Pain, Hormones, HPA axis info

[Geno]

Here is an interesting abstract article from Practical Pain Management journal. I found it particularly interesting due to my own chronic low back pain requiring opiod medication use and what I have experienced in the past 20 years of how my chronic low back pain (nerve damage ) may definitely have contributed to my mental health problem (Major Depression) hormone issues, stress related Adrenal issues, many years of insomnia, etc. For those of us who have had to suffer with chronic pain for many years before a proper treatment was found, you know how depressing and uncomfortable it can be on one’s life. I tried just about every low back pain treatment available except for surgery, and it was only after too many years of trial and error when I found a Pain Management Doctor who finally put me on a moderately low dose of Morphine which worked miraculously for me.

Hormone Treatments in Chronic and Intractable Pain

by Forest Tennant MD, DrPH

Once chronic or intractable pain is reasonably well controlled, patient and physician alike want some curative or permanent amelioration, in addition to symptom relief. To date, some physical therapy techniques and possibly some nutritional supplements provide a degree of permanent amelioration of pain, but these measures often fall short of wanted results.

Although early in what is clearly an emerging practice, some hormone treatments appear — albeit based primarily as anecdotal reports — to greatly enhance symtomatic pain control and possibly bestow some curative and ameliorative properties. Basic science research on some hormones distinctly points out sound reasons why some hormones should enhance pain treatment. Summarized here is a compilation of hormone treatments and their rationale for current usage by pain physicians to compliment their standard symptomatic treatments.

Definition of Hormone
For purposes here, a hormone is defined as a compound which is produced in a body organ and secreted into the blood stream to perform some physiologic function(s). Some hormones, such as gamma amino butyric acid (GABA) and pregnenolone are produced within neurons and secreted into the blood as well as function within neurons as neurotransmitters.1-4

Why Are Hormone Treatments Needed?
Undertreated severe, chronic, and intractable pain depletes many hormones.5-8 With good pain control, some low serum hormone concentrations may return to normal.9 Some adrenal stress hormones, such as cortisol and adrenalin, may elevate in uncontrolled pain as evidenced by tachycardia and hypertension. Prolonged hypercortisolemia produced in severe, intractable pain may produce manifestations of Cushing’s disease including osteoporosis, dental erosion, obesity, fatigue, and muscle wasting. Adrenal insufficiency, with symptoms of Addison’s disease including cachexia, hypotension, electrolyte depletion and muscle wasting, may occur as the adrenal gland exhausts. While severe, chronic pain produces some hormone deficiencies, opioid administration may also suppress pituitary excretion and worsen some hormone deficiencies, particularly testosterone and possibly thyroid.10,11 Hormone treatments are basically given to replace those that are depleted or suppressed by severe, chronic, or intractable pain and/or the underlying disease. It may also be that intermittent supraphysiologic serum levels of some hormones such as pregnenolone, adrenal androgens, GABA, human growth hormone, and chorionic gonadotropin may promote healing of nerve and other soft tissues to permanently reduce pain12-15 (see Table 1).

Please refer to the Apr/May 2005 issue for the complete text. In the event you need to order a back issue, please click here.

[DrMariano2]

I would define a hormone as a signal produced by a cell that travels distances longer than the distance between a cells in a synapse.

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Opioid pain medications, such as Morphine, suppress adrenal function. This may cause several problems including increased sensitivity to pain. As such, adrenal support may be necessary with opioid pain medications.

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Suboptimal thyroid hormone may increase one’s sensitivity to pain. Thus thyroid signal optimization may help various pain conditions.

[Author]

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