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Multiple Sclerosis l: Introduction01:19

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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Testosterone in Relapsing-Remitting Multiple Sclerosis: A Case-Control Study.

Iwona Rościszewska-Żukowska1,2, Małgorzata Popiel1,2, Adam Perenc1,2

  • 1Department of Neurology, St. Jadwiga Queen Clinical Hospital, 60 Lwowska Street, 35-301 Rzeszow, Poland.

Journal of Clinical Medicine
|June 26, 2026
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Summary
This summary is machine-generated.

Low free testosterone (fT) is prevalent in men with relapsing-remitting multiple sclerosis (RRMS), especially younger patients. Longer disease duration is a significant risk factor for low fT, which is linked to depression.

Keywords:
free testosteronehypogonadismmultiple sclerosis

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Area of Science:

  • Neurology
  • Endocrinology
  • Immunology

Background:

  • Relapsing-remitting multiple sclerosis (RRMS) affects young and middle-aged adults.
  • Hypogonadism, characterized by low testosterone levels, can impact men's health.
  • Disease-modifying therapies (DMTs) are standard treatments for RRMS.

Purpose of the Study:

  • To determine the prevalence of hypogonadism in male RRMS patients on DMTs.
  • To investigate the association between hypogonadism and clinical/MRI parameters in RRMS.
  • To explore the relationship between low testosterone and depression, quality of life, and disease characteristics.

Main Methods:

  • 126 male RRMS patients on DMTs and 35 healthy controls were assessed.
  • Evaluated clinical disability (EDSS, T25FW, SDMT), MRI findings, depression (BDI), and androgen deficiency symptoms (ADAM).
  • Measured serum total testosterone (TT), SHBG, and free testosterone (fT) from morning blood samples.

Main Results:

  • Most RRMS patients (93.6%) had normal TT; however, 43.7% had low fT, compared to 34.3% in controls.
  • Low fT was significantly more common in MS patients under 38 years old (p=0.015).
  • Low fT correlated with depression (p=0.016), higher BDI and ADAM scores, longer disease duration (p=0.004), and increased steroid treatment (p=0.003), but not with clinical or MRI parameters.

Conclusions:

  • Total testosterone levels are generally normal in male RRMS patients on DMTs.
  • Low free testosterone is prevalent, particularly in younger RRMS patients.
  • Longer MS duration is a significant risk factor for low fT, which is associated with increased depression.