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August 13, 2012

It's a Pain

Pain relief is one of the top reasons that people seek medical attention, and the abuse of prescription pain relievers is at an all-time high. This begs the question:what is causing all this pain? And, furthermore, is resorting to addictive and potentially dangerous narcotics the only answer?
We believe that the link between hormone imbalances and the prevalence of chronic pain deserves further exploration. Consider these findings:
Thyroid: A scientist, specialized in pain treatment, had issues with chronic pain himself, along with numerous symptoms of hypothyroidism, and he suspected the two might be related. Working with his mentors, they confirmed that his thyroid levels were indeed low, despite “normal” lab test results. He started thyroid hormone therapy and soon also became pain free. Upon further scrutiny of his patients seeking pain relief, he found that 98% of them also exhibited signs of hypothyroidism, which he determined needed to be addressed first. He also observed that many of his patients presented with a type of autoimmune hypothyroidism. These patients tended to be gluten intolerant and highly allergic, and had to be treated with bioidentical T3 (liothyronine) and T4 (levothyroxine) rather than whole thyroid gland to successfully address their pain and hypothyroid symptoms. 
Cortisol: One researcher suggests that the pain associated with rheumatoid arthritis may be very closely linked to hormone disturbances in his book, Safe Uses of Cortisol. As evidence, he points out that arthritis symptoms tend to disappear during pregnancy, when many hormone levels are high; that women with a history of infertility or a reduced menstrual timespan have a stronger likelihood of developing arthritis; and that women are more prone to arthritis after natural or surgical menopause.
Other scientist notes that, although high doses of synthetic cortisol derivatives such as prednisone have been effective for relieving pain, it is a poor choice for long-term treatment due to the side effects. Instead, he recommends using bioidentical cortisol or cortisone in small physiologic doses to achieve safer pain relief. 
Estrogens:  In Bioidentical Hormones 101, there are numerous citations regarding the treatment of osteoarthritis with estrogens. He points out that the conventional medical treatment for osteoarthritis is pretty grim, typically starting with Tylenol and non-steroidal anti-inflammatories such as ibuprofen and pain relief creams; followed by painful injections of steroids into the joints and physical therapy; and finally, when the pain becomes unbearable, joint replacement is proposed as the last option. Dich et.al cites studies that demonstrate osteoarthritis pain as a result of estrogen deprivation, as well as animal and human studies showing the benefits of restoring estrogen.
Progesterone:  Accompanying the decline of estrogens is a corresponding decline in the production of progesterone. Adequate progesterone levels encourage the normal production of collagen, which is needed for structural support and promotes the normal growth and maintenance of connective tissue, bone and soft tissue. According to Ross Hauser et al, this may explain why supplementing progesterone in postmenopausal women can help relieve chronic pain.
Testosterone: A study states that a testosterone deficiency is increasingly recognized as a concern in both men and women who suffer chronic pain. This finding is not too surprising given that adequate testosterone must be present to bind the body’s own pain-relieving compounds to their receptors, and also for the transport of hormones in the brain, including dopamine and norepinephrine. Testosterone is also necessary for the maintenance of muscles and bones, as well as for healing and controlling inflammation. A lack of testosterone results in poor pain control, depression, sleep loss and general loss of energy.
The stress of chronic pain can also create or exacerbate a testosterone deficiency by overworking the hypothalamus and pituitary glands so much that they stop signaling the body to produce more testosterone.  Ironically, narcotic type drugs can also suppress testosterone production by disrupting the hypothalamus, adrenal glands and sex organs, and diminishing the pain tolerance even as more pain medications are used.
It has also seen some success treating pain with human chorionic gonadotropin (HCG), another anabolic hormone that is most often associated with fertility and pregnancy. He believes the pain relief may be mediated through HCG’s ability to influence the thyroid gland, adrenal glands and sex organs to produce more hormones.
Vitamin D:  Non-specific neuromuscular pain may be linked to low levels of vitamin D, according to the Mayo Clinic, and therefore they recommend screening all people with such pain. This type of pain is not relieved by anything else except Vitamin D supplements. (Remember that Vitamin D, in spite of its name, is also a hormone related to the sex and adrenal hormones.) 
Oxytocin: Studies suggests that oxytocin, a hormone from the pituitary gland typically associated with orgasm and nursing, shows promise in treating the pain associated with fibromyalgia but that further studies are needed.
It is clear that many different hormones play various roles in keeping our bodies functioning well—and possibly pain free. So, when dealing with chronic pain, it makes sense to speak with your healthcare practitioner about the possibility that a hormone imbalance may be an underlying issue. Could a hormone imbalance be part of the problem? Or, better yet, could hormones be part of the solution?
by
Akshaya Srikanth
Pharm.D
Hyderabad, India