Physical trauma (eg: car accident)
Physical trauma such as a road accident or a fall can precipitate fibromyalgia and ME/CFS, particularly if a head or neck injury is sustained (such as whiplash or concussion).
Fibromyalgia and ME/CFS can appear immediately after an accident, or begin to develop over the subsequent months.1 2 One study found fibromyalgia was 13 times more likely to occur following neck injury compared to lower extremity injury.1
However, note that hypopituitarism will occur in up to 30% of people who sustain a moderate or severe traumatic brain injury (TBI), and can sometimes occur even in mild TBI. Hypopituitarism can have symptoms very close to those of ME/CFS.1 Thus there is a real danger of misdiagnosing such symptoms ME/CFS when the true cause is hypopituitarism. If a traumatic brain injury is involved, and ME/CFS-like symptoms ensue, testing for hypopituitarism would be advised. The short synacthen test (also called the ACTH stimulation test) is a standard test for hypopituitarism, but this test is not very accurate, and in fact misses 40% of hypopituitarism cases. A more accurate but more complex and risky test for hypopituitarism is the insulin tolerance test.
A trauma to the spine can sometimes cause a syringomyelia to later form in the spinal cord, which may result in ME/CFS-like symptoms. Syringomyelia can be treated surgically.
It may be worthwhile to see an endocrinologist to discuss the effects of your concussion. If it turns out that the concussion has caused some damage to the pituitary, then hormone replacement of the hormones that aren't being produced would be in order.
I researched traumatic brain injury (TBI) and how it affects hormones because I had a whiplash injury shortly before developing ME/CFS. I just recently shared some of these articles with my primary doc and endocrinologist. Here are some of the articles I found:
Hypopituitarism after traumatic brain injury
I think the article is saying that hypopituitarism is common even with mild concussion.
A low T4 in the absence of elevated TSH indicates secondary hypothyroidism. TSH deficiency has been found in TBI patients evaluated by assessing either basal hormone levels (1–22%)or response to TRH stimulation (4.5%). A previous series demonstrated a very high occurrence of thyrotropin deficiency among TBI patients with hypopituitarism, suggesting TBI as an important cause of otherwise unexplained central hypothyroidism.
Title: Endocrine evaluation of patients after brain injury: what else is needed to define specific clinical recommendations?
Brain Injury and Pituitary Dysfunction
Occurrence of pituitary dysfunction following traumatic brain injury
Reduced reactivity and enhanced negative feedback sensitivity of the hypothalamus-pituitary-adrenal axis in chronic whiplash-associated disorder
Here's a good outline discussing hypopitutiarism:
In the 90's there was a psychiatrist, Dr. Jay Seastrunk, who was doing trials using Neurontin on people who had neuro trauma prior to getting CFS. I had been in a car accident in the late 80's and my head hit the steering wheel so I qualified for his study.
He had a questionnaire to determine if you qualified. I can't remember most of what was on it but he did ask if you heard music when a hair dryer was on, did you experience J'aime vous? I can't remember any more.
So was on 3200 mgs of Neurontin. After about a year I had gained 60 lbs and right before I started to titrate off I was hallucinating. But for awhile I felt ok.
Here is a link I found.