According to the Centers for Disease Control and Prevention (CDC) an estimated 58.5 million US adults (23.7%) had been diagnosed with some form of arthritis during 2016-2018. While there is no known cure for RA, treatment focuses on managing symptoms and preventing further progression. Could testosterone therapy be a potential option?
Recent research suggests testosterone replacement may help modulate immune function and reduce inflammation in RA. Read on to learn more about the link between testosterone and rheumatoid arthritis, and whether hormone therapy could be right for you.
What is Rheumatoid Arthritis?
Rheumatoid arthritis is an autoimmune and inflammatory disease where the immune system mistakenly attacks healthy tissue in the joints. This leads to painful swelling, stiffness, and potential joint damage over time.
RA typically affects the small joints in the hands and feet first, such as the knuckles and ball of the foot. As it progresses, larger joints like the knees, ankles, elbows, and shoulders can be impacted.
The disease fluctuates between periods of flares and remission. It can also cause fatigue, appetite loss, fever, and firm lumps (nodules) under the skin.
While the exact cause is unknown, rheumatoid arthritis likely results from a combination of genetic and environmental factors. It is 2-3 times more common in women than men.
How is it Diagnosed?
Rheumatoid arthritis is typically diagnosed based on a combination of factors such as:
- physical examination of the joints
- blood tests
- imaging scans
- evaluation of symptoms
- response to treatment
- exclusion of other conditions
During a physical exam, a doctor will check for symmetric swelling and tenderness in multiple joints, often in the hands, wrists, elbows, knees, ankles, and feet. Blood tests may detect elevated inflammation markers like erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), as well as rheumatoid factor and anti-CCP antibodies. X-rays or MRI scans can reveal early joint damage, though this damage may not be visible on x-rays initially.
Patients usually have symptoms like morning joint stiffness lasting over 30 minutes and pain in multiple joints for more than 6 weeks. If symptoms improve with anti-inflammatory medications, it supports a rheumatoid arthritis diagnosis. Other conditions that can mimic rheumatoid arthritis are ruled out through additional testing.
An early diagnosis within 6 months of symptom onset is recommended so that medications can be started promptly to slow disease progression.
What is the Relationship Between Testosterone and Arthritis?
Research suggests an association between lower testosterone levels and increased arthritis risk, but the exact relationship is complex. Studies have found testosterone deficiency can accelerate osteoarthritis progression, likely due to the hormone’s role in maintaining muscle and bone strength.
Lower testosterone levels are also associated with higher rheumatoid arthritis likelihood, though the mechanisms are unclear. While rheumatoid arthritis patients often have low testosterone, it is unlikely that testosterone deficiency directly causes the autoimmune disease. Rather, low testosterone may result from chronic inflammation or other factors.
Though more research is needed, the relationships appear correlative, not causative. Still, lifestyle interventions like aerobic exercise may benefit both testosterone levels and osteoarthritis symptoms through improving muscle strength and joint health.
Can Testosterone Therapy Modulate the Immune System in Rheumatoid Arthritis?
Emerging research shows testosterone therapy can modulate immune function and reduce excessive inflammation associated with rheumatoid arthritis.
Specifically, studies have found testosterone treatment can:
- Increase the number of CD8+ T-cells, which help regulate the immune response
- Inhibit the release of inflammatory cytokines
- Reduce B-cell proliferation and autoantibody production
- Modulate metabolism of immunosuppressant drugs like cyclosporine
- Testosterone helps counteract the hyperactive immune response involved in RA. This leads to an overall reduction in painful joint inflammation and swelling.
One 6-month clinical trial on 35 men with RA found that monthly testosterone injections significantly improved symptoms compared to placebo. Patients receiving testosterone therapy had decreased joint tenderness, reduced morning stiffness, and improved functional ability.
How Does Hormone Replacement Therapy Control Joint Inflammation in Rheumatoid Arthritis?
Along with testosterone, estrogen hormone replacement therapy (HRT) may also help control inflammatory joint symptoms in rheumatoid arthritis.
Some analyses have found an association between postmenopausal estrogen use and lower RA severity. Researchers believe estrogen’s anti-inflammatory effects likely underlie its protective abilities against rheumatoid arthritis progression:
- Estrogen suppresses release of inflammatory cytokines like TNF-alpha and IL-1beta
- Estrogen increases anti-inflammatory cytokines such as IL-10
- Estrogen blocks activation of osteoclasts involved in bone resorption
Through these mechanisms, estrogen HRT is thought to prevent excessive immune activation that accelerates joint damage. Estrogen therapy may be particularly beneficial for postmenopausal women with rheumatoid arthritis.
Lifestyle Changes That Can Complement Hormone Therapy
In addition to hormone replacement, certain lifestyle measures may help complement RA treatment:
- Exercise: Low-impact activities like walking, swimming, and yoga can improve joint mobility without further damaging joints.
- Healthy diet: An anti-inflammatory diet high in fruits, vegetables, fish, nuts and olive oil may help reduce joint swelling and pain.
- Stress management: Techniques like meditation, deep breathing, and tai chi can lower stress hormones that exacerbate RA inflammation.
- Vitamins and supplements: Fish oil, turmeric, ginger, and glucosamine supplements have natural anti-inflammatory effects that may reduce arthritis symptoms.
- Massage therapy: Studies show massage can improve pain, stiffness, and range of motion in people with rheumatoid arthritis.
- Acupuncture: Insertion of thin needles into specific body points has been found to reduce arthritis pain and morning stiffness.
- Hot-cold therapy: Alternating hot packs and cold compresses on painful joints increases circulation and reduces swelling.
Who is a Good Candidate for Testosterone Replacement Therapy?
Testosterone therapy may be a potential option for men with rheumatoid arthritis who also have clinically low testosterone levels. Signs and symptoms of low testosterone in men include:
| Signs and Symptoms |
| Reduced muscle mass and strength |
| Increased body fat and difficulty losing weight |
| Low energy and fatigue |
| Decreased libido (sex drive) |
| Erectile dysfunction |
| Depressed mood and irritability |
| Reduced bone density (osteoporosis) |
Blood testing is required to definitively diagnose low testosterone (hypogonadism). Your physician can check your total testosterone, free testosterone, and other hormone levels.
If hypogonadism is identified, testosterone replacement therapy may provide dual benefits by alleviating deficiency symptoms and reducing rheumatoid arthritis disease activity.
However, testosterone therapy is not recommended for men with normal testosterone levels. Supratherapeutic doses can lead to side effects like polycythemia, edema, gynecomastia, and cardiac complications.
What are the Risks and Side Effects of Testosterone Therapy?
While testosterone therapy can potentially help treat RA symptoms, there are some potential side effects and risks to consider:
- Increased red blood cell production (polycythemia)
- Prostate enlargement
- Worsening sleep apnea
- Acne and oily skin
- Breast enlargement (gynecomastia)
- Testicular atrophy
- Increased risk of blood clots
- Liver toxicity at high doses
That’s why it’s critical to work with an experienced hormone therapy specialist to minimize risks. Your physician will monitor your hormone levels, red blood cell counts, and prostate health, to ensure your customized treatment plan remains safe and effective.
Look, Feel, and Live Better with Physician’s Rejuvenation Centers
Don’t let rheumatoid arthritis or hormone imbalance prevent you from enjoying life to the fullest. Physician’s Rejuvenation Centers specialize in customized care plans to help patients restore their vitality, health and confidence.
We’ve seen first-hand how optimized hormone levels and reducing joint inflammation can transform quality of life. Our proven holistic programs have helped thousands nationwide:
- Reduce joint pain and stiffness
- Increase mobility and range of motion
- Build strength, muscle tone and bone density
- Boost energy, mood and mental clarity
- Improve skin texture, tone and elasticity
- Enhance libido and sexual performance
- Strengthen immune function
- Support heart health and weight management
We provide individualized care for women and men using cutting-edge therapies, top medical expertise and premium ingredients. Contact us today for a free consultation, or give us a call at (561) 783-5153. Our knowledgeable staff is ready to answer your questions, address your concerns, and help you develop a treatment plan tailored to your individual needs.
We look forward to helping you thrive in life again as your best, healthiest self!