Arthritis is much more than joint pain, and it is one of the most complex medical problems. There are various types and subtypes of arthritis, and each one of them has a number of risk factors making it very difficult to trace the exact cause in a given patient. However, there are statistics about arthritis we can use to understand the disease, and one of them is that it is more prevalent in women than men.
Is there any hormonal factor associated with this prevalence? Is testosterone involved? Does testosterone help with arthritis as we grow older?
Testosterone and the Prevalence of Arthritis
Since 1988, it was made clear that there’s a link between testosterone and rheumatoid arthritis. Compared to osteoarthritis and other forms of joint pain, patients who suffer from rheumatoid arthritis have a higher chance of displaying low serum concentrations of testosterone. These deficient levels were determined at the baseline, and even after using human chorionic gonadotrophin hormone to stimulate testosterone secretion, serum concentrations remained lower than healthy patients.
A recent large-scale, longitudinal study published in the journal Clinical Rheumatology found that in 2016 it was still possible to verify the prevalence of testosterone deficit in patients with rheumatoid arthritis. Other studies have compared testosterone levels in female patients with their healthy counterparts and found out lower testosterone levels in rheumatic patients. But, is it possible to provide an explanation?
Why is it that male and female patients with rheumatoid arthritis usually have lower testosterone levels than the average? If we dig into the function of testosterone, we might find a few mechanisms that are likely to explain this phenomenon:
- Testosterone deficiency is associated with an increase in various inflammatory markers, including our circulating C-Reactive Protein, serum Interleukin-6, and Tumor Necrosis Factor. All of them are involved in the autoimmune pathology of rheumatoid arthritis.
- Testosterone is known to have anti-inflammatory functions. One of its various roles in the human body is modulating (often suppressing) the cellular and humoral response of the immune system. The former is mediated by antibodies, and it is found in the initial phase of rheumatoid arthritis while the latter involves the activation of immune cells, and it is often found in a later stage of the disease.
Still, it is possible that this association has the opposite temporal sequence.
Autoimmune reactions in rheumatoid arthritis might result in testosterone deficit, and impair the normal synthesis of testosterone by the human testis in a vicious cycle that is likely to aggravate the symptoms.
Thus, there’s another mechanism we should consider:
- Proinflammatory cytokines are known to suppress the hypothalamus-pituitary-gonad axis. In other words, they block the signal that triggers hormonal synthesis in the male testis. Thus, it is possible that arthritis patients have a secondary loss of gonadal function that responds to their higher levels of circulating proinflammatory cytokines.
If we compare these mechanisms and see the evidence, they are both reasonable. However, the most likely event sequence is that low testosterone levels trigger rheumatoid arthritis. This may be demonstrated by studies performed in healthy patients who displayed lower levels of testosterone than the average and were diagnosed positive for rheumatoid arthritis over the course of 12 years after the initial screening. Find out more about the 5 stages of Rheumatoid Arthritis as we grow older.
with thanks www.ncbi.nlm.nih.gov
Low levels of Testosterone might predispose to Joint Degeneration
As we mentioned in our introductory remark, there are many types of arthritis, and the progression of the disease is different from one patient to another. However, the majority of them are associated with various degrees of joint degeneration.
The inflammatory process of arthritis eventually leads to degenerative changes in the articulation. This is true in cases of mechanic arthritis (osteoarthritis), autoimmune disease (rheumatoid arthritis) and infectious causes (septic arthritis). In turn, these degenerative changes aggravate the symptoms and may cause deformation.
In this regard, testosterone is known to have a protective effect against joint degeneration, and according to studies, low levels of testosterone make it more difficult for articulations to recover from inflammatory damage.
For example, in a study published in the journal Annals of the Rheumatic Diseases, doctors showed in animal models that testosterone is capable of protecting the articulation and reversing damage of the cartilage. They suggest that testosterone replacement therapy should be included in patients with joint disease and low testosterone levels, and their findings are still significant today.
A final word on Testosterone as we Age…
Testosterone is known to be a protective factor of other types of joint pain, including temporomandibular joint pain. This type of pain affects the masticatory muscles and, similar to arthritis, it is more common in women than men. Recent studies have demonstrated that testosterone is capable of reducing the perception of pain in cases of temporomandibular joint dysfunction, an effect attributed to the anti-inflammatory response triggered by this hormone. Discover how to increase and boost you Testosterone in your 40s and 50s.
Finally, it is interesting to note that arthritis is known to improve joint function and motility in the elderly by at least three different processes:
- By preventing arthritis and reducing its progression as reviewed in this article.
- By enhancing chondrogenesis (cartilage formation) in the intervertebral discs.
- By improving muscle mass and enhancing muscle contraction.
Thus, the role of testosterone for joint health is indisputable. It is one of the reasons why arthritis is more common in females compared to males, and it is a potential therapeutic target to improve the quality of life of elderly patients and those with a diagnosis of rheumatoid arthritis and low testosterone levels.
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