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Low Testosterone Linked to Rheumatoid Arthritis Risk

May 07, 2013

New research out of Sweden has shed some new light on the link between the sex hormone testosterone and rheumatoid arthritis (RA).

Previous research had shown that men with RA tended to have low testosterone. However, scientists didn’t know when, exactly, a decrease happened. Could low testosterone signal a future RA diagnosis? Or did RA trigger a decrease in testosterone levels?

The study was published online in April in the Annals of the Rheumatic Diseases. But before we look at the study in more detail, let’s get some background on RA.

Rheumatoid Arthritis

According to the Arthritis Foundation, there are over 100 types of arthritis, a disease that can damage joints, bones, and related tissues. Rheumatoid arthritis is an autoimmune disease. This means that a person’s body is attacked by his or her own immune system. In the case of RA, the membrane that lines the joints is attacked, causing fluid to accumulate.

Symptoms of RA include inflammation, pain, fatigue, limited range of motion, and swelling. Some patients go into periods of remission, when they have no symptoms. Others have symptoms all the time.

Scientists are not sure what causes RA. Genetics may be involved, as certain gene markers have been found. The roles of bacteria, viruses, and smoking are also being investigated.

The Arthritis Foundation estimates that 1.3 million people in the United States have RA. The disease is more common in women, who tend to develop it in their thirties, forties, or fifties. Men usually develop it later in life.

There is no cure for rheumatoid arthritis, but medications and physical therapy benefit some patients.

The Study: Rheumatoid Arthritis and Low Testosterone

To learn more about testosterone and RA, the Swedish researchers turned to the Swedish Malmo Preventive Medicine Program, which started in 1974 and included health data on over 33,000 people born between 1921 and 1949.

Participants in this program underwent medical testing, completed questionnaires, and gave fasting blood samples, which were stored for many years. Using this data and other national registers, the researchers were able to determine which program participants developed RA after giving their blood sample.

The researchers measured the levels of testosterone in samples of 104 men who had been diagnosed with RA. They also looked at samples of 174 matched controls – men of similar age who did not eventually get RA. Blood samples were taken around the same time. On average, the samples had been stored for about thirteen years.

After accounting for smoking and body mass index, two factors that may increase a person’s risk for RA, the researchers found that the men who had lower testosterone levels in their blood were more likely to develop RA later.

These results suggest that hormonal changes occur before RA develops.

RA and Low Testosterone: What Does This Mean for Men?

Having low testosterone does not necessarily mean a man will develop RA later in life. Scientists are not sure what causes RA and are studying genetic and environmental links. Some people with RA have genetic markers that increase their likelihood of developing the disease. But some people with RA don’t have these markers. And not everyone with the markers gets RA.

However, if a man has low testosterone and a family history of RA, it may be worthwhile to discuss the connection with his doctor.


Annals of the Rheumatic Diseases

Pikwer, Mitra, et al.

“Association between testosterone levels and risk of future rheumatoid arthritis in men: a population-based case–control study”

(Abstract. First published online: April 3, 2013)

“Low testosterone levels may herald rheumatoid arthritis in men”

(News release. April 4, 2013)

Arthritis Foundation

“Rheumatoid Arthritis”

HealthDay via WebMD

Preidt, Robert

“Low Testosterone Linked to Later Arthritis”

(April 3, 2013)

Medscape Today

Kelly, Janis C.

“Rheumatoid Arthritis Risk Influenced by Testosterone Level”

(April 8, 2013)