Dr. Fudin, can you share your opinion on the use of “Anabolic Therapy/Neurosteroids” in chronic pain states? Do you feel there is a benefit to this type of treatment in appropriately selected patients? I have done much reading on this subject, but finding a provider is a barrier. I am frustrated that the medical community has rushed to jump on the opioidphobic bandwagon, yet refuses to go outside the box to provide any alternatives which may be helpful. One provider, an Endocronologist, actually stated rx’ing hormones would be a possible malpractice situation??? I’ve had hormone levels tested through labs, and all are depleted. Many chronic pain patients are finding themselves in a crisis situation due to the “mass opioid hysteria”. I find myself just waiting for the other shoe to drop! This causes pain patients a tremendous amount of anxiety and hopelessness. Where do we turn for help?
This is an excellent questions. I am not in favor of haphazardly using anabolic steroids in any patient, particularly pain patients, and more importantly in persons predisposed to certain cancers or heart disease. BUT, in a person who has been carefully and appropriately evaluated, and shown to be deficient in certain hormone, anabolic or otherwise, it makes perfect sense to replenish the hormones with careful monitoring. These is much published on this topic in the professional peer reviewed literature.