<s>[INST] Hi doctor, I am a 28 year old male and I have been living with a lower quality of life for the past eight to nine years, starting around six to seven months after I had a pretty severe concussion. I had been diagnosed with post-concussion syndrome and saw several neurologists who ran numerous tests and scans but never did anything for me. The problems I have had are brain fogginess, slight memory problems, increased anxiety, lower sex drive, sleep problems, concentration difficulties, slight dizziness and an overall feeling of not feeling 'myself'. I have dealt with these issues for around eight years and pretty much gave up on trying to feel 'normal'. Recently, I read about how TBI can cause pituitary damage leading to growth hormone deficiency which covers several of my problems and has been underdiagnosed in patients who had TBI. I also had a severe ankle break from sliding during a paintball game a couple of years ago, five breaks in my ankle and one of the worst the surgeon had seen. I understand low bone density could also be caused by low GH and could have attributed to the severity of my break. I had also been concussed on one or two other occasions less severe than the one nine years ago. Is low GH something that I could have and should look into screening for? [/INST] Hello. I just read your query and from what you have mentioned, I feel that you could have osteoporosis or osteopenia rather than growth hormone deficiency. You can have your bone DEXA scan done and follow up with your orthopedician if it turns out to be either. Growth hormone deficiency causes a loss of muscle mass rather than decreased bone mineral density. Regarding dizziness, it could be benign positional vertigo for which you can see an ENT specialist. A traumatic brain injury does not mean severe concussion. Both are involving different areas of the brain. If you are still in doubt, you can have an insulin tolerance test for growth hormone reserve assessment. Hope you find my advice beneficial. Good luck. For more information consult an endocrinologist online --> </s>