From Hormones to Horses: How Veterans Are Finally Getting Help for Brain Injuries

Brandon Alt’s transition from combat Marine to college student was stormy — the Afghanistan veteran fought headaches and pain, memory loss, a bad temper.

Then came the seizures, knocking him to the ground, paralyzing him for dark, lost stretches of time.

Like many post-9/11 vets, Alt believed his symptoms were related to post-traumatic stress. The infantry Marine had provided security for Army dustoff operations near Marjah, protecting medics and helping retrieve the gruesomely wounded, usually under heavy fire — a harrowing experience that left its scars.

The seizures were a clue, however, that something other than PTSD might be going on in Alt’s brain. While seizures can be caused by psychological trauma, they are more commonly linked to a physical problem such as chemical imbalance, tumor or stroke. In Alt’s case, they were attributed to a traumatic brain injury, or TBI, caused by the numerous bumps and blast exposure he experienced while deployed.

Prior to his first grand mal seizure, the kind that causes muscle contractions and loss of consciousness, Alt never had been seen by a neurologist or received a brain scan. A glance at a post-seizure MRI was all it took for a physician to tell Alt he had a TBI.

Four years of trying nearly everything, from conventional medicine to non-traditional therapies, followed. Cannabidiol and medical marijuana. Anti-seizure medications. Antidepressants. Antipsychotics. But finally he found a treatment that let him sleep again, revived his energy levels, boosted his memory and stopped the seizures. He hasn’t had one since 2018.

“I’d had multiple overdoses. I was suicidal all the time. I felt like there was no way that I was ever going to get better and that I was just screwed up,” Alt said during an interview from his home in Denver. “It took a podcast for me to figure out what helped. How scary is that?”

For years, treatment for traumatic brain injury has proven elusive. First, military leadership was hesitant to confront the problem, then slow to act. But even when decisions were made to start more aggressively combating the burgeoning issue that was blighting so many veterans, medical science was far behind. Brain damage is irreversible, and most treatments and therapies seek to address symptoms and restore function by training the brain to operate differently.

As Generation Z appears hesitant to enlist in part because of the possibility of physical injury or psychological trauma, the Defense Department is moving to embrace a brain health approach it hopes will serve current members well now and prevent head injuries in future troops, unveiling a new strategy this year that could reshape how the agency handles TBI.

“We want you in for the long haul. We want you to have a highly functional and productive life when you leave the military,” said Katherine Lee, a senior health policy analyst with DoD and a force behind the department’s recently unveiled brain health strategy. “These monitoring programs, documentation of brain threats, understanding the late and long-term effects [of injury] and putting mitigation strategies in place is based on trying to have you perform at your highest levels.”

And as the nearly 460,000 service members and veterans with TBI age, understanding the lasting effects, treating TBI and providing long-term care will be key to helping them live full lives, according to advocates and physicians.

But for affected service members and veterans, there are signs that effective treatment is beginning to come into view. Medical research is finally yielding results in the area of concussion detection as well as treatment.

One treatment that might be able to do more than manage symptoms — hormone replacement therapy.

Alt learned about that treatment from a podcast featuring Dr. Mark Gordon, a family medicine physician at the University of Southern California, who has studied hormone replacement and reducing inflammation as treatments for TBI. TBI often impacts the pituitary gland, harming hormone production and causing a cascade of medical ailments for those afflicted.

Alt had his hormone levels checked and was put on human growth hormone as well as testosterone. Having tried so many different things across the years, he wasn’t too optimistic.

Three weeks later, his mood and energy levels lifted. He slept better. And in eight weeks, he reached a “natural state of homeostasis.”

“I felt foggy and depressed and anxiety-ridden and wasn’t getting any sleep from the time I got out of the Marine Corps in 2012 until 2018 … that’s when I finally started hormone replacement therapy full time, and I’m not going to stop until I die,” Alt said.

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