Re: Testosterone Where Did It Go!

January 21, 2012

I would not think so but how much acetimen did you take with the oxy? That can affect the liver and may have changed spiro metabolism giving you higher effects. Will need to check again what in the liver metabolizes spiro. Aldo is cleared 100% from the blood that goes thru the liver. And look at the drug metabolism effects of other meds you were on.What was your testosterone level then and now?On Jan 21, 2012, at 5:01 PM, wrote: Dr. Grim, do you think being on Oxycodone and Methodone for 5+ years could have any effect on my adverse reaction to Spironolactone? What about street drugs which I don't use? Maybe at the minimum there should be a drug test so you know what may be ahead! Maybe Inspra would be a better choice! Health Information, Tips, Community and More at HealthCentral.com http://www.healthcentral.com/chronic-pain/c/23153/113990/testosterone/pf/ ChronicPainConnection.com See all of our health sites at www.HealthCentral.com Chronic Pain Home > General > Treatment > Alternative Treatment > Chronic Pain Medication Lead to Sexual Dysfunction, Other Problems for Men Testosterone Replacement Therapy for Men in Pain by Lasich, MD Monday, June 14, 2010 How many men would take pain pills if they knew that the pills might shrink their testicles? Besides testicular size, pain pills can wreck havoc on a man's ability to have sex, make babies, build muscles, and enjoy life. All of these side effects to opioid medications are caused by the fact that chronic opioid use lowers testosterone levels. This fact is not widely known, yet widely experienced. "Opioid-induced androgen deficiency" affects thousands of men. In a complex process that involves some very important hormones, both men and women can experience symptoms of low testosterone. The most common symptoms from abnormally low testosterone levels - hypogonadism - are: Fatigue Depression Low libido Erectile dysfunction Sexual dysfunction Osteoporosis Low muscle mass Infertility Hot flashes Night sweats Testicular atrophy If any of this sounds familiar, a doctor can order a simple blood test (the Total Testosterone Level) to check your testosterone level. This test is best done early in the morning to get the most accurate reading. Checking baseline hormonal levels, including the testosterone level, before and after initiating opioid treatment is recommended by some experts. Additionally, when consenting for opioid treatment, the patient should also be informed about the potential for opioids to drastically lower testosterone levels. If this discussion took place, many men might elect to avoid opioids. If men knew that upwards of 80% of those who begin taking opioids will experience erectile dysfunction from low testosterone levels, they might want to seek alternative pain relieving options. Those who do agree to opioid pain management despite the risks should know about testosterone-replacement therapy. Testosterone-replacement therapy is utilized to treat opioid-induced testosterone insufficiency. Prior to initiating testosterone treatment men need to have the prostate specific antigen level (PSA) test because testosterone can worsen prostate conditions like cancer and hypertrophy. Additionally, other conditions could also worsen like heart failure and sleep apnea. So, not every man is a candidate for testosterone replacement. Those who are candidates have a few different modes of replacement like injections, patches, gels and bio-identicals hormones. One study showed that the testosterone patch delivering 7.5 mg per day was effective at normalizing testosterone levels and relieving symptoms of hypogonadism. In fact, that same study showed that pain intensity actually improved as the testosterone levels normalized. Testosterone-replacement therapy is probably the most underutilized, yet most often needed adjunct therapy for someone who is a long-term opioid user. Everyone, both men and women need to be more aware of the long-term effects that opioids have on the human body. Testosterone and all the hormones related to the hypothalamic-pituitary axis (thyroid, adrenaline, and sex hormones) have the potential for becoming abnormally low. At some point, these hormonal imbalances have the potential to affect quality of life more than the pain itself. At that point, the risks of long-term opioid use needs to be re-evaluated because the risks might outweigh the benefits. At some point, opioid pain management might not be worth the price. We comply with the HONcode standard for trustworthy health information: verify here. About Us | Contact Us | Privacy Policy | Terms of Use | Security Policy By using this service, you accept our Terms of Use. Please read them. The consumer health information on is for informational purposes only and is not a substitute for medical advice or treatment for any medical conditions. You should promptly seek professional medical care if you have any concern about your health, and you should always consult your physician before starting a fitness regimen. Copyright © 2012 Remedy Health Media, LLC. . Current Opinion in Endocrinology & Diabetes: June 2006 - Volume 13 - Issue 3 - p 262-266 doi: 10.1097/01.med.0000224806.08824.dc Androgens Opioid-induced androgen deficiency l, Harry W & #65532; Abstract Purpose of review: Opioid-induced androgen deficiency has become one of the most common causes of testosterone deficiency among men in many communities. Its increase parallels the large increase in opioid use. This form of hypogonadotrophic hypogonadism is present in most men chronically consuming sustained-action opioids, including those receiving methadone for heroin addiction and those consuming opioids for control of either malignant or non-malignant chronic pain. A similar, but less well defined illness occurs in women. Opioid-induced androgen deficiency is not widely recognized. This review examines its pathophysiology, some of its signs and symptoms, and indicates some areas where current observations suggest additional investigations would be fruitful. Recent findings: Recognition of opioid-induced androgen deficiency in men not receiving methadone for heroin addiction is a new observation, and in these men contributes to fatigue, depression, vasomotor phenomena, anemia, diminished libido, erectile dysfunction and osteoporosis. These signs and symptoms improved during testosterone replacement therapy in several small non-placebo-controlled trials. Summary: A large majority of men consuming sustained-action opioids have symptomatic androgen deficiency which apparently responds to replacement therapy. Opioid-induced androgen deficiency is frequently overlooked, with its symptoms attributed to underlying disease states including malignant disease, chronic back disorders, HIV disease, and psychosocial illnesses contributing to opioid habituation. © 2006 Lippincott & Wilkins, Inc. - 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011 due to adverse SX. Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD and PTSD. Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

January 21, 2012

OXY 5MG/ACETAM 325MG bid, METHADONE 10MG bid and I was on them for a year after

I started SPIRO. I'll have to look up other meds when I get time, I know there

were 7 meds and they weren't stopped for 6 - 8 months.

Your higher effect theory may be very valid since everything was controlled and

I grew boobs on 25MG bid!

I do not know what my testosterone level was or is now. In fact, I didn't even

know what androgen was or that it and testosterone were related! That's why I

am advocating a standard to test to prior and periodically during

implementation, that of course after determining the low threshold unless we can

find another med. that will do the trick with out affecting Androgen!

At the minimum, IMHO we should recognize and advertise items to consider when

determining what to RX, ie: age, opioids, MDD maybe, etc. Then we should make

sure to tell what to look for to determine adverse reaction and start with

removing the word " painful " from the word gyneocomastia! We might play off

other SX of gender change like body hair loss. My mind is not working well

tonight, " brain fog " from working on performance (or lack thereof) appraisal of

a Chief of Endocronology!

- 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with

previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59

BS 125. D/C Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

>

> > Dr. Grim, do you think being on Oxycodone and Methodone for 5+ years

> > could have any effect on my adverse reaction to Spironolactone? What

> > about street drugs which I don't use? Maybe at the minimum there

> > should be a drug test so you know what may be ahead! Maybe Inspra

> > would be a better choice!

> >

> > Health Information, Tips, Community and More at HealthCentral.com

> > http://www.healthcentral.com/chronic-pain/c/23153/113990/testosterone/pf/

> > ChronicPainConnection.com

> >

> > See all of our health sites at www.HealthCentral.com

> >

> > Chronic Pain Home >

> > General >

> > Treatment >

> > Alternative Treatment >

> > Chronic Pain Medication Lead to Sexual Dysfunction, Other Problems

> > for Men

> > Testosterone Replacement Therapy for Men in Pain

> > by Lasich, MD

> > Monday, June 14, 2010

> > How many men would take pain pills if they knew that the pills might

> > shrink their testicles? Besides testicular size, pain pills can

> > wreck havoc on a man's ability to have sex, make babies, build

> > muscles, and enjoy life. All of these side effects to opioid

> > medications are caused by the fact that chronic opioid use lowers

> > testosterone levels. This fact is not widely known, yet widely

> > experienced. " Opioid-induced androgen deficiency " affects thousands

> > of men. In a complex process that involves some very important

> > hormones, both men and women can experience symptoms of low

> > testosterone.

> > The most common symptoms from abnormally low testosterone levels -

> > hypogonadism - are:

> > Fatigue

> > Depression

> > Low libido

> > Erectile dysfunction

> > Sexual dysfunction

> > Osteoporosis

> > Low muscle mass

> > Infertility

> > Hot flashes

> > Night sweats

> > Testicular atrophy

> > If any of this sounds familiar, a doctor can order a simple blood

> > test (the Total Testosterone Level) to check your testosterone

> > level. This test is best done early in the morning to get the most

> > accurate reading. Checking baseline hormonal levels, including the

> > testosterone level, before and after initiating opioid treatment is

> > recommended by some experts. Additionally, when consenting for

> > opioid treatment, the patient should also be informed about the

> > potential for opioids to drastically lower testosterone levels.

> > If this discussion took place, many men might elect to avoid

> > opioids. If men knew that upwards of 80% of those who begin taking

> > opioids will experience erectile dysfunction from low testosterone

> > levels, they might want to seek alternative pain relieving options.

> > Those who do agree to opioid pain management despite the risks

> > should know about testosterone-replacement therapy.

> > Testosterone-replacement therapy is utilized to treat opioid-induced

> > testosterone insufficiency. Prior to initiating testosterone

> > treatment men need to have the prostate specific antigen level (PSA)

> > test because testosterone can worsen prostate conditions like cancer

> > and hypertrophy. Additionally, other conditions could also worsen

> > like heart failure and sleep apnea. So, not every man is a candidate

> > for testosterone replacement. Those who are candidates have a few

> > different modes of replacement like injections, patches, gels and

> > bio-identicals hormones. One study showed that the testosterone

> > patch delivering 7.5 mg per day was effective at normalizing

> > testosterone levels and relieving symptoms of hypogonadism. In fact,

> > that same study showed that pain intensity actually improved as the

> > testosterone levels normalized. Testosterone-replacement therapy is

> > probably the most underutilized, yet most often needed adjunct

> > therapy for someone who is a long-term opioid user.

> > Everyone, both men and women need to be more aware of the long-term

> > effects that opioids have on the human body. Testosterone and all

> > the hormones related to the hypothalamic-pituitary axis (thyroid,

> > adrenaline, and sex hormones) have the potential for becoming

> > abnormally low. At some point, these hormonal imbalances have the

> > potential to affect quality of life more than the pain itself. At

> > that point, the risks of long-term opioid use needs to be re-

> > evaluated because the risks might outweigh the benefits. At some

> > point, opioid pain management might not be worth the price.

> >

> > We comply with the HONcode standard for

> > trustworthy health information: verify here.

> > About Us |

> > Contact Us |

> > Privacy Policy |

> > Terms of Use |

> > Security Policy

> > By using this service, you accept our Terms of Use. Please read

> > them. The consumer health information on is for informational

> > purposes only and is not a substitute for medical advice or

> > treatment for any medical conditions. You should promptly seek

> > professional medical care if you have any concern about your health,

> > and you should always consult your physician before starting a

> > Rights Reserved.

> >

> > Current Opinion in Endocrinology & Diabetes:

> > June 2006 - Volume 13 - Issue 3 - p 262-266

> > doi: 10.1097/01.med.0000224806.08824.dc

> > Androgens

> > Opioid-induced androgen deficiency

> > l, Harry W

> > & #65532;

> > Abstract

> > Purpose of review: Opioid-induced androgen deficiency has become one

> > of the most common causes of testosterone deficiency among men in

> > many communities. Its increase parallels the large increase in

> > opioid use. This form of hypogonadotrophic hypogonadism is present

> > in most men chronically consuming sustained-action opioids,

> > including those receiving methadone for heroin addiction and those

> > consuming opioids for control of either malignant or non-malignant

> > chronic pain. A similar, but less well defined illness occurs in

> > women. Opioid-induced androgen deficiency is not widely recognized.

> > This review examines its pathophysiology, some of its signs and

> > symptoms, and indicates some areas where current observations

> > suggest additional investigations would be fruitful.

> > Recent findings: Recognition of opioid-induced androgen deficiency

> > in men not receiving methadone for heroin addiction is a new

> > observation, and in these men contributes to fatigue, depression,

> > vasomotor phenomena, anemia, diminished libido, erectile dysfunction

> > and osteoporosis. These signs and symptoms improved during

> > testosterone replacement therapy in several small non-placebo-

> > controlled trials.

> > Summary: A large majority of men consuming sustained-action opioids

> > have symptomatic androgen deficiency which apparently responds to

> > replacement therapy. Opioid-induced androgen deficiency is

> > frequently overlooked, with its symptoms attributed to underlying

> > disease states including malignant disease, chronic back disorders,

> > HIV disease, and psychosocial illnesses contributing to opioid

> > habituation.

> >

> > - 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma

> > with previous rt. flank pain. Treating with DASH. Stats w/o meds =

> > BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011 due to adverse

> > SX.

> > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2,

> > Gynecomastia, MDD and PTSD.

> > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin

> > and Metformin 2000MG. Started washing Spironolactone 12/20/11 to

> > prepare for AVS.

> >

>

January 22, 2012

We include the word " painful " as a determinant for switching treatment. In 16

months it never caused me pain yet symptoms of femininity progressed for 16

months. Change was not considered because the breasts were not painful, in

fact, it took 3 requests even after 16 months and with other signs of what was

happening. (Loss of body hair, libido, and significant reduction in penis and

testicle size!) If you want full disclosure maybe you need to add those

symptoms!

> > >

> > > > Dr. Grim, do you think being on Oxycodone and Methodone for 5+

> > years

> > > > could have any effect on my adverse reaction to Spironolactone?

> > What

> > > > about street drugs which I don't use? Maybe at the minimum there

> > > > should be a drug test so you know what may be ahead! Maybe Inspra

> > > > would be a better choice!

> > > >

> > > > Health Information, Tips, Community and More at HealthCentral.com

> > > >

http://www.healthcentral.com/chronic-pain/c/23153/113990/testosterone/pf/

> > > > ChronicPainConnection.com

> > > >

> > > > See all of our health sites at www.HealthCentral.com

> > > >

> > > > Chronic Pain Home >

> > > > General >

> > > > Treatment >

> > > > Alternative Treatment >

> > > > Chronic Pain Medication Lead to Sexual Dysfunction, Other Problems

> > > > for Men

> > > > Testosterone Replacement Therapy for Men in Pain

> > > > by Lasich, MD

> > > > Monday, June 14, 2010

> > > > How many men would take pain pills if they knew that the pills

> > might

> > > > shrink their testicles? Besides testicular size, pain pills can

> > > > wreck havoc on a man's ability to have sex, make babies, build

> > > > muscles, and enjoy life. All of these side effects to opioid

> > > > medications are caused by the fact that chronic opioid use lowers

> > > > testosterone levels. This fact is not widely known, yet widely

> > > > experienced. " Opioid-induced androgen deficiency " affects

> > thousands

> > > > of men. In a complex process that involves some very important

> > > > hormones, both men and women can experience symptoms of low

> > > > testosterone.

> > > > The most common symptoms from abnormally low testosterone levels -

> > > > hypogonadism - are:

> > > > Fatigue

> > > > Depression

> > > > Low libido

> > > > Erectile dysfunction

> > > > Sexual dysfunction

> > > > Osteoporosis

> > > > Low muscle mass

> > > > Infertility

> > > > Hot flashes

> > > > Night sweats

> > > > Testicular atrophy

> > > > If any of this sounds familiar, a doctor can order a simple blood

> > > > test (the Total Testosterone Level) to check your testosterone

> > > > level. This test is best done early in the morning to get the most

> > > > accurate reading. Checking baseline hormonal levels, including the

> > > > testosterone level, before and after initiating opioid treatment

> > is

> > > > recommended by some experts. Additionally, when consenting for

> > > > opioid treatment, the patient should also be informed about the

> > > > potential for opioids to drastically lower testosterone levels.

> > > > If this discussion took place, many men might elect to avoid

> > > > opioids. If men knew that upwards of 80% of those who begin taking

> > > > opioids will experience erectile dysfunction from low testosterone

> > > > levels, they might want to seek alternative pain relieving

> > options.

> > > > Those who do agree to opioid pain management despite the risks

> > > > should know about testosterone-replacement therapy.

> > > > Testosterone-replacement therapy is utilized to treat opioid-

> > induced

> > > > testosterone insufficiency. Prior to initiating testosterone

> > > > treatment men need to have the prostate specific antigen level

> > (PSA)

> > > > test because testosterone can worsen prostate conditions like

> > cancer

> > > > and hypertrophy. Additionally, other conditions could also worsen

> > > > like heart failure and sleep apnea. So, not every man is a

> > candidate

> > > > for testosterone replacement. Those who are candidates have a few

> > > > different modes of replacement like injections, patches, gels and

> > > > bio-identicals hormones. One study showed that the testosterone

> > > > patch delivering 7.5 mg per day was effective at normalizing

> > > > testosterone levels and relieving symptoms of hypogonadism. In

> > fact,

> > > > that same study showed that pain intensity actually improved as

> > the

> > > > testosterone levels normalized. Testosterone-replacement therapy

> > is

> > > > probably the most underutilized, yet most often needed adjunct

> > > > therapy for someone who is a long-term opioid user.

> > > > Everyone, both men and women need to be more aware of the long-

> > term

> > > > effects that opioids have on the human body. Testosterone and all

> > > > the hormones related to the hypothalamic-pituitary axis (thyroid,

> > > > adrenaline, and sex hormones) have the potential for becoming

> > > > abnormally low. At some point, these hormonal imbalances have the

> > > > potential to affect quality of life more than the pain itself. At

> > > > that point, the risks of long-term opioid use needs to be re-

> > > > evaluated because the risks might outweigh the benefits. At some

> > > > point, opioid pain management might not be worth the price.

> > > >

> > > > We comply with the HONcode standard for

> > > > trustworthy health information: verify here.

> > > > About Us |

> > > > Contact Us |

> > > > Privacy Policy |

> > > > Terms of Use |

> > > > Security Policy

> > > > By using this service, you accept our Terms of Use. Please read

> > > > them. The consumer health information on is for informational

> > > > purposes only and is not a substitute for medical advice or

> > > > treatment for any medical conditions. You should promptly seek

> > > > professional medical care if you have any concern about your

> > health,

> > > > and you should always consult your physician before starting a

> > > > Rights Reserved.

> > > >

> > > > Current Opinion in Endocrinology & Diabetes:

> > > > June 2006 - Volume 13 - Issue 3 - p 262-266

> > > > doi: 10.1097/01.med.0000224806.08824.dc

> > > > Androgens

> > > > Opioid-induced androgen deficiency

> > > > l, Harry W

> > > > & #65532;

> > > > Abstract

> > > > Purpose of review: Opioid-induced androgen deficiency has become

> > one

> > > > of the most common causes of testosterone deficiency among men in

> > > > many communities. Its increase parallels the large increase in

> > > > opioid use. This form of hypogonadotrophic hypogonadism is present

> > > > in most men chronically consuming sustained-action opioids,

> > > > including those receiving methadone for heroin addiction and those

> > > > consuming opioids for control of either malignant or non-malignant

> > > > chronic pain. A similar, but less well defined illness occurs in

> > > > women. Opioid-induced androgen deficiency is not widely

> > recognized.

> > > > This review examines its pathophysiology, some of its signs and

> > > > symptoms, and indicates some areas where current observations

> > > > suggest additional investigations would be fruitful.

> > > > Recent findings: Recognition of opioid-induced androgen deficiency

> > > > in men not receiving methadone for heroin addiction is a new

> > > > observation, and in these men contributes to fatigue, depression,

> > > > vasomotor phenomena, anemia, diminished libido, erectile

> > dysfunction

> > > > and osteoporosis. These signs and symptoms improved during

> > > > testosterone replacement therapy in several small non-placebo-

> > > > controlled trials.

> > > > Summary: A large majority of men consuming sustained-action

> > opioids

> > > > have symptomatic androgen deficiency which apparently responds to

> > > > replacement therapy. Opioid-induced androgen deficiency is

> > > > frequently overlooked, with its symptoms attributed to underlying

> > > > disease states including malignant disease, chronic back

> > disorders,

> > > > HIV disease, and psychosocial illnesses contributing to opioid

> > > > habituation.

> > > >

> > > > - 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma

> > > > with previous rt. flank pain. Treating with DASH. Stats w/o meds =

> > > > BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011 due to

> > adverse

> > > > SX.

> > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2,

> > > > Gynecomastia, MDD and PTSD.

> > > > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg

> > aspirin

> > > > and Metformin 2000MG. Started washing Spironolactone 12/20/11 to

> > > > prepare for AVS.

> > > >

> > >

> >

>

January 22, 2012

I did not find fEn... but did find fInesteride and looking at that in

MedLineplus I presume that is what you meant. If so the answer is " no " and no

reason for it since last PSA in Nov 2011 = .27 (0 - 4.0). PCP even made it

optional since " Previous test was so low " .

Then when I looked it up and found this, " It is important to note that a man who

is receiving hormone therapy for prostate cancer may have a low PSA level

during, or immediately after, treatment. The low level may not be a true measure

of the man's PSA level. Men receiving hormone therapy should talk with their

doctor, who may advise them to wait a few months after hormone treatment before

having a PSA test. "

Am I having hormone treatment (Spironolactone), it's just not for prostate

cancer? Maybe another caution we should publish? O a reason to choose a

medicine that does NOT AFFECT ANDROGEN if we can find one!

- 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma with

previous rt. flank pain. Treating with DASH. Stats w/o meds = BP 175/90 HR 59

BS 125. D/C Spironolactone 12/20/2011 due to adverse SX.

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, Gynecomastia, MDD

and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin and

Metformin 2000MG. Started washing Spironolactone 12/20/11 to prepare for AVS.

Added Added Amlodipine Besylate 5MG bid 1/12/12.

> > > > >

> > > > > > Dr. Grim, do you think being on Oxycodone and Methodone for 5+

> > > > years

> > > > > > could have any effect on my adverse reaction to Spironolactone?

> > > > What

> > > > > > about street drugs which I don't use? Maybe at the minimum there

> > > > > > should be a drug test so you know what may be ahead! Maybe Inspra

> > > > > > would be a better choice!

> > > > > >

> > > > > > Health Information, Tips, Community and More at HealthCentral.com

> > > > > >

http://www.healthcentral.com/chronic-pain/c/23153/113990/testosterone/pf/

> > > > > > ChronicPainConnection.com

> > > > > >

> > > > > > See all of our health sites at www.HealthCentral.com

> > > > > >

> > > > > > Chronic Pain Home >

> > > > > > General >

> > > > > > Treatment >

> > > > > > Alternative Treatment >

> > > > > > Chronic Pain Medication Lead to Sexual Dysfunction, Other Problems

> > > > > > for Men

> > > > > > Testosterone Replacement Therapy for Men in Pain

> > > > > > by Lasich, MD

> > > > > > Monday, June 14, 2010

> > > > > > How many men would take pain pills if they knew that the pills

> > > > might

> > > > > > shrink their testicles? Besides testicular size, pain pills can

> > > > > > wreck havoc on a man's ability to have sex, make babies, build

> > > > > > muscles, and enjoy life. All of these side effects to opioid

> > > > > > medications are caused by the fact that chronic opioid use lowers

> > > > > > testosterone levels. This fact is not widely known, yet widely

> > > > > > experienced. " Opioid-induced androgen deficiency " affects

> > > > thousands

> > > > > > of men. In a complex process that involves some very important

> > > > > > hormones, both men and women can experience symptoms of low

> > > > > > testosterone.

> > > > > > The most common symptoms from abnormally low testosterone levels -

> > > > > > hypogonadism - are:

> > > > > > Fatigue

> > > > > > Depression

> > > > > > Low libido

> > > > > > Erectile dysfunction

> > > > > > Sexual dysfunction

> > > > > > Osteoporosis

> > > > > > Low muscle mass

> > > > > > Infertility

> > > > > > Hot flashes

> > > > > > Night sweats

> > > > > > Testicular atrophy

> > > > > > If any of this sounds familiar, a doctor can order a simple blood

> > > > > > test (the Total Testosterone Level) to check your testosterone

> > > > > > level. This test is best done early in the morning to get the most

> > > > > > accurate reading. Checking baseline hormonal levels, including the

> > > > > > testosterone level, before and after initiating opioid treatment

> > > > is

> > > > > > recommended by some experts. Additionally, when consenting for

> > > > > > opioid treatment, the patient should also be informed about the

> > > > > > potential for opioids to drastically lower testosterone levels.

> > > > > > If this discussion took place, many men might elect to avoid

> > > > > > opioids. If men knew that upwards of 80% of those who begin taking

> > > > > > opioids will experience erectile dysfunction from low testosterone

> > > > > > levels, they might want to seek alternative pain relieving

> > > > options.

> > > > > > Those who do agree to opioid pain management despite the risks

> > > > > > should know about testosterone-replacement therapy.

> > > > > > Testosterone-replacement therapy is utilized to treat opioid-

> > > > induced

> > > > > > testosterone insufficiency. Prior to initiating testosterone

> > > > > > treatment men need to have the prostate specific antigen level

> > > > (PSA)

> > > > > > test because testosterone can worsen prostate conditions like

> > > > cancer

> > > > > > and hypertrophy. Additionally, other conditions could also worsen

> > > > > > like heart failure and sleep apnea. So, not every man is a

> > > > candidate

> > > > > > for testosterone replacement. Those who are candidates have a few

> > > > > > different modes of replacement like injections, patches, gels and

> > > > > > bio-identicals hormones. One study showed that the testosterone

> > > > > > patch delivering 7.5 mg per day was effective at normalizing

> > > > > > testosterone levels and relieving symptoms of hypogonadism. In

> > > > fact,

> > > > > > that same study showed that pain intensity actually improved as

> > > > the

> > > > > > testosterone levels normalized. Testosterone-replacement therapy

> > > > is

> > > > > > probably the most underutilized, yet most often needed adjunct

> > > > > > therapy for someone who is a long-term opioid user.

> > > > > > Everyone, both men and women need to be more aware of the long-

> > > > term

> > > > > > effects that opioids have on the human body. Testosterone and all

> > > > > > the hormones related to the hypothalamic-pituitary axis (thyroid,

> > > > > > adrenaline, and sex hormones) have the potential for becoming

> > > > > > abnormally low. At some point, these hormonal imbalances have the

> > > > > > potential to affect quality of life more than the pain itself. At

> > > > > > that point, the risks of long-term opioid use needs to be re-

> > > > > > evaluated because the risks might outweigh the benefits. At some

> > > > > > point, opioid pain management might not be worth the price.

> > > > > >

> > > > > > We comply with the HONcode standard for

> > > > > > trustworthy health information: verify here.

> > > > > > About Us |

> > > > > > Contact Us |

> > > > > > Privacy Policy |

> > > > > > Terms of Use |

> > > > > > Security Policy

> > > > > > By using this service, you accept our Terms of Use. Please read

> > > > > > them. The consumer health information on is for informational

> > > > > > purposes only and is not a substitute for medical advice or

> > > > > > treatment for any medical conditions. You should promptly seek

> > > > > > professional medical care if you have any concern about your

> > > > health,

> > > > > > and you should always consult your physician before starting a

> > > > > > Rights Reserved.

> > > > > >

> > > > > > Current Opinion in Endocrinology & Diabetes:

> > > > > > June 2006 - Volume 13 - Issue 3 - p 262-266

> > > > > > doi: 10.1097/01.med.0000224806.08824.dc

> > > > > > Androgens

> > > > > > Opioid-induced androgen deficiency

> > > > > > l, Harry W

> > > > > > & #65532;

> > > > > > Abstract

> > > > > > Purpose of review: Opioid-induced androgen deficiency has become

> > > > one

> > > > > > of the most common causes of testosterone deficiency among men in

> > > > > > many communities. Its increase parallels the large increase in

> > > > > > opioid use. This form of hypogonadotrophic hypogonadism is present

> > > > > > in most men chronically consuming sustained-action opioids,

> > > > > > including those receiving methadone for heroin addiction and those

> > > > > > consuming opioids for control of either malignant or non-malignant

> > > > > > chronic pain. A similar, but less well defined illness occurs in

> > > > > > women. Opioid-induced androgen deficiency is not widely

> > > > recognized.

> > > > > > This review examines its pathophysiology, some of its signs and

> > > > > > symptoms, and indicates some areas where current observations

> > > > > > suggest additional investigations would be fruitful.

> > > > > > Recent findings: Recognition of opioid-induced androgen deficiency

> > > > > > in men not receiving methadone for heroin addiction is a new

> > > > > > observation, and in these men contributes to fatigue, depression,

> > > > > > vasomotor phenomena, anemia, diminished libido, erectile

> > > > dysfunction

> > > > > > and osteoporosis. These signs and symptoms improved during

> > > > > > testosterone replacement therapy in several small non-placebo-

> > > > > > controlled trials.

> > > > > > Summary: A large majority of men consuming sustained-action

> > > > opioids

> > > > > > have symptomatic androgen deficiency which apparently responds to

> > > > > > replacement therapy. Opioid-induced androgen deficiency is

> > > > > > frequently overlooked, with its symptoms attributed to underlying

> > > > > > disease states including malignant disease, chronic back

> > > > disorders,

> > > > > > HIV disease, and psychosocial illnesses contributing to opioid

> > > > > > habituation.

> > > > > >

> > > > > > - 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma

> > > > > > with previous rt. flank pain. Treating with DASH. Stats w/o meds =

> > > > > > BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011 due to

> > > > adverse

> > > > > > SX.

> > > > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2,

> > > > > > Gynecomastia, MDD and PTSD.

> > > > > > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg

> > > > aspirin

> > > > > > and Metformin 2000MG. Started washing Spironolactone 12/20/11 to

> > > > > > prepare for AVS.

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 22, 2012

Medline explains it well enough so even I understood what you were thinking. It

apparently can cause gyneo on its own and I'M sure coadministering with spiro

wouldn't help matters at all!

> > > > > > >

> > > > > > > > Dr. Grim, do you think being on Oxycodone and Methodone

> > for 5+

> > > > > > years

> > > > > > > > could have any effect on my adverse reaction to

> > Spironolactone?

> > > > > > What

> > > > > > > > about street drugs which I don't use? Maybe at the

> > minimum there

> > > > > > > > should be a drug test so you know what may be ahead!

> > Maybe Inspra

> > > > > > > > would be a better choice!

> > > > > > > >

> > > > > > > > Health Information, Tips, Community and More at

> > HealthCentral.com

> > > > > > > >

http://www.healthcentral.com/chronic-pain/c/23153/113990/testosterone/pf/

> > > > > > > > ChronicPainConnection.com

> > > > > > > >

> > > > > > > > See all of our health sites at www.HealthCentral.com

> > > > > > > >

> > > > > > > > Chronic Pain Home >

> > > > > > > > General >

> > > > > > > > Treatment >

> > > > > > > > Alternative Treatment >

> > > > > > > > Chronic Pain Medication Lead to Sexual Dysfunction,

> > Other Problems

> > > > > > > > for Men

> > > > > > > > Testosterone Replacement Therapy for Men in Pain

> > > > > > > > by Lasich, MD

> > > > > > > > Monday, June 14, 2010

> > > > > > > > How many men would take pain pills if they knew that the

> > pills

> > > > > > might

> > > > > > > > shrink their testicles? Besides testicular size, pain

> > pills can

> > > > > > > > wreck havoc on a man's ability to have sex, make babies,

> > build

> > > > > > > > muscles, and enjoy life. All of these side effects to

> > opioid

> > > > > > > > medications are caused by the fact that chronic opioid

> > use lowers

> > > > > > > > testosterone levels. This fact is not widely known, yet

> > widely

> > > > > > > > experienced. " Opioid-induced androgen deficiency " affects

> > > > > > thousands

> > > > > > > > of men. In a complex process that involves some very

> > important

> > > > > > > > hormones, both men and women can experience symptoms of

> > low

> > > > > > > > testosterone.

> > > > > > > > The most common symptoms from abnormally low

> > testosterone levels -

> > > > > > > > hypogonadism - are:

> > > > > > > > Fatigue

> > > > > > > > Depression

> > > > > > > > Low libido

> > > > > > > > Erectile dysfunction

> > > > > > > > Sexual dysfunction

> > > > > > > > Osteoporosis

> > > > > > > > Low muscle mass

> > > > > > > > Infertility

> > > > > > > > Hot flashes

> > > > > > > > Night sweats

> > > > > > > > Testicular atrophy

> > > > > > > > If any of this sounds familiar, a doctor can order a

> > simple blood

> > > > > > > > test (the Total Testosterone Level) to check your

> > testosterone

> > > > > > > > level. This test is best done early in the morning to

> > get the most

> > > > > > > > accurate reading. Checking baseline hormonal levels,

> > including the

> > > > > > > > testosterone level, before and after initiating opioid

> > treatment

> > > > > > is

> > > > > > > > recommended by some experts. Additionally, when

> > consenting for

> > > > > > > > opioid treatment, the patient should also be informed

> > about the

> > > > > > > > potential for opioids to drastically lower testosterone

> > levels.

> > > > > > > > If this discussion took place, many men might elect to

> > avoid

> > > > > > > > opioids. If men knew that upwards of 80% of those who

> > begin taking

> > > > > > > > opioids will experience erectile dysfunction from low

> > testosterone

> > > > > > > > levels, they might want to seek alternative pain relieving

> > > > > > options.

> > > > > > > > Those who do agree to opioid pain management despite the

> > risks

> > > > > > > > should know about testosterone-replacement therapy.

> > > > > > > > Testosterone-replacement therapy is utilized to treat

> > opioid-

> > > > > > induced

> > > > > > > > testosterone insufficiency. Prior to initiating

> > testosterone

> > > > > > > > treatment men need to have the prostate specific antigen

> > level

> > > > > > (PSA)

> > > > > > > > test because testosterone can worsen prostate conditions

> > like

> > > > > > cancer

> > > > > > > > and hypertrophy. Additionally, other conditions could

> > also worsen

> > > > > > > > like heart failure and sleep apnea. So, not every man is a

> > > > > > candidate

> > > > > > > > for testosterone replacement. Those who are candidates

> > have a few

> > > > > > > > different modes of replacement like injections, patches,

> > gels and

> > > > > > > > bio-identicals hormones. One study showed that the

> > testosterone

> > > > > > > > patch delivering 7.5 mg per day was effective at

> > normalizing

> > > > > > > > testosterone levels and relieving symptoms of

> > hypogonadism. In

> > > > > > fact,

> > > > > > > > that same study showed that pain intensity actually

> > improved as

> > > > > > the

> > > > > > > > testosterone levels normalized. Testosterone-replacement

> > therapy

> > > > > > is

> > > > > > > > probably the most underutilized, yet most often needed

> > adjunct

> > > > > > > > therapy for someone who is a long-term opioid user.

> > > > > > > > Everyone, both men and women need to be more aware of

> > the long-

> > > > > > term

> > > > > > > > effects that opioids have on the human body.

> > Testosterone and all

> > > > > > > > the hormones related to the hypothalamic-pituitary axis

> > (thyroid,

> > > > > > > > adrenaline, and sex hormones) have the potential for

> > becoming

> > > > > > > > abnormally low. At some point, these hormonal imbalances

> > have the

> > > > > > > > potential to affect quality of life more than the pain

> > itself. At

> > > > > > > > that point, the risks of long-term opioid use needs to

> > be re-

> > > > > > > > evaluated because the risks might outweigh the benefits.

> > At some

> > > > > > > > point, opioid pain management might not be worth the

> > price.

> > > > > > > >

> > > > > > > > We comply with the HONcode standard for

> > > > > > > > trustworthy health information: verify here.

> > > > > > > > About Us |

> > > > > > > > Contact Us |

> > > > > > > > Privacy Policy |

> > > > > > > > Terms of Use |

> > > > > > > > Security Policy

> > > > > > > > By using this service, you accept our Terms of Use.

> > Please read

> > > > > > > > them. The consumer health information on is for

> > informational

> > > > > > > > purposes only and is not a substitute for medical advice

> > or

> > > > > > > > treatment for any medical conditions. You should

> > promptly seek

> > > > > > > > professional medical care if you have any concern about

> > your

> > > > > > health,

> > > > > > > > and you should always consult your physician before

> > starting a

> > LLC. All

> > > > > > > > Rights Reserved.

> > > > > > > >

> > > > > > > > Current Opinion in Endocrinology & Diabetes:

> > > > > > > > June 2006 - Volume 13 - Issue 3 - p 262-266

> > > > > > > > doi: 10.1097/01.med.0000224806.08824.dc

> > > > > > > > Androgens

> > > > > > > > Opioid-induced androgen deficiency

> > > > > > > > l, Harry W

> > > > > > > > & #65532;

> > > > > > > > Abstract

> > > > > > > > Purpose of review: Opioid-induced androgen deficiency

> > has become

> > > > > > one

> > > > > > > > of the most common causes of testosterone deficiency

> > among men in

> > > > > > > > many communities. Its increase parallels the large

> > increase in

> > > > > > > > opioid use. This form of hypogonadotrophic hypogonadism

> > is present

> > > > > > > > in most men chronically consuming sustained-action

> > opioids,

> > > > > > > > including those receiving methadone for heroin addiction

> > and those

> > > > > > > > consuming opioids for control of either malignant or non-

> > malignant

> > > > > > > > chronic pain. A similar, but less well defined illness

> > occurs in

> > > > > > > > women. Opioid-induced androgen deficiency is not widely

> > > > > > recognized.

> > > > > > > > This review examines its pathophysiology, some of its

> > signs and

> > > > > > > > symptoms, and indicates some areas where current

> > observations

> > > > > > > > suggest additional investigations would be fruitful.

> > > > > > > > Recent findings: Recognition of opioid-induced androgen

> > deficiency

> > > > > > > > in men not receiving methadone for heroin addiction is a

> > new

> > > > > > > > observation, and in these men contributes to fatigue,

> > depression,

> > > > > > > > vasomotor phenomena, anemia, diminished libido, erectile

> > > > > > dysfunction

> > > > > > > > and osteoporosis. These signs and symptoms improved during

> > > > > > > > testosterone replacement therapy in several small non-

> > placebo-

> > > > > > > > controlled trials.

> > > > > > > > Summary: A large majority of men consuming sustained-

> > action

> > > > > > opioids

> > > > > > > > have symptomatic androgen deficiency which apparently

> > responds to

> > > > > > > > replacement therapy. Opioid-induced androgen deficiency is

> > > > > > > > frequently overlooked, with its symptoms attributed to

> > underlying

> > > > > > > > disease states including malignant disease, chronic back

> > > > > > disorders,

> > > > > > > > HIV disease, and psychosocial illnesses contributing to

> > opioid

> > > > > > > > habituation.

> > > > > > > >

> > > > > > > > - 65 yo super ob., fastidious male - 12mm X 13mm

> > rt. a.adnoma

> > > > > > > > with previous rt. flank pain. Treating with DASH. Stats

> > w/o meds =

> > > > > > > > BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011

> > due to

> > > > > > adverse

> > > > > > > > SX.

> > > > > > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19,

> > DM2,

> > > > > > > > Gynecomastia, MDD and PTSD.

> > > > > > > > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG,

> > 81mg

> > > > > > aspirin

> > > > > > > > and Metformin 2000MG. Started washing Spironolactone

> > 12/20/11 to

> > > > > > > > prepare for AVS.

> > > > > > > >

> > > > > > >

> > > > > >

> > > > >

> > > >

> > >

> >

>

January 22, 2012

Not sure what the VA would do if they found your testosterone or androgen a bit

low.

I just got a update of my records seems in my case they over look a few abnormal

tests. Also there interpretation of what I say can be much different from what I

am saying. They also put answers to questions that I am never asked.

> >

> > > Dr. Grim, do you think being on Oxycodone and Methodone for 5+ years

> > > could have any effect on my adverse reaction to Spironolactone? What

> > > about street drugs which I don't use? Maybe at the minimum there

> > > should be a drug test so you know what may be ahead! Maybe Inspra

> > > would be a better choice!

> > >

> > > Health Information, Tips, Community and More at HealthCentral.com

> > > http://www.healthcentral.com/chronic-pain/c/23153/113990/testosterone/pf/

> > > ChronicPainConnection.com

> > >

> > > See all of our health sites at www.HealthCentral.com

> > >

> > > Chronic Pain Home >

> > > General >

> > > Treatment >

> > > Alternative Treatment >

> > > Chronic Pain Medication Lead to Sexual Dysfunction, Other Problems

> > > for Men

> > > Testosterone Replacement Therapy for Men in Pain

> > > by Lasich, MD

> > > Monday, June 14, 2010

> > > How many men would take pain pills if they knew that the pills might

> > > shrink their testicles? Besides testicular size, pain pills can

> > > wreck havoc on a man's ability to have sex, make babies, build

> > > muscles, and enjoy life. All of these side effects to opioid

> > > medications are caused by the fact that chronic opioid use lowers

> > > testosterone levels. This fact is not widely known, yet widely

> > > experienced. " Opioid-induced androgen deficiency " affects thousands

> > > of men. In a complex process that involves some very important

> > > hormones, both men and women can experience symptoms of low

> > > testosterone.

> > > The most common symptoms from abnormally low testosterone levels -

> > > hypogonadism - are:

> > > Fatigue

> > > Depression

> > > Low libido

> > > Erectile dysfunction

> > > Sexual dysfunction

> > > Osteoporosis

> > > Low muscle mass

> > > Infertility

> > > Hot flashes

> > > Night sweats

> > > Testicular atrophy

> > > If any of this sounds familiar, a doctor can order a simple blood

> > > test (the Total Testosterone Level) to check your testosterone

> > > level. This test is best done early in the morning to get the most

> > > accurate reading. Checking baseline hormonal levels, including the

> > > testosterone level, before and after initiating opioid treatment is

> > > recommended by some experts. Additionally, when consenting for

> > > opioid treatment, the patient should also be informed about the

> > > potential for opioids to drastically lower testosterone levels.

> > > If this discussion took place, many men might elect to avoid

> > > opioids. If men knew that upwards of 80% of those who begin taking

> > > opioids will experience erectile dysfunction from low testosterone

> > > levels, they might want to seek alternative pain relieving options.

> > > Those who do agree to opioid pain management despite the risks

> > > should know about testosterone-replacement therapy.

> > > Testosterone-replacement therapy is utilized to treat opioid-induced

> > > testosterone insufficiency. Prior to initiating testosterone

> > > treatment men need to have the prostate specific antigen level (PSA)

> > > test because testosterone can worsen prostate conditions like cancer

> > > and hypertrophy. Additionally, other conditions could also worsen

> > > like heart failure and sleep apnea. So, not every man is a candidate

> > > for testosterone replacement. Those who are candidates have a few

> > > different modes of replacement like injections, patches, gels and

> > > bio-identicals hormones. One study showed that the testosterone

> > > patch delivering 7.5 mg per day was effective at normalizing

> > > testosterone levels and relieving symptoms of hypogonadism. In fact,

> > > that same study showed that pain intensity actually improved as the

> > > testosterone levels normalized. Testosterone-replacement therapy is

> > > probably the most underutilized, yet most often needed adjunct

> > > therapy for someone who is a long-term opioid user.

> > > Everyone, both men and women need to be more aware of the long-term

> > > effects that opioids have on the human body. Testosterone and all

> > > the hormones related to the hypothalamic-pituitary axis (thyroid,

> > > adrenaline, and sex hormones) have the potential for becoming

> > > abnormally low. At some point, these hormonal imbalances have the

> > > potential to affect quality of life more than the pain itself. At

> > > that point, the risks of long-term opioid use needs to be re-

> > > evaluated because the risks might outweigh the benefits. At some

> > > point, opioid pain management might not be worth the price.

> > >

> > > We comply with the HONcode standard for

> > > trustworthy health information: verify here.

> > > About Us |

> > > Contact Us |

> > > Privacy Policy |

> > > Terms of Use |

> > > Security Policy

> > > By using this service, you accept our Terms of Use. Please read

> > > them. The consumer health information on is for informational

> > > purposes only and is not a substitute for medical advice or

> > > treatment for any medical conditions. You should promptly seek

> > > professional medical care if you have any concern about your health,

> > > and you should always consult your physician before starting a

> > > Rights Reserved.

> > >

> > > Current Opinion in Endocrinology & Diabetes:

> > > June 2006 - Volume 13 - Issue 3 - p 262-266

> > > doi: 10.1097/01.med.0000224806.08824.dc

> > > Androgens

> > > Opioid-induced androgen deficiency

> > > l, Harry W

> > > & #65532;

> > > Abstract

> > > Purpose of review: Opioid-induced androgen deficiency has become one

> > > of the most common causes of testosterone deficiency among men in

> > > many communities. Its increase parallels the large increase in

> > > opioid use. This form of hypogonadotrophic hypogonadism is present

> > > in most men chronically consuming sustained-action opioids,

> > > including those receiving methadone for heroin addiction and those

> > > consuming opioids for control of either malignant or non-malignant

> > > chronic pain. A similar, but less well defined illness occurs in

> > > women. Opioid-induced androgen deficiency is not widely recognized.

> > > This review examines its pathophysiology, some of its signs and

> > > symptoms, and indicates some areas where current observations

> > > suggest additional investigations would be fruitful.

> > > Recent findings: Recognition of opioid-induced androgen deficiency

> > > in men not receiving methadone for heroin addiction is a new

> > > observation, and in these men contributes to fatigue, depression,

> > > vasomotor phenomena, anemia, diminished libido, erectile dysfunction

> > > and osteoporosis. These signs and symptoms improved during

> > > testosterone replacement therapy in several small non-placebo-

> > > controlled trials.

> > > Summary: A large majority of men consuming sustained-action opioids

> > > have symptomatic androgen deficiency which apparently responds to

> > > replacement therapy. Opioid-induced androgen deficiency is

> > > frequently overlooked, with its symptoms attributed to underlying

> > > disease states including malignant disease, chronic back disorders,

> > > HIV disease, and psychosocial illnesses contributing to opioid

> > > habituation.

> > >

> > > - 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma

> > > with previous rt. flank pain. Treating with DASH. Stats w/o meds =

> > > BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011 due to adverse

> > > SX.

> > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2,

> > > Gynecomastia, MDD and PTSD.

> > > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin

> > > and Metformin 2000MG. Started washing Spironolactone 12/20/11 to

> > > prepare for AVS.

> > >

> >

>

January 23, 2012

I do know there is treatment for low testosterone. It is that In think our Local

VA at least in my case doesn't do anything about abnormal test results. This is

other tests other then testosterone.

> > > >

> > > > > Dr. Grim, do you think being on Oxycodone and Methodone for 5+ years

> > > > > could have any effect on my adverse reaction to Spironolactone? What

> > > > > about street drugs which I don't use? Maybe at the minimum there

> > > > > should be a drug test so you know what may be ahead! Maybe Inspra

> > > > > would be a better choice!

> > > > >

> > > > > Health Information, Tips, Community and More at HealthCentral.com

> > > > >

http://www.healthcentral.com/chronic-pain/c/23153/113990/testosterone/pf/

> > > > > ChronicPainConnection.com

> > > > >

> > > > > See all of our health sites at www.HealthCentral.com

> > > > >

> > > > > Chronic Pain Home >

> > > > > General >

> > > > > Treatment >

> > > > > Alternative Treatment >

> > > > > Chronic Pain Medication Lead to Sexual Dysfunction, Other Problems

> > > > > for Men

> > > > > Testosterone Replacement Therapy for Men in Pain

> > > > > by Lasich, MD

> > > > > Monday, June 14, 2010

> > > > > How many men would take pain pills if they knew that the pills might

> > > > > shrink their testicles? Besides testicular size, pain pills can

> > > > > wreck havoc on a man's ability to have sex, make babies, build

> > > > > muscles, and enjoy life. All of these side effects to opioid

> > > > > medications are caused by the fact that chronic opioid use lowers

> > > > > testosterone levels. This fact is not widely known, yet widely

> > > > > experienced. " Opioid-induced androgen deficiency " affects thousands

> > > > > of men. In a complex process that involves some very important

> > > > > hormones, both men and women can experience symptoms of low

> > > > > testosterone.

> > > > > The most common symptoms from abnormally low testosterone levels -

> > > > > hypogonadism - are:

> > > > > Fatigue

> > > > > Depression

> > > > > Low libido

> > > > > Erectile dysfunction

> > > > > Sexual dysfunction

> > > > > Osteoporosis

> > > > > Low muscle mass

> > > > > Infertility

> > > > > Hot flashes

> > > > > Night sweats

> > > > > Testicular atrophy

> > > > > If any of this sounds familiar, a doctor can order a simple blood

> > > > > test (the Total Testosterone Level) to check your testosterone

> > > > > level. This test is best done early in the morning to get the most

> > > > > accurate reading. Checking baseline hormonal levels, including the

> > > > > testosterone level, before and after initiating opioid treatment is

> > > > > recommended by some experts. Additionally, when consenting for

> > > > > opioid treatment, the patient should also be informed about the

> > > > > potential for opioids to drastically lower testosterone levels.

> > > > > If this discussion took place, many men might elect to avoid

> > > > > opioids. If men knew that upwards of 80% of those who begin taking

> > > > > opioids will experience erectile dysfunction from low testosterone

> > > > > levels, they might want to seek alternative pain relieving options.

> > > > > Those who do agree to opioid pain management despite the risks

> > > > > should know about testosterone-replacement therapy.

> > > > > Testosterone-replacement therapy is utilized to treat opioid-induced

> > > > > testosterone insufficiency. Prior to initiating testosterone

> > > > > treatment men need to have the prostate specific antigen level (PSA)

> > > > > test because testosterone can worsen prostate conditions like cancer

> > > > > and hypertrophy. Additionally, other conditions could also worsen

> > > > > like heart failure and sleep apnea. So, not every man is a candidate

> > > > > for testosterone replacement. Those who are candidates have a few

> > > > > different modes of replacement like injections, patches, gels and

> > > > > bio-identicals hormones. One study showed that the testosterone

> > > > > patch delivering 7.5 mg per day was effective at normalizing

> > > > > testosterone levels and relieving symptoms of hypogonadism. In fact,

> > > > > that same study showed that pain intensity actually improved as the

> > > > > testosterone levels normalized. Testosterone-replacement therapy is

> > > > > probably the most underutilized, yet most often needed adjunct

> > > > > therapy for someone who is a long-term opioid user.

> > > > > Everyone, both men and women need to be more aware of the long-term

> > > > > effects that opioids have on the human body. Testosterone and all

> > > > > the hormones related to the hypothalamic-pituitary axis (thyroid,

> > > > > adrenaline, and sex hormones) have the potential for becoming

> > > > > abnormally low. At some point, these hormonal imbalances have the

> > > > > potential to affect quality of life more than the pain itself. At

> > > > > that point, the risks of long-term opioid use needs to be re-

> > > > > evaluated because the risks might outweigh the benefits. At some

> > > > > point, opioid pain management might not be worth the price.

> > > > >

> > > > > We comply with the HONcode standard for

> > > > > trustworthy health information: verify here.

> > > > > About Us |

> > > > > Contact Us |

> > > > > Privacy Policy |

> > > > > Terms of Use |

> > > > > Security Policy

> > > > > By using this service, you accept our Terms of Use. Please read

> > > > > them. The consumer health information on is for informational

> > > > > purposes only and is not a substitute for medical advice or

> > > > > treatment for any medical conditions. You should promptly seek

> > > > > professional medical care if you have any concern about your health,

> > > > > and you should always consult your physician before starting a

> > > > > Rights Reserved.

> > > > >

> > > > > Current Opinion in Endocrinology & Diabetes:

> > > > > June 2006 - Volume 13 - Issue 3 - p 262-266

> > > > > doi: 10.1097/01.med.0000224806.08824.dc

> > > > > Androgens

> > > > > Opioid-induced androgen deficiency

> > > > > l, Harry W

> > > > > & #65532;

> > > > > Abstract

> > > > > Purpose of review: Opioid-induced androgen deficiency has become one

> > > > > of the most common causes of testosterone deficiency among men in

> > > > > many communities. Its increase parallels the large increase in

> > > > > opioid use. This form of hypogonadotrophic hypogonadism is present

> > > > > in most men chronically consuming sustained-action opioids,

> > > > > including those receiving methadone for heroin addiction and those

> > > > > consuming opioids for control of either malignant or non-malignant

> > > > > chronic pain. A similar, but less well defined illness occurs in

> > > > > women. Opioid-induced androgen deficiency is not widely recognized.

> > > > > This review examines its pathophysiology, some of its signs and

> > > > > symptoms, and indicates some areas where current observations

> > > > > suggest additional investigations would be fruitful.

> > > > > Recent findings: Recognition of opioid-induced androgen deficiency

> > > > > in men not receiving methadone for heroin addiction is a new

> > > > > observation, and in these men contributes to fatigue, depression,

> > > > > vasomotor phenomena, anemia, diminished libido, erectile dysfunction

> > > > > and osteoporosis. These signs and symptoms improved during

> > > > > testosterone replacement therapy in several small non-placebo-

> > > > > controlled trials.

> > > > > Summary: A large majority of men consuming sustained-action opioids

> > > > > have symptomatic androgen deficiency which apparently responds to

> > > > > replacement therapy. Opioid-induced androgen deficiency is

> > > > > frequently overlooked, with its symptoms attributed to underlying

> > > > > disease states including malignant disease, chronic back disorders,

> > > > > HIV disease, and psychosocial illnesses contributing to opioid

> > > > > habituation.

> > > > >

> > > > > - 65 yo super ob., fastidious male - 12mm X 13mm rt. a.adnoma

> > > > > with previous rt. flank pain. Treating with DASH. Stats w/o meds =

> > > > > BP 175/90 HR 59 BS 125. D/C Spironolactone 12/20/2011 due to adverse

> > > > > SX.

> > > > > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2,

> > > > > Gynecomastia, MDD and PTSD.

> > > > > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg aspirin

> > > > > and Metformin 2000MG. Started washing Spironolactone 12/20/11 to

> > > > > prepare for AVS.

> > > > >

> > > >

> > >

> >

> > Reply to sender | Reply to group | Reply via web post | Start a New Topic

> > Messages in this topic (11)

> > RECENT ACTIVITY:

>

January 23, 2012

Do you think the VA treatment caused this? If you do then file a claim. If it is

shown that the VA caused this then all treatments would be paid for by the VA.

This would include travel pay.

> > > >

> > > > > Dr. Grim, do you think being on Oxycodone and Methodone for 5+

> > > years

> > > > > could have any effect on my adverse reaction to Spironolactone?

> > > What

> > > > > about street drugs which I don't use? Maybe at the minimum there

> > > > > should be a drug test so you know what may be ahead! Maybe Inspra

> > > > > would be a better choice!

> > > > >

> > > > > Health Information, Tips, Community and More at HealthCentral.com

> > > > >

http://www.healthcentral.com/chronic-pain/c/23153/113990/testosterone/pf/

> > > > > ChronicPainConnection.com

> > > > >

> > > > > See all of our health sites at www.HealthCentral.com

> > > > >

> > > > > Chronic Pain Home >

> > > > > General >

> > > > > Treatment >

> > > > > Alternative Treatment >

> > > > > Chronic Pain Medication Lead to Sexual Dysfunction, Other Problems

> > > > > for Men

> > > > > Testosterone Replacement Therapy for Men in Pain

> > > > > by Lasich, MD

> > > > > Monday, June 14, 2010

> > > > > How many men would take pain pills if they knew that the pills

> > > might

> > > > > shrink their testicles? Besides testicular size, pain pills can

> > > > > wreck havoc on a man's ability to have sex, make babies, build

> > > > > muscles, and enjoy life. All of these side effects to opioid

> > > > > medications are caused by the fact that chronic opioid use lowers

> > > > > testosterone levels. This fact is not widely known, yet widely

> > > > > experienced. " Opioid-induced androgen deficiency " affects

> > > thousands

> > > > > of men. In a complex process that involves some very important

> > > > > hormones, both men and women can experience symptoms of low

> > > > > testosterone.

> > > > > The most common symptoms from abnormally low testosterone levels -

> > > > > hypogonadism - are:

> > > > > Fatigue

> > > > > Depression

> > > > > Low libido

> > > > > Erectile dysfunction

> > > > > Sexual dysfunction

> > > > > Osteoporosis

> > > > > Low muscle mass

> > > > > Infertility

> > > > > Hot flashes

> > > > > Night sweats

> > > > > Testicular atrophy

> > > > > If any of this sounds familiar, a doctor can order a simple blood

> > > > > test (the Total Testosterone Level) to check your testosterone

> > > > > level. This test is best done early in the morning to get the most

> > > > > accurate reading. Checking baseline hormonal levels, including the

> > > > > testosterone level, before and after initiating opioid treatment

> > > is

> > > > > recommended by some experts. Additionally, when consenting for

> > > > > opioid treatment, the patient should also be informed about the

> > > > > potential for opioids to drastically lower testosterone levels.

> > > > > If this discussion took place, many men might elect to avoid

> > > > > opioids. If men knew that upwards of 80% of those who begin taking

> > > > > opioids will experience erectile dysfunction from low testosterone

> > > > > levels, they might want to seek alternative pain relieving

> > > options.

> > > > > Those who do agree to opioid pain management despite the risks

> > > > > should know about testosterone-replacement therapy.

> > > > > Testosterone-replacement therapy is utilized to treat opioid-

> > > induced

> > > > > testosterone insufficiency. Prior to initiating testosterone

> > > > > treatment men need to have the prostate specific antigen level

> > > (PSA)

> > > > > test because testosterone can worsen prostate conditions like

> > > cancer

> > > > > and hypertrophy. Additionally, other conditions could also worsen

> > > > > like heart failure and sleep apnea. So, not every man is a

> > > candidate

> > > > > for testosterone replacement. Those who are candidates have a few

> > > > > different modes of replacement like injections, patches, gels and

> > > > > bio-identicals hormones. One study showed that the testosterone

> > > > > patch delivering 7.5 mg per day was effective at normalizing

> > > > > testosterone levels and relieving symptoms of hypogonadism. In

> > > fact,

> > > > > that same study showed that pain intensity actually improved as

> > > the

> > > > > testosterone levels normalized. Testosterone-replacement therapy

> > > is

> > > > > probably the most underutilized, yet most often needed adjunct

> > > > > therapy for someone who is a long-term opioid user.

> > > > > Everyone, both men and women need to be more aware of the long-

> > > term