Five of the 16 subjects (31.3%) using any psychiatric medication were in the lowest quartile of total testosterone with four (25%) of these subjects also in the lowest quartile for free testosterone. Spearman correlation matrices were performed to determine the relationship between continuous variables of interest and baseline serum free total testosterone values. While scant evidence suggests that functional status in such men may improve with testosterone replacement therapy, there are currently no published studies evaluating a potential correlation between diffuse musculoskeletal pain and male hypogonadism. Additionally, due to the small numbers of subjects taking psychiatric medications in this cohort, effects of multiple medication usage could not be determined. We will examine potential associations between baseline total and free testosterone with demographic and health related characteristics and psychiatric medication usage. In a cohort of 45 hypogonadal men with diffuse musculoskeletal pain we found a negative correlation between the duration of pain in years and baseline total testosterone values. We had few subjects who were evaluated after at least 3 months of testosterone replacement therapy, and we did not differentiate between subjects based on their post treatment testosterone concentrations. Benzodiazepine use may have mixed effects on serum testosterone concentrations depending on duration of therapy.29–31 Our review did not include analysis of the duration of psychiatric medication use; therefore we do not know the chronicity of benzodiazepine use in each patient. In our case series of hypogonadal men with diffuse pain, we found a negative correlation between the duration of pain in years and baseline total testosterone values, but no significant correlation with baseline free testosterone values. If subjective pain complaints of hypogonadal men who undergo testosterone replacement therapy improve, further studies should be done to determine a possible cause and effect relationship as well as a prospective randomised controlled trial with active treatment and placebo arms. Patients with mental illness commonly have multiple somatic complaints, including pain.14 Likewise, patients with multiple somatic symptoms are at greater risk for developing mental illness.15 In fact, testosterone supplementation has been used for treatment of refractory depression in hypogonadal men with promising but variable results.16–18 There are also reports linking psychiatric medications themselves to low testosterone. Diffuse pain in men is less likely to fit the diagnostic criteria for fibromyalgia, if based on the original published criteria, requiring the presence of a defined set of tender points.1–3 Rheumatologists have made anecdotal observations that some men presenting with diffuse musculoskeletal pain have testosterone concentrations below the normal range for their age. A prospective study would more clearly evaluate a potential relationship between diffuse musculoskeletal pain and testosterone values in men and might determine if testosterone replacement leads to any measurable improvement. Some men presenting with diffuse musculoskeletal pain have testosterone values below the normal range for their age. Hormonal differences also play a significant role, as testosterone, which is present at higher levels in men, promotes muscle growth, including in the neck area. There was also no standard timing of laboratory testing or of return visits which could have skewed results based on timing of testosterone replacement dosing and peak effect on serum testosterone values. As previously discussed with regard to a loss in sexual desire, this decrease in energy levels can also affect other parts of your life. If you are worried about changes in your mood, take the time to talk to a healthcare professional. Low testosterone can affect that link, causing changes in mood and a decrease in that pleasure. The issues caused by low testosterone can mirror that of anxiety and depression. Sudden changes in mood could be a direct indication of issues caused by low testosterone. Whether you're looking for multivitamins, fish oil or CoQ10, we offer a quality, science-based formula for every health need! Take advantage of 50% off this calcium and vitamin D combo. You can’t stop the clock, but you can slow the hands of time with our newest formula for healthy biological aging! While direct research linking TRT to cervical spine health is sparse, the general anabolic effects of testosterone could theoretically contribute to bone density, potentially benefiting the cervical vertebrae. Physically, low testosterone can lead to reduced bone strength and muscle mass in men. A clinical trial showed that two plant extracts significantly reduced lower back pain for 79% of patients in 30 days. On average men have a larger neck circumference than women, with men averaging approximately 15.2 inches (38.7 cm) and women around 13.1 inches (33.3 cm). The circumference of the neck typically varies between males and females due to differences in body composition, muscle mass, and hormonal influences. There is limited evidence that men taking commonly used psychiatric medications have lower testosterone.19,20,22–32 In our review, we found that 31.3% and 25% of the men using any psychiatric medication were in the lowest quartile of total and free testosterone, respectively; however, the relationships between total or free testosterone and degree of hypogonadism failed to reach statistical significance. Overall there was no significant difference in testosterone concentrations between users and non-users of psychiatric medications. We also did not find a significant change in self reported pain score after hormone replacement therapy; however, many of these patients were lost to follow-up or did not have post-replacement pain scores, thus data are not sufficient to fully evaluate the impact of testosterone replacement therapy on pain. Spearman correlation coefficients were determined to show the relationship between variables of interest and baseline serum total and free testosterone values (table 2). None of the subjects had been previously treated with testosterone replacement therapy.
