Brain trauma can lead to low testosterone

by Kirik Jenness | source:

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."

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Recent Comments »

Gnarls Gnarlington site profile image  

3/23/12 8:42 PM by Gnarls Gnarlington

great read. thanx for sharing!

DanTheWolfman site profile image  

3/23/12 6:37 PM by DanTheWolfman

On Supplements, addressing the Estrogen issue more..........Also, watch beginning if you want to see Frank Shamrock kicked out of the ring by Yuki Kondo. Please note in my first vid I posted, talking about HCG, that is towards Mr. Regular Joe, not fighters, and most if not all commissions event with TUE TRT exemptions do NOT ALLOW HCG use, nor does the IOC (though IMO if it's range in use can be tested low dose typical prescription dose of 500iu/week should be allowed for the fighters well being as well as still having a chance to conceive if they should wish......if you have Low T, a real medical issue, you should also be able to keep your job and be allowed to have still have a family IMO and not have to choose) Please do not flame me for these blogs, I am merely sharing my story and non-medical expert advise and hope it helps some or makes you more aware. I would say if you are like 32 or already getting a gut you definitely should be aware of these issues, ie Estrogen, Zinc, D3 common problems etcPlease take a look at and subscribe to

DanTheWolfman site profile image  

3/23/12 6:28 PM by DanTheWolfman

My Test TT has gone from a low low 312 to a super low below range 202 in the past couple years...........and after many changes I have only gotten it up to 246 per my results I got yesterdayAlso, Boxing study shows a much higher rate of boxers developing Auto-Immune diseases which also then effect hormone levels. In my case, Lupus and Sjorgen's. I am seeing one of the top hormone specialists in the world, and will likely do a Combat Sports brain study with MRI/MRA etc hopefully that study can look for Pituitary Tumor or damage. This is REAL IMOAnd keep in mind we have 25-30% lower Testosterone than our Grandfathers. Also, many young guys, and almost all guys by mid 30's have high Estrogen. Our diets and water supply have a lot to do with both. The high use of birth control compared to the years of yore is pee'd out and does not get filtered out when put back into the water supply. If you look at all the hormone and anti-aging health forums there are tons of guys with messed up hormone panels like myself, but what is shocking is how many young guys, I mean early 20's have similarly bad hormone in-balances. Sparring so hard so often at a particular gym I went to, and a couple of MMA gyms were famous for is not in a fighters best interest IMO opinion in the long run. How many MMA STARS were famous and on top with great chins for awhile that you can think of, that have fallen to the way side and are not nearly as effective years later? (Especially those from the hard sparring gym wars gyms)Don't be so quick to judge if you really haven't done your research and are not in the fighters shoe's.

The Principal site profile image  

3/23/12 5:24 PM by The Principal

Most use TRT to have the same attributes they had when they were younger and b/c they are fighting others that are younger or use it themselves. Lots of conditions lower testosterone, especially aging. The extent mma fighters experience low testosterone due to head trauma/pituitary damage isn't known. The number of fighters that use TRT and never report it isn't known either. I would assume true low test is a lot rarer then you would think. Most anti-aging Docs prescribe it like Botox.

SC MMA MD site profile image  

3/23/12 4:57 PM by SC MMA MD

 It turns out that the study quoted from the Journal of Athletic Training is a case report of hypopituitarism from multiple concussions in a teenager. The boxing studies discuss retired boxers.  If the theory that combat sport athletes can have hypotituitarism that leads to low testosterone at young ages is proven true, that changes my thought process about TRT.  However, as many have stated above, it is known that steroid use is common in MMA, and that it can lead to hypogonadism; so it is premature to assume that everyone on TRT had a medical need that was not created by prior steriod abuse. Interesting topic.

Standup29 site profile image  

3/23/12 4:52 PM by Standup29

Guys who are young like Duff could have either been born with the issue, got sick or as most seem to think abused steroids. Course we always think the worst but since most forget they look at more than just test levels when approving Tue's for try I am going to fall on the not cheating steroid abusers.

goku site profile image  

3/23/12 4:45 PM by goku

i think the concern is that people are looking down the line...they see these huge muscled high performing athletes getting the TUE and really question how difficult it really is to get and how this could very well be a trend that grows... also, even if its just a few guys, look at rampage's slam on bader...looking at hendo causing brain damage to multiple opponents...the risks are huge...and if some people have a legitimate condition that requires trt, fine, but it doesnt mean they should be allowed to hurt other people in sanctioned mma fights  

SC MMA MD site profile image  

3/23/12 4:42 PM by SC MMA MD

 This.  I was under the impression that tons of fighters have them.  Apparently not.  The quoted studies seem to imply that head trauma can lead to hypopituitarism LATER IN LIFE, but some of the known fighters with TUEs are fairly young.  I am waiting for the full study to see how old the subjects were.  It will be interesting to see if the brain injury study currently looking at professional fighters adds any knowledge here, but I am not sure that the protocol includes endocrine testing.  Has anyone on here signed up for the study or have the study protocol?

UGCTT_mrthesnake site profile image  

3/23/12 4:33 PM by UGCTT_mrthesnake

Interesting to hear a young guy like duffee being a recipient of a TUE

Slaughter on Tenth Avenue site profile image  

3/23/12 4:09 PM by Slaughter on Tenth Avenue

It's a health issue and quality of life issue. As Chael Sonnen said on last week's MMA Uncensored TRT is legal too.