WEDNESDAY, April 3, 2013 —Men with low levels of testosterone may be at higher risk of developing rheumatoid arthritis, according to a study published in the Annals of the Rheumatic Diseases, and experts say testosterone supplements may help prevent RA.
Using data from the Swedish Malmo Preventive Medicine Program, a long-term study that tracks the health of more than 33,000 people born between 1921 and 1949, researchers at Lund University in Sweden identified 104 men who had developed rheumatoid arthritis over the course of the study. They compared those men to 174 healthy controls, and found that men in both groups who had low levels of testosterone were approximately twice as likely to develop rheumatoid arthritis as men with higher levels.
“Rheumatoid arthritis is less common among men than women, and sex hormones have been suggested to play a part,” the researchers wrote in the study, which was led by Mitra Pikwer MD, a rheumatology fellow at Lund University.
“This study demonstrated a negative association” between low levels of testosterone and rheumatoid arthritis, they added.
Previous studies have linked low testosterone and rheumatoid arthritis, the researchers wrote, but until now it had been unclear whether the low testosterone was a risk factor for RA or a consequence of it. And while they could not say for sure why low testosterone increased RA risk, they think testosterone may suppress the inflammatory effects of RA in the immune system.
Len Horovitz, MD, attending physician and men’s health specialist at Lenox Hill Hospital in New York City is skeptical of the link between low testosterone and RA.
“I don’t think there’s a lot of literature linking low-T to RA,” he said. “RA is usually something that seems to be genetic. It’s an autoimmune disease, and they usually have a genetic influence.”
However, Dr. Horovitz said, for men with low levels of the hormone, prescribing testosterone works really well at alleviating low-T symptoms like fatigue, erectile and sexual dysfunction, and depression.
“The good news is that you can screen for these things and fix them,” he said. “Testosterone works. It’s like it’s a miracle.” If the link between low testosterone and RA is eventually confirmed, he said, prescribing testosterone could work to prevent or treat RA.
Michael Wald, MD, director of nutritional services at Integrated Medicine of Mount Kisco in Mount Kisco, NY, said that testosterone may help restore tissue that rheumatoid arthritis breaks down.
“Low testosterone increases risk for RA because testosterone, as an anabolic steroid, helps tissue repair, and RA is a degenerative tissue condition,” he said. “Testosterone is also needed to control inflammation in the body and modify immune response.”
Low testosterone is typically caused a malfunction of the hypothalamus or pituitary gland, which stimulate testosterone production, the researchers wrote in the study, and it has been linked depression, diabetes, sexual dysfunction, and other conditons.
Men have a higher risk for RA if they are genetically predisposed, smokers or have poor diet and exercise habits. However, the last two risk factors are modifiable, said Wald, who added that “a good diet and exercise will enhance testosterone levels and production in the body.”