The Power of Hormones
Never Underestimate the Power of Hormones. Hormones are powerful, little messengers that run the entire body. As such, these messages can also feed into pain and suffering. Hormonal imbalance may go unnoticed when one has chronic conditions like erectile dysfunction, depression, pain, anxiety, or insomnia. Doctors need to stay vigilant in case the root of any or all of these problems is a hormonal imbalance. The problem with having medications that only mask a symptom is that everyone stops looking for the real problem, the root of the problem. Let’s examine some common hormonal imbalances that can affect those with chronic pain.
The thyroid hormone is produced by the thyroid gland that sits in the front of the throat. This hormone is important for heart and lung function, muscle and nerve function, metabolism and gut motility. With such wide-spread importance, imbalances of the thyroid hormone can masquerade as many problems including: depression, menopause, insomnia, pain, and even psychosis. In fact, imbalances are so common and can be so difficult to recognize, it is recommended that everyone over the age of 35 get their TSH (thyroid stimulating hormone) checked every five years. TSH is the signal from the mother gland, the pituitary gland, which tells the thyroid gland to make thyroid hormone. But, the TSH level only tells half the thyroid story. An attentive doctor will also check the Free T4 level to make sure that the TSH signal is appropriate relative to the amount of thyroid hormone available. Thyroid imbalances are missed if both the TSH and Free T4 are not monitor. Do not accept the answer, “Your thyroid is fine”. Make sure that both tests are within normal range** and** that the levels are normal relative to each other. Relative to each other means that both should not be low. If one is low, then the other should be high. Because of this proportional relationship, the so-called reference ranges can be misleading especially when monitoring thyroid function. Rushed doctors can be easily mislead and miss thyroid imbalances.
The testosterone hormone is important in both men and women for growth, libido, and energy levels. Many areas of the body produce testosterone including the testes, ovaries, and adrenal gland. People taking pain medications should be aware that abnormally low testosterone levels are commonly associated with the long term use of opioid medications. Testosterone deficiency leads to impotence, decreased libido, and low energy. Normally, the testosterone levels are measured as “Total Testosterone” levels. Both men and women have different normal ranges which vary by age (Adult male 300-1000 ng/dl, Adult female 30-70 ng/dl). Because the so-called “normal” range is large, an individual’s symptoms should also come into play. “Normal” should also be relative to how you feel as an individual.
Estrogen is not only responsible for reproduction, but it also has a role in bone health, skin health, and cardiovascular health. However, estrogen also has a dark side because it is linked to cancer, dementia, strokes and pain. Many women who have pain are also experiencing changes of the estrogen level–menopause. During menopause, estrogen levels fall along with progesterone and testosterone. As estrogen levels decline, thyroid levels will follow because estrogen effects thyroid hormone production. See how everything is connected? So, how does estrogen connect to chronic pain? Well, artificially elevated levels of estrogen like found with hormone replacement therapy and oral contraception are strongly linked to joint pain. Women who use these hormone products are more likely to experience spinal pain for example. Estrogen has also been linked to arthritis. Using estrogen is like adding fuel to the painful fire. Estrogen is not a no-risk fountain of youth. (Please also see the article about the link between brain shrinkage and hormone replacement therapy on the Alzheimer site www.healthcentral.com/alzheimers/c/62/56374/replacement). Thus, estrogen-containing hormone products should not be used for indefinite periods of time.
Attention Women With Insomnia: Many experts believe that sleep disruption is the precursor to depression, anxiety, and pain. Hormonal changes in estrogen and progesterone have been directly linked to insomnia. Low dose, short duration HRT (or herbal supplements like soy products and black cohosh) may be needed to restore healthy sleep.
In conclusion, our bodies are a sea of hormones which, although small in size, pack a mighty punch and run the entire show. For women, hormonal fluctuations are natural and do not necessarily cause major, debilitating problems. However, if someone is experiencing hormonal imbalances, chronic conditions are highly likely, including pain. Everyone needs to empower themselves with the knowledge necessary to recognize the warning signs of hormones gone astray. Oprah is leading the cause with her own testimonial about her hormonal imbalances that went unnoticed for some time. She has recruited experts in the field to offer advice and her February issue of O will feature this issue. You can also see her website http://www.oprah.com/dated/oprahshow/oprahshow_20090114_bioidentical for more information. Women’s health and hormones are finally gaining the spotlight that they deserve. Please take the time to do your own investigation because you should never underestimate the power of health education or hormones.
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.