Low Testosterone And Joint Pain
is regarded as the most common cause of chronic joint pain, and is marked by swelling, redness, pain, loss of function and ongoing inflammation of joints. According to latest statistics reported by Centers for Disease Control and Prevention (1), approximately 22.7% adults in the United States (corresponding to 52.5 million individuals) are diagnosed with some form of arthritis each year (such as gout, rheumatoid arthritis, lupus, fibromyalgia or osteoarthritis).
Although, physiological aging is a well-established risk factor in the pathogenesis of arthritis, it is believed that several other risk factors can also aggravate the risk of joint wear and tear that may lead to arthritis in the younger adults. For example, according to a new study reported in the Annals of the Rheumatic Diseases (2), investigators suggested that low levels of testosterone are very strongly linked to an aggravated risk of developing rheumatoid arthritis (RF Factor negative variety) in otherwise healthy adults. In a case- study series conducted on a medium-sized sample of patients, investigators concluded that persistently low levels of testosterone can lead to rheumatoid arthritis in males and can influence the severity and frequency of symptoms as well. It is highly recommended to take every case of joint pain seriously in order to minimize the risk of complications.
What Are Some Classic Symptoms Of Low Testosterone Levels?
With advancing age, the testosterone levels declines progressively but in most cases, the dip in serum testosterone is gradual and unnoticeable. However, sudden or serious drop can present with a wide variety of symptoms. Clinically low testosterone is described as having less than 300 nanogram per deciliter of testosterone in the blood. Classic symptoms include:
- Loss of libido (sexual drive)
- Abrupt changes in weight due to abnormalities in the basal metabolism
- Development or enlargement of breast tissue in males
- Extreme fatigue
Pathophysiology Of Joint Pain In The Setting Of Rheumatoid Arthritis
The two most common varieties of arthritis include; osteoarthritis (due to age-related wear and tear of joints) and rheumatoid arthritis (an autoimmune variety that is more common in some genetically susceptible individuals). The mechanism or pathophysiology of either variety of arthritis is different; for example:
- Low testosterone levels are often associated with negative changes in the metabolism and resulting weight gain that may aggravate the risk of developing osteoarthritis due to aggravated wear and tear changes in the joints. If joint pain is due to poor metabolism and weight gain; then the pain is more likely to be felt in hips, back and knees (and other weight bearing joints of the body).
- Testosterone help in maintaining normal bone-mineral density and several studies have suggested that low testosterone level can aggravate the risk of osteoporosis. Osteoporosis is a condition in which bones become flimsy and are more vulnerable to trauma/ injuries.
Osteoporosis can be diagnosed by testing bone mineral density (BMD). Greater the deviation in the BMD from normal levels, greater will be the risk of developing severe osteoporosis. Arthritis and osteoporosis are two different conditions and pain in osteoporosis in only felt if/when a bone fracture occurs
Treatment For Low Testosterone And Joint Pain
Lower testosterone levels can be treated by a number of strategies; such as testosterone replacement therapy. Restoring normal serum testosterone levels help in improving the sex drive and energy level as well as restoring optimal bone density. Testosterone replacement therapy can be obtained via patches, gels or oral formulations. But there are a number of cautions and concerns; for example testosterone therapy is not suitable for men with a history of prostate cancer.
Testosterone replacement therapy doesn’t repair existing joint damage but can definitely reduce the risk of further deterioration. If you are suffering from serious joint pain, speak to your primary care provider regarding the efficacy of over-the-counter pain killers such as ibuprofen and acetaminophen. You can also consider prescription drugs or a variety of sophisticated treatments (or surgeries such as joint replacement therapy). Exercising regularly can also help in preventing joint deterioration in future. You should discuss your condition with doctor in detail so that you can get most appropriate treatment and move towards comfort.
Poorly managed joint pain is a leading cause of morbidity in general population. Statistics reported by CDC suggests that arthritis and joint pain costs US economy $128 billion in lost earnings and medical billing costs each year. With early identification and proper management of testosterone dysfunction, a number of other health issues can be managed to improve the overall quality of life.
1. Centers for Disease Control and Prevention (CDC. (2013). Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation–United States, 2010-2012. MMWR. Morbidity and mortality weekly report, 62(44), 869.
2. Pikwer, M., Giwercman, A., Bergström, U., Nilsson, J. Å., Jacobsson, L. T., & Turesson, C. (2013). Association between testosterone levels and risk of future rheumatoid arthritis in men: a population-based case–control study. Annals of the rheumatic diseases, annrheumdis-2012.