was told I need a Neuroendocrinologist to try to help me can you tell me where I can get one I will travel residing in Ontario Canada

    Liked by 2 people

  11. Dear Hope TBI
    Because I suffered a brain injury and have been experiencing other systems, my Cognitive Therapist recommended I see. a Neuro Endocrinologist. Could you please recommend someone in Northern California?
    Thank you so much!
    Patricia

    Liked by 1 person

  12. Hello,
    Thanks for the article. I am having ongoing issues with my sodium levels and they won’t seem to stabilize with sodium chloride increase or fluid restriction. Are there any neuro endocrinologist is the San Diego CA area? I can’t seem to find any.

    Liked by 1 person

    • Here is the link to the blog post we just released today. There is one in San Francisco.

      Hihttps://hopetbi.com/2021/08/17/new-page-added-clinical-neuroendocrinologists/

      Like

  13. In researching some resources for you I found the following in California. I cannot speak to the professionalism, adequate diagnosis/treatment, or bedside manner of these providers as I have not utilized them personally. I would suggest to read reviews, make calls, schedule an appointment if interested in exploring more and then come back and let us all know how it went (we are always appreciative of word of mouth referrals). It may take more than one visit, or more than one provider to get your needs met. You are your best self-advocate after all. One thing you may ask is if they have experience dealing with brain injury or polytrauma, or complex cases.

    https://www.ucsfhealth.org/providers/dr-lewis-blevins

    https://www.barrowneuro.org/doctor-profiles/pituitary-center-neuroendocrinologist-kevin-yuen/ (in Arizona)

    Like

    • I am looking for names of Neuroendocrinologists near the Richmond VA area – any would be much appreciated! My husband was in a car accident when he was 15 – massive TBI – he is 48 now and experiencing worsening symptoms. Thank you!

      Like

      • Lisa, progression of brain injury symptoms years later is a common occurance with no easy answers. I commend you on working to help find your husband the assistance he may need to further his quality of life. I am putting together a list of Clinically practicing Neuroendocrinologists and will be providing this as soon as it is completed. This is a work in progress as there are not many Clinically practicing ones. There are numerous ones that solely work in labs and do research, so it is an arduous task to find one. I will be updating this page when I get more information.

        Like

  14. Hello!
    I love this website, great information!
    I need help finding a Neuroendocrinologist here the Northern California Bay Area. I saw in a previous comment someone else asked the same question. My daughter has a TBI, and definitely is having some endocrine/metabolic issues post accident. Any recommendations? I’m willing to drive as far as i need to.

    Liked by 1 person

  15. My son suffered a severe TBI in 2009 and after researching how many TBI patients have hypothalamic pituitary damage as well, I would like to have my son evaluated by a Neuro endocrinologist who understands TBI but I’m having trouble locating on. I live in Northern California. Are you aware of anyone here and I’d do, can you please give me their contact information. Thank you, Bobbi

    Liked by 1 person

      • Dear Hope TBI
        Because I suffered a brain injury and have been experiencing other systems, my Cognitive Therapist recommended I see. a Neuro Endocrinologist. Could you please recommend someone in Northern California?
        Thank you so much!
        Patricia

        Like

  16. I was born with hypospadias (thought to be caused by hormone deficiency in the whom) and now I have infertility and hypothyroidism. I also now have pre-diabetes,hypertension despite blood pressure medications and cholesterol problems. I used to be a very healthy person before I had a few seizures. My nervous system was definatly destroyed and has destroyed my life. I’ve gotten to the point I can’t work or live a normal life. I know something else is going on with my endocrine system. My symptoms include dizziness, severe brain fog,kidney pain, light headed, weakness, constantly high levels of adrenal, breathing problems and that’s just to name a few things. My body can’t handle it any more and I don’t know what to do. Any help would be great ,tks justin

    Like

    • First off Justin, I am not a Doctor or Specialist. I am unable to offer any diagnosis or treatment. I do like to provide folks with resources though and am glad to help where I can in that regard.

      I am curious. Have you had surgery for your hypospadias? My understanding is that most repairs lead to normal healthy function.

      Do you have an Endocrinologist you are working with for your Hypothyroidism and Pre-Diabetes?

      Some things come to mind right away. Perhaps a Nephrologist for your kidney challenges would be beneficial; a neurologist regarding the seizures.

      A great site to get information about Hypothyroidism is https://stopthethyroidmadness.com/ They have an enormous amount of information, lab suggestions, diet, etc. that may be able to help you.

      Has any provider ever suggested a Sleep study to rule out apnea? or seeing a Pulmonologist for your breathing challenges?

      Thank you for sharing your medical evolvement with us. There are answers out there for all of us. We just have to keep searching and never give up.

      Like

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