Hormone Testing for People with Chronic Pain
What kinds of messages are being sent in your body?? The little messages in your body are called hormones. They stimulate cells, tissues and organs into action. Without these little messengers, many things in the body would stop working properly. This type of system failure causes everything from erectile dysfunction to sleepless nights.
Why should people with chronic pain be concerned about the hormones in their bodies? Two very good reasons to be concerned exist. One is that pain affects the system that makes the hormones, called the endrocrine system. Initially, pain will cause an increase in hormonal production because of the stress it produces. But as the pain persists, the hormone system can burn out and falter causing levels to drop.
The second reason why people experiencing pain should be concerned about hormones is that opioid pain medications suppress the production of hormones. This is especially true of the sex hormones: testosterone and estrogen. In fact, the hormonal problem caused by opioids is called “opioid endocrinopathy”. It has been estimated that between 60-85% of those using opioids experience hormone suppression and associated symptoms like erectile dysfunction and sleepless nights. (1) (2) (3)
Which hormones should be tested in those with chronic pain? Several hormones levels are important to test and many laboratories offer hormone panels to make it easier than ever to get tested. The following should be included:
- Corticotropin (ACTH)
- Dehydropiandrosterone (DHEA)
- Thyroid Stimulating Hormone (TSH)
- Vitamin D (considered a hormone)
In the future, more tests for special hormones within the nervous system will become available. Hormone treatment is becoming increasingly important for the treatment of chronic pain.
Who should be tested? Anyone that is taking opioid pain medications on a daily basis should be tested. Anyone with severe pain on most days should be tested. And anyone with constant pain that requires a sleep aid should be tested.
All systems should start working better when hormonal deficits are corrected. Not only should energy levels should improve, sleep should also improve. Once hormones are balanced, pain intensity levels may decrease which means that less medications may be needed. Many aspects of life might get better when all those little hormonal messengers start getting back to work after being on strike because of chronic pain.
- Tennant, Forest; Hormones: Testing and treatment in chronic pain management; Pain Week Journal; 2015; Vol. 3Q2; 18-23
- Rubinstein, A; et al; Elucidating Risk Factors for Androgen Deficiency Associated with Daily Opioid Use; American Journal of Medicine; 2014; Dec. 127(12): 1195-201
- Rubinstein, A; et al; Hypogonadism in Men with Chronic Pain linked to use of long-acting rather than short acting Opioids; The Clinical Journal of Pain; 2013; Oct; 29(10): 840-845
Additional Articles of Interest:
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.