As the field of anti-aging medicine is becoming a cutting-edge specialty, many doctors enter it with a wide variety of backgrounds and experiences. After 13 years of private practice in physical medicine, rehabilitation and pain management, I became acutely aware of the devastation caused by sedentary living, lack of proper nutrition and fitness, and the effects of imbalanced hormones on my patients. I have had the privilege of taking care of patients with very challenging problems caused by life-changing injuries or chronic diseases such as diabetes, osteoporosis, arthritis, and obesity. These medical conditions would often result in loss of function and quality of life for my patients.
My Dallas/Fort Worth-based BodyLogicMD practice affords me the opportunity to offer patients additional treatment options to address these complex diseases. For example, testosterone is a vital hormone for both men and women and many times its levels are impacted by chronic diseases treated by traditional medicine and prescription drugs.
Testosterone plays a key role in the health and well being of both males and females –benefits include:
• Improves brain function
• Increases energy
• Increases strength
• Increases bone density
• Increases libido
• Improves sexual sensitivity
• Improves sexual function
• Improves HDL and LDL levels
• Improves cardiovascular health
What many don’t realize is testosterone plays a key role in decreasing pain and inflammation.
Opioid (narcotic) medications such as Vicodin actually decrease testosterone levels and result in erectile dysfunction in men.
Women are also susceptible to these effects. Studies show that women with severe, persistent pain treated with narcotics develop low testosterone levels and benefit from testosterone replacement. Seventy-one percent of treated women reported an increase in libido, pain control, endurance, and energy with testosterone replacement therapy.
Hormone balance also plays a role in arthritis. Studies show that patients with rheumatoid arthritis often have lower levels of testosterone and DHEAS and higher levels of estradiol. Correcting these hormonal imbalances improves results for both male and female patients. Testosterone replacement therapy is also showing promise in the treatment of osteoarthritis, with a positive association with serum testosterone at all tibial cartilage sites.
In addition, type-2 diabetic men can achieve better glucose control, while reducing their reliance on insulin, when restoring testosterone levels.
Balancing testosterone levels is possible via patches, cream, injection, or with pellet therapy insertion. Pellet therapy is a sustainable delivery method for bioidentical hormone therapy, which is an ideal way to help balance body chemistry and restore health and vitality. The effect is similar to the way hormones produce in healthy 30-something men and women.
Overall, in my experience, I have seen testosterone replacement therapy provide marked anti-inflammatory effects often improving lifestyle in formerly inactive patients, decreasing pain in osteoarthritis and rheumatoid arthritis, increasing libido and sexual function as well as muscle mass and bone density while decreasing fat mass. Patients often report improved energy, mood and quality of life.
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References
Daniell HW et al. Hypogonadism in men consuming sustained-action oral opioids. JPain. 2002 Oct;3(5):377-84.
Tennent et alo. Hypotestosteronemia and testosterone replacement in females with severe, persistent pain. American Pain society, 2004
Tengstrand B et al. Abnormal levels of serum dehydroepiandrosterone, estrone, and estradiol in men with rheumatoid arthritis: high correlation between serum estradiol and current degree of inflammation. J Rheumatol. 2003 Nov;30(11);2338-43.
Cutolo M. Sex hormone adjuvant therapy in rheumatoid arthritis Rheum Dis Clin North Am. 2000 Nov;26(4);881-95.
Cicuttini FM et al. Factors affecting knee cartilage volume in healthy men. Rheumatology (Oxford). 2003 Feb;42(2):258-62
Lichten E. Testosterone’s overlooked role in the treatment of diabetes in men. Life Extension 2007 Jul 23-29
My 55 year old husband has been on disability for 1 1/2 years being treated for severe depression and anxiety. He’s so tired he has to take multiple naps a day. He’s on a coctail of medications. Recently the GP gave him testostrone. His mood, mental clarify, labido, energy (not so much tiredness) improved so much, we wanted to throw away all the anti-depressants (Wellbutrin, Budeprion, Citalopram, Lamictal, Trieptal, Flomax, Neupro, Lipitor. High PSA levels made us have to decrease the testosterone. Prostrate biopsies were negative. So they slowly started the testosterone again. We’re going to see an endocrinologisy next week. I was interested in increasing the testosterone and looking into hyperparathyroidism. He’s had kidny stones and some abnormality between the kidney and blatter. He also has ostoarthritis.
If you have any ideas, I’d love to hear them.
He’s gained at least 20 pounds almost binge eating, like getting the munchies. Excessive portions and is always hungry. We assumed it was the medicine. He should pobably have a test for hypoglycemia as well.
Thanks
ssri s ,or anti depressants can cause low libido and excessive tiredness, to much pain meds vicodin can cause low sex driveafter taking it for 3 to 4 years try morphine sulfate 30 to 60 mg. time release,I do not know his pain level.
I have had three shoulder surgeries as result of accident in 10/2004. I use a Duragesic 50 mcg patch and a Fentanyl 12 mcg patch every 48 hours and take Opana for breakthrough pain. I now have difficulty passing my water and take Flomax. I also use Androgel to help with weakness when my testosterone level dropped to 133. Could the pain medicine cause the urine and low testosterone problem ? Thank you for any help you can offer.
William Clark
William – Yes, pain medications can suppress Testosterone levels and pain medications may also lead to difficulties with urination.
I am a 50 year old female who has been suffering from persistant pain in my knee for the past 10 months. The pain killers, corteosteroid and synvisc shots, and PT haven’t helped. I was started on a low dose of testosterone cream for an unrelated reason 2 months ago. For the past month I have had little to no pain in my knee. This is great, but I would like to better understand how hormone replacement therapy can have such a popsitve and profound effect on my osteoarthritic knee. I also wonder that my knee doctor never explored this possible therapy option. How new and unexplored is it? Thank you for your reply.
Dear L. Howard,
Thanks for this excellent question and I am so excited that you stumbled onto one of testosterone great positive effects! Testosterone replacement in women can help relieve aches and pains and improve muscle tone. It helps the body regenerate and heal. This is why it has been used by athletes for years (mind you they have had a tendency to abuse this and use more than the physiologic dose required). Furthermore, testosterone for women may also help improve energy, body composition, sexual desire and can improve bladder problems.
It is not that your orthopedic doctor wasn’t doing all of the correct textbook treatments for osteoarthritis but not many physicians are aware of the great effects that hormone treatment can have on the musculoskeletal system.
It should be stressed that testosterone replacement therapy should be under the supervision of a doctor that specializes in bioidentical hormone replacement therapy and that all hormones should be balanced, not just testosterone.
Stay Well,
Dr. Eric Honing, BodyLogicMD Phoenix, Arizona
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My pain management doc says he wants me on testosterone for my blood level of 10. my GP says it is normal. My question at this time is side effects for women. Anyone got input on them while I consider this treatment>
Dr. Linder:
My age is 68 and I have been diagnosed with and treated for osteoarthritis in knees, shoulders and spine. The orthopedic surgeon treating me for spinal osteoarthritis recommended testosterone evaluation, but my primary care MD countered with warnings of heightened risk for prostrate cancer. What are the negative aspects of testosterone replacement therapy?
i had my doctor test me for Low T, I had all the symptoms, at the time of first test my Total Test. was 292, estradiol was 109. two months later my Total T was 213 and my estradiol was 35. I am taking a few natural products to help lower my estradiol. Progestrone cream, and Dim . I am concerned about the lower T. I thought It would go up, I don’t feel any better, still have all the symptoms of low T. any ideas.
There are several factors that may be at play. One of the major factors may be the adrenal glands and their output of cortisol. In many people with adrenal fatigue their testosterone levels can change in this unpredictable way. Adrenal fatigue is caused by stress and stress can play a big role in Testosterone for your body. Controlling estrogen is important and DIM and progesterone are good ways to do that, but sometimes stronger medication is needed to control estrogen. Another factor may be that other estrogens, like estrone may be elevated. Also, you should understand levels of Testosterone and optimal versus normal. Your testosterone levels are at the lowest levels of what would be considered normal. The upper end of the normal range would be around 800-1000. Your low testosterone symptoms will not likely resolve until testosterone levels are brought closer to the optimal range with testosterone replacement. This would need to be done with special attention to estrogen levels by a doctor who has advanced training in bioidentical hormone replacement therapy.
Good luck!
Dr. Jennifer Landa of BodyLogicMD of Orlando
I take one vicodin a day for anxiety. I have been tested and found I have very low testestrone. If vicodin is the cause and I quit it could my normal testestrone level return? What about other side effects such as hearing and tinnitus?
depends on your age 1 vicodin should have no effect on low testerone age is a factor 79 to 85?
I am 59 1/2 bad back good pay job because of bad back I have had unusual treatment at work ,they recently want me to get a physical
and I have been saying NO,advise from my steward one year is the statute on workers comp.
report it as soon as you suspect back problems or any med. problems. I take 5 norco a day
Arth. doc has me on 5 pills a day for both type of Arth. My GP has just started me on T. shots, totally in connection with other symtoms, and the relief for Arth. pain is incredible. Good luck, TXJ
What is the normal range of testosterone for a man age 47?