- Dr. Zev Mellman - Your Chiropractor
Truth About Pain-Relievers
Proceedings of the National Academy of Sciences (PNAS, USA) January 8, 2018 [epub]
(Drug designed to give pain relief without loss of consciousness)
This is the first randomized, controlled clinical trial of ibuprofen administration to identify its possible effects on pituitary–gonadal feedback in young men.
Study subjects were given 600 mg of ibuprofen daily for a maximum of 44 days.
*An important study published in 2017 documented an alarming 60% decline in the quantity and quality of human sperm over a 38-year period (1973-2011):
Article Title- Temporal Trends in Sperm Count
*The 2014 book “A Nation in Pain” suggests half of the adults in our nation suffer from chronic daily pain, many of whom manage their pain by consuming nonsteroidal anti-inflammatory drugs (NSAIDs).
*A 2011 study indicated that nearly half of men between ages 45–69 years of age are regularly users of NSAIDs, and 55% of men 60–69 years of age are regular users of NSAIDs; this study linked the consumption of these NSAIDs to increased incidence of erectile dysfunction:
Article Title- Regular Nonsteroidal Anti-Inflammatory Drug Use and Erectile Dysfunction
This current study indicates that NSAIDs are endocrine (hormone) disruptors, including the reduced production of testosterone. Although the alarming global reduction in sperm quality/quantity, fertility rates, testicular function, and erectile dysfunction are multifactorial, these articles suggest that an important contributor to all of these is the over consumption of NSAIDs.
In addition, this study only assessed the influence of NSAIDs, but clearly references that other contributors include other pain medications, including aspirin and acetaminophen.
Lastly, this study notes that fetal-life exposure to analgesics may adversely affect the development of the child’s gonads and be linked to adult fertility problems.
KEY POINTS FROM THIS ARTICLE:
1) “Over-the-counter mild analgesics (hereafter simply called ‘analgesics’), such as acetaminophen/paracetamol, acetylsalicylic acid/aspirin, and ibuprofen, are among the most commonly used pharmaceutical compounds worldwide.”
2) “Much concern has been raised over declining male reproductive health, and the disruption of male endocrinology has been suggested to play a central role.”
3) Male reproduction and general health rely on androgens that are mainly produced by testicular Leydig and Sertoli cells. These androgens also produce anabolic effects on muscle mass and influence cognitive functions.
4) “Several studies have shown that mild analgesics exposure during fetal life is associated with anti-androgenic effects and congenital malformations.” [Scary]
• “Exposure to analgesics can generate negative endocrine and reproductive effects during fetal life.”
• Animal studies have shown that long-term fetal exposure to acetaminophen and acetylsalicylic acid (aspirin) leads to infertility in adulthood.
5) “Through a clinical trial with young men exposed to ibuprofen, we show that
the analgesic resulted in the clinical condition named ‘compensated hypogonadism,’ a condition prevalent among elderly men and associated with reproductive and physical disorders.”
6) In this study, ibuprofen consumption altered the endocrinology in the human testes, thereby “inducing compensated hypogonadism.”
7) In this study, ibuprofen consumption suppressed testosterone production.
8) The levels of LH in the ibuprofen group had increased by 23% after 14 d of administration, and this increase was even more pronounced to 33% at 44 d.
9) Ibuprofen induced a state of compensated hypogonadism, which occurred as early as 14 days and was maintained until the end of the trial at 44 days.
• Compensated hypogonadism is induced by ibuprofen and is already established after 14 days of ibuprofen use.
10) Ibuprofen consumption significantly decreased testosterone.
11) “The pituitary–gonadal axis plays key roles in growth, sex development,
metabolism, musculoskeletal build-up, strength, mood, energy, immune system, libido, and reproduction.” Disruption of this axis results in:
• Coronary heart disease/heart attack
• Autoimmune diseases
• Compensated hypogonadic men increase the likelihood of reproductive,
cognitive, and physical symptoms
12) The hypogonadism in men caused by analgesics and other endocrine disruptors may be linked to:
• Increased insulin resistance
• Type 2 diabetes
• The metabolic syndrome
• Rheumatic autoimmune disease
• Cardiovascular disease
• Decreased sexual desire
• Long-term depression
• Increased all-cause mortality
13) Studies on adult testis have also shown anti-androgenic effects from exposure to:
• Indomethacin [a prescription NSAID]
• Bisphenol A (BPA)
14) Using ibuprofen can “result in changes in the testis at gene level, resulting in perturbations at higher physiological levels in the adult human.”
15) “The striking dual effect of ibuprofen observed here on both Leydig and Sertoli cells [both testosterone producing cells in the testes] makes this NSAID the chemical compound, of all the chemical classes considered, with the broadest endocrine-disturbing properties identified so far in men.” [Key Point]
16) “Exposure to analgesics in men has been associated with increased time to pregnancy.” [meaning they adversely alter fertility rates]
17) “In the clinical setting, compromised Leydig cell function resulting in increased insensitivity to LH is defined as compensated hypogonadism, an entity associated with all-cause mortality.”
18) “Ibuprofen appears to be the preferred pharmaceutical analgesic for long- term chronic pain and arthritis.” “It is also of concern that men with compensated hypogonadism may eventually progress to overt primary hypogonadism, which is characterized by low circulating testosterone and prevalent symptoms including reduced libido, reduced muscle mass and strength, and depressed mood and fatigue.” [Important]
19) Significance from authors:
• “Concern has been raised over declining male reproductive health in humans.”
• “Using a unique combination of a randomized, controlled clinical trial and ex vivo and in vitro approaches, we report a univocal depression of important aspects of testicular function, including testosterone production, after use of over-the-counter ibuprofen.”
• “The study shows that ibuprofen use results in selective transcriptional repression of endocrine cells in the human testis. This repression results in the elevation of the stimulatory pituitary hormones, resulting in a state of compensated hypogonadism, a disorder associated with adverse reproductive and physical health disorders.”
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Dr. Zev Mellman - Chiropractor
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