Interesting item regarding hormones, joint regeneration, and their effects on chronic pain:
From: http://www.caringmedical.com/prolotherapy-news/hormone-levels-cartilage-regeneration/
Danielle.Steilen.ProlotherapistDanielle R. Steilen, MMS, PA-C
In this article we discuss the use of human growth hormone (HGH), estrogen, and testosterone for their roles in accelerating wound healing as both an injectable in Prolotherapy solutions and supplementation.
Prolotherapy doctors have long recognized that hormones are a required part of injury and wound healing. New research supports the use of hormones in chronic pain patients.
Hormone abnormalities are biomarkers of severe, uncontrolled pain
The use of prescription opioids has increased dramatically over the past 20 years. Painkillers appear to affect multiple hormonal pathways leading to abnormal levels of different hormones, such as testosterone, cortisol and prolactin.1 In new research doctors found that men with androgen deficiency (low testosterone) brought on by overuse of painkillers and other pain medications, showed improvements in pain, sexual desire, body composition, and aspects of quality of life.2
In other research doctors noted that some patients with severe and chronic pain failed to obtain adequate pain relief with standard pain medications, including low to moderate dosages of opioids.
Physicians might not believe patients who claim that a standard opioid dosage is an ineffective treatment.
These patients may be severely impaired, nonfunctional, and bedridden or housebound. To help characterize these individuals and develop treatment strategies for them, a serum hormone profile consisting of adrenocorticotropin, cortisol, pregnenolone, progesterone, dehydroepiandrosterone, and testosterone was obtained on 61 chronic pain patients who failed standard treatments; 49 patients (80.3%) demonstrated hormone abnormality and 7 patients (11.5%) showed a severe pituitary-adrenal-gonadal deficiency as indicated by deficient serum levels of adrenocorticotropin and more than 2 adrenal-gonadal hormones.
The doctors concluded hormone serum abnormalities are biomarkers of severe, uncontrolled pain, and, in a patient who has failed standard treatment, they are an indicator that enhanced analgesia is required and that hormone replacement may be indicated.3
Hormones regenerate damaged cartilage
Whenever it comes to cartilage injury or wear and tear, anabolic hormones such as testosterone play a role in regenerating it. Research shows that estrogen receptors are present in cartilage and that estrogen stimulates cartilage growth.4
A Swedish study recently focused on the effects of testosterone on chondrocytes (regrowing cartilage). The research concluded that testosterone promotes differentiation of chondrocytes (prodcuing cartilage cells) and increases collagen production.5
Many people believe that testosterone is only a male hormone, but it plays a pivotal role in the female body chemistry as well. Man or women, if one has a low testosterone level, then they will likely experience more difficulty healing.
Testosterone is made by men in the testicles, and females the ovaries. There is also a small production that is created in the adrenal glands. Although the adrenal gland is able to produce a small amount of testosterone, many patients of both genders suffer from depleted adrenals as a result of stress. This stress can arise from pain, lack of sleep, and a myriad of personal issues. So sometimes treating adrenal fatigue to optimize hormone production is called for.
Various hormone factors that can affect knee cartilage
Many studies show that a woman is more likely to get injured during the part of the menstrual cyle (around ovulation) when estrogen levels are highest. Women who take birth control pills or get Premarin after menopause are more likely to get injured and have chronic pain. It is true also that women compared to men are more prone to injuries as a result of ligament and connective tissue laxity. This relates to a man’s physiology being testosterone driven whereas a females physiology is estrogen driven.
Testosterone has the great effect of helping ligaments tighten and tissues heal whereas estrogen unfortunately for woman helps fat accumulate and ligaments not heal. Specifically estrogen has been shown to inhibit fibroblastic profileration which means that collagen synthesis is inhibited the more estrogen a woman has in her blood.
So for women who take birth control pills or Premarin or other estradiol (main estrogen) driven hormone replacement, you may wish to seek an alternative if you have chronic pain.
In another study - how androgens (anabolic hormones) reversed cartilage damage. Women are two to three more times more common and more likely to have the disease become more disabling and aggressive than men. It suggests that a long-term androgen replacement may help prevent joint damage and disability.6
Another study looked at various factors that can affect knee cartilage volume. Earlier studies had shown that tibial cartilage volume in healthy men decreased 2.8% per year. They were particularly interested in measuring serum testosterone levels and total bone mineral content. They hypothesized that hormonal manipulation and/or treatment with bone antiresorptive drugs could reduce cartilage loss/osteoarthritis in men. They found that, “serum testosterone level at baseline and urinary NTx, a marker of bone turnover were inversely related to cartilage loss.”
So again, it seems like there may be a correlation between optimal testosterone levels and healthy cartilage.7
In this study, there are factors that are looked at in prevention and management of osteoarthritis. 45 males were included. The total knee, medial and lateral cartilage volumes were inversely associated with age, BMI and amount of physical activity and positively associated with total bone content. Tibial cartilage is proportionate to serum testosterone and serum testosterone explains variation in cartilage volume. In conclusion:
Testosterone can help improve cartilage health and making sure your hormonal levels are optimal is pivotal to stable healthy joints. This new knowledge is key to the future diagnosis of degenerative diseases; it will help keep patients unnecessarily off the operating table and allow them to improve on their quality of life without painful recovery times.
In addition to these facts, avoiding degenerative treatments such as NSAIDs and steroid injections, and choosing regenerative treatments such as Prolotherapy and stem cell injection therapy, will allow patients to regenerate their cartilage and avoid joint replacement surgery.
References for this article
1.Demarest SP, Gill RS, Adler RA. Opioid Endocrinopathy. Endocr Pract. 2014 Dec 22:1-26. [Epub ahead of print]
2. Basaria S, Travison TG, Alford D, Knapp PE, Teeter K, Cahalan C, Eder R, Lakshman K, Bachman E, Mensing G, Martel MO, Le D, Stroh H, Bhasin S, Wasan AD, Edwards RR. Effects of testosterone replacement in men with opioid-induced androgen deficiency: a randomized controlled trial. Pain. 2015 Feb;156(2):280-8. doi: 10.1097/01.j.pain.0000460308.86819.aa.
3. Tennant F. Hormone abnormalities in patients with severe and chronic pain who fail standard treatments. Postgrad Med. 2015 Jan;127(1):1-4. Epub 2014 Dec 15.
4. Richmond RS, Carlson CS, Register TC, Shanker G, Loeser RF. Functional estrogen receptors in adult articular cartilage: estrogen replacement therapy increases chondrocyte synthesis of proteoglycans and insulin-like growth factor binding protein.
5. Lorentzon M, Swanson C, Andersson N, Mellstrom D, Ohlsson C. Free Testosterone is a Positive, Whereas free Estradoil Is a Negative, Predictor of Coritcal Bone Size in Young Swedish Men: The GOOD Study. Journal of Bone and Mineral Research 2005; 20(8) : 1334-1339.
6. Irie, T, Aizawa, T, Kokubun, S. The role of sex hormones in the kinetics of chondrocytes in the growth plate. The Journal of Bone and Joint Surgery 2005; 87-B: 1278-1285.
7. Hanna F, Ebeling P R , Wang, et. al. Factors influencing longitudinal change in knee cartilage volume measured from magnetic resonance imaging in healthy men. Ann Rheum Dis 2005; 64 : 1038-1045.
From: http://www.caringmedical.com/prolotherapy-news/hormone-levels-cartilage-regeneration/
Danielle.Steilen.ProlotherapistDanielle R. Steilen, MMS, PA-C
In this article we discuss the use of human growth hormone (HGH), estrogen, and testosterone for their roles in accelerating wound healing as both an injectable in Prolotherapy solutions and supplementation.
Prolotherapy doctors have long recognized that hormones are a required part of injury and wound healing. New research supports the use of hormones in chronic pain patients.
Hormone abnormalities are biomarkers of severe, uncontrolled pain
The use of prescription opioids has increased dramatically over the past 20 years. Painkillers appear to affect multiple hormonal pathways leading to abnormal levels of different hormones, such as testosterone, cortisol and prolactin.1 In new research doctors found that men with androgen deficiency (low testosterone) brought on by overuse of painkillers and other pain medications, showed improvements in pain, sexual desire, body composition, and aspects of quality of life.2
In other research doctors noted that some patients with severe and chronic pain failed to obtain adequate pain relief with standard pain medications, including low to moderate dosages of opioids.
Physicians might not believe patients who claim that a standard opioid dosage is an ineffective treatment.
These patients may be severely impaired, nonfunctional, and bedridden or housebound. To help characterize these individuals and develop treatment strategies for them, a serum hormone profile consisting of adrenocorticotropin, cortisol, pregnenolone, progesterone, dehydroepiandrosterone, and testosterone was obtained on 61 chronic pain patients who failed standard treatments; 49 patients (80.3%) demonstrated hormone abnormality and 7 patients (11.5%) showed a severe pituitary-adrenal-gonadal deficiency as indicated by deficient serum levels of adrenocorticotropin and more than 2 adrenal-gonadal hormones.
The doctors concluded hormone serum abnormalities are biomarkers of severe, uncontrolled pain, and, in a patient who has failed standard treatment, they are an indicator that enhanced analgesia is required and that hormone replacement may be indicated.3
Hormones regenerate damaged cartilage
Whenever it comes to cartilage injury or wear and tear, anabolic hormones such as testosterone play a role in regenerating it. Research shows that estrogen receptors are present in cartilage and that estrogen stimulates cartilage growth.4
A Swedish study recently focused on the effects of testosterone on chondrocytes (regrowing cartilage). The research concluded that testosterone promotes differentiation of chondrocytes (prodcuing cartilage cells) and increases collagen production.5
Many people believe that testosterone is only a male hormone, but it plays a pivotal role in the female body chemistry as well. Man or women, if one has a low testosterone level, then they will likely experience more difficulty healing.
Testosterone is made by men in the testicles, and females the ovaries. There is also a small production that is created in the adrenal glands. Although the adrenal gland is able to produce a small amount of testosterone, many patients of both genders suffer from depleted adrenals as a result of stress. This stress can arise from pain, lack of sleep, and a myriad of personal issues. So sometimes treating adrenal fatigue to optimize hormone production is called for.
Various hormone factors that can affect knee cartilage
Many studies show that a woman is more likely to get injured during the part of the menstrual cyle (around ovulation) when estrogen levels are highest. Women who take birth control pills or get Premarin after menopause are more likely to get injured and have chronic pain. It is true also that women compared to men are more prone to injuries as a result of ligament and connective tissue laxity. This relates to a man’s physiology being testosterone driven whereas a females physiology is estrogen driven.
Testosterone has the great effect of helping ligaments tighten and tissues heal whereas estrogen unfortunately for woman helps fat accumulate and ligaments not heal. Specifically estrogen has been shown to inhibit fibroblastic profileration which means that collagen synthesis is inhibited the more estrogen a woman has in her blood.
So for women who take birth control pills or Premarin or other estradiol (main estrogen) driven hormone replacement, you may wish to seek an alternative if you have chronic pain.
In another study - how androgens (anabolic hormones) reversed cartilage damage. Women are two to three more times more common and more likely to have the disease become more disabling and aggressive than men. It suggests that a long-term androgen replacement may help prevent joint damage and disability.6
Another study looked at various factors that can affect knee cartilage volume. Earlier studies had shown that tibial cartilage volume in healthy men decreased 2.8% per year. They were particularly interested in measuring serum testosterone levels and total bone mineral content. They hypothesized that hormonal manipulation and/or treatment with bone antiresorptive drugs could reduce cartilage loss/osteoarthritis in men. They found that, “serum testosterone level at baseline and urinary NTx, a marker of bone turnover were inversely related to cartilage loss.”
So again, it seems like there may be a correlation between optimal testosterone levels and healthy cartilage.7
In this study, there are factors that are looked at in prevention and management of osteoarthritis. 45 males were included. The total knee, medial and lateral cartilage volumes were inversely associated with age, BMI and amount of physical activity and positively associated with total bone content. Tibial cartilage is proportionate to serum testosterone and serum testosterone explains variation in cartilage volume. In conclusion:
Testosterone can help improve cartilage health and making sure your hormonal levels are optimal is pivotal to stable healthy joints. This new knowledge is key to the future diagnosis of degenerative diseases; it will help keep patients unnecessarily off the operating table and allow them to improve on their quality of life without painful recovery times.
In addition to these facts, avoiding degenerative treatments such as NSAIDs and steroid injections, and choosing regenerative treatments such as Prolotherapy and stem cell injection therapy, will allow patients to regenerate their cartilage and avoid joint replacement surgery.
References for this article
1.Demarest SP, Gill RS, Adler RA. Opioid Endocrinopathy. Endocr Pract. 2014 Dec 22:1-26. [Epub ahead of print]
2. Basaria S, Travison TG, Alford D, Knapp PE, Teeter K, Cahalan C, Eder R, Lakshman K, Bachman E, Mensing G, Martel MO, Le D, Stroh H, Bhasin S, Wasan AD, Edwards RR. Effects of testosterone replacement in men with opioid-induced androgen deficiency: a randomized controlled trial. Pain. 2015 Feb;156(2):280-8. doi: 10.1097/01.j.pain.0000460308.86819.aa.
3. Tennant F. Hormone abnormalities in patients with severe and chronic pain who fail standard treatments. Postgrad Med. 2015 Jan;127(1):1-4. Epub 2014 Dec 15.
4. Richmond RS, Carlson CS, Register TC, Shanker G, Loeser RF. Functional estrogen receptors in adult articular cartilage: estrogen replacement therapy increases chondrocyte synthesis of proteoglycans and insulin-like growth factor binding protein.
5. Lorentzon M, Swanson C, Andersson N, Mellstrom D, Ohlsson C. Free Testosterone is a Positive, Whereas free Estradoil Is a Negative, Predictor of Coritcal Bone Size in Young Swedish Men: The GOOD Study. Journal of Bone and Mineral Research 2005; 20(8) : 1334-1339.
6. Irie, T, Aizawa, T, Kokubun, S. The role of sex hormones in the kinetics of chondrocytes in the growth plate. The Journal of Bone and Joint Surgery 2005; 87-B: 1278-1285.
7. Hanna F, Ebeling P R , Wang, et. al. Factors influencing longitudinal change in knee cartilage volume measured from magnetic resonance imaging in healthy men. Ann Rheum Dis 2005; 64 : 1038-1045.