PAIN KILLERS & TESTOSTERONE
There are 3 main types of pain killers
1. Opioids , examples codeine, hydrocodone, morphine, oxycodone,
2. NSAID’s examples; Advil , aspirin,, ibuprofen, and naproxen
3. Corticosteroid examples: hydrocortisone, dexamethasone, fludrocortisone.
I’ll start with the most severe. Opioid induced androgen deficiency is common term in the medical profession. Just one they don’t share with patients much. Which means Opioid induced Testosterone deficiency. It seems rather contradictory to common sense to prescribe opioids for muscular skeletal injuries since one of the most crucial things for healing is our testosterone. Obviously excruciating pain is going to take precedence but its so common for people to get addicted and strung out on opioids that are very obviously not needed simply because Doctors don’t share the severity of the very common side affects In one study Eighty-seven percent of opioid-ingesting men who reported normal erectile function before opioid use reported severe erectile dysfunction or diminished libido after beginning their opioid therapy. Commonly prescribed opioids in sustained-action dosage forms usually produce subnormal sex hormone levels, which may contribute to a diminished quality of life for many patients with painful chronic illness. [1] If pain management treatment leads to decreased male hormones depression is very likely to set in which commonly causes more self medicating or self numbing. A dangerous path to start down if one is unaware of obstacles on that road. Another study of opioid administration resulted in a significant reduction in serum testosterone. This was associated with a reduction in libido and potency. Luteinizing hormone and follicle-stimulating hormone levels remained within reference ranges, indicating central rather than peripheral suppression. The study conclusion stated: Administration of opioids may result in hypogonadotrophic hypogonadism. As part of the consent for therapy process, patients should be informed about this effect and its management. With long-term opioid administration, the hypothalamic-pituitary-gonadal axis should be monitored. [2]
Now for the less severe pain killers, Commonly known as NSAIDS. These are the standard over the counter pain meds , aspirin , ibuprofen, Tylenol , Nuprofen. These act on our bodies much differently then the Opioid painkillers do , they help reduce pain and inflammation by preventing the COX enzymes from releasing the prostaglandin chemicals that cause pain and inflammation. There is not much research connecting NSAIDs use to androgen hormone changes, which is good news but don’t go downing that Advil bottle just yet . There is a very common side affect of continued NSAID use is intestinal bleeding and ulcers, So if you enjoy eating a steak or any food pain free I would keep the NSAID intake to minimal instances. A couple for head ache not enough to cause a problem. Daily intake is a different story.
The third type of common pain killer is called a corticosteroid. Such as hydrocortisone, dexamethasone, fludrocortisone . These can administered in a cream, injection, inhaler or orally. Cortisone was first used to treat arthritis in 1949 and is very commonly used as injection treatment for specific joint or muscle pain. It is a powerful anti-inflammatory and short-term use for injuries shows little side affects. The main issue with using cortisone is that if a persons pain goes away they generally forget they are injured and go back to their prior physical activity before they are actually healed , making it very easy to exacerbate their condition. Interestingly some studies have shown that acute cortisone administration impairs retrieval of long-term declarative memory [3} which essentially means it isn’t going to help to get a cortisone injection before a job interview or a big test or anything that is going to be mentally taxing and optimal performance is important.
Long term use of corticosteroids does have more detrimental side affects. According to an article in the Jama journal of psychiatry , a cortiicosteroid dosage may be correlated to the risk of developing mental disturbances, neither dosage nor duration of treatment seems to affect the time of onset, duration, severity, or type of mental disturbances; euphoria, depression, and psychotic reactions are the common manifestations of corticosteroidinduced mental disturbances; females seem to be more prone to these disturbances than males; [4]
Conclusion – I stay away from Opioid pain relievers at all cost. Unless I am screaming in pain. The side affects and physical addiction are just very detrimental . Over the counter NSAIDs and Corticosteroids are a much better option for pain relief if they can be taken on short term basis.
[1] Harry W. Daniel Hypogonadism in men consuming sustained-action oral opioids© 2002 by the American Pain Society
[2]. Roberts, Lindy Clinical Journal of Pain: Sex Hormone Suppression by Intrathecal Opioids: A Prospective Study May 2002
[3] Acute cortisone administration impairs retrieval of long-term declarative memory in humans Dominique J.-F. de Quervain1,2, Benno Roozendaal3, Roger M. Nitsch1, James L. McGaugh3 and Christoph Hock1,2
[4] Side Effects of Corticosteroid TherapyPsychiatric Aspects
Michael H. M. Ling, MS; Paul J. Perry, PhD; Ming T. Tsuang, MD, PhD
Arch Gen Psychiatry. 1981;38(4):471-477. doi:10.1001/archpsyc.1981.01780290105011
There are 3 main types of pain killers
1. Opioids , examples codeine, hydrocodone, morphine, oxycodone,
2. NSAID’s examples; Advil , aspirin,, ibuprofen, and naproxen
3. Corticosteroid examples: hydrocortisone, dexamethasone, fludrocortisone.
I’ll start with the most severe. Opioid induced androgen deficiency is common term in the medical profession. Just one they don’t share with patients much. Which means Opioid induced Testosterone deficiency. It seems rather contradictory to common sense to prescribe opioids for muscular skeletal injuries since one of the most crucial things for healing is our testosterone. Obviously excruciating pain is going to take precedence but its so common for people to get addicted and strung out on opioids that are very obviously not needed simply because Doctors don’t share the severity of the very common side affects In one study Eighty-seven percent of opioid-ingesting men who reported normal erectile function before opioid use reported severe erectile dysfunction or diminished libido after beginning their opioid therapy. Commonly prescribed opioids in sustained-action dosage forms usually produce subnormal sex hormone levels, which may contribute to a diminished quality of life for many patients with painful chronic illness. [1] If pain management treatment leads to decreased male hormones depression is very likely to set in which commonly causes more self medicating or self numbing. A dangerous path to start down if one is unaware of obstacles on that road. Another study of opioid administration resulted in a significant reduction in serum testosterone. This was associated with a reduction in libido and potency. Luteinizing hormone and follicle-stimulating hormone levels remained within reference ranges, indicating central rather than peripheral suppression. The study conclusion stated: Administration of opioids may result in hypogonadotrophic hypogonadism. As part of the consent for therapy process, patients should be informed about this effect and its management. With long-term opioid administration, the hypothalamic-pituitary-gonadal axis should be monitored. [2]
Now for the less severe pain killers, Commonly known as NSAIDS. These are the standard over the counter pain meds , aspirin , ibuprofen, Tylenol , Nuprofen. These act on our bodies much differently then the Opioid painkillers do , they help reduce pain and inflammation by preventing the COX enzymes from releasing the prostaglandin chemicals that cause pain and inflammation. There is not much research connecting NSAIDs use to androgen hormone changes, which is good news but don’t go downing that Advil bottle just yet . There is a very common side affect of continued NSAID use is intestinal bleeding and ulcers, So if you enjoy eating a steak or any food pain free I would keep the NSAID intake to minimal instances. A couple for head ache not enough to cause a problem. Daily intake is a different story.
The third type of common pain killer is called a corticosteroid. Such as hydrocortisone, dexamethasone, fludrocortisone . These can administered in a cream, injection, inhaler or orally. Cortisone was first used to treat arthritis in 1949 and is very commonly used as injection treatment for specific joint or muscle pain. It is a powerful anti-inflammatory and short-term use for injuries shows little side affects. The main issue with using cortisone is that if a persons pain goes away they generally forget they are injured and go back to their prior physical activity before they are actually healed , making it very easy to exacerbate their condition. Interestingly some studies have shown that acute cortisone administration impairs retrieval of long-term declarative memory [3} which essentially means it isn’t going to help to get a cortisone injection before a job interview or a big test or anything that is going to be mentally taxing and optimal performance is important.
Long term use of corticosteroids does have more detrimental side affects. According to an article in the Jama journal of psychiatry , a cortiicosteroid dosage may be correlated to the risk of developing mental disturbances, neither dosage nor duration of treatment seems to affect the time of onset, duration, severity, or type of mental disturbances; euphoria, depression, and psychotic reactions are the common manifestations of corticosteroidinduced mental disturbances; females seem to be more prone to these disturbances than males; [4]
Conclusion – I stay away from Opioid pain relievers at all cost. Unless I am screaming in pain. The side affects and physical addiction are just very detrimental . Over the counter NSAIDs and Corticosteroids are a much better option for pain relief if they can be taken on short term basis.
[1] Harry W. Daniel Hypogonadism in men consuming sustained-action oral opioids© 2002 by the American Pain Society
[2]. Roberts, Lindy Clinical Journal of Pain: Sex Hormone Suppression by Intrathecal Opioids: A Prospective Study May 2002
[3] Acute cortisone administration impairs retrieval of long-term declarative memory in humans Dominique J.-F. de Quervain1,2, Benno Roozendaal3, Roger M. Nitsch1, James L. McGaugh3 and Christoph Hock1,2
[4] Side Effects of Corticosteroid TherapyPsychiatric Aspects
Michael H. M. Ling, MS; Paul J. Perry, PhD; Ming T. Tsuang, MD, PhD
Arch Gen Psychiatry. 1981;38(4):471-477. doi:10.1001/archpsyc.1981.01780290105011