With low testosterone on the rise around the world, more research and focus has been made on the health effects of low-T for men, and even women. We’ve realized that low-T can cause serious problems, such as depression, as well as other issues such as erectile dysfunction, poor muscle mass leading to sarcopenia, fat gain, etc.
For women, it’s usually a low sex drive and painful sex. In addition, it’s been noted in multiple studies that men with low testosterone are more susceptible to COVID-19 and exhibit worse symptoms the lower their testosterone is. Now, scientific research is showing us that low testosterone may be related to a joint disease: rheumatoid arthritis.
Low-T – A Sign of Arthritis to Come?
A recent study has concluded that men with lower levels of testosterone may be more likely to develop rheumatoid arthritis in the future. However, this is not definitive because the testosterone levels between the two groups were not that different, but enough to be significantly different in terms of statistics.
We know that arthritis is caused by inflammation in the joints and testosterone has been shown to actually reduce inflammation in the body – for example, lung inflammation with asthma and the inflammation associated with COVID-19. Therefore, it does make sense that adequate testosterone levels would tend to keep inflammatory disease, such as arthritis, at bay.
Previous research has shown that men with rheumatoid arthritis have lower testosterone levels than those without arthritis. Unfortunately, we do not know if the hormonal changes took place before or after the arthritis developed. To try and figure this out, Mitra Pikwer, MD, from the Lund University in Sweden, decided to study men who were known to have rheumatoid arthritis from a health survey called the Malmo Preventive Medicine Program (MPMP).
The participants in the study had multiple tests performed, questionnaires and blood samples drawn. From this data, Pikwer and researchers were able to get a good start on their research into low testosterone and how it relates to rheumatoid arthritis.
What is Rheumatoid Arthritis?
Before we go any further, let's find out what rheumatoid arthritis is and how it compares to other types of arthritis. Rheumatoid is actually an autoimmune and inflammatory disease. Autoimmune means that the patient’s own immune system is attacking healthy cells in the body, specifically cells of the joints in this case. This causes inflammation and pain in the joints.
The joints most affected are in the hands, wrists and knees. Ouch! With rheumatoid arthritis, the lining of the joint becomes inflamed, and this causes damage to the joint tissue. This damage can become chronic, leading to chronic pain, lack of balance and deformity of the joints. If the rheumatoid arthritis is not treated, it can also affect other tissues, causing health problems in the heart, lungs and eyes.
The symptoms of rheumatoid arthritis include pain or aches in more than one joint, stiffness in the joints, tenderness and swelling, weight loss, fatigue, fever and weakness. There is no known cause of rheumatoid arthritis, but it can be treated with medication and self-management strategies. The medications used are medications that slow down the extent of the disease and prevent deformities.
Could Hormone Levels Be Biomarker of Future Arthritis?
A total of 278 men were involved in the scientific study led by Pikwer who used the blood samples to find 104 men who went on to develop arthritis and 174 men who matched controls, or men of the same age how did not develop the disease.
With these blood samples, Pikwer measured levels of testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and sex hormone-binding globulin (SHBG). The goal here was to see if differences in the hormone levels between the health patients and the arthritic patients could be spotted years in advance before the arthritic patients were diagnosed.
The time between giving a blood sample and diagnosis of patients who developed rheumatoid arthritis varied from one to 28 years.
There is a protein that is produced by the immune system called RF (rheumatoid factor). High levels of RF are associated with rheumatoid arthritis patients. Pikwer and colleagues also measured the rheumatoid factor status at the time of diagnosis of 83 men in the study who developed the disease.
Out of these men, 73% tested positive for the protein. This is another contentious factor in rheumatoid arthritis development because RF can be detected in healthy patients and some people with rheumatoid have normal levels of it.
Low Testosterone Linked to Higher Odds of Developing Rheumatoid Arthritis
The results of the study show that lower levels of the sex hormone, testosterone, are linked to higher odds of developing rheumatoid arthritis, and more specifically, the RF-negative type. The association was more apparent when other factors were accounted for that increase the risk of arthritis, such as smoking and obesity (Isn’t it crazy that there are some people who still smoke today?).
There only small differences in testosterone levels between men who developed rheumatoid arthritis and those who did not, though still statistically significant. The levels ranged from 20 nmol/L to 22 nmol/L.
Except for an even smaller study in Finland, this was the first study to explore hormone levels in men to see if they could be biomarkers for development of rheumatoid arthritis. Because the differences in testosterone in pre-rheumatoid arthritis men were only more apparent when the models were adjusted for other confounders, such as smoking or obesity, it makes it more complicated to use testosterone measurements as a predictor of rheumatoid arthritis in a clinical setting.
The researchers also stated, “Since this is the first major study of testosterone and related hormones in the preclinical phase of rheumatoid arthritis, our findings should be verified in other populations.” Verification of results is always something that should be welcome in scientific circles and no surprise that the researchers would suggest that. The more research conducted, the better and more definitive results.
In conclusion, it would not be surprising if testosterone levels do truly have a link to rheumatoid arthritis and other inflammatory diseases. It has been noted before in the scientific literature that testosterone has an anti-inflammatory effect, such as with asthma and even COVID-19, as noted previously.
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