T Nation

Traumatic Brain Injury + Low T


35 yr old male, 6ft 3 195 lbs. Was involved in a Tbone car accident 6 years ago. I got hit by a car going 60mph and my SUV went airborne and landed on it’s side. After I escaped from the small gap in the driver side window and the road, I collapsed on the ground, started hyperventilating, and a painful burning sensation went through my extremities.

Diagnosed with mild TBI. My symptoms are brain fog, headaches, sensitivity to light and sound, low energy, neck pain/muscle tightness, sleep issues, post convergence insufficiency(eyes struggle to converge and track objects).

Medications: Lortab, ambien. Lortab started about 2 years ago. I had my second child and with the lack of sleep, I couldn’t control the pain. Several attempts to stop longest being 2 months but not successful thus far.

Below are my blood test.

Dihydrotestosterone 179 pg/mL 112 - 955 pg/mL

Testosterone,Free 6.42 ng/dL 4.85 - 19.0 ng/dL

Testosterone, Bioavailable 79 ng/dL 72 - 235 ng/dL

TESTOSTERONE,TOTAL 207 ng/dL 240 - 950 ng/dL

T3, Free 2.9 pg/mL 1.7 - 3.7 pg/mL

Free T4 1.16 ng/dL 0.70 - 1.48 ng/dL

TSH 1.36 mcIU/mL 0.35 - 4.94 mcIU/mL

Cortisol 10.2 mcg/dL

Prolactin 12.7 ng/mL 3.5 - 19.4 ng/mL

FSH 2.0 mIU/mL See Below mIU/mL
LH 1.9 mIU/mL See Below mIU/mL
Estradiol, Sensitive 23 pg/mL 10 - 40 pg/mL
Vitamin D, 25-OH, Total 103 ng/mL

A couple months later I got another test done which was normal

Total T 573 ng/dL
T Bioavailable 252 ng/DL range 72-235
FSH 3.5IU/L range 1-18
LH(S) 5.5 IU/L
AM Cortisol 9.2 mcg/DL range 7-25

My first blood test 6 months ago showed Total T 429.

My MRI w DTI showed no damage. Reading about HPA dysfunction, it seems that may be my issue and explains why I can’t handle any stressors, sleep disturbances and low energy. I’m not sure if pituitary would show up as damaged or not on MRI of the brain.

There’s a book by Dr Larry Komer who’s theory is that people with head injuries need optimal levels of Testosterone, above 600+ in order for brain to start to heal.

At this point, I’m ready to try anything. I’m suffering every second. My primary doctor was ready to start TRT but I said I wanted to wait till I was off pain pills for 6 months+. Also, I just did 6 weeks of keto but my pain got worse and had to stop it today.

I appreciate any input. Thanks!


For the moment it sounds like you’ve got a good doctor, it’s really important to start TRT without these medications that damage your hormones, these medications will diminish TRT effectiveness. He also is most likely wanting to see your levels after these drugs are out of your system and see where you’re at.

If you want to improve fertility on TRT you’ll need HCG as part of your TRT protocol. 30 year Klonopin user here, it fried my pituitary gland when I attempted to taper off the drug, these drugs will always cause health problems down the road.

Hopefully you won’t need them as TRT brings about calmness and clarity, but only if you get off these drugs. TSH looks great, best indicator of fT3 status is taking body temps using glass thermometer upon waking and 12-2pm. Should be 97.7 upon waking and 98.6 12-2pm.