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Opioid endocrinopathy.

Susan P Demarest1, Ranjodh S Gill2, Robert A Adler2

  • 1Department of Endocrinology and Metabolism, Virginia Commonwealth University, Richmond, Virginia.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|December 25, 2014
PubMed
Summary
This summary is machine-generated.

Prescription opioids can disrupt hormone levels, particularly testosterone and cortisol, leading to hypogonadism and potential bone metabolism issues. Further research is needed to understand these endocrine effects and guide patient treatment.

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Bone Metabolism

Background:

  • Opioid use has surged in the last two decades.
  • Opioids impact multiple endocrine pathways, affecting hormones like testosterone, cortisol, and prolactin (PRL).

Purpose of the Study:

  • To review current data on opioid effects on the hypothalamus, pituitary, and bone metabolism.
  • To synthesize findings on opioid-induced endocrine dysfunction.

Main Methods:

  • PubMed search for articles on opioids and specific hormones (testosterone, estrogen, cortisol, thyroid, GH) and bone metabolism.
  • Inclusion of studies from 1980-2014, prioritizing controlled studies over case reports.

Main Results:

  • Opioids affect pituitary hormone pathways and bone metabolism.
  • Hypogonadism is the most common effect; adrenal axis suppression is also noted.
  • Evidence suggests increased fracture risk, potentially linked to hypogonadism and falls.

Conclusions:

  • More research is required to identify specific opioids causing endocrine dysfunction and patient populations needing screening.
  • The timeline for hormonal changes and reversibility upon opioid cessation remains unclear.