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Low Testosterone as an Indicator for the Development of Arthritis

Low testosterone (also called low T) is a condition where men have low levels of the male sex hormone testosterone. Scientists now believe that low T can be an indicator for the future development of rheumatoid arthritis (RA), which is a painful, autoimmune disorder that affects the joints. It is estimated that approximately 1.5 million adults in the United States are affected with RA, according to the Centers for Disease Control and Prevention (CDC). Also, women are more likely to develop this debilitating condition.

A new study from Sweden found that men who have low levels of this androgen (testosterone) in their blood stream are more likely develop RA. Published in the Annals of the Rheumatic Diseases, these research findings suggest that hormonal changes often precede the onset of RA and they also appear to influence disease severity, according to Swedish scientists. Sex hormones have immunomodulatory properties that affect the pathogenesis of rheumatoid arthritis. The prospective study found a negative association between men's testosterone levels and the risk of rheumatoid factor-negative RA onset.

Study Links Sex Hormones to Development of Rheumatoid Arthritis

The study involved a literature review that involved several aspects of hormonal factors in RA, as well as clinical and epidemiologic observations. Also, the researchers conducted a review of data on related pathomechanisms related to RA development. Sex hormones are believed to play a role in RA, as men and women with RA both had lower levels in their blood compared to people without the disease. The scientists are unsure whether the low T is a contributing factor or just a mere consequence of the disease.

The Swedish researchers evaluated people who participated in Sweden's Malmo Preventive Medicine Program, which is a survey that began in 1974 and tracked more than 33,000 people of Scandinavian origin who were born between 1921 and 1949. They screened over 22,000 men in the program who had low testosterone, and discovered that 150 later developed rheumatoid arthritis.

The investigators analyzed blood samples of 104 men who later developed RA and compared this to 174 men of the same age who did not develop the disease. The average time between blood sample collection and the diagnosis of RA was less than 13 years but ranged between 1 to 28 years. After considering RA risk factors, such as weight and smoking, the scientists found that men with low testosterone levels were at increased risk for rheumatoid arthritis. However, they were not able to prove a cause-and-effect link between the two conditions.

Conclusions

The researchers also noted significantly higher levels of follicle stimulating hormone (FSH) in the participants. FSH is a hormone that is involved with sexual maturation and reproduction. These findings indicated that hormonal changes that occur before RA onset could influence severity of disease.

Resources:

American Academy of Family Physicians. Rheumatoid arthritis. Retrieved from:
http://familydoctor.org/familydoctor/en/diseases-conditions/rheumatoid-arthritis.printerview.all.html

Tureson, C & Pikwer, M. (2014). The Role of Testosterone and Other Hormonal Factors in the Development of Rheumatoid Arthritis CME. Retrieved from:
http://www.medscape.org/viewarticle/819962

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