Post from MEDPEDIA A valuable resource.
“Study Finds Patients On Long~ Term Opioids Likely Have Hormone Abnormalities.”
Joseph V Pergolizzi MD Sep 28, 2011 at 12:04pm Medscape
(9/28, Melville) reports findings presented at the American Academy of Pain Management (AAPM) 22nd Annual Clinical Meeting in which “18 patients, including 10 men and 8 women, with an age range of 40 to 75 years, who had been maintained on high-dose opioids (equivalent to 300 mg morphine for 20 or more years)” were profiled. Researchers found “widely varied hormone abnormalities, and only 1 patient demonstrated normal levels on all 6 assays testing for cortisol, pregnenolone, testosterone, estrogen, corticotrophin, and follicle stimulation hormone (FSH).” Low FSH and low testosterone were common. In addition, for some patients, “opioids were not controlling the pituitary and adrenal gland as well they should have” and resulted in overactivity. Lead researcher Forest Tennant, MD said that for patients with intractable pain, “pituitary-adrenal-gonadal axis screening is critical, and patients should be clinically treated for deficient or excessive hormone levels.”
My comments below: (I believe it’s imperative that we lay-people give as much input as possible to the medical community. I have been dealing with this problem far too long and am only now finding any credible information concerning this issue.)
Once again I feel the need to preface this comment with I am “just” a layperson who lives with intractable pain. Have for over 27 yrs now. Out of all these years I have been treated successfully for intractable pain with opiate pain medications for a about 25 of those years. Thank you Dr. Pergolizzie for bringing this report to a discussion forum. I believe from personal experience it has merit. Can I lend my personal experience to this discussion? I have been fighting the symptom of what I refer to as overheating for 27 years. If I had my way I would keep the ambient temperature close to 65 degrees everywhere I am because my body no longer seems able to cool itself. I often refer to it as if it feels like my internal thermostat is broken. Because at the age of 35 I had a complete hysterectomy it was naturally assumed that my problem was related to the surgical induced menopause and I was put on Hormone Replace Therapy. (HRT) I also am fighting two foreign materials in my body from implants in my jaws that were later recalled by the FDA but only after my implants had unknowingly fragmented completely. I’m convinced that this also plays a role. A series of HRT’s were prescribed over those first 5-7 years after the surgery with no benefit received for the overheating problems. I can tell the difference between a hot flash and my body not being able to cool itself off. This is not hot flashes I am dealing with. FYI ; the HRT’s did nothing to relieve my symptoms and with my internists guidance I stopped taking them because I felt the risks outweighed any benefit I was receiving. This report only validates that what is going on with my body and it is not from my hysterectomy. At least not alone. I have been prescribed a very minimal dosage of Clonidine (o.1mg) for my problem with “overheating” by my internist. Not for Hyper Tension but for the symptom of not being able to keep my body at a regular & comfortable temperature. I also take a Soy supplement which with the combination of the Clonidine has made a vast improvement. I’m not 100% comfortable but if having to do without these two medicines I would be very embarrassingly uncomfortable. From a layperson’s point knowing that this kind of symptom is being recognized and researched gives me hope.