Brain injury fatigue is common yet hormonal imbalance seems an unusual complication of brain injury. Depression must always be screened for.
The following tests (serum/plasma sample)* should be performed at 09:00:
- Men: Urea, creatinine and electrolytes Free T4 and thyroid-stimulating hormone (TSH), Cortisol Luteinising hormone (LH), follicle-stimulating hormone (FSH), testosterone, sex hormone-binding globulin, albumin.
- Women: Urea, creatinine and electrolytes Free T4 and TSH Cortisol* and In premenopausal women. If menstrual cycle has become abnormal post-TBI, check LH, FSH, oestradiol In postmenopausal women FSH.
*If the patient is taking an oestrogen-containing oral contraceptive pill or oral hormone replacement therapy, we recommend seeking endocrine advice prior to assessing hypothalamic–pituitary–adrenal axis function.