Low Testosterone in Combat Veterans
Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.
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Many combat veterans are at risk for low testosterone, which may be one of the symptoms of post-traumatic stress disorder (PTSD). There is an overlap between TBI and symptoms associated with low testosterone, including increased weight, irritability, apathy, sleeplessness, depression, erectile dysfunction and low sex drive. Because of this, symptoms of PTSD may be mistaken for low testosterone. But this condition does not necessarily lead to a diagnosis of PTSD.
PTSD
A recent study found a link between low testosterone and PTSD. Soldiers in Iraq were tracked and their saliva samples collected to measure hormone levels. These soldiers had been exposed to stressful situations before they went on deployment, and soldiers with abnormal cortisol levels were at a higher risk of developing PTSD after being deployed. The study, known as the Texas Combat PTSD Risk Project, was funded by the Defense Advanced Research Projects Agency.
The results of the study found that plasma levels of testosterone in CR-PTSD patients were similar to those in normal controls. It was theorized that the reduction in testosterone was due to the acute stress response of the HPG axis during the deployment period and adaptation to chronic psychological stress. In one study, researchers followed a 29-year-old Marine who had suffered two blast concussions, a brief loss of consciousness, hyperacusis, and irritability. The patient's symptoms persisted despite the completion of cognitive therapy and psychopharmacologic trials.
Testosterone levels were significantly lower than those of normal subjects in the PSQI and CES-D. The study also found that testosterone levels were higher in the PCL group than in the CONT and PS groups. However, the results of the study were not statistically significant. Low testosterone levels may be the cause of the higher risk of PTSD in combat veterans. There is still no conclusive proof that low testosterone levels cause PTSD, but this is a strong indication that more research is needed to confirm the link.
The connection between low testosterone and PTSD has long been suspected. The findings of the study suggest that low testosterone may trigger the symptoms of PTSD and TBI. Many men who experience low testosterone are at risk for suicide and other psychological disorders. It is important to note that these symptoms often mimic other physical ailments. If not treated, they can be mistaken for depression and can even worsen the conditions associated with PTSD. If left untreated, testosterone may become more severe.
TBI
A study from the PTSD Initiative Vietnam Veteran Study found that combat veterans with low testosterone levels were at a higher risk of developing PTSD. This increased risk of testosterone deficiency has been associated with reduced muscle mass and insulin resistance. Researchers looked at the relationship between testosterone and personality in combat veterans. Interestingly, lower testosterone levels were associated with antisocial, aggressive and intemperate behavior. These findings were particularly strong in men who were recruited from low socioeconomic backgrounds. This is a troubling finding for combat veterans, who may be susceptible to depression and drug abuse.
TBI can damage the pituitary gland, which regulates testosterone levels in the body. This causes an imbalance of cortisol, the stress hormone, to remain elevated. This is harmful for the brain, which needs testosterone to function properly. In combat veterans, the hormones are depleted for as long as three years. But the condition can be reversed. The brain is designed to respond to a low level of testosterone, so the first step is to identify the cause.
A study of male brain testosterone levels during wartime stress revealed a connection between low testosterone levels and "unmanly" behavior. The study also revealed a connection between lower testosterone levels and mental breakdown. Men in combat have been labeled as "babies" and "hysterical" because of the trauma and stress they experience. This study did not investigate the gender differences, however, but the findings have implications for the treatment of PTSD and for combat veterans.
The study included 28 male veterans and active duty U.S. service members with mTBI, blast exposure, and other conditions. Enrollment was conducted in 2012-2015, and informed consent was obtained from all participants before the study began. The study protocol was approved by the National Institutes of Health's Combined Neuroscience Institutional Review Board, and participants signed the research protocol after receiving information about the study and its procedures.
Vitamin D deficiency
The effects of vitamin D deficiency in combat veterans with lowered testosterone have not yet been fully understood. But a new study suggests that supplemental vitamin D may improve the performance of combat veterans. Vitamin D is a nutrient that our bodies produce in response to ultraviolet light. It regulates the gene expression of nearly 300 genes, including those involved in immune function, stress response, and the movement of calcium throughout the body. Combat veterans are expected to have widespread vitamin D deficiency. In addition, vitamin D levels and testosterone are highly correlated.
A study of active duty servicemen found that 35% had serum 25(OH)D levels below 20 ng/ml. In the same study, researchers observed that 57% of female recruits were in the deficient range at the start of basic training, and this percentage increased to 75% after eight weeks of outdoor training. In addition, combat training occurs during fall, so the soldiers are not exposed to the sun for adequate vitamin D production.
The results of this study suggest a link between low vitamin D levels and traumatic brain injury. In a study of service members, men with traumatic brain injury (TBI) were at a higher risk for low testosterone, while non-TBI veterans had lower levels. Vitamin D is a critical regulator of inflammation, so supplementation may improve the immune system's response to mTBI. The study also identifies the frequency of testosterone prescriptions among service members.
Future research should prospectively assess the prevalence of vitamin D deficiency in servicemen. In addition to identifying clinically significant associations between vitamin D levels and lipid profiles, such as those seen in combat veterans with low testosterone, these studies should investigate the mechanisms underlying vitamin D deficiency. Such intervention studies may help explain the complex relationship between hormones and lipid metabolism. In the meantime, the results should encourage researchers to recommend supplemental vitamin D supplementation as a supplement.
PTSD causes suicide ideation
Suicide ideation in combat veterans is a troubling trend. The cause of the problem has not been determined yet, but a lack of testosterone is likely to play a role. Suicide is often framed as dishonoring the fallen, and in some cases, the victim has no idea that he will ever get back to his former life. But there are ways to counter the problem and help combat veterans stay alive.
The basic principle behind therapeutic approaches is the locus-of-control shift. A combat veteran processes information through his or her developmentally normal cognitive apparatus, while the general population processes information through their magical child's mind. The magical child believes that he is the center of the universe and can make anything happen. It is a developmental stage that is characterized by primary narcissism and concrete operations.
The study was conducted on the linked Millennium Cohort Study data. Researchers analyzed combat experiences, and analyzed medical encounters. This data was used to determine whether combat exposures were associated with suicide ideation in combat veterans. In addition, the data included combat-specific questionnaires. After removing those who had attempted suicide prior to enrollment, the study population comprised 57 841 participants. However, the research results cannot be applied to all combat veterans.
Despite the fact that men account for the majority of suicides, women are disproportionately affected by this problem. Women veterans, while a smaller proportion of the military, die by suicide than their male counterparts. In fact, female service members die by suicide at a higher rate than non-veterans. The report showed that suicide attempts among women veterans were 2.2 times higher than those of non-veterans.
Low testosterone levels increase risk of mortality
The low testosterone levels of combat veterans are linked to a higher risk of mortality. Although these risks have been associated with cardiovascular disease, the exact mechanisms are unknown. The researchers based their findings on decades of observational studies. Many population-based studies show a negative relationship between testosterone and mortality. In addition, it has been shown that low testosterone levels are associated with more severe cardiovascular events. Although this association is still being explored, there is some preliminary evidence suggesting that testosterone levels may benefit cardiovascular health.
The results of the new VA study are likely to attract attention due to its size and the relatively long follow-up period. However, this study does not support a blanket prescription of testosterone therapy for combat veterans. According to Dr. Rajat Barua, corresponding author of the study, "Treatment of low testosterone without raising testosterone levels appears to have no benefit in reducing cardiovascular risk."
A new study of US military veterans has demonstrated that low testosterone levels are a strong predictor of death. Men who experienced critical illness were significantly more likely to die than men with normal testosterone levels. But the results of the study do not hold for the general population. The Veterans Association Puget Health Care System and University of Washington studied 858 men to find out if testosterone levels increase or decrease their risk of mortality.
The study also found that low testosterone levels are associated with an increased risk of mortality among combat veterans. Although equivocal testosterone levels did not differ significantly from men with normal testosterone levels, men with low testosterone were found to have an 88% higher mortality risk than those with normal testosterone. This relationship remained after the study took into account age and other factors. Further, even after fully adjusting the model, men with low testosterone levels had a higher risk of death.
