{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T01:09:23Z","timestamp":1784596163597,"version":"3.55.0"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Over the last two decades, there has been a substantial change in the understanding of post-traumatic hypopituitarism (PTHP), 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-mild traumatic brain injury (mTBI) symptoms that may indicate hypopituitarism reflect true pituitary insufficiency or are attributable to other hormonal aberrations. The study aimed to assess the relationship between self-reported symptoms of PTHP and hormonal test results following mTBI. Setting: Patients were recruited from a tertiary trauma center Emergency Department (ED) in northern Poland from January 2023 to October 2025. Participants: The participants were adult (18 &gt; y.o.) individuals with mTBI who met the inclusion criteria. Design: This was a 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. Methods: Pituitary and thyroid hormones were measured using the chemiluminescence immunoassay method and the heterogenous immunochemiluminescence method. The questionnaire used, Questionnaire for the Assessment of Symptoms of Anterior Pituitary Insufficiency in Patients After Mild Traumatic Brain Injury (mTBI) Hospitalized in the Emergency Department, was designed for the purposes of this study. 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 (\u03c1 = 0.730; p = 0.0013), whereas after 12 months a downward trend in free triiodothyronine (fT3) levels was observed compared with the baseline. Conclusions: Persistent symptoms reported by patients following mTBI at 6 and 12 months, particularly fatigue and impaired concentration, showed statistical associations with prolactin levels at 6 months and lower fT3 levels at 12 months. These findings reflect correlations identified in the statistical analysis and do not support inferences regarding causality or the presence of true PTHP.<\/jats:p>","DOI":"10.3390\/diagnostics16060955","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T13:53:34Z","timestamp":1774274014000},"page":"955","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Endocrine Sequelae of Mild Traumatic Brain Injury in Patients Admitted to the Emergency Department: A 12-Month Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Maria","family":"Ka\u0142as","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8219-2912","authenticated-orcid":false,"given":"Mariusz","family":"Siemi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ewelina","family":"St\u0119pniewska","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.mcna.2019.11.001","article-title":"Traumatic Brain Injury: An Overview of Epidemiology, Pathophysiology, and Medical Management","volume":"104","author":"Capizzi","year":"2020","journal-title":"Med. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1007\/s11845-019-02007-6","article-title":"Hypopituitarism Post Traumatic Brain Injury (TBI): Review","volume":"188","author":"Kgosidialwa","year":"2019","journal-title":"Ir. J. Med. Sci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1016\/S1474-4422(25)00154-1","article-title":"A New Characterisation of Acute Traumatic Brain Injury: The NIH-NINDS TBI Classification and Nomenclature Initiative","volume":"24","author":"Manley","year":"2025","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1089\/neu.2015.4126","article-title":"Epidemiology of Traumatic Brain Injury in Europe: A Living Systematic Review","volume":"38","author":"Brazinova","year":"2021","journal-title":"J. Neurotrauma"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1016\/S1474-4422(22)00309-X","article-title":"Traumatic Brain Injury: Progress and Challenges in Prevention, Clinical Care, and Research","volume":"21","author":"Maas","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S1474-4422(17)30279-X","article-title":"The Chronic and Evolving Neurological Consequences of Traumatic Brain Injury","volume":"16","author":"Wilson","year":"2017","journal-title":"Lancet Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/s11102-019-00957-9","article-title":"Traumatic Brain Injury: Neuropathological, Neurocognitive and Neurobehavioral Sequelae","volume":"22","author":"Pavlovic","year":"2019","journal-title":"Pituitary"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S1474-4422(23)00065-0","article-title":"Traumatic Brain Injury as a Chronic Disease: Insights from the United States Traumatic Brain Injury Model Systems Research Program","volume":"22","author":"Juengst","year":"2023","journal-title":"Lancet Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Gasco, V., Cambria, V., Bioletto, F., Ghigo, E., and Grottoli, S. (2021). Traumatic Brain Injury as Frequent Cause of Hypopituitarism and Growth Hormone Deficiency: Epidemiology, Diagnosis, and Treatment. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.634415"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s11910-023-01263-5","article-title":"Neuroendocrine Disruptions Following Head Injury","volume":"23","author":"Wexler","year":"2023","journal-title":"Curr. Neurol. Neurosci Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e00146","DOI":"10.1002\/edm2.146","article-title":"Prevalence of Hypopituitarism and Quality of Life in Survivors of Post-Traumatic Brain Injury","volume":"3","author":"Bensalah","year":"2020","journal-title":"Endocrinol. Diabetes Metab."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1007\/s11102-018-0925-z","article-title":"A Neurosurgical Approach to Traumatic Brain Injury and Post-Traumatic Hypopituitarism","volume":"22","author":"Tan","year":"2019","journal-title":"Pituitary"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Kgosidialwa, O., Hakami, O., Muhammad Zia-Ul-Hussnain, H., and Agha, A. (2019). Growth Hormone Deficiency Following Traumatic Brain Injury. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20133323"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1210\/er.2014-1065","article-title":"Pituitary Dysfunction after Traumatic Brain Injury: A Clinical and Pathophysiological Approach","volume":"36","author":"Tanriverdi","year":"2015","journal-title":"Endocr. Rev."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Karaboue, M.A.A., Ministeri, F., Sessa, F., Nannola, C., Chisari, M.G., Cocimano, G., Di Mauro, L., Salerno, M., and Esposito, M. (2024). Traumatic Brain Injury as a Public Health Issue: Epidemiology, Prognostic Factors and Useful Data from Forensic Practice. Healthcare, 12.","DOI":"10.3390\/healthcare12222266"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1007\/s11102-019-00953-z","article-title":"The Role of Autoimmunity in Pituitary Dysfunction Due to Traumatic Brain Injury","volume":"22","author":"Bellastella","year":"2019","journal-title":"Pituitary"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Mele, C., Pingue, V., Caputo, M., Zavattaro, M., Pagano, L., Prodam, F., Nardone, A., Aimaretti, G., and Marzullo, P. (2021). Neuroinflammation and Hypothalamo-Pituitary Dysfunction: Focus of Traumatic Brain Injury. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22052686"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1080\/02688697.2018.1485875","article-title":"The Autoimmune Basis of Hypopituitarism in Traumatic Brain Injury: Fiction or Reality?","volume":"33","author":"Harsh","year":"2019","journal-title":"Br. J. Neurosurg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1080\/17446651.2020.1733411","article-title":"Long-Term Neuroendocrine Consequences of Traumatic Brain Injury and Strategies for Management","volume":"15","author":"Hacioglu","year":"2020","journal-title":"Expert. Rev. Endocrinol. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1530\/eje.1.02071","article-title":"Prevalence of Anterior Pituitary Insufficiency 3 and 12 Months after Traumatic Brain Injury","volume":"154","author":"Schneider","year":"2006","journal-title":"Eur. J. Endocrinol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2632","DOI":"10.1016\/S0140-6736(24)00342-8","article-title":"Hypopituitarism","volume":"403","author":"Fleseriu","year":"2024","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1038\/nrendo.2017.103","article-title":"Chronic Endocrine Consequences of Traumatic Brain Injury\u2014What Is the Evidence?","volume":"14","author":"Klose","year":"2018","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1001\/jama.298.12.1429","article-title":"Hypothalamopituitary Dysfunction Following Traumatic Brain Injury and Aneurysmal Subarachnoid Hemorrhage: A Systematic Review","volume":"298","author":"Schneider","year":"2007","journal-title":"JAMA"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1016\/j.apmr.2023.03.036","article-title":"The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury","volume":"104","author":"Silverberg","year":"2023","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1097\/00003246-199202000-00011","article-title":"Hormonal Responses to Trauma","volume":"20","author":"Woolf","year":"1992","journal-title":"Crit. Care Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1677\/JOE-09-0412","article-title":"Mechanisms behind the Non-Thyroidal Illness Syndrome: An Update","volume":"205","author":"Warner","year":"2010","journal-title":"J. Endocrinol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1425","DOI":"10.3109\/02699052.2014.917201","article-title":"Quality-of-Life in Patients with Post-Traumatic Hypopituitarism","volume":"28","author":"Nourollahi","year":"2014","journal-title":"Brain Inj."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Talhada, D., Santos, C.R.A., Gon\u00e7alves, I., and Ruscher, K. (2019). Thyroid Hormones in the Brain and Their Impact in Recovery Mechanisms After Stroke. Front. Neurol., 10.","DOI":"10.3389\/fneur.2019.01103"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1002\/j.2040-4603.2021.tb00174.x","article-title":"The Role of Thyroid Hormone in Neuronal Protection","volume":"11","author":"Liu","year":"2021","journal-title":"Compr. Physiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"102001","DOI":"10.1016\/j.beem.2025.102001","article-title":"The Interplay between Thyrotropic Axis, Neurological Complications, and Rehabilitation Outcomes in Patients with Traumatic Brain Injury","volume":"39","author":"Mele","year":"2025","journal-title":"Best. Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1159\/000363153","article-title":"The Role of Thyroid Hormones for Brain Development and Cognitive Function","volume":"26","author":"Rovet","year":"2014","journal-title":"Endocr. Dev."},{"key":"ref_32","first-page":"584","article-title":"Hypopituitarism after Traumatic Brain Injury in Adults: Clinical Guidelines of the Neuroendocrinology Area of the Spanish Society of Endocrinology and Nutrition (SEEN)","volume":"70","author":"Bernabeu","year":"2023","journal-title":"Endocrinol. Diabetes Nutr."},{"key":"ref_33","first-page":"113","article-title":"Effect of Posttraumatic Serum Thyroid Hormone Levels on Severity and Mortality of Patients with Severe Traumatic Brain Injury","volume":"50","author":"Malekpour","year":"2012","journal-title":"Acta Med. Iran"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e44805","DOI":"10.1097\/MD.0000000000044805","article-title":"Influence of Traumatic Brain Injury on Serum Levels of Pituitary, Thyroid, Adrenal and Gonadal Hormones","volume":"104","author":"Zhang","year":"2025","journal-title":"Medicine"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/s40618-021-01656-8","article-title":"Thyroid Function in the Subacute Phase of Traumatic Brain Injury: A Potential Predictor of Post-Traumatic Neurological and Functional Outcomes","volume":"45","author":"Mele","year":"2022","journal-title":"J. Endocrinol. Investig."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Mele, C., Bagnato, S., De Tanti, A., Lucca, L.F., Saviola, D., Marcuccio, L., Moretta, P., Scarponi, F., Losavio, E., and Picciola, E. (2023). Free Thyroxine (fT4) as a Potential Biomarker of Neurological and Functional Outcome in Acquired Brain Injury: A Prospective Multicenter Cohort Study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12237433"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Khandelwal, M., Ying, Z., and Gomez-Pinilla, F. (2025). Thyroid Hormone T4 Alleviates Traumatic Brain Injury by Enhancing Blood\u2013Brain Barrier Integrity. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26199632"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.mce.2017.05.023","article-title":"Thyroid Hormone Treatment Activates Protective Pathways in Both in Vivo and in Vitro Models of Neuronal Injury","volume":"452","author":"Li","year":"2017","journal-title":"Mol. Cell. Endocrinol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.phrs.2012.12.009","article-title":"Exogenous T3 Administration Provides Neuroprotection in a Murine Model of Traumatic Brain Injury","volume":"70","author":"Crupi","year":"2013","journal-title":"Pharmacol. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1038\/s41419-020-02836-9","article-title":"Dual Effects of Thyroid Hormone on Neurons and Neurogenesis in Traumatic Brain Injury","volume":"11","author":"Lin","year":"2020","journal-title":"Cell Death Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1007\/s40618-020-01482-4","article-title":"An Update on Non-Thyroidal Illness Syndrome","volume":"44","author":"Fliers","year":"2021","journal-title":"J. Endocrinol. Investig."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/S0025-7125(16)30093-1","article-title":"The Endocrine Response to Critical Illness","volume":"79","author":"Rolih","year":"1995","journal-title":"Med. Clin. N. Am."},{"key":"ref_43","first-page":"e230363","article-title":"Pituitary Dysfunction Following Mild Traumatic Brain Injury in Female Athletes","volume":"13","author":"Lund","year":"2024","journal-title":"Endocr. Connect."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1007\/s10143-024-03088-3","article-title":"Acute and Chronic Hypopituitarism Following Traumatic Brain Injury: A Systematic Review and Meta-Analysis","volume":"47","author":"Aljboor","year":"2024","journal-title":"Neurosurg. Rev."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2551","DOI":"10.1017\/S0033291718003495","article-title":"Posttraumatic Stress Disorder and Incidence of Thyroid Dysfunction in Women","volume":"49","author":"Jung","year":"2019","journal-title":"Psychol. Med."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1530\/eje.1.02191","article-title":"Incidence of GH Deficiency\u2014A Nationwide Study","volume":"155","author":"Stochholm","year":"2006","journal-title":"Eur. J. Endocrinol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"102830","DOI":"10.1016\/j.bas.2024.102830","article-title":"Acute Neuroendocrine Changes after Traumatic Brain Injury","volume":"4","author":"Stankovics","year":"2024","journal-title":"Brain Spine"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"118547","DOI":"10.1016\/j.lfs.2020.118547","article-title":"The Protective Effects of Prolactin on Brain Injury","volume":"263","author":"Yousefvand","year":"2020","journal-title":"Life Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"100049","DOI":"10.1016\/j.cpnec.2021.100049","article-title":"Plasma Prolactin Is Higher in Major Depressive Disorder and Females, and Associated with Anxiety, Hostility, Somatization, Psychotic Symptoms and Heart Rate","volume":"6","author":"Elgellaie","year":"2021","journal-title":"Compr. Psychoneuroendocrinol."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/6\/955\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T14:05:44Z","timestamp":1774274744000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/6\/955"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,23]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["diagnostics16060955"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16060955","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,23]]}}}