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Opioid use may lead to endocrine deficits, dysfunction
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NEW ORLEANS — Men who use opioids may increase their likelihood for developing hypogonadism, and these patients require consistent assessment of endocrine function, according to findings presented at the Endocrine Society Annual Meeting.
“We know that the use of opioids is increasing tremendously in the last years, and it will only increase in the future. We also know that exogenous opioids affect the endocrine system primarily by affecting the hypothalamus ... which basically orchestrates the whole endocrine system by regulating different organs in the body, producing hormones regulating all kind of vital functions,” Amir H. Zamanipoor Najafabadi, a PhD candidate in the department of neurosurgery at Leiden University Medical Center in the Netherlands, said during a press conference. “Because the number of opioid users is increasing, and because we assume that by treating patients with opioid-overuse endocrine deficits we might improve the quality of life, we wanted to know the frequency of these endocrine effects due to opioid exposure.”
Najafabadi and colleagues conducted a systemic review of literature from eight electronic databases in May 2018. The researchers limited their search to studies that examined endocrine function in relation to opioid use. Fifty-two articles met the criteria and included data from 18,428 patients. The researchers noted that morphine (n = 17 studies) and methadone (n = 15 studies) were the most used opioids, and participants used opioids for pain in 21 studies and for maintenance treatment for opioid addiction in 9 studies; healthy volunteers took opioids in 4 studies.
In a sample of 15 studies (n = 3,250; 99.5% men), 65% of men using chronic opioids had hypogonadism (95% CI, 57-73) based on the pooled weighted average of participants with insufficient levels of testosterone. Hypercortisolism occurred in 19% of participants (95% CI, 10-29) in a sample of five studies (n = 207; 57.5% men) based on a pooled weighted average. Najafabadi noted that these patients are at increased risk for symptoms including fatigue and muscle weakness.
“We need to use this information to acknowledge the symptoms that our patients might have by treating them with opioids. This information can also be used to discourage people who are using opioids ... because it comes at the expense of their sexual function,” Najafabadi said. “Using this information, we might be able to select patients who are at higher risk for developing these deficiencies.” – by Phil Neuffer
Reference:
Bruin M, et al. SUN-489. Opioid epidemic and related endocrine effects: A systematic review and meta-analysis. Presented at: The Endocrine Society Annual Meeting; March 23-26, 2019; New Orleans.
Disclosure: Najafabadi reports no relevant financial disclosures.