Hormonal Disruption Post-Concussion

When most people think about concussion recovery, they focus on the physical symptoms: headaches, dizziness, brain fog, and fatigue. But there's another critical piece of the puzzle potentially contributing to these symptoms that often goes unrecognized—the role of hormones and the endocrine system, especially in women. In two important episodes of Life After Impact: The Concussion Recovery Podcast (Episode 18 and Episode 19), I spoke with Dr. Tatiana Habanova, a clinician who, like myself, integrates functional medicine and functional neurology. We talked at length about the deep—and often under-appreciated—connection between brain injuries, pituitary changes, and hormonal health. Here’s a re-cap of some of the points we discussed.

How Brain Injuries Disrupt Hormones

Before specializing in concussion recovery, my clinical focus was on fertility and women’s health. That background proved invaluable when I began noticing a pattern: many of my female concussion patients experienced worsening hormonal symptoms after their injuries. Irregular periods, heightened PMS, and cyclical migraines were just some of the complaints that became more pronounced.

This makes perfect sense when you consider how the brain orchestrates hormonal function. The hypothalamus and pituitary gland—two key players in the endocrine system—are located in the brain and vulnerable to injury during a concussion. The result? Disrupted communication between the brain and glands like the thyroid, adrenals, and ovaries.

As Dr. Habanova pointed out, the hypothalamus is a rare brain region where the neurological, immune, and endocrine systems converge. When inflammation occurs in the brain (neuroinflammation), it can ripple through these systems, triggering hormonal imbalances, immune dysfunction, and continued neurological symptoms.

Hormonal Symptoms Can Mask as Concussion Symptoms

One of the challenges in treating concussion-related hormonal issues is that neuroendocrine symptoms can look a lot like post-concussion symptoms: fatigue, brain fog, sleep disturbances, anxiety, and mood swings. Clinicians—and patients—may not immediately recognize that these could be driven by hormonal shifts rather than direct neurological damage.

In women, tracking symptoms alongside the menstrual cycle can be revealing. Many of my patients notice that symptoms worsen at specific times of the month. When headaches or fatigue are no longer daily but cluster around ovulation or menstruation, it’s a clear sign that hormones are playing a role and need further investigation.

What Tests Can Reveal Hidden Imbalances?

Here are some key tests for identifying hormonal disruptions:

• Dutch Test (Dried Urine Test for Comprehensive Hormones): Offers a deep look at hormone levels, metabolites, adrenal function, and circadian rhythm. It’s my go-to for evaluating estrogen, progesterone, testosterone, and cortisol patterns and includes an organic acid test to screen for B-vitamin deficiencies, gut dysbiosis markers, and neuroinflammation.

• Thyroid Panel: A full panel includes TSH, free T3, free T4, reverse T3, and thyroid antibodies (thyroid peroxidase and thyroglobulin). Post-concussion, thyroid dysfunction is common and often missed with only a TSH test.

• Iron and B12 Markers: ferritin, iron saturation, and methylmalonic acid to assess stored iron and B12 status, which are crucial for oxygen delivery to the brain.

• Gut Health Testing: Since brain injuries can lead to leaky gut and increased immune reactivity, gut panels can reveal food sensitivities, inflammation, and microbiome imbalances.

  
  

Why Baseline Labs Matter—Even Before Injury

One of the concepts we talked about was the importance of baseline lab work. Just like athletes get baseline cognitive testing, knowing your hormone levels when you feel good provides a valuable reference point if you ever experience a brain injury—or just start feeling “off.” It’s a proactive step toward personalized care.

Thyroid Dysfunction should be looked at Differently Post-Concussion

Thyroid dysfunction can be secondary to a brain injury, and needs to be treated differently than standard approaches. Several key concepts to consider are:

• Thyroid function can become hypo, or hyper following a brain injury

• Autoimmune thyroid conditions may develop, due to immune changes following a brain injury. This is why including thyroid antibodies (thyroid peroxidase and thyroglobulin) is important.

• Testing should be done approximately 6 weeks following an injury and monitored closely every 3 months if there are abnormalities

• Thyroid medications may not be needed forever, as is the case many times in primary hypothyroidism for example, and this is why frequent testing is so important. As the brain heals, the need for thyroid support may change.

• Thyroid imbalances can also be supported through non-pharmaceutical means, often by working with providers trained in functional medicine and knowledgeable about natural thyroid support.

Recovery Is Not One-Size-Fits-All

Concussions don't happen in a vacuum. They interact with your unique physiology, history, and lifestyle. For many women, the hormonal impact is a major driver of persistent symptoms—and addressing this piece can be the key to finally feeling better. Healing is about using the right tool for the right job. Whether it's functional medicine, functional neurology, or hormone balancing protocols, the path to recovery is multifaceted—and powerful when these systems are treated as one integrated whole.

If you or someone you love is struggling with post-concussion symptoms that just won’t budge, there may be a hormonal component that needs to be explored. You can listen to Episode 18 and Episode 19 of Life After Impact on this website, or your favorite streaming platform.

Apple Podcasts Episode 18 Episode 19

Spotify Episode 18 Episode 19

YouTube Episode 18 Episode 19