JRE #574 – Dr. Mark Gordon, Matthew Gosney & Jason Hall

This Joe Rogan podcast dives deep into the world of traumatic brain injury (TBI) and its impact on veterans, athletes, and even everyday individuals. The episode features Dr. Mark Gordon, a leading expert in interventional endocrinology and TBI treatment, along with Matthew Gosney, a former Navy SEAL and patient of Dr. Gordon’s, and Jason Hall, screenwriter of the movie “American Sniper.” The conversation explores the complexities of TBI, its often-overlooked hormonal dimension, and the limitations of traditional treatment methods, prompting discussions about the urgent need for holistic approaches to healing.

Provocative topics include the distinction between PTSD and TBI, the effectiveness of hormone replacement therapy in treating TBI symptoms, the financial and ideological barriers to accessing this treatment, and the ongoing suicide crisis within the military. Underlying themes delve into the impact of trauma on the mind and body, the importance of personalized medicine, the failures of traditional medical systems in addressing TBI, and the urgent need for greater awareness and advocacy.

Major Topics:

1. Traumatic Brain Injury (TBI) and PTSD:
   1. Distinguishing between PTSD and TBI: PTSD is a psychological response to traumatic experiences, while TBI involves physical damage to the brain.
   2. TBI’s prevalence among veterans and athletes: Advancements in medical technology have saved lives, but they’ve also led to a greater awareness of the prevalence of TBI in soldiers returning from combat and athletes in contact sports.
   3. The hidden impact of TBI: TBI can lead to a range of symptoms, including depression, anxiety, cognitive impairment, and chronic pain, often going undiagnosed or misdiagnosed.
   4. The importance of recognizing the signs: The conversation highlights the need for greater awareness of TBI symptoms and for healthcare professionals to screen for TBI as a potential cause of mental and physical health issues.
2. Hormonal Deficiencies and TBI:
   1. The hormonal dimension of TBI: Dr. Gordon explains that TBI can disrupt the brain’s ability to produce and regulate hormones, leading to deficiencies in testosterone, growth hormone, and other critical hormones.
   2. The impact of hormonal imbalances: Hormone deficiencies can contribute to a wide range of TBI-related symptoms, including depression, fatigue, cognitive decline, and chronic pain.
   3. The effectiveness of hormone replacement therapy: Dr. Gordon presents compelling evidence that hormone replacement therapy, tailored to individual needs, can effectively alleviate TBI symptoms and improve overall well-being.
   4. The promise of personalized medicine: The podcast underscores the importance of individualized treatment approaches, emphasizing the need for thorough hormonal assessments and personalized hormone replacement regimens.
3. The Limitations of Traditional Treatment:
   1. The reliance on medication: The conversation critiques the common practice of treating TBI symptoms with antidepressants, anti-anxiety medications, and pain killers, without addressing the underlying hormonal imbalances.
   2. The shortcomings of talk therapy: While acknowledging the importance of mental health support, the podcast argues that traditional talk therapy alone may not be effective in addressing TBI-related issues, especially without addressing the physiological dimension.
   3. The “masking” effect of medication: Dr. Gordon suggests that medication often masks TBI symptoms without truly addressing the root cause, leading to dependence and potentially masking the true nature of the problem.
   4. The need for a multi-faceted approach: The podcast highlights the need for a more holistic approach to TBI treatment, integrating hormone replacement therapy, nutritional support, lifestyle changes, and mental health support.
4. The Military’s Response to TBI:
   1. The underfunding of TBI treatment: Joe Rogan expresses his frustration at the lack of investment in TBI treatment within the military, despite the significant financial resources allocated to combat operations.
   2. The stigma associated with TBI: The conversation explores the stigma surrounding TBI within the military and the culture of “toughing it out,” often preventing veterans from seeking help or acknowledging their struggles.
   3. The challenges of transitioning to civilian life: The podcast addresses the complexities of transitioning back to civilian life after combat, highlighting the lack of adequate support and resources for veterans dealing with TBI.
   4. The need for systemic change: The conversation emphasizes the need for systemic change within the military and the VA, urging for greater awareness, better screening, and more comprehensive treatment options for TBI.
5. The Controversy of Hormone Replacement Therapy:
   1. The stigma associated with hormone replacement: The podcast discusses the public perception of hormone replacement therapy, often associated with athletic performance enhancement or perceived as “artificial” or “unnatural.”
   2. The financial barriers to access: The conversation highlights the cost of hormone replacement therapy and its potential inaccessibility for those who lack insurance or financial resources, perpetuating a cycle of under-treatment.
   3. The importance of evidence-based medicine: Dr. Gordon emphasizes the importance of evidence-based medicine in addressing the controversy surrounding hormone replacement therapy, citing the wealth of scientific research supporting its effectiveness in specific conditions.
   4. The need for open dialogue: The podcast promotes a more open and informed dialogue about hormone replacement therapy, challenging misconceptions and promoting a better understanding of its potential benefits and risks.
6. The Case for Holistic Health:
   1. The interconnectedness of mind and body: The conversation emphasizes the interconnectedness of mind and body, suggesting that treating mental health issues without addressing the physical dimension can be ineffective.
   2. The importance of lifestyle factors: The podcast acknowledges the role of lifestyle factors such as nutrition, exercise, stress management, and sleep in promoting overall health and well-being, particularly in the context of TBI.
   3. The need for individualized care: The conversation highlights the need for personalized treatment plans that address the unique needs and circumstances of each individual, recognizing that a one-size-fits-all approach may not be effective.
   4. The potential for transformation: The podcast presents a hopeful message, emphasizing that through a holistic approach, individuals struggling with TBI can experience significant improvements in their mental and physical health.
7. Transgender Athletes and the Ethics of Competition:
   1. The complexities of gender identity: The conversation addresses the complexities of gender identity and the ethical considerations surrounding transgender athletes competing in sports.
   2. The role of hormones in gender development: The podcast explores the role of hormones in shaping the physical development and characteristics of individuals, highlighting the potential impact of hormonal transitions on athletic performance.
   3. The need for fairness and inclusivity: The conversation acknowledges the importance of fairness and inclusivity in sports, emphasizing the need to balance the rights of transgender athletes with the principles of competitive fairness.
   4. The lack of consensus and ongoing debate: The podcast acknowledges the lack of definitive answers and the ongoing debate surrounding the inclusion of transgender athletes in competitive sports, urging for continued research and open dialogue.

Memorable Quotes:

1. “You cannot fix the mind when the body is not working. When it’s physiologically not working correctly, the mind will never get better.” – Matthew Gosney underscores the importance of addressing the physical dimension of TBI in order to facilitate mental healing.
2. “The point of foundation is the distinction between what PTSD is versus minimal or mild traumatic brain injury…The distinction between the 2 is a psychological one, which is PTSD, and they physical one which is traumatic brain injury.” – Dr. Mark Gordon highlights the crucial difference between PTSD and TBI and the need to recognize both.
3. “There’s so much money for weapons and so much money…for the latest high-tech ways to kill people and so little money on how to treat these guys when they come back.” – Joe Rogan expresses his dismay at the disparity in funding for combat operations versus TBI treatment.
4. “We’re talking about a fucking blood test. Yeah, talking about a blood test to test their hormones. And it’s like, oh, what a crazy idea.” – Joe Rogan underscores the simplicity of the hormone testing approach, lamenting the resistance to this straightforward solution.
5. “It’s a it’s a subject that’s very near and dear to my heart…And when sometimes when you hear things and you don’t hear it echoed in other places, you say, well, maybe I’m talking to a crackpot.” – Joe Rogan articulates his own journey of understanding TBI and the skepticism he initially faced.