top of page

Veterans and Athletes Might be at Risk for Low Testosterone

Updated: Mar 23, 2023

Athletes, especially in contact sports are at risk for TBI and low testosterone
Athletes, especially those who play contact sports such as football, lacrosse, or rugby, are at increased risk for traumatic brain injury.

Both spinal cord injury (SCI) and traumatic brain injury (TBI) are major conditions that can affect a person's physical and mental well-being. The influence that these traumas can have on testosterone levels in both men and women is one such consequence that is frequently disregarded. Spinal cord injuries and traumatic brain injuries are much more common in military veterans and athletes than in the rest of the population. In this article, we'll look at how TBI and SCI might result in low testosterone and discuss possible solutions.


Testosterone is primarily a male hormone most of which is produced in the testicles in men. Male sex organs and secondary sexual traits including muscular bulk, body hair, and a deep voice are all developed as a result of testosterone. Because it affects energy levels, mood control, and bone density, testosterone is crucial for overall wellness and health.

Symptoms of low testosterone can include decreased libido, erectile dysfunction, exhaustion, sadness, and decreased muscle mass. When combined with the mental and emotional difficulties caused by TBI or SCI, these symptoms can significantly reduce a person's quality of life.

What is Traumatic Brain Injury?

When an external force impacts the brain, it can result in a traumatic brain injury (TBI). This force can be a result of a blow to the head or body, sudden acceleration or deceleration, or even an object penetrating the skull. The severity of TBI ranges from mild, like a concussion, to severe and can lead to various symptoms, including headaches, dizziness, confusion, memory problems, and even loss of consciousness. Depending on the severity and location of the injury, TBI can have long-term effects on a person's physical, cognitive, and emotional well-being. Early diagnosis and proper treatment are crucial in managing TBI. With the right treatment, many individuals can recover and lead fulfilling lives.

What is Spinal Cord Injury?

When damage occurs to the spinal cord, it results in a spinal cord injury (SCI). There are many causes of SCI, including traumatic events like falls, car accidents, or sports injuries, as well as non-traumatic events like diseases or infections. The severity of the injury can range from mild to severe and can result in a range of symptoms, including loss of movement, loss of sensation, and changes in bodily functions like breathing or bowel control. An SCI can have lifelong effects on a person's mobility and daily life, depending on the severity and location of the injury. However, with early diagnosis and proper treatment, people with SCI can lead fulfilling and independent lives with the assistance of assistive devices and rehabilitation therapies.

Military veterans TBI low testosterone
Military veterans serving overseas are at increased risk of traumatic brain injury and spinal cord injury due to the nature of combat.

How do TBI and SCI Cause Low Testosterone?

When a person experiences a TBI or SCI, the injury can damage the pituitary gland. The pituatary gland is a small area of the brain that is responsible for production of hormones such as luteinizing hormone (LH) and follicle stiulating hormone (FSH). LH, in turn, stimulates the testicles or ovaries to produce testosterone. If the pituitary gland is not producing enough LH, testosterone levels will drop significantly. Aside from TBI or SCI, injuries to the testicles themselves can also cause a decrease in testosterone production.

Treatment for Low Testosterone

What can be done to address low testosterone levels in those who have suffered from TBI or SCI? The first step is to obtain a correct diagnosis via a blood test that measures testosterone levels. In case of low levels, hormone replacement therapy (HRT) may be suggested. HRT entails administering synthetic testosterone to bring levels back to normal. HRT can come in different forms, such as patches, injections, gels, and pellets.

In addition to HRT, there are other lifestyle changes that can be made to support healthy testosterone levels. These include regular exercise, a healthy diet rich in protein and healthy fats, stress management techniques like meditation or yoga, and adequate sleep. These changes can help to support overall hormonal balance and promote the body's natural testosterone production.

A systematic review published in Cerus in January 2023 looked at the effects of traumatic brain injury (TBI) and spinal cord injury (SCI) and the impact of testosterone replacement. The authors wrote that SCI and TBI increase the risk for a low testosterone levels, resulting in adverse changes in body composition and poor functional outcomes. The authors concluded that "Testosterone therapy with exercise may help improve muscle mass, bone health, strength, energy expenditure, and cardiac health in men with SCI without major adverse effects." Although there was evidence to support the use of testosterone replacement therapy in SCI, there still isn't enough scientific data to support the use of HRT in those affected by TBI.


To sum up, TBI and SCI can cause low testosterone levels in men, leading to various symptoms and reducing their quality of life. However, there are ways to manage this issue, including hormone replacement therapy and lifestyle modifications. If you or someone you know has experienced TBI or SCI, it's crucial to speak with a license physician or other healthcare professional about the possibility of low testosterone and the appropriate steps to take to manage it.

Here at Black Tie Health™, we offer preliminary men's health consultations via telehealth for only $99. During these consultations, we can discuss treatment options, write prescriptions, and order tests - all of it done online. We can also help you with information on which dietary supplements are likely to be best for your specific medical situation, as well as provide you with recommended dosages.

Telehealth appointments can be made using the "Book Now" button below.


McLoughlin RJ, Lu Z, Warneryd AC, Swanson RL 2nd. A Systematic Review of Testosterone Therapy in Men With Spinal Cord Injury or Traumatic Brain Injury. Cureus. 2023 Jan 27;15(1):e34264. doi: 10.7759/cureus.34264. PMID: 36855479; PMCID: PMC9968415.


bottom of page