Traumatic brain injury, abnormal growth hormone secretion, and gut dysbiosis

Peyton A. Armstrong, Navneet Venugopal, Traver J. Wright, Kathleen M. Randolph, Richard D. Batson, Kevin C.J. Yuen, Brent E. Masel, Melinda Sheffield-Moore, Randall J. Urban, Richard B. Pyles

Research output: Contribution to journalReview articlepeer-review


The gut microbiome has been implicated in a variety of neuropathologies with recent data suggesting direct effects of the microbiome on host metabolism, hormonal regulation, and pathophysiology. Studies have shown that gut bacteria impact host growth, partially mediated through the growth hormone (GH)/insulin-like growth factor 1 (IGF-1) axis. However, no study to date has examined the specific role of GH on the fecal microbiome (FMB) or the changes in this relationship following a traumatic brain injury (TBI). Current literature has demonstrated that TBI can lead to either temporary or sustained abnormal GH secretion (aGHS). More recent literature has suggested that gut dysbiosis may contribute to aGHS leading to long-term sequelae now known as brain injury associated fatigue and cognition (BIAFAC). The aGHS observed in some TBI patients presents with a symptom complex including profound fatigue and cognitive dysfunction that improves significantly with exogenous recombinant human GH treatment. Notably, GH treatment is not curative as fatigue and cognitive decline typically recur upon treatment cessation, indicating the need for additional studies to address the underlying mechanistic cause.

Original languageEnglish (US)
Article number101841
JournalBest Practice and Research: Clinical Endocrinology and Metabolism
Issue number6
StatePublished - Dec 2023


  • brain injury associated fatigue and altered cognition (BIAFAC)
  • growth hormone
  • gut-brain axis
  • microbiome
  • pituitary
  • traumatic brain injury

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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