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to forward operating bases, nutrition is limited to what 2. McHugh PR, Treisman G. PTSD: a problematic diagnostic
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reduction in processed foods that contain a high level 1089–1096.
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important modification for a healthy diet. Nutritional agnosis of mild traumatic brain injury, posttraumatic stress
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Although TBIs occur too commonly in the Armed Ser- cessed 22 September 2014.
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nostic criteria from DSM-IV-TR. Washington, DC: American
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mind. Active duty, training, and deployment have their 11. American Psychiatric Association. Diagnostic and statistical
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discharging rifles, mortars, or other ordinance, there is can Psychiatric Publishing; 2013.
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the lungs or through the skin. Inhaled microscopic metal 13. McMillan TM. Errors in diagnosing post-traumatic stress dis-
particles or particles deposited on the skin can be ab- order after traumatic brain injury. Brain Inj. 2001;15:39–46.
sorbed into the body. Heavy metals build up over time 14. Sbordone RJ, Ruff RM. Re-examination of the controversial
and can result in neurological injury that can mimic TBI, coexistence of traumatic brain injury and posttraumatic stress
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personnel being exposed to environmental hazards and 15. Sumpter RE, McMillan TM. Misdiagnosis of post-traumatic
chemicals have been well documented and may have stress disorder following severe traumatic brain injury. Br J
neurological and psychological consequences. 41,42 The Psychiatry. 2005;186:423–426.
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and wreak havoc with hormone balance and neurologi- lence of chronic pituitary and target-organ hormone abnor-
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Disclosure rum free triiodothyronine, total triiodothyronine, thy-
roxine-binding globulin, and total thyroxine levels in
The authors have nothing to disclose. combat-related posttraumatic stress disorder. Arch Gen Psy-
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