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The Use
of Hormones for Chronic Pain
Forest Tennant, MD, DrPH
abstract
Anabolic hormone therapies and Prolotherapy are innovative
approaches to treating chronic pain. They are complimentary and
can be simultaneously administered.
Journal of Prolotherapy. 2010;2(4):489-494.
Introduction
Hormone administration is progressively becoming more and more
important in treatment of chronic pain. Some specific hormonal
therapies offer the patient real opportunities to greatly reduce
and even eliminate pain and suffering.2, 3 They can be
simultaneously administered to patients who participate in
Prolotherapy or take opioids which is the standard symptomatic
medication now used by about 10 million Americans. In some cases
hormone treatments are necessary to save a life or prevent
incapacitation and suffering. This report reviews the hormone
treatment and replacement needs that may exist in chronic pain
patients. Many of these treatments can be simply and
inexpensively incorporated as adjunctive measures to a
practitioner’s current regimens.
Why hormones?
Proper pain treatment may require specific hormone
administration. Adrenal corticoid hormones are long known to
resolve inflammation and allow healing of injured and inflamed
tissue sites. Proper blood levels of adrenal corticoids are also
necessary to effectively treat patients with opioids and other
pharmacologic agents that must cross the blood brain barrier and
affect central nervous system receptors.2, 3 The claims and
concerns about “hyperalgesia” are probably related to hormonal
deficiencies that could be easily corrected.
Hyperalgesia - an increased sensitivity to pain.
The androgenic compounds testosterone, androstenedione, and
dehydroepiandrosterone (DHEA) promote tissue growth and help
regulate opioid receptors.5-7 Pregnenolone, the precursor of all
adrenal and gonadal steroids, is critical for pain control
mechanisms, but poorly recognized as essential to pain control.
(See Figure 1.) It is ubiquitous in brain and nervous tissue and
interacts with gamma-amino-butyric acid and N-methl-D-aspartate
(NMDA) receptors to help regulate neurogenic processes.8-12 The
tissue building hormones, human growth hormone (HGH) and human
chorionic gonadotropin (HCG) are emerging as true breakthroughs
in some pain patients.13-15 In particular, HCG is a relatively
inexpensive compound that appears to permanently lower pain
intensity in some pain patients.1 Besides hormone
administration, the understanding of pain’s affects on the
endocrine system, particularly the pituitary-adrenal-gonadal
axis, is critical to help guide pain management. Excess pain
causes catecholamine release resulting in tachycardia and
hypertension. Pituitary, adrenal, or gonadal hypofunction may
occur with unabated, uncontrolled, and undertreated pain,
requiring a need for hormone replacement.
Continue at the Journal of Prolotherapy
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