Even small improvements in core strength can make a big difference for spine health. Physical therapy also includes stretching, mobility work, and manual therapy. When these muscles work well, the spine has better support and can handle daily stress more easily. Because of this, most people benefit from a combined approach that treats the whole body, not only hormones. However, testosterone testing is usually part of a larger evaluation, not the first or only step. Men with low serum T have more unfavorable body composition and cardiometabolic health outcomes after SCI. Thus, to develop timely preventive strategies, future methodologically sound longitudinal studies are required to disentangle the complex association between hormone levels and aging, visceral adiposity, physical inactivity and functional recovery post-injury. In this study we observed an improvement in total testosterone and DHEA-S in men over first inpatient rehabilitation. Working with several healthcare professionals ensures that every part of the problem is examined and treated. But when TRT is combined with targeted spine care, exercise, and healthy habits, the results can be far better. For example, if someone has both low testosterone and a disc problem, treating only the hormone issue will not fully relieve symptoms. 4 was devised using data from studies with TRT dosages ≤7.5 mg/day as shorter studies tended to use higher doses, which would have confounded the analyses. 2 was devised using data from studies with TRT dosages ≤7.5 mg/day as shorter studies tended to user higher doses, which would have confounded the analyses. 4 Value presented are % body fat not FM (kg), without the provision of body weight pre-post it is not possible to work out Δ in FM. This is because higher doses (10 mg/day) were primarily administered for a shorter period of time (3–6 months) and predominantly in the gel format (Table 1), which would have impacted the analysis. The duration of treatment and dosage ranged from 3–36 months and 2.5–10 mg/day, respectively. This scoping review identified 14 and 13 studies that reported the effect of TRT on LBM and FM, respectively. The second and third authors extracted descriptive and outcome data from the included studies, which were then fact-checked by the primary author. To our knowledge, this is the first study to explore longitudinal changes in androgen levels using linear mixed model approach, which is a robust and powerful tool for analyzing complex datasets with repeated or clustered observations. Total testosterone levels were above 2.4 nmol/L among 37.5% of women at baseline. We observed lower levels of DHEA in women with non-traumatic as compared to traumatic injury. Previous studies reported a dose-related DHEA-S deficiency in adults who are chronically consuming sustained-action oral or transdermal opioids . The data in this study are cross-sectional and are compiled from two separate studies using the same methods of measuring body composition and metabolic profiles. Combined with previous findings , the current results suggest that an increase in serum T may attenuate loss in muscle mass, decrease ectopic adiposity and improve cardiometabolic profile by possibly inducing mitochondrial biogenesis. Previous findings demonstrated that serum T is positively correlated with total trunk muscle CSA in men with SCI . Positive relationships were found between serum T and lean mass analyzed by DXA and absolute whole thigh skeletal muscle CSA analyzed by MRI only after accounting for BMI. As a result, Cooper et al. suggested testosterone treatment may attenuate muscle loss and possibly bone loss after SCI (59, 60). TRT + finasteride produced anticipated hormonal responses, evidenced by higher total testosterone (+460 ± 115%) and lower dihydrotestosterone (−49 ± 17%) vs. baseline, across timepoints. Specifically, five of seven TRT + finasteride participants exhibited nadir total testosterone above the reference range upper limit (869 ng/dL), necessitating TRT dose adjustment based on our a priori criteria. However, the incidence of total testosterone, dihydrotestosterone, and estradiol concentrations outside standard reference ranges was more than double in TRT + finasteride vs. vehicle+placebo. Baseline total testosterone was 291 ± 135 ng/dL (TRT + finasteride) vs. 280 ± 120 ng/dL (vehicle+placebo). TRT, testosterone replacement therapy; KE, knee extensor; CSA, cross-sectional area; MVIC, maximal voluntary isometric contraction; aBMD, areal bone mineral density; L2-L4, lumbar spine vertebrae 2–4; CTX, type I collagen cross-linked C-telopeptide; TRAcP 5b, tartrate-resistant acid phosphatase 5b (derived from osteoclasts). Estrogen is vital for maintaining bone density and the health of connective tissues, including intervertebral discs. This article explores the relationship between hormones and spinal disc health, and how hormonal imbalances can predispose individuals to injuries. Testosterone levels were also related to time since injury and hemoglobin and prolactin levels. Hormonal changes after spinal cord injury and their clinical implications. Testosterone is only one part of a complex system, but it can influence energy, muscle metabolism and long-term metabolic health.
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