Hormone abnormalities in patients with severe and chronic pain who fail standard treatments.

Abstract:

:Some patients with severe and chronic pain fail to obtain adequate pain relief with standard pharmacologic treatment agents, including low to moderate dosages of opioids. Understandably, physicians might not believe patients who claim that a standard opioid dosage is an ineffective treatment. These patients may be severely impaired, nonfunctional, and bedridden or housebound. To help characterize these individuals and develop treatment strategies for them, a serum hormone profile consisting of adrenocorticotropin, cortisol, pregnenolone, progesterone, dehydroepiandrosterone, and testosterone was obtained on 61 chronic pain patients who failed standard treatments; 49 patients (80.3%) demonstrated ≥ 1 hormone abnormality defined as a serum concentration or level above or below the normal range, and 7 patients (11.5%) showed a severe pituitary-adrenal-gonadal deficiency as indicated by deficient serum levels of adrenocorticotropin and ≥ 2 adrenal-gonadal hormones. Hormone serum abnormalities are biomarkers of severe, uncontrolled pain, and, in a patient who has failed standard treatment, they are an indicator that enhanced analgesia is required and that hormone replacement may be indicated.

journal_name

Postgrad Med

journal_title

Postgraduate medicine

authors

Tennant F

doi

10.1080/00325481.2014.996110

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

1-4

issue

1

eissn

0032-5481

issn

1941-9260

pii

10.1080/00325481.2014.996110

journal_volume

127

pub_type

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