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Lower testosterone levels may increase the risk of arthritis

man with a beard stretching on rooftop
New evidence confirms the link between testosterone levels and arthritis risk. Image credit: Drs Producoes/Getty Images.
  • Arthritis is a common and chronic condition. It is sometimes unclear why certain individuals develop arthritis and others do not. 
  • Researchers are still seeking to understand what factors put people most at risk for developing arthritis, including how hormones play a role.  
  • A new study found that lower levels of serum testosterone may be associated with an increased risk for arthritis. 

While anyone can develop arthritis, certain factors may increase someone’s chances of developing different arthritis types.

Researchers who conducted a recent cross-sectional study published in Scientific Reports Trusted Source International Journal of Obesity Peer reviewed journal Go to source examined the association between testosterone levels and arthritis risk.

Through their analysis of over 10,000 adults, they found that lower levels of testosterone were associated with an increased risk of developing arthritis.

Future research can see how this relates to clinical practice and possible ways to minimize arthritis risk. 

The impact of arthritis and its risk factors

Arthritis Trusted Source National Institute of Arthritis and Musculoskeletal and Skin Diseases Governmental authority Go to source  affects joints and mobility. While there are different types of arthritis, the two main characteristics of arthritis are joint inflammation and pain.

Different types of arthritis include osteoarthritis, psoriatic arthritis, and rheumatoid arthritis. Arthritis can impact everyday life, including people’s ability to work, perform daily tasks, and exercise. 

Certain risk factors Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source  can increase a person’s chances of developing arthritis, including being overweight and sustaining injuries to particular joints.

Osteoarthritis risk factors Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source  include advanced age, weak muscles, and injured joints. Some people may also develop osteoarthritis because they have another predisposing condition. Risk factors Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source  for rheumatoid arthritis include smoking and having a certain genetic makeup. 

Dr. Alexander King, an osteopathic physician specializing in neuromusculoskeletal medicine and
owner of King Osteopathic Medicine & Medical Acupuncture, who was not involved in the recent research, emphasized some particular risk factors for arthritis to Medical News Today.

These included weight, joint injuries, and a person’s professional occupation.

“Being overweight or obese increases the risk of developing knee osteoarthritis,” Dr. King told MNT. He explained:

“Excess weight places additional stress on weight-bearing joints like the hips and knees. Maintaining a healthy weight through proper diet and exercise can help reduce this risk.”

“Overuse or injury to joints, such as repetitive stress or knee bending, can contribute to the development of osteoarthritis,” he also noted, advising that a person can look after the health of their joints by performing specially designated exercises.

For similar reasons, “[o]ccupations involving repetitive knee bending and squatting are associated with knee osteoarthritis,” said Dr. King. “Ensure your worksite is free of fall hazards and provides appropriate equipment and tools.”

Link between testosterone levels and arthritis

The authors of the current study noted that previous research already suggested that testosterone levels may impact the development of arthritis. They wanted to delve further into the association in their study analysis. 

For this, the researchers used data from the National Health and Nutrition Examination Survey Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source  (NHANES), collected from individuals in the United States. After excluding participants who had missing data on arthritis or testosterone values, the researchers included 10,439 participants in their analysis. 

They accounted for specific factors in their data collection, including alcohol use, smoking, diabetes, level of education, sex, and marital status. They used three models to account for slightly different covariates. 

The study found that participants with arthritis had lower serum testosterone levels than participants who did not have arthritis. It also found that lower testosterone levels were associated with a higher risk for arthritis in analysis using certain models.

Their subgroup analysis found that the association between lower testosterone and arthritis was higher among participants with a higher body mass index and among female participants.

The researchers also divided participants into four groups based on testosterone levels. When they did this, they found that the group with the highest testosterone level had a 51% reduced risk for arthritis compared to the group that had the lowest level of testosterone. 

Dr. Cory Rice, chief clinical advisor at Biote, and internist and functional medicine specialist, not involved in this study, commented on the findings to MNT.

According to him, “[t]his is an interesting study because it is a pattern that many of us see frequently in clinical practice among our patients.”

“That is to say, both male and female patients with the lowest hormone levels are often those who complain arthritic-type pain. This includes general age-related wear and tear-type joint arthropathies but also the autoimmune-type arthropathies that we are seeing more of these days in outpatient medicine,” Dr. Rice added.

“The clinical implications of this study are that we should continue to pay attention to the importance of joint arthropathies as it relates to hormone levels while we continue to await large scale studies further illustrating this pattern. The next logical step will be looking at HRT [hormone replacement therapy] in a scientifically rigorous way as it relates to joint health, both objectively and subjectively.”

– Dr. Cory Rice

Study limitations and continued research

This research also faced some limitations. First and foremost, the authors cautioned that this type of study cannot establish a causal relationship between any of the factors.

Second, researchers relied on participant reporting for arthritis diagnosis, which can potentially introduce bias.

The researchers further noted that the findings may not apply to other groups or people in different regions. They also had missing data on certain covariables, which may affect the study’s accuracy.

Finally, they acknowledged the possibility of measurement errors and missing specific confounders. 

Dr. King noted the following to MNT:

“The study didn’t necessarily reveal a ‘causal’ relationship between testosterone levels and arthritis. It is worth investigating possible reasons why subjects that have higher testosterone levels, leading to lower incidences of arthritis, such as increased exercise and a more balanced diet, therefore decreased body weight, which could lead to less arthritis. Generally speaking, it seems that subjects with better health habits will maximize testosterone levels, and limit causes of arthritis.”

Overall, the results indicate the potential helpfulness of monitoring testosterone levels among people at a higher risk for arthritis.

The authors concluded: “Our studies have shown a significant association between serum testosterone levels and arthritis. The current findings emphasize the importance of serum testosterone levels in patients with arthritis. However, the findings could not establish a causal relationship and further extensive prospective studies are required.”

This article originally appeared on Medical News Today.

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