Ep. 52
If you’ve noticed changes in your libido since your concussion, or you feel more symptomatic after sex or orgasm, you are not alone. This is a question our team hears often, and it’s one many people find hard to ask out loud.

In this episode, Dr. Paul Hrkal, Dr. Cameron Marshall, and Melinda Krynen Hill answer a real member question about libido changes and symptom flares after intimacy, and break down the different layers that can be involved.


- Hormones can shift slowly after a concussion. The pituitary gland helps regulate reproductive, thyroid, and adrenal hormones. Changes can build gradually, sometimes 6 to 12 months or more after injury, rather than showing up right away.

- The nervous system and physical capacity both play a role. Arousal relies on a calm, parasympathetic state, while climax is a quick shift toward sympathetic activation. With autonomic imbalance after concussion, that shift can feel like a lot.

- Sex is also a form of exercise, so if your heart rate threshold is low, that can contribute to symptoms.

- Mood, confidence, and fatigue matter just as much. Living with symptoms can affect how we see ourselves. Fear, anxiety, low mood, and heavy fatigue can all lower desire, and each one points to a different kind of support. A rise in libido can also happen, and it can sometimes be a way of coping with loss.

Takeaways

Talk about it. Changes in intimacy are common, and sharing them with a provider or someone you trust is a helpful first step.

Work on isolating variables. A sub-symptom threshold exercise program can help you learn whether the physical effort of sex is a trigger, or whether something else is going on.

Consider getting objective information. Hormone testing and a mood evaluation can help you and your care team understand which layers apply to you.

Timestamps
0:30 Welcome and today’s member question
1:06 Hormones and the pituitary gland
2:51 The parasympathetic to sympathetic “toggle” and symptoms after orgasm
3:55 Fear, anxiety, and the nervous system response to intimacy
6:32 How PCS affects confidence, identity, and desire
8:14 Symptoms, fatigue, and exercise intolerance
10:01 Sub-symptom threshold exercise: how to isolate the physical variable
11:30 Four areas to explore and where to start
12:49 Hormone testing and working with your care team
13:53 Depression, anxiety, and fatigue: telling them apart
15:23 Why libido changes can sneak up months later
16:18 When libido increases: the hormone and coping perspectives
19:58 Parting words: normalize the conversation
23:19 Closing

Remember, recovery is possible. You are not alone.

Learn more about the Concussion Fix program for PCS - https://www.concussionfix.com/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx

Don't forget to subscribe to the podcast so you can be notified about more valuable content on concussion recovery!

Learn more about the Concussion Fix program for PCS - https://concussiondoc.io/offer/the-concussion-fix/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx


Remember, these insights are not medical advice. Always consult with your healthcare provider before making any changes to your treatment plan.

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

Episode 50
If you have ever felt like anxiety, overwhelm, or a racing nervous system is making your concussion symptoms worse, you are not alone. And you are not imagining it.

In this episode, Melinda Krynen Hill guides Dr. Cameron Marshall and Nikki Fraser through three live nervous system regulation practices that you can use right now, wherever you are, no experience required.

Here is what they cover:
What the window of tolerance actually means and why it matters so much in concussion recovery
How grounding foot and palm presses can anchor your nervous system when you are feeling activated or overwhelmed
Why box breathing is one of the most accessible tools for managing high-distress moments, like right before a meeting or a difficult task
How the three-minute breathing space works and when to use it
The difference between hyperarousal and hypoarousal, and why going too deep too fast can actually leave you feeling worse
What to do if you drop into a numb, flat, or shutdown state after a regulation practice
Why seated meditation is not always the right tool when you are highly dysregulated, and what to do instead
How to use movement as a bridge back into your window of tolerance

Dr. Cam started the session at an 8 out of 10 on the distress scale and ended at a 3. Nikki moved from a 5 to a 2. These are simple practices. And they work.

If your nervous system feels like it is constantly running too hot, or sometimes completely shut down, this episode was made for you. Recovery is possible, and learning to regulate your nervous system is one of the most foundational steps in the process.

Visit www.concussionfix.com to learn more about the step-by-step Concussion Fix program and find the support you deserve. Subscribe so you never miss an episode.

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io


Learn more about the Concussion Fix program for PCS - https://www.concussionfix.com/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx

Don't forget to subscribe to the podcast so you can be notified about more valuable content on concussion recovery!

Learn more about the Concussion Fix program for PCS - https://concussiondoc.io/offer/the-concussion-fix/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx


Remember, these insights are not medical advice. Always consult with your healthcare provider before making any changes to your treatment plan.

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

Episode 49

If you are living with persistent concussion symptoms and feel exhausted no matter what you do, this episode is for you.

Fatigue is one of the most common and most misunderstood symptoms in post-concussion syndrome. It is also one of the most layered. In Episode 49 of the Concussion Fix Podcast, Nikki Fraser sits down with Dr. Paul Hrkal and Melinda Krynen Hill to unpack many of the dimensions of PCS fatigue, from nutritional deficiencies and hormonal disruption to emotional exhaustion, deconditioning, and sensory overload.

This is not a one-size-fits-all conversation. The panel walks you through a systematic, detective-style approach to figuring out what is actually driving your fatigue so you can stop guessing and start addressing the right things in the right order.

Here is what they cover in this episode:

• Why emotional exhaustion is the most overlooked cause of fatigue in PCS, and why validating it first changes everything
• How iron deficiency and B12 deficiency can quietly drain your energy, and why concussion often surfaces these pre-existing issues
• The role of the pituitary gland and why concussion can disrupt thyroid function, cortisol, testosterone, growth hormone, and more
• Why standard blood panels often miss adrenal dysfunction, and what kind of testing actually gives you accurate results
• What morning fatigue specifically tells you about your cortisol and adrenal health
• Why waking up tired after a full night of sleep is a completely separate problem from not sleeping enough
• How physical deconditioning after concussion turns ordinary daily tasks like grocery shopping or riding transit into exhausting events
• Why sensory overload from light and noise is itself a significant source of fatigue, and how graduated exposure helps rebuild tolerance
• The emotional weight of identity loss, life disruption, and the pressure to be who you were before your injury
• How clinical depression and anxiety, even mild versions, drain neurochemical and physical energy
• A simple pen-and-paper self-assessment Dr. Hrkal recommends to identify your personal fatigue drivers
• How to find a therapist or counsellor who understands traumatic brain injury, depression, anxiety, and life transitions
• Why sub-symptom-threshold cardiovascular exercise is one of the most evidence-based tools for rebuilding energy capacity
• How the Concussion Fix Pyramid guides you to address emotional and nervous system regulation before jumping into clinical testing

The most important thing to know is this: PCS fatigue is not laziness, weakness, or something you just have to live with. It is multifactorial, it is real, and there is a clear, structured path to understanding and addressing it.

Explore the full step-by-step Concussion Fix program at www.concussionfix.com. Subscribe so you never miss an episode.

Don't forget to subscribe to the podcast so you can be notified about more valuable content on concussion recovery!

Learn more about the Concussion Fix program for PCS - https://concussiondoc.io/offer/the-concussion-fix/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx


Remember, these insights are not medical advice. Always consult with your healthcare provider before making any changes to your treatment plan.

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

Episode 48
If your child is living with persistent concussion symptoms, you are probably doing everything you possibly can to help them heal. But what if some of that help is actually slowing their recovery down?
In this episode, Nikki Fraser sits down with Dr. Cameron Marshall and Dr. Paul Hrkal to talk about one of the most emotionally charged dynamics in concussion recovery: the role of parents when their child has PCS.

This conversation was sparked by a real question from one of our program members, a mom navigating recovery alongside her older teenage son, and the discussion that followed was one we knew we had to share.

Here is what we cover:
- Why doing the program on your child's behalf can backfire, no matter how well-intentioned
- The age ranges at which parental involvement should shift from hands-on to background support
- Age of the child does matter. Young kids - parents completing the program. Younger teens - a partnership between parent and child. Older teens - they need to do the program themselves, with parents offering some support.
- How parental anxiety is actually a documented predictor of prolonged recovery in kids
- Why teen athletes with PCS face unique emotional and identity challenges
- The three things parents can do right now to genuinely support their child's recovery
- When to bring in additional professional support, and why a clinician's voice often lands differently than a parent's

Recovery is possible, even for kids who feel stuck, angry, or shut down. The path forward starts with giving them the tools to walk it themselves.

Learn more and explore the Concussion Fix program at www.concussionfix.com. Subscribe so you never miss an episode.

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

#ConcussionRecovery #PersistentConcussionSyndrome #TeenConcussion #PostConcussionSyndrome #ConcussionFix #KidsConcussion #PCSRecovery #ConcussionParent #BrainHealth #YouthAthletes #ConcussionAwareness #ParentingWithPCS

Don't forget to subscribe to the podcast so you can be notified about more valuable content on concussion recovery!

Learn more about the Concussion Fix program for PCS - https://concussiondoc.io/offer/the-concussion-fix/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx


Remember, these insights are not medical advice. Always consult with your healthcare provider before making any changes to your treatment plan.

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

Episode 47

Struggling with concussion symptoms every time the temperature rises? You are not imagining it, and you are not alone.

In this episode of the Concussion Fix Podcast, Nikki Fraser sits down with Dr. Paul Hrkal and Dr. Cameron Marshall to answer a question that hits close to home for many members right now: how does heat actually affect persistent concussion symptoms, and what can you do about it?

With heat waves increasing in frequency across the globe, this episode could not be more timely.
If you have ever noticed your symptoms flaring in warm weather, felt dizzy or faint in the heat, or found yourself hiding in the one cool corner of your home just to get through the day, this episode was made for you.

Here is what Dr. Hrkal and Dr. Marshall cover:

- Why autonomic nervous system dysregulation makes people with PCS so much more sensitive to heat
- How heat acts as a stressor on the same systems that concussion already disrupts, including blood flow regulation, heart rate control, and vasodilation
- Why avoidance makes heat intolerance worse over time, and what to do instead
- The gradual exposure method: how to safely build heat tolerance the same way athletes acclimatize to hot climates
- Short-term survival strategies for getting through a heat wave right now
- The role of hydration and electrolytes, especially sodium, in managing autonomic dysfunction
- Practical cooling tools like wet towels, cold basins for hands and feet, and frozen water bottles
- How anticipatory anxiety about heat can make symptoms worse and what you can do to calm your nervous system before heading out
- Why the morning hours are your best window for errands and outdoor activity in summer

Recovery is possible, even in the middle of a heat wave. The key is small, consistent, gradual steps forward.

Learn more and explore the full Concussion Fix program at www.concussionfix.com. Subscribe so you never miss an episode.

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

Don't forget to subscribe to the podcast so you can be notified about more valuable content on concussion recovery!

Learn more about the Concussion Fix program for PCS - https://concussiondoc.io/offer/the-concussion-fix/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx


Remember, these insights are not medical advice. Always consult with your healthcare provider before making any changes to your treatment plan.

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

Episode 46
Are your concussion symptoms getting worse and you can't figure out why? If you're a woman in your 40s or 50s, hormones might be the missing piece of your recovery puzzle.
In this episode of the Concussion Fix Podcast, Nikki Fraser sits down with Dr. Paul Hrkal and Melinda Krynen Hill to unpack the complicated relationship between perimenopause, menopause, and persistent concussion symptoms (PCS). This is one of the most common questions from members of our program, and for good reason.
Here's what we cover:

How a concussion can disrupt hormone production, sometimes months or even a year later
Why perimenopause and PCS symptoms look so similar, and how to tell them apart
Simple at-home tracking strategies to see if your cycle is affecting your mood and symptoms
What hormone testing to ask for and who to see
How balancing hormones creates a "neuropermissive environment" for brain healing

Recovery is complex, and for many women, hormonal dysregulation is a layer of the onion that goes unaddressed for far too long. You deserve answers that actually account for everything your body is going through.
If this resonates, you are not alone, and recovery is absolutely possible.
Visit us at www.concussionfix.com to learn more about the Concussion Fix program and the step-by-step support waiting for you there. Subscribe so you never miss an episode.

Learn more about the Concussion Fix program for PCS - https://www.concussionfix.com/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

#ConcussionRecovery #PersistentConcussionSyndrome #PCSRecovery #Perimenopause #HormoneHealth #BrainHealth #WomensHealth #ConcussionFix #PostConcussionSyndrome #TraumaInformedCare

Don't forget to subscribe to the podcast so you can be notified about more valuable content on concussion recovery!

Learn more about the Concussion Fix program for PCS - https://concussiondoc.io/offer/the-concussion-fix/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx


Remember, these insights are not medical advice. Always consult with your healthcare provider before making any changes to your treatment plan.

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

Episode 45
Nikki Fraser sits down with Dr. Paul Hrkal, ND, to unpack one of the most common and frustrating symptoms after a concussion: sleep disruption. If you've been lying awake at 3am wondering why your brain just won't settle, this episode is for you. You are not alone, and there are real answers here.
What You'll Learn:
Why up to 70% of people experience sleep disruption after a concussion, including how circadian rhythm, inflammation, and neurotransmitter imbalance all play a role
The truth about the old advice to wake someone up every 30 minutes after a concussion (and when it actually does and doesn't apply)
How different sleep disorders (insomnia, hypersomnia, sleep apnea) require different approaches to treatment
Why napping can help in the acute phase but may work against you in PCS recovery
Sleep hygiene essentials: darkness, cool temperature, managing noise, screen use and blue light exposure
Why stomach sleeping is the worst position, and how side sleeping supports your brain's glymphatic system (its overnight detox process)
The top 3 free things you can do right now to start improving your sleep: optimize your sleep environment, get natural light during the day, and regulate your nervous system before bed
Why sleep medications should be a last resort, not a first step, and the risks of long-term use
How to start a sleep journal to track what's helping and what's hurting
Key Takeaways: Start with one thing. You do not have to do it all at once. Build slowly, one habit at a time, just like recovery itself. [2]

Don't forget to subscribe to the podcast so you can be notified about more valuable content on concussion recovery!

Learn more about the Concussion Fix program for PCS - https://concussiondoc.io/offer/the-concussion-fix/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx


Remember, these insights are not medical advice. Always consult with your healthcare provider before making any changes to your treatment plan.

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

Episode 44
This week's episode dives into one of the most complex questions we've received from our community: Can a concussion cause intermittent paralysis?

A member of the Concussion Fix program shared their experience, a TBI followed by recurring episodes of losing motor function in their legs, triggered by cognitive overload and stress. No pain, no clear diagnosis, despite an ICU admission, spinal and brain MRIs, and an fMRI. Usually lasting a few weeks until they push through and can walk or even jog again, until the next episode.

In this episode, Dr. Marshall, Dr. Hrkal, and Melinda discuss:
Why paralysis is not a typical concussion symptom, and what to rule out first
The neurological workup you should seek if you're experiencing unusual symptoms
What Functional Neurological Disorder (FND) is, and why it came up in this discussion
The difference between concussion causing a symptom vs. concussion as a system stressor
How chronic stress, cognitive overload, and pre-existing conditions can amplify and manifest as neurological symptoms after a concussion
The concept of parasympathetic shutdown (freeze response) and how it may play a role
Why PCS is really a reflection of your overall health going into the injury
How other stressors (Long COVID, mould, trauma, grief) can produce the same PCS-like symptoms
Why shifting the mindset, from "my brain is damaged" to "my systems are dysregulated," is key to recovery

Key takeaway: A concussion doesn't directly cause paralysis. But the nervous system dysregulation, chronic stress cycle, and predisposing factors that follow a concussion can sometimes manifest in complex and unexpected ways. Always rule out serious neurological causes first, and then explore the whole-person picture.

Please note: The Concussion Fix team are not your primary healthcare providers. Nothing discussed in this episode or in these show notes constitutes medical advice, a diagnosis, or a treatment plan. We are sharing a general discussion based on a question asked by a community member, with limited information available to us. Every person's situation is unique, and we strongly encourage you to work with your own qualified healthcare team for anything related to your personal health. Always seek professional medical advice before making any changes to your care.
Remember, recovery is possible. You are not alone. 💚

Learn more about the Concussion Fix program for PCS - https://www.concussionfix.com/
Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/
Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io

Don't forget to subscribe to the podcast so you can be notified about more valuable content on concussion recovery!

Learn more about the Concussion Fix program for PCS - https://concussiondoc.io/offer/the-concussion-fix/

Hear what people are saying about the Concussion Fix Program - https://concussiondoc.io/offer/love-page/

Take part in one of our free 90-minute patient workshops to learn how you can conquer your PCS - https://webinar.concussiondoc.io/s/qMKYfx


Remember, these insights are not medical advice. Always consult with your healthcare provider before making any changes to your treatment plan.

Intro song credit - I Feel Good - All Good Folks, Orfium (Hexacorp Ltd.)- downloaded from Uppbeat.io