Testosterone Joints

Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.

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Although testosterone plays a critical role in muscle and bone health during puberty, many men do not recognize that its influence remains important as you age.

If testosterone levels decrease over time, your risk for joint pain and other physical issues increases significantly. 

Lack of testosterone can increase your risk of osteoporosis, weakening bones and increasing fracture risks.

Testosterone plays an integral part in supporting bone health; stimulating osteoblast cells to produce new bones while inhibiting osteoclast cells that break down bone tissue.

The Role of Testosterone

Testicles and ovaries both produce testosterone. Too little or too much production of testosterone can have a negative impact on your mental and physical health.

The hormone testosterone is found in both humans and other animals. Testosterone is mainly produced by the testicles in men. The ovaries of women also produce testosterone, but in smaller quantities.

After age 30, the production of testosterone begins to decrease.

Testosterone, which is often linked to sex desire and sperm production, plays an important role. It affects the men's fat storage, bone and muscle mass and even the production of red blood cells.

The testosterone level of a man can affect his mood.

 The Impact of Low Testosterone

Low testosterone (also called Low T Levels) can cause a number of symptoms for men.

  • Reduced sex drive
  • Less energy
  • Weight gain
  • Feelings of depression
  • Moodiness
  • Low self-esteem
  • Less body hair
  • Thinner bones

Other factors can also cause hormone levels in men to fall.

The production of testosterone can be negatively affected by injuries to the testicles or cancer treatments like chemotherapy and radiotherapy.

Stress and chronic health conditions can also decrease testosterone production. These include:

Low T levels in women can cause a number of symptoms including:

  • Low libido
  • Reduced bone strength
  • poor concentration

Women with low T levels can be affected by removing their ovaries, as well as pituitary, adrenal, and hypothalamic diseases.

Women with low testosterone levels may receive testosterone therapy, but its effectiveness in improving sexual or cognitive function is not clear.

How to Test Your Testosterone Levels

Simple blood tests can be used to determine testosterone levels. The bloodstream contains a range of healthy or normal testosterone levels.

According to University of Rochester Medical Center, the normal testosterone levels for males range from 280-1100 nanograms/deciliter (ng/dL). For females, it is between 15-70 ng/dL.

The ranges of results can differ between labs. It's therefore important to discuss your results with your doctor.

According to the American Urological Association, if an adult male has testosterone levels below 300 ng/dL a doctor will perform a test to determine the reason for low testosterone.

Low levels of testosterone may be an indication that pituitary problems are present. The pituitary sends a hormone signal to the testicles in order to increase testosterone production.

Low T results in adult men could indicate that the pituitary isn't functioning properly. A young teen who has low testosterone may be experiencing delayed puberty.

Men with moderately elevated testosterone levels may not show any symptoms. Higher testosterone levels in boys can cause them to begin puberty sooner. Women who have high levels of testosterone can develop masculine characteristics.

A high level of testosterone can be caused by an adrenal gland disorder or cancer of the testes.

It is possible to have high testosterone levels in conditions that are less serious. congenital hyperplasia is one rare, but natural, cause of elevated testosterone levels.

Your doctor may order additional tests to determine the cause if your testosterone levels are very high.

Joints Explained

A joint is the point at which two bones meet. Joints are classified histologically and functionally.

The histological classification depends on the predominant type of connective tissues, while the functional classification depends on the range of motion allowed. 

The three joints of the body can be classified histologically as:

  • fibrous
  • cartilaginous¬†
  • synovial

The two classification schemes can be correlated: synarthroses are fibrous, amphiarthroses are cartilaginous, and diarthroses are synovial. 

Two classification schemes are correlated. Synarthroses have fibrous tissue, while amphiarthroses have cartilaginous tissue, and diarthroses have synovial tissue.

The embryological origin of joints, which are composed of bones and connective tissues, is mesenchyme. The bones develop either directly by intramembranous or indirectly by endochondral osteossification.

There are patterns for each joint. Each joint has its own unique innervation and vascular supply scheme. The muscles provide stability for joints. There is a direct relationship between muscle strength, especially with synovial joint, and joint stability.

There are many pathophysiological conditions that affect the joints. These can be classified by their histological classes.

A thorough understanding of the structure and function of joints is important for clinical purposes because diseases affecting the joints are prevalent throughout the lifespan.

Function of Joints 

Joints can be classified in a variety of ways, both histologically and functionally. 

Histological classification, as mentioned above, is based upon the predominant type of connective tissues, while functional classification is determined by the amount of movement allowed.

The three types of joints are

  • synovial
  • amphiarthrosis
  • fibrous

Functionally, the three types are synarthrosis and amphiarthrosis.

The two classification schemes are correlated. Synarthroses have fibrous tissue, while amphiarthroses have cartilaginous tissue. Diarthroses, on the other hand, are synovial.

Each joint type within these categories (suture, gomphosis, syndesmosis, synchondrosis, saddle, planar, pivot, condyloid, ball and socket ) performs a particular function in the human body.

Fibrous Joints

Fibrous joints are fixed joints where connective tissue collagenous and fibrous is used to connect two bones. Synarthroses are immobile and do not have a joint cavity. Subdivided into sutures (also called gomphoses), syndesmoses, and other subgroups.

Only the cranium has sutures, which are immobile joints. At birth, the plate-like skull bones are only slightly mobile due to the connective tissue that lies between them.

Fontanelles are the spaces between bones. The initial joint flexibility allows for the fetal skull to pass through birth canal and brain enlargement following birth.

The fontanelles become a thin layer of connective fibrous sutures which bind the bony plates. Sharpey fibres are the connective tissue that makes up this tissue. 

The cranial sutures will eventually ossify. Eventually, two adjacent plates fuse together to form a single bone. This fusion is called synostosis.

The gomphoses are immobile joints that can only be found between teeth and their sockets on the maxilla and mandible. The fibrous tissue connecting the tooth to its socket is called the periodontal ligament.

Syndesmoses (amphiarthroses) are joints that can be moved slightly. This type of fibrous joints maintains integrity between the long bones, and resists attempts to separate them.

All syndesmoses have amphiarthroses. However, each syndesmosis joint allows for a different amount of movement.

The interosseous membranes of the forearm and leg are also areas of muscle attachment. Interosseous membranes are areas where muscles attach to the forearm and leg.

Cartilaginous Joints

In cartilaginous joint, the bones are attached by either hyaline or fibrocartilage. The joints can be classified into primary cartilaginous or secondary cartilaginous ones depending on the type cartilage.

Synchondrosis or primary cartilaginous joints only involve hyaline articular cartilage. They can be permanent or temporary.

The epiphyseal (growth) plate is a temporary synchondrosis. It allows for bone lengthening to occur during development. In children, the epiphyseal plates connect the diaphysis with the epiphysis.

The cartilaginous plates expand and are replaced by bone over time, increasing the diaphysis.

When all of the hyaline articular cartilage is ossified and the bone has finished its lengthening process, the diaphysis will fuse with the epiphysis to form synostosis. 

The ilium and ischium of the hip are joined by other temporary synchondroses. These will also fuse over time into one hip bone.

A permanent synchondrosis retains its hyaline hyaline cartilage. As a synarthrosis, permanent synchondroses connect the bones without movement.

The first sternocostal join is an example. It occurs in the thoracic cavity, where the costal cartilage of the first bone connects it to the manubrium. The relationship between the anterior ends of the 11 other ribs and their costal cartilage is another example.

The symphysis or secondary cartilaginous joints are made of fibrocartilage.

 Symphyses are able to resist pulling or bending forces because fibrocartilage, which is thick and sturdy, can do so. 

The fibrocartilage is strong and firmly connects adjacent bones. However, the joint remains an amphiarthrosis. It allows for limited movement.

A symphysis may be narrow or broad. The pubic symphysis is a narrow symphysis, as are the manubriosternal and manubrio-sternal joints.

The pubic symphysis is a joint that connects the left and the right pubic bones. This mobility is crucial for females during childbirth.

Synovial Joints

The synovial joints are the most important functional joints in the body. They are mobile and can move freely. Synovial joints are characterized by a joint space.

The main purpose of the synovial joints is to prevent friction within the joint cavity.

The joint cavity, or joint capsule, is surrounded by an articular cap. This fibrous connective tissue is attached to the bone of each participant just below its articulating surface.

The synovial membrane, which lines the capsule of the articular joint, secretes synovial liquid into the joint cavity. The articular cartilage is composed of hyaline cartilage. It covers the entire articulating surfaces of each bone.

The synovial membrane and the articular cartilage are one continuous membrane. Some synovial joints also have fibrocartilage associated between the articulating bone. The menisci in the knee are a good example.

All synovial joints have diarthroses. However, the range of motion varies between subtypes. This is usually limited by the ligaments connecting the bones.

Synovial joints can be further classified based on the types of movements that they allow. 

There are six types of synovial joints:

  • hinge
  • condyloid¬†
  • planar
  • saddle
  • pivot
  • ball-and-socket¬†

Joints and Muscles 

The muscles are the most important in supporting synovial joints.

Muscles and tendons that cross a joint act as "ligaments" to resist forces.

The strength of the muscles is essential for the stability and function of the synovial joints. This is especially true for joints that have weaker ligaments such as the glenohumeral.

Blood Supply and Lymphatic System

Each joint has its own blood supply, but there are certain patterns that can be identified based on histological classification.

Fibrous joints can be supplied by perforating the branches of the vessels.

The blood supply to the tibiofibular joints is provided by branches of the anterior (tibial) artery and peroneal artery.

Cartilaginous joint vascular supply is only at the peripheral area because cartilage tissue is avascular. Capillaries of the vertebral body supply the intervertebral disks at their margins.

The periarticular system, which is a dense anastomosis between arteries on either side of the synovial joint, provides vascular supply to the joints.

Some vessels can penetrate the fibrous cap to form a richer plexus in the synovial tissue.

The circulus vasculosus is a deeper plexus that forms a loop at the articular margins. It supplies the synovial membrane and terminal bone.

Synovial fluid nourishes the articular cartilage (avascular hyaline hyaline).

The lymphatic vessels of every joint follow the drainage of surrounding tissues; some joints have lymph nodes like the popliteal nodes of the popliteal fosse of the knee.

Causes and Symptoms of Joint Pain

Joint pain can have many causes. It's most often caused by an injury, conditions or arthritis. Osteoarthritis is often the cause of joint pain in older people.

Joint pain can be caused by:

  • Overuse or trauma (e.g.¬†Exercise).
  • Fractures which do not heal properly
  • Tendonitis is an inflammation and irritation of the tendon attached to the joint.
  • Strains and sprains of a Ligament¬†(e.g.¬†sport's injuries)
  • The underlying disease (e.g.¬†osteoarthritis, gout)

Osteoarthritis

This type of arthritis is most common in the hands, knees and hips but can affect any joint.

Most often, it affects people in their middle age or older. It can cause pain and:

  • Swollen joints
  • Stiffness when moving after sleeping or sitting
  • Clicking noises when you move
  • Reduced mobility of the joint

Injuries

When you have a dislocation, a strain or sprain, you may experience pain around or in your joints. 

These injuries can occur suddenly during an accident or a fall. Sometimes, however, they are caused by overuse. For example, runner's leg.

A torn Ligament, or a knee fracture may also cause bleeding in the joint (hemarthrosis). You may experience inflammation or stiffness in the area of injury.

You could have inflammation of the joint lining if you've recently injured a joint. This is the thin layer around your joints.

 This condition is called traumatic synovitis and usually does not cause heat or redness.

Bursitis

Bursitis occurs when the bursae, which are fluid-filled sacs, that cushion your joints become inflamed. 

Bursitis is most commonly found in the shoulder, leg, arm or hip. Bursitis is usually caused by repetitive movements, such as throwing a ball or bending down to scrub the floor.

When you press or move your joint, it may hurt more.

Viral Infections

Some infections cause swelling and joint pain. Parvovirus is one of the viruses that can cause joint pain and swelling. 

Rubella (German Measles), HIV, Hepatitis B and Hepatitis C are other viruses that can cause joint pain. You may also experience joint pain and a fever when you have these viruses.

Tendinitis 

Tendinitis can occur when you injure or overuse a tendon. These are the thick cords connecting your muscles to bones.

This condition is most common in the shoulder, elbow, and heel. Tennis Elbow is one type of tendinitis. The joint may be tender and swollen, with a dull pain.

I have tendinitis in my shoulder that was caused by heavy weight lifting and playing rugby. You may get injections of a corticosteroid to help alleviate the pain (I had two) and prescribed certain exercises.

However, my shoulder is still limited, and I cannot lift heavy weight using a barbell or dumbbells and have to use the machines in the gym.

Multiple Joint Pain: Rheumatoid Arthritis 

Arthritis is inflammation of the joints. Over 100 different types of arthritis exist. Although their symptoms may be similar, the underlying causes can vary.

Osteoarthritis, the most common form of arthritis, is relatively common. It is far more common than Rheumatoid Arthritis.

 Wear and tear of your joints can cause osteoarthritis. When you have rheumatoid, your immune system -- which normally protects your body against infection and disease -- starts attacking the joint tissues.

Rheumatoid Arthritis can affect anyone. Most often, the disease begins in middle-age or later. It can happen at any age. Even children can get similar forms of arthritis. Rheumatoid Arthritis can affect the entire body.

Each form of arthritis requires a different treatment. Doctors use a medical history, physical examinations, X-rays and laboratory tests to diagnose rheumatoid arthritis. The disease cannot be diagnosed by a single test. 

The swelling of the joints in rheumatoid is squishy and different from the bony enlargements that are sometimes present in osteoarthritis.

Your joints might feel hot and appear red. After a rest or after waking up, stiffness and pain may be more severe. Your immune system will damage the cartilage (a tough, flexible tissue) that lines your joints over time. The damage to your joints can be severe.

Scientists do not know what exactly causes rheumatoid arthritis. The cause is likely a combination genetics and environmental factors, like tobacco smoke or viruses.

Hormones can also play a part. Rheumatoid Arthritis is diagnosed more often in women than men. Sometimes the disease improves or flares after pregnancy.

Scientists do know that immune system malfunctions are to blame for the damage. 

The body's immune system attacks by mistake the membrane that lines the joints such as the fingers, toes and wrists. The joints in the neck, knees and hips can be affected.

Gout

The gout is an inflammatory form of arthritis caused by crystals that build up inside a joint. It affects only one joint, usually your big toe. 

The symptoms are intense and start abruptly. They tend to change. These include:

  • Pain and tenderness
  • Swelling
  • Redness
  • Heat

Crystal deposits can also cause pseudogout, which has similar symptoms. It most commonly occurs in the knees.

Testosterone and Joints: A Link? 

Androgen hormones such as testosterone have a protective impact on cartilage. Researchers have known for decades that androgens can help prevent cartilage damage and inflammation.

Evidence also indicates that testosterone replacement therapy can counteract joint damage and pain in men who have a testosterone deficiency.

This can be caused by a surgery or chronic illness. It may also result from an injury.

Many men, even those with low testosterone, don't know that this condition can have serious effects on joint health.

If your testosterone levels are low you could be more prone to inflammation and joint pain.

It can cause stiffness, mobility problems, and even discouragement. Joint stiffness and joint pain will likely worsen if you don't move regularly.

Lack of exercise can lead to weight gain and increased joint strain. The impact can be serious.

Men with hypogonadal hormones who undergo testosterone replacement therapy (TRT), show improvements in well-being.

These include improved bone density, muscle strength, physical power, and sexual function.

Research

According to studies, serum testosterone levels are strongly associated with the pathogenesis and development of arthritis. 

This 2023 study showed that the arthritis group had lower testosterone levels than the non-arthritis group. 

This prospective, longitudinal, and observational analysis published in 2016 reveals a significant improvement in long-term health related quality of life for men with late-set hypogonadism who were treated with testosterone.

According to this 2014 study there is a strong association between testosterone and the risk of developing rheumatoid arthritis in men.

Based on data from a population-based health survey, researchers found that men with lower levels of testosterone were more likely to develop rheumatoid arthritis in the years that followed, particularly the version of rheumatoid arthritis not associated with autoimmune factors.

The connection between joint health and testosterone is further illuminated by research that focuses on treatment.

Men with hypogonadism, or an androgen deficiency, who were treated with undecanoate testosterone reported reduced joint and muscle pain over the course of the treatment.

A study that was published in the Journal of Sexual Medicine a year before found that testosterone therapy reduced joint pain, as well as blood pressure, cholesterol, weight, waist circumference and BMI, in men who had late-onset hypogonadism.

The authors of the study were able, in part, to observe an overall improvement in quality of life as a result of these improvements.

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What is Testosterone Replacement Therapy (TRT)?

Hypogonadism, the medical term for low testosterone levels, is simply a lack of testosterone. When the testes don't function properly, it can cause hypogonadism.

It can be caused by a problem with the testes where testosterone is produced, or the pituitary under the brain which controls the function testes.

Men of all ages can have low testosterone. As men age, testosterone levels tend to decline.

You may be able to benefit from supplemental testosterone if your body is not producing enough. Your endocrinologist will initiate testosterone replacement therapy if indicated.

The most common way to administer testosterone is by injecting testosterone undecanoate three times a month, but it can be administered using other forms of testosterone or at different intervals. Other treatments include:

  • Topical testosterone cream or gel
  • Testosterone pellets
  • Testosterone patches
  • Oral testosterone therapy¬†

Risks of TRT

It is difficult to estimate the likelihood of TRT having adverse effects over a long period of time, since there is no high-quality data based on prospective randomized studies that would allow for a recommendation in favor or against it.

TRT is linked to an increased risk for cardiovascular and metabolic diseases. However, the nature and extent of this relationship are still unclear.

Recent evidence indicates that TRT could increase the risk of adverse cardiovascular events among men with significant comorbidities.

Prostate 

The effect of testosterone on the prostate is one of the main risks associated with its administration.

Anti-androgens can reduce prostate volume for patients with BPH. Furthermore, Androgen deprivation remains the cornerstone treatment for men who have advanced prostate cancer.

It is therefore no surprise that TRT has been contraindicated among men with prostate cancer as well as in high-risk groups, such as men with relatives who also had prostate cancer or African-Americans with a prostate-specific antigen.

Breast Cancer

Although there is not a direct link between testosterone and breast cancer, high testosterone levels may increase aromatization into an active estrogen derivative, which may ultimately stimulate breast tissue receptors, increasing the risk of male cancer.

Cardiac Events 

Polycythemia, is an accepted side effect of TRT. Although testosterone has a positive impact on men with anemia at baseline, it can cause polycythemia for over 20% of those who are treated with TRT.

A polycythemia can increase the risk of stroke, myocardial ischemia, and deep veins thrombosis, with pulmonary emboli possible.

Obstructive Sleep Apnea (OSA)

Men who are starting TRT therapy should be informed of the potential risk of OSA, even though there is no link. 

The men should be closely monitored for any increased symptoms such as fatigue or snoring during sleep.

How to Safely Increase Testosterone Levels?

As we age, testosterone levels decrease, leading to less energy and muscle loss. A low testosterone level has also been linked with depression symptoms; therefore maintaining an ideal level can help make life happier.

Military Muscle testosterone booster increases testosterone touts its product as offering "steroid-like results without needles."

Instead of synthetic hormones, this natural ingredient supplement uses herbs, vitamins, minerals, and plant extracts to increase hormone levels naturally.

Fenugreek may help stimulate testosterone secretion for improved performance; additionally, it contains Ashwagandha, Vitamin D3, Boron, Tongkat Ali as well as Mucuna Pruriens for additional benefits.

Military Muscle was developed over three years by a team of sports nutritionists and military physical training instructors, and tested by serving soldiers, fitness enthusiasts in gyms and athletes on sporting fields.

Military Muscle's testosterone booster increase testosterone booster formula claims it can reverse this decline and help you meet your goals no matter your age.

These nutrients are provided in an optimal blend to ensure their absorption. As such, this supplement can be taken by both men and women alike.

Conclusion 

Joint health is one of the areas that testosterone can impact. Your joints will likely be healthy and functional if you have a balanced testosterone level.

According to research, testosterone is crucial in limiting the inflammation of all parts of the body. Healthy testosterone levels can help to maintain joint health, as joint problems are often accompanied by inflammation. Low testosterone can cause joint pain.

However, joint pain can come in many forms and have different causes. The two most common forms of arthritis include Osteoarthritis (OA), and Rheumatoid Arthritis (RA).

RA is a form of autoimmune disease. OA is caused by wear and tear of your joints. You may also be more likely to develop OA if your low T causes you to gain weight.

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