Testosterone, Pain and Painkillers
Have you ever known someone addicted to prescription pain medications? I have known a few, and it is ugly. It completely changes their personality and I don’t mean for the better. They usually struggle holding a job, develop medical issues and become toxic to their family and friends. The tragic thing is that there is no signs of this epidemic abating anytime soon. Consider a couple of U.S. statistics showing the inundation and permeation of society with these medications.:
–Over 200 million opiate prescriptions are written every year. That’s over a billion pills in one year!
–There are at least 2 million people addicted or abusing painkillers each year.
When I talk about painkillers, which include such household names as oxycodone, hydrocodone, codeine, morphine, fentanyl, methadone, Demerol, Dilatid, and Oxycontin, I am referring on this page to the opiates. These are in the same class of compounds as heroin and cocaine and bind to the same receptor. The other more “mild” painkillers have their own problems. NSAIDs are notorious for ripping up the GI tract, and Tylenol lowers glutathione levels, always a bad idea.
1. A 2016 study showed greatly increased odds of low testosterone for men on painkillers. The biggest drops in testosterone, 27% and 38%, were seen in senior aged men between the ages of 60 and 70 and 70+, respectively. 
2. A 2009 study attempted to deal more with the legitimate use of those using opiod painkillers and noted that the endocrine system should be monitored when these medications have to be used.  As you will see below, it would be hard to patch all the holes however.
3. A 2015 study showed the growing prevalence and recognition of this and coined the term OPIAD, “Opiate Induced Androgen Deficiency.”
3. Another 2009 study noted that painkillers negatively impacted virtually all the major hormones that we men hold dear for sexual and cognitive performance, body composition and muscle gains:
“Sustained-action opioids used on a daily basis for more than a month have a number of adverse effects on human endocrine function.5-14 For example, opioids decrease levels of the gonadal sex hormones, growth hormone, cortisol, and dehydroepiandrosterone sulfate (DHEAS).6,9 Opioids also blunt the cortisol response to corticotropin.” 
NOTE: I cover other nasty issues in my page on illegal drugs here: Cocaine, Heroin and Erectile Dysfunction. On there I discuss a study that shows methodone users having testosterone 43% less than controls.
Notice that your hormones start going downhill after just one month. This is how quickly painkillers do their damage on the brain, and their effect is all encompassing. If you’ve ever been around someone addicted to these medications, you know that they can create aggressiveness, irritability, withdrawal, depression and anxiety, etc. And it’s no wonder considering that their hormones are all under seige!
1. Back and Joint Pain (Part I). This is actually fairly common in men starting on HRT. And the reason is simple: men feel better (on well done) testosterone therapy and start working out more often and harder. It is very easy to overdo it. Libido is up usually and so you want to impress the every female within a five mail radius and so you’re adding a few extra plates on the bar without even thinking about it.
Of course, the solution here is to ramp up your workouts S-L-O-W-L-Y and gradually. You don’t have to be ready for the Olympics in two weeks, so just scale back a little and enjoy your newfound recovery and recuperative powers.
2. Back and Joint Pain (Part II). There are can be a potentially more serious problem causing this kind of pain: low estradiol. Some men are very sensitive to Arimidex (and other aromatase inhibitors) and find their estradiol levels plummeting after using them. When estradiol levels fall below about 12 pg/ml, joints can start hurting and aching. And, unfortunately it usually takes a couple weeks for estradiol levels to climb back up to their steady state, baseline level. This can even take longer a little longer if a Suicide Inhibitor was used.