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Brain trauma can lead to low testosterone

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3/23/12 12:37 PM

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Underground Blog 27 The total sum of your votes up and votes down

Member Since: 12/3/08
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MixedMartialArts.com

The cynical story goes like this:
MMA fighter takes illegal PEDs.
PEDs inhibit your body's natural generation of testosterone (sometimes permanently, yikes)
Fighter stops at the end of the cycle, and natural levels of testosterone lower.
Fighter goes to a sympathetic MD and complains of fatigue, poor sleep, etc.
Doctor diagnoses low testosterone, and prescribes Testosterone Replacement Therapy (TRT).
Fighter goes to AC and gets Therapuetic Use Exemption (TUE).

The cynical story is that lots of fighters are doing it, and that AC TUEs in MMA are irresponsible.

"That’s a joke. Forget it. It’s a joke," said Dr. Don Catlin, member of the International Olympic Committee's medical commission responsible for reviewing TUE applications. "I think in all the years I’ve done it, we’ve given two."

However, two factors are casting this narrative in a clearer light.

First, TUE in MMA is rare. as determined by a survey of the leading Athetic Commissions in the US.

"We've given out three in 12 years," says Nevada's Keith Kizer, to Dan Henderson, Todd Duffee, and Shane Roller. New Jersey's Nick Lembo put the number at "less than five." The busiest commissioner in the world, Ohio's Bernie Profato has given only two, to Henderson and Strikeforce fighter Bristol Marundo.

So out of 15,000 regulated fighters, only a handful of TUEs have ever been granted. That is not an epidemic.

"It’s very rare, but there are some legitimate needs," Lembo explains. "My biggest concern is that most commissions don’t even test for these things in the first place so we’re over-penalizing the people that are coming forward and saying, ‘Hey, do whatever you want to me. Test me before and after the fight. Test me randomly. I need this, I’m on it and I’m going to be within normal limits.’ There are a lot of commissions who don’t believe in TUEs for any reason, but why be hard on the ones coming forward?"

The second factor - one that until now was largely unknown - is that head trauma can lead to low levels of testosterone. In a truly important piece, Mike Chiappetta explains.

In 2007, a paper published in the Journal of Athletic Training reported the first known connection between mild concussions and hypopituitarism, a deficiency that can lead to low testosterone.

That research, along with how traumatic brain injuries impact the pituitary gland, is being continued by Dr. Daniel F. Kelly, the director of the Brain Center and Pituitary Disorders Program in Santa Monica, California.

Kelly is currently in the midst of a study of 75 former NFL players. In an interview with MMA Fighting, Kelly said that preliminary data from the study suggests that pituitary damage is occurring in a subset of the retirees.

That study seems to corroborate a 2006 finding in Turkey that found that head injuries incurred by pro kickboxers have resulted in damage to the pituitary gland.

Dr. Fahrettin Kelestimur, a professor of endocrinology at Erciyes University in Turkey who authored the 2006 study, told MMA Fighting that the most common damage has caused growth hormone deficiency and hypogonadism, respectively.

Only a handful of state commissions require an MRI in order to grant a fighter’s license, but MRIs don’t always show the problem. A blood draw is more likely to determine if an issue exists, according to Kelly. Tests for luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone, growth hormone (GH) and IGF-1 (insulin-like growth factor 1) could serve as an effective screening tool to determine any pituitary damage.

Dr. Kelly, who has been working on issues pertaining to the pituitary gland for nearly 20 years, in 2008 co-authored a study that concluded chronic hypopituitarism occurred in approximately 20 percent of patients who had suffered mild, moderate or traumatic brain injury.

"(MMA) fighters are getting repeated insults to the head, sometimes more than concussive events," Kelly said. "And if you did a careful analysis of those people, I'm sure you'd see a significant rate of pituitary gland dysfunction. That's my prediction."

"I guess what’s really amazing, if you look at it another way, is how infrequently it occurs, and how sturdy the system is, how much damage it can take. The pituitary gland is this tiny little thing that’s less than a centimeter cubed. It’s sitting in a little, bony depression in the skull base and it’s getting banged around, and the connection is getting banged around repeatedly, yet it keeps it on ticking in most people. It’s a pretty resilient system, but only up to a point."

Read entire article...

3/23/12 1:05 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
crowbar 326 Member Since: 1/1/01 Posts: 30453	Mmmmm more loopholes. You have ignored this user.

3/23/12 1:17 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
Mike Chiappetta 14 Member Since: 1/31/07 Posts: 2057	Underground Blog - In a truly important piece, Mike Chiapetta explains How dare you misspell the name of a respected forum member! You have ignored this user.

3/23/12 1:30 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
Kirik 505 Member Since: 1/1/01 Posts: 46639 The Underground, Mayor for Life	Mike Chiappetta - Underground Blog - In a truly important piece, Mike Chiapetta explains How dare you misspell the name of a respected forum member! DOH You have ignored this user.

3/23/12 1:35 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
KevinMcAllister 181 Member Since: 10/20/10 Posts: 5657	Oh man, Mike is fucking PISSED. You have ignored this user.

3/23/12 2:17 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
Mike Chiappetta 14 Member Since: 1/31/07 Posts: 2058	KevinMcAllister - Oh man, Mike is fucking PISSED. Yep. This is my last post (until my next one). In all seriousness, I hope people take a look at this story. I always read complaints on here that there's no real journalism in MMA, but when we do serious stories like this, there isn't a lot of feedback. You have ignored this user.

3/23/12 2:19 PM

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Porkchop 45 The total sum of your votes up and votes down

Member Since: 6/26/07
Posts: 6778

Mike Chiappetta -
KevinMcAllister - Oh man, Mike is fucking PISSED.

Yep. This is my last post (until my next one).

In all seriousness, I hope people take a look at this story. I always read complaints on here that there's no real journalism in MMA, but when we do serious stories like this, there isn't a lot of feedback.

Journalism in MMA usually sucks but I found your story very, very serious. :)

3/23/12 2:26 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
goku Member Since: 8/6/08 Posts: 15334	and so the solution is to give them trt so they can cause brain trauma to other fighters? You have ignored this user.

3/23/12 2:32 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
JohnnyChrist Member Since: 12/20/10 Posts: 510	Thank you, finally, an actual mma news site and journalist publishing a really important point on TRT. Everytime in the past I brought up that head trauma IS a cause for low testosterone, it gets completely ignored. You have ignored this user.

3/23/12 2:32 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
JohnnyChrist Edited: 03/23/12 2:31 PM Member Since: 12/20/10 Posts: 511	You have ignored this user.

3/23/12 2:39 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
Funaki Masakatsu #1 132 Member Since: 9/18/09 Posts: 1753	I made a thread on this topic a few weeks ago. This is a very real issue. Anybody who thinks TRT automatically = past steroid use is so wrong it's crazy. You have ignored this user.

3/23/12 2:41 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
Porkchop 45 Member Since: 6/26/07 Posts: 6782	ttt for You have ignored this user.

3/23/12 2:43 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
goku Member Since: 8/6/08 Posts: 15336	and so? does this somehow justify giving them trt to elongate the career that gave them brain damage so that they can also inflict brain damage on others? if your fights have cause you to take such damage that your hormones have been knocked out of whack maybe its god telling you to hang it up You have ignored this user.

3/23/12 2:48 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
Porkchop 45 Member Since: 6/26/07 Posts: 6786	i say we pump them full of as many roids as we can before they get in the cage. fuck it. they want to kill eachother anyways. You have ignored this user.

3/23/12 2:49 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
zedlepln 99 Member Since: 2/24/09 Posts: 14710	Piece by ESPN 5 years ago. You have ignored this user.

3/23/12 2:51 PM

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Funaki Masakatsu #1 132 The total sum of your votes up and votes down

Member Since: 9/18/09
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goku - and so?

does this somehow justify giving them trt to elongate the career that gave them brain damage so that they can also inflict brain damage on others?

if your fights have cause you to take such damage that your hormones have been knocked out of whack maybe its god telling you to hang it up

It's less about stereotypical "brain" trauma and more about pituitary gland damage. It's not so much your typical "punch drunk", slurry speech brain trauma that causes low testosterone but a rea in the pituitary gland caused by the culumative number of hard punches to the front of the skull. Phone Post

3/23/12 2:53 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
zedlepln 99 Member Since: 2/24/09 Posts: 14711	goku - and so? I don't think Mike was making any normative claims. His article is informative, not editorial. You have ignored this user.

3/23/12 2:55 PM

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KevinMcAllister 181 The total sum of your votes up and votes down

Edited: 03/23/12 2:55 PM
Member Since: 10/20/10
Posts: 5658

Mike Chiappetta -
KevinMcAllister - Oh man, Mike is fucking PISSED.

Yep. This is my last post (until my next one).

In all seriousness, I hope people take a look at this story. I always read complaints on here that there's no real journalism in MMA, but when we do serious stories like this, there isn't a lot of feedback.

You and Fowlkes are some of the only guys who bother doing serious stories at all. Keep it up, the sport needs more real newsmen instead of these TMZ style hacks.

3/23/12 3:05 PM

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Kirik 505 The total sum of your votes up and votes down

Member Since: 1/1/01
Posts: 46641
The Underground, Mayor for Life

Mike Chiappetta -
KevinMcAllister - Oh man, Mike is fucking PISSED.

Yep. This is my last post (until my next one).

In all seriousness, I hope people take a look at this story. I always read complaints on here that there's no real journalism in MMA, but when we do serious stories like this, there isn't a lot of feedback.

This is the most important story I have read this year, and was really curious to how the UG would respond, if at all.

3/23/12 3:07 PM

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Mike Chiappetta 14 The total sum of your votes up and votes down

Member Since: 1/31/07
Posts: 2059

goku - and so?

does this somehow justify giving them trt to elongate the career that gave them brain damage so that they can also inflict brain damage on others?

if your fights have cause you to take such damage that your hormones have been knocked out of whack maybe its god telling you to hang it up

Dr. Dan Kelly, who I spoke with for the article and who has made it his life's work to study the brain and pituitary gland (Google him), said it is very possible that a fighter could have damage to the pituitary but have no other problems. It is possible that the cumulative effect of hits over the years leads to this issue without a fighter ever having been concussed or have any other long-term brain-related issues (motor skill problems, etc).

3/23/12 3:12 PM

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Funaki Masakatsu #1 132 The total sum of your votes up and votes down

Member Since: 9/18/09
Posts: 1755

Mike Chiappetta -
goku - and so?

does this somehow justify giving them trt to elongate the career that gave them brain damage so that they can also inflict brain damage on others?

if your fights have cause you to take such damage that your hormones have been knocked out of whack maybe its god telling you to hang it up

Dr. Dan Kelly, who I spoke with for the article and who has made it his life's work to study the brain and pituitary gland (Google him), said it is very possible that a fighter could have damage to the pituitary but have no other problems. It is possible that the cumulative effect of hits over the years leads to this issue without a fighter ever having been concussed or have any other long-term brain-related issues (motor skill problems, etc).

This exactly.

Great work on the story, Mike. There's too much ridiculously ignorant opinions on TRT in MMA. Hopefully this helps change things. Phone Post

3/23/12 3:17 PM

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zedlepln 99 The total sum of your votes up and votes down

Edited: 03/23/12 3:18 PM
Member Since: 2/24/09
Posts: 14713

Mike Chiappetta -
goku - and so?

does this somehow justify giving them trt to elongate the career that gave them brain damage so that they can also inflict brain damage on others?

if your fights have cause you to take such damage that your hormones have been knocked out of whack maybe its god telling you to hang it up

Dr. Dan Kelly, who I spoke with for the article and who has made it his life's work to study the brain and pituitary gland (Google him), said it is very possible that a fighter could have damage to the pituitary but have no other problems. It is possible that the cumulative effect of hits over the years leads to this issue without a fighter ever having been concussed or have any other long-term brain-related issues (motor skill problems, etc).

I would be very curious to hear what his best guess, if he can form one, as to risk by activity. MMA is still in its infancy but the last few years have seen an influx in the impact of CTE. Football, hockey, boxing, and pro wrestling all have felt the sting of brain trauma.

WIth respect to MMA, my concern moreso focuses on training than actual competition. Jessica Bednark, a top 10 female at 145, spent 30 days in a coma almost 3 years ago from an injury sustained while training (with headgear, no less). Training involves much more repititive head impact, making me question that environment and how trainers conduct sparring sessions.

3/23/12 3:21 PM

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goku

Member Since: 8/6/08
Posts: 15337

Mike Chiappetta -
goku - and so?

does this somehow justify giving them trt to elongate the career that gave them brain damage so that they can also inflict brain damage on others?

if your fights have cause you to take such damage that your hormones have been knocked out of whack maybe its god telling you to hang it up

Dr. Dan Kelly, who I spoke with for the article and who has made it his life's work to study the brain and pituitary gland (Google him), said it is very possible that a fighter could have damage to the pituitary but have no other problems. It is possible that the cumulative effect of hits over the years leads to this issue without a fighter ever having been concussed or have any other long-term brain-related issues (motor skill problems, etc).

possible...ok...like time travel is possible?

how likely is it tho?

3/23/12 3:23 PM	Ignore \| Quote \| Edit \| Warn Admin \| Vote Down \| Vote Up \| Delete Post
Sylaarr 1 Member Since: 11/14/11 Posts: 113	Interesting read! You have ignored this user.

3/23/12 3:26 PM

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zedlepln 99 The total sum of your votes up and votes down

Member Since: 2/24/09
Posts: 14715

goku -
Mike Chiappetta -
goku - and so?

does this somehow justify giving them trt to elongate the career that gave them brain damage so that they can also inflict brain damage on others?

if your fights have cause you to take such damage that your hormones have been knocked out of whack maybe its god telling you to hang it up

Dr. Dan Kelly, who I spoke with for the article and who has made it his life's work to study the brain and pituitary gland (Google him), said it is very possible that a fighter could have damage to the pituitary but have no other problems. It is possible that the cumulative effect of hits over the years leads to this issue without a fighter ever having been concussed or have any other long-term brain-related issues (motor skill problems, etc).

possible...ok...like time travel is possible?

how likely is it tho?

Just guessing, but "very possible" does imply a non-trivial degree of likelihood.

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