Drug info - Do opiates lower testosterone levels?

[Herbal Healer 019]

SWIM works out 3-7 days a week & has been tryin 2 bulk up 4 a while, leaving his adolescent crack head physique behind, but frequently uses opiates and various other recreational drugs.

Does using opiates and other drugs (benzos, adderall, barbiturates; less frequently than opiates) 1-2 times a week lower testosterone levels or inhibit muscle growth in males?

[Jasim]

Not aware of anything relating opiates to testosterone or muscle growth. Opiates act on the area in the brain related to perception of pain. They don't affect rate of metabolism, the peripheral nervous system, or protein synthesis.

[holku]

Short answer - yes. Opioids (possibly bupe less so or notat all) lower testosterone levels and this is why they are associated withlibido/erectile problems in men.

J Pain. 2006 Mar;7(3):200-10. Links
Open-label pilot study of testosterone patch therapy in men with opioid-induced androgen deficiency.

Daniell HW, Lentz R, Mazer NA.
Department of Family Practice, University of California Davis Medical School, Redding, California, USA.
We conducted a 24-week open-label pilot study of testosterone (T) patch therapy in 23 men with opioid-induced androgen deficiency (OPIAD). The T dosage was 5 mg/day for the first 12 weeks and 7.5 mg/day for the second 12 weeks. Seven subjects discontinued prematurely: 4 for noncompliance, 2 for skin irritation and 1 for hepatitis C treatment. In the "completers" population (n = 16), mean (SD) free T levels (normal range 52 to 280 pg/mL) were 28.5 (18.6) pg/mL at baseline, 72.8 (29.6) pg/mL on 5 mg/day (P < .001 vs. baseline), and 120.2 (69.5) pg/mL on 7.5 mg/day (P < .001 vs. baseline and P < .01 vs. 5 mg/day). Total T, dihydrotestosterone, and estradiol showed parallel changes. Sex hormone-binding globulin levels were elevated at baseline and decreased modestly with treatment (P < .05 vs. baseline at 5 mg/day; P < .01 vs. baseline at 7.5 mg/day). Luteinizing hormone levels were in the low-normal range at baseline and suppressed markedly with treatment (P < .001 vs. baseline at both doses). Androgen deficiency symptoms (ADSQ), sexual function (Watts SFQ), mood (PGWB), depression (BDI-II), and hematocrit levels showed improvement during treatment, generally more so at the 7.5 mg/day dosage (P < .001 vs. baseline for most parameters). Pain scores (BPI-SF) decreased slightly on 7.5 mg/day (interference score: P < .05 vs. baseline and 5 mg/day); the use of opioids did not change appreciably. The testosterone patches were generally well tolerated. PERSPECTIVE: Long-acting opioid preparations suppress the hypothalamic-pituitary-gonadal axis in men and produce a symptomatic state of opioid-induced androgen deficiency (OPIAD). Testosterone patch therapy at a dose of 7.5 mg/day normalizes hormone levels and appears to improve a number of quality of life parameters (eg, sexual function, well-being, mood) in men with OPIAD.

Reputation Comments on this post:

good information....please list a source next time though....keep up the good work!

[Fantasian]

IMO i think part of the story is that the effect of opiates on opioid receptors means that the bodies natural effect on these receptors with endorphins is not as effective so when one does orgasm/get pleasure from sex etc the feeling is not as intense(or barely felt at all). Which therefore leads to a lacking of desire.

[Herbal Healer 019]

So basically SWIM's frequent use of opiates could lead to ED and lowered testosterone levels, even at once or twice a week?

Also SWIM notices that his food takes forever to digest while under the influence of opiates which seems like it could effect nutrient absorption and possibly inhibit muscle growth as a result. More importantly SWIM can't cum for at least an hour no matter how kinky or amazing sex is, & when he does it isn't nearly as intense or pleasurable as it is while not under the influence of opiates as fantasian mentioned.

Reputation Comments on this post:

Agreed, makes sense

[Fantasian]

Originally Posted by Herbal Healer 019

SWIM notices that his food takes forever to digest while under the influence of opiates which seems like it could effect nutrient absorption and possibly inhibit muscle growth as a result..

Opiates almost completely stop peristalysis, and inhibit much of the gut movement hence why they create constipation. Which would explain SWIY's feelings above. It's a fair point too that often people on high doses of opiates frequently often lose appetite and this combined with the slower digestion can often lead to malnutrition which in turn reduces libedo.

[duke9011]

SWIM is a pre medical student and a chronic pain suffer so he has read plenty of articles on long term opiod use. Yes long term, high dose, opiod use can lead to decreased testosterone levels. Its usually nothing that could be considered dangerous but it might be significant enough to interefere with "bulking up". you say that you only use one or two times a week that probably isnt enough to lower testosterone. as far as the sex thing goes that could just be general numbness due to the opiods. swim has the same thing happen to him and he gets his testosterone checked on a regular basis to make sure his drugs arent doing anything to him. fantasian is right about the gut too. there are an extremely large number of opiod receptors in the intestines and pretty much all opiods slow peristalysis significantly and can cause constipation.

[Zendo]

A combination of Creatine 1 hour before a workout, followed by a high intake of Protein after a workout (before the muscle cools down) will bulk swiy up pretty fast,

like swiy mentioned, all opiate useage will do is lower the appetitate, leading to less nutrients, slowing the digestive system also.
however if only using opiates 3 times a week? leaves plenty of days for proper nutrition,
dont forget that after a workout the body is like a furnace, anyfood that goes into you gets absorbed very fast...

Using Creatine and Protein dinks/meals correctly swiy should see very positive results within a month, even with daily opiate use.

[frankz81]

not only will opiates lower testosterone, they will increase estrogen levels, causing lumps under the breasts of some men, although not neccesarily cancerous. testosterone supplements and injections are available for this reason alone.

[Richard_smoker]

yes, but the ACTUAL level of testosterone doesn't change. it's the RELATIVE testosterone level that decreases...

the real change is that opiates cause your estrogen & progesterone to go way up. the effects of these high female sex hormones COULD make you grow breasts, but that's not likely unless you've got liver disease or obesity. What's likely to happen is the following:

1. decreased sex drive.
2. erectile dysfunction (to some degree at least)
3. increased subcutaneous fat layer (the 'smoothing' fat layer that females have--not very in-line with the body-building efforts) some people refer to this as "water weight." it could be anywhere from 5 to 25 pounds of "swelling."

-DiCK

[Jasim]

This thread is getting pretty interesting, but has some conflicting viewpoints. Could we get some more sources please?
And Holku, I've been unable to find the paper swiy is referring to, could swiy provide a copy/source? I would be very interested in reading it.

EDIT:
I'm sure a lot of this is in other threads, perhaps some links to related topics would be nice. Thanks.

[frankz81]

less sex drive,true!
i find it worse on methadone though. on oxys, swim uses for a week a month, and for that week he is not interested in it, and if he does have sex in that week, he finds it hard to 'finish' and alot of the time cant.

swim had a lump under his left breast, its still here just alot smaller, obviously cos of the increased estrogen, i left it at first then got it looked at and has scans and bio opsy as i thought it may have been cancer but its all good thankgod, as men CAN get breast cancer,and happens at a much younger age than women.

[duke9011]

SWIM loves having sex on his Opana. He can last for hours and still have a satisfying orgasim. That could just be because SWIM is still a relatively young guy(20) but it doesn't effect his sex drive at all and he's on a pretty good dose.

[snapper]

SWIM finds even kratom drops testosterone levels. When swim uses kratom daily, SWIM is not nearly as strong at the gym and gains are poor, though SWIM does not test testosterone to document it. SWIM suspects stronger opiates would make it even worse. SWIM also thinks that if it is an increase in estrogen as Richard Smoker says using an aromatase inhibitor like the herbal divanil, epistane or prescription nolvadex may help to reverse this process, but SWIM would not recommend considering any kind of anabolic supplements without researching them very carefully and monitoring hormone levels while using them. They can cause problems if used inappropriately and unless one is a dedicated bodybuilder, are not worth the trouble. Better just to lay off the opaites if SWIY wants to bulk up at the gym and do it the right way - ie - good nutrition and hard work.

[Jasim]

Swim agrees with most posts here about delay of orgasm and difficulty ejaculating. Swim uses tramadol regularly and if swim can get an erection (not always easy if swim has taken a large dose), then swim can go and go and go without reaching orgasm. The wife really enjoys it

[Richard_smoker]

Originally Posted by betsym

Swim is now wondering if taking hydrocodone on a regular basis negates or reduces the effectiveness of her testosterone cream? She thinks she may have a consult about that because she doesn't want that to happen! She is in the process of cutting them back anyway, as much as her discs and Carpel Tunnel will allow, and the libido issue is certainly worth making the sacrifice for, lol .

no, the hydros won't negate the testosterone cream...

well, actually to properly address this question, we need to know why you're on the test cream. didn't you say it was for osteoporosis?? if so, there's plenty of stuff out there specific for bone building--have never heard of testosterone having any kind of bone building property...

although the high estrogen levels that women have (compared to men) are essentially linked to the onset of osteo. The testosterone cream would serve to decrease the relative estrogen ratio.

actually you should still be ok because the hydros might only screw up your own natural LH/FSH levels that could influence your natural testosterone production. they won't do anything to your cream-acquired testosterone levels.

the best thing to do would be to just keep taking your cream as prescribed. Then get a bone scan after a year of using the cream as directed. if your new bone scan shows loss of density after a year then the test cream isn't strong enough--and you prob need a new drug like actonel or another bisphosphonate.

but i doubt that's gonna happen just because of hydros. i'd bet on it that you're gonna be fine with the test cream as directed. -DICK

[Herbal Healer 019]

...

So say SWIM works out & then decides l8r that nite he wants to pop some oxy, would that hault any growth of muscle & therefore make for a wasted workout?

SWIM really would'nt expect it to have that much of an effect on the muscle growth/testosterone levels @ only using once or twice per week.

[Richard_smoker]

effects of a single dose after workout would be minimal--not even measureable. realize though that many people get hooked this way. because the post-workout 'high' is from endorphins (endogenous opiates made by the body). if you take opiates 'recreationally' but not addicted after working out, you are creating a super 'runner's high' that is EXTREMELY addictive. ymmv. be safe. -DICK

[Herbal Healer 019]

Damn so endorphins from working out boost the opiate high?

I def. can c how the brain would enforce such behavior w/ like an extra reward system associating opiates with working out.

But as far as addiction SWIM has alot of self control at this point being addicted to DXM at an early age & would never b so stupid as to land in the same mindset as back then, none the less thanx 4 the advice.

[Richard_smoker]

to answer your question about what happens when you take both adderall and opiates, the effect is the same as opiates alone on testosterone. The reason for the opiate-testosterone connection has to do with the way the body creates natural opiates (endorphin). We make a single pre-cursor molecule that gets sliced up into 3 hormones. it's called pro-opio-melano-cortin. it is responsible for corisol-stress hormone response, the signal to secrete FSH & LH which signal the testicles to make testosterone and to make semen as well as stimulating spermatogenesis. For women, FSH & LH go to the ovaries and regulate ovulation and sex hormones as well.

adderall's effect on sex-appetite is simply a well-known affect of amphetamines on behavior (both human and mouse), causing an increase in repeated, self-administered pleasure. has nothing to do with hormones, it's a primary (immediate) effect of the drug on the brain (probably involved with dopamine & the reward-circuit getting juiced up & ready for increased signaling capacity by the pleasure-reward-memory-emotion loop of the limbic system)
-DICK

[Richard_smoker]

um, let's see.

your question is 'does that mean that swim's opiates & adderall would be affecting her sex drive/testosterone levels without the cream?'

well, yeah. the opiate will continue to decrease the testosterone levels and adderall will continue doing nothing--but possibly increasing the pleasure-reward-seeking repetitive behavior-associated sexual activity.

without taking the cream the testosterone levels will continue to decrease.

something else that we haven't mentioned is that if you're a female (or male for that matter) and supplementing your hormone levels with testosterone, you will not only be increasing your testosterone levels, but you will also be increasing your estrogen levels... there's an enzyme that men & women have in abundance called "aromatase." The function of this enzyme is to convert extra testosterone into estrogen and vice-versa.

i'm not sure what the omission was over--but i could certainly tell that swiy got a good laugh! -DICK

[holku]

Originally Posted by Jasim

This thread is getting pretty interesting, but has some conflicting viewpoints. Could we get some more sources please?
And Holku, I've been unable to find the paper swiy is referring to, could swiy provide a copy/source? I would be very interested in reading it.

Hope this attachment works.

EDIT:
I'm sure a lot of this is in other threads, perhaps some links to related topics would be nice. Thanks.

Here are some other abstracts related to the issue

Clin J Pain. 2000 Sep;16(3):251-4. Links
Hypogonadism in patients treated with intrathecal morphine.

Finch PM, Roberts LJ, Price L, Hadlow NC, Pullan PT.
Perth Pain Management Centre, South Perth, Western Australia.
OBJECTIVE: The objective of this study was to investigate the hypothalamic-pituitary-gonadal response to intrathecal opioids. PATIENTS: Thirty patients receiving intrathecal morphine for chronic nonmalignant pain were studied for clinical and biochemical evidence of hypogonadism. Ten men and 10 postmenopausal women with chronic pain of similar duration but who were not receiving any form of opioid therapy acted as control subjects. RESULTS: Men and both premenopausal and postmenopausal women had evidence of hypogonadism with low levels of serum testosterone or estrogen coupled with low levels of pituitary gonadotrophins. Control subjects had hormone levels in the expected range for their sex and age. Two men demonstrated recovery after ceasing intrathecal opioid therapy. CONCLUSIONS: Hypogonadotrophic hypogonadism is a common complication of intrathecal opioid therapy in both men and women.

J Clin Endocrinol Metab. 2000 Jun;85(6):2215-22. Links
Endocrine consequences of long-term intrathecal administration of opioids.

Abs R, Verhelst J, Maeyaert J, Van Buyten JP, Opsomer F, Adriaensen H, Verlooy J, Van Havenbergh T, Smet M, Van Acker K.
Department of Endocrinology, University Hospital Antwerp, Belgium.
Intrathecal administration of opioids is a very efficient tool in the long-term control of intractable nonmalignant pain. However, despite the well known role of opioids in endocrine regulation, few data are available about possible effects on hypothalamic-pituitary function during this treatment. Seventy-three patients (29 men and 44 women; mean age, 49.2 +/- 11.7 yr) receiving opioids intrathecally for nonmalignant pain were enrolled for extensive endocrine investigation. At the time of hormonal determination, the mean duration of opioid treatment was 26.6 +/- 16.3 months; the mean daily dose of morphine was 4.8 +/- 3.2 mg. The control group consisted of 20 patients (11 men and 9 women; mean age, 54.2 +/- 14.0 yr) with a comparable pain syndrome but not treated with opioids. Decreased libido or impotency was present in 23 of 24 men receiving opioids. The serum testosterone level was below 9 nmol/L in 25 of 29 men and was significantly lower than that in the control group (P < 0.001). The free androgen index was below normal in 18 of 29 men and was significantly lower than that in the control group (P < 0.001). The serum LH level was less than 2 U/L in 20 of 29 men and was significantly lower than that in the control group (P < 0.001). Serum FSH was comparable in both groups. Decreased libido was present in 22 of 32 women receiving opioids. All 21 premenopausal females developed either amenorrhea or an irregular menstrual cycle, with ovulation in only 1. Serum LH, estradiol, and progesterone levels were lower in the opioid group. In all 18 postmenopausal females significantly decreased serum LH (P < 0.001) and FSH (P = 0.012) levels were found. The 24-h urinary free cortisol excretion was below 20 microg/day in 14 of 71 opioid patients and was significantly lower than that in the control group (P = 0.003). The peak cortisol response to insulin-induced hypoglycemia was below 180 microg/L in 9 of 61 opioid patients and was significantly lower than that in the nonopioid group (P = 0.002). The insulin-like growth factor I SD score was below -2 SD in 12 of 73 opioid patients and was significantly lower than that in the control group (P = 0.002). The peak GH response to hypoglycemia was below 3 microg/L in 9 of 62 subjects and was significantly lower than that in the control group (P = 0.010). Thyroid function tests and PRL levels were considered normal. No metabolic disturbances were recorded, apart from significantly decreased high density lipoprotein cholesterol levels (P = 0.041) and elevated total/high density lipoprotein cholesterol ratio (P = 0.008) in the opioid group compared to the control group. Supplementation with gonadal steroids improved sexual function in most patients. In conclusion, of all patients receiving intrathecal opioids, the large majority of men and all women developed hypogonadotropic hypogonadism, about 15% developed central hypocorticism, and about 15% developed GH deficiency. These findings suggest that further investigations are required to determine the need for systematic endocrine work-up in these patients and the necessity for substitutive therapy.

Clin J Pain. 2002 May-Jun;18(3):144-8. Links
Sex hormone suppression by intrathecal opioids: a prospective study.

Roberts LJ, Finch PM, Pullan PT, Bhagat CI, Price LM.
Western Australian Pain Management Centre, Department of Anesthesia, Sir Charles Gairdner Hospital, Western Australia, Australia.
OBJECTIVE: Sexual dysfunction and low testosterone levels have been observed previously in males with chronic noncancer pain treated with intrathecal opioids. To investigate the hypothesis that intrathecal opioids suppress the hypothalamic-pituitary-gonadal axis, a prospective nonrandomized investigation of the function of this axis was undertaken. DESIGN: Ten males with chronic noncancer pain were evaluated for clinical and biochemical evidence of hypogonadism at baseline and during the first twelve weeks of intrathecal opioid therapy. RESULTS: Intrathecal opioid administration resulted in a significant (p <0.0001) reduction in serum testosterone, from 7.7 +/- 1.1 (mean +/- SEM) nmol/L at baseline to 2.0 +/- 0.7, 2.8 +/- 0.5, and 4.0 +/- 0.9 nmol/L at 1, 4, and 12 weeks, respectively. This was associated with a reduction in libido and potency. Luteinizing hormone and follicle-stimulating hormone levels remained within reference ranges, indicating central rather than peripheral suppression. CONCLUSIONS: Administration of intrathecal opioids may result in hypogonadotrophic hypogonadism. As part of the consent for therapy process, patients should be informed about this effect and its management. With long-term intrathecal opioid administration, the hypothalamic-pituitary-gonadal axis should be monitored. Where indicated, testosterone replacement should be undertaken to improve sexual function and prevent the potential metabolic effects of hypogonadism, in particular, osteoporosis.

Neuroscience. 2006 Jul 7;140(3):929-37. Epub 2006 Apr 3. Links
Single opioid administration modifies gonadal steroids in both the CNS and plasma of male rats.

Ceccarelli I, De Padova AM, Fiorenzani P, Massafra C, Aloisi AM.
Pain and Stress Neurophysiology Laboratory, Neuroscience and Applied Physiology Section, Department of Physiology, University of Siena, Via Aldo Moro, 2, 53100 Siena, Italy.
While morphine remains one of the most widely used opioids for the treatment of painful conditions, other opioids are also commonly employed. Because of the interactions between opioids and gonadal hormones, in particular opioid-induced hypogonadism, this study investigated the effects of widely used opioids on plasma testosterone and estradiol levels and brain testosterone levels in male rats. Animals were s.c. injected with two concentrations of morphine (5 or 10 mg/kg), fentanyl (0.05 or 0.1 mg/kg), tramadol (10 or 40 mg/kg), buprenorphine (0.05 or 0.1 mg/kg) or saline (0.7 ml/kg). Four or 24 h after treatment, the rats were deeply anesthetized to collect blood samples from the abdominal aorta and to perfuse the brains with saline. Plasma and brain hormone levels were measured by radioimmunoassay. In rats studied 4 h after treatment, all the opioids except tramadol 10 mg/kg decreased plasma testosterone in comparison with saline administration. At the same time, plasma estradiol levels were lower than control in the groups treated with the low doses of morphine, tramadol and buprenorphine, while estradiol remained at control levels in the other groups. Twenty-four hours after treatment, plasma testosterone levels were different (higher) than control in the animals treated with the low doses of morphine, fentanyl and buprenorphine. Estradiol was lower than control in the low dose groups, while the high doses did not produce any changes with respect to control. Four hours after treatment, brain testosterone was drastically decreased in all groups except buprenorphine, in which it remained at control levels. All groups returned to control levels at 24 h after treatment. In conclusion, opioids exert important effects on plasma and CNS sex hormone levels. The different magnitude and time-course of the effects of the different opiates on testosterone and estradiol levels are likely due to their different mechanism of action.

Some evidence that the decline in testosterone is related to an increased conversion of tesosterone to DHT in the CNS which would effectively tell the HPTA that the body is producing more testosterone than it actually is.

Int J Dev Neurosci. 2005 Nov;23(7):621-6. Epub 2005 Sep 6. Links
In vivo evidence for an increase in 5alpha-reductase activity in the rat central nervous system following morphine exposure.

Amini H, Ahmadiani A.
Department of Pharmacology, Neuroscience Research Center, Shaheed Beheshti University of Medical Sciences, P.O. Box 19835-355, Tehran, Iran.
In the present study, the effects of acute and chronic morphine exposure on testosterone concentrations in the central nervous system (CNS) and serum were investigated in rats. Acute morphine administration (5 mg/kg, s.c.) reduced significantly testosterone levels in serum and spinal cord but not in the brain. Following chronic morphine administration (orally for 21 days), the brain testosterone was also significantly reduced as well as serum and spinal cord. Since, the decrease in testosterone levels following morphine exposure was more obvious in the CNS than serum, we suggested that it cannot be caused by only a direct decline in testosterone levels in periphery, and an increased local metabolism of testosterone in the CNS might be attributed in these effects. This hypothesis was supported with the findings that pretreatment with finasteride, a 5alpha-reductase inhibitor (5 mg/kg, s.c.) blocked testosterone elimination from the CNS following morphine exposure. Moreover, the serum concentration of 5alpha-reduced metabolites of testosterone, dihydrotestosterone and 3alpha-diol glucuronide was increased significantly following chronic morphine exposure, but not after co-treatment with finasteride. These results suggest that morphine exposure increase the CNS activity of 5alpha-reductase, which is an important metabolizing enzyme for testosterone.

Horm Behav. 2007 May;51(5):605-10. Epub 2007 Mar 2. Links
Finasteride, a 5alpha-reductase inhibitor, potentiates antinociceptive effects of morphine, prevents the development of morphine tolerance and attenuates abstinence behavior in the rat.

Verdi J, Ahmadiani A.
Department of Physiology and Pharmacology, Kashan University of Medical Sciences, Kashan, Iran.
It has been shown that morphine increases 5alpha-reductase enzyme activity in the rat central nervous system; however importance of this finding on morphine analgesia, tolerance and dependence has not been reported. In the present study, we investigated inhibition of 5alpha-reductase enzyme on morphine effects using finasteride. To determine whether the 5alpha-reductase enzyme interact with morphine analgesia, finasteride (5 mg/kg, i.p.) was administrated with morphine (5 and 7 mg/kg, i.p.). The tail-flick test was used to assess the nociceptive threshold, before and 15, 30, 45, 60 and 90 min after drug administration. In tolerance experiments, morphine 20 mg/kg was injected i.p., twice daily for 4 days. The development and expression of dependence were assessed in the naloxone precipitation test 5 days after the morphine (20-30 mg/kg, i.p.) administration. We found that finasteride could potentiate the antinociceptive effect of morphine. In addition, chronic finasteride administration effectively blocked development of tolerance and dependence to morphine. Following chronic morphine administration, single dose injection of finasteride failed to reverse tolerance but prevented naloxone precipitate withdrawal syndrome. Therefore, it was concluded that there is a functional relationship between 5alpha-reductase enzyme and morphine.

Reputation Comments on this post:

Thanks for the sources