Increasing Neck Pain, Low Libido, Weight Gain – Maybe Your Opioid Medication Is to Blame?
Symptoms of chronic pain or signs of OPIAD?
Improving Symptoms of Chronic Illness with Testosterone Therapy
Results of a study presented at the ENDO 2013: the Endocrine Society 95th Annual Meeting in June suggest that patients with opioid induced androgen deficiency (OPIAD) may be able to reduce both pain and reliance on pain medications through androgen replacement therapy. Men suffering from testosterone deficiency brought on by chronic use of opioids were given a transdermal gel to use for three months in order to boost testosterone, with the results showing that this helped improve pain tolerance compared to placebo.
Androgens and Signs of Deficiency
Testosterone deficiency has also been seen to affect pain response in animal studies with supplementation increasing rats’ capacity to tolerate pain. This is the first human study showing similar effects and it may help highlight the increasing prevalence of insufficient androgen production in patients with chronic pain conditions.
Androgens are sex hormones, including testosterone, that rely on sufficient levels of gonadotropins (follicle stimulating hormone and luteinizing hormone) to be produced. Gonadotropins can be adversely affected by opioids, leading to lower levels of sex hormone production and symptoms of low testosterone. Both men and women can suffer the effects of OPIAD with symptoms including:
- Reduced libido
- erectile dysfunction
- fatigue
- hot flashes
- depression
- reduction in facial and body hair
- anemia
- decreased muscle mass
- weight gain
- osteopenia or osteoporosis
- infertility
Diagnosing OPIAD in Patients with Chronic Pain
Low testosterone connected to long-term opioid use in conditions such as neck pain is not always easy to spot. This is because many of the physical and emotional effects of chronic degenerative spine diseases, as well as the after-effects of neck trauma or neck surgery, can appear similar to symptoms of low levels of circulating androgens. Patients may feel that their symptoms are a normal response to a traumatic experience or a chronic illness and simply not report them to their physician. Many physicians may lack knowledge of OPIAD and, unfortunately, dismiss patients’ symptoms as a typical set of effects connected to chronic ill health.
Dismissing Symptoms of OPIAD
When neck pain affects a person’s ability to exercise, work, and socialize, it may be seen as inevitable that that person will become depressed, overweight, and have issues with their libido and energy levels. That this is not always the case has, however, been illustrated by a study published just last week that found that men taking opioids for back pain were about 50% more likely to fill out a prescription for drugs for erectile dysfunction than men with back pain who were not taking opioid medications.
Testing and Treating Androgen Deficiency
Patients are unlikely, and ill-advised to simply cease taking pain medications to see if their symptoms of OPIAD improve. Luckily, blood tests can determine if free and total testosterone levels are abnormally low and patients may then be offered androgen replacement therapy to address the issue. Increasingly, physicians are encouraged to monitor patients taking opioids long-term for signs of OPIAD and to work with patients to prevent severe symptoms arising. Women with OPIAD will likely be prescribed dehydroepiandrosterone (DHEA) while men will be prescribed testosterone to restore functional sex hormone levels and, according to this latest research, this may also help improve pain tolerance and allow them to reduce their use of opioids.
Risks and Benefits of Androgen Replacement Therapy
There are some risks of androgen replacement therapy, however, such as prostate disease in men and so patients are not recommended to pursue self-treatment with DHEA or testosterone using store bought products or medications purchased over the internet. Careful monitoring by a qualified physician needs to be carried out to reduce risks and manage symptoms. The use of androgen replacement therapy has not been well studied in women and benefits may be marginal with some potential side effects including hirsutism, acne, polycythaemia, increased high-density lipoproteins and risk of cardiovascular disease, and endometrial hyperplasia. However, some benefits that have been reported include: improved libido, increasing initiation and enjoyment of sex, and enhanced ability to reach orgasm. Patients in this latest study also reported improvements in emotional symptoms affecting their daily quality of life.
Those suffering with neck pain who have found that opioid pain medications are decreasingly effective at managing their pain and who are experiencing symptoms that may indicate opioid induced androgen insufficiency are encouraged to discuss their concerns with their doctor.
References
ENDO 2013: the Endocrine Society’s 95th Annual Meeting. Abstract LB-FP-6, presented June 15, 2013.
Smith HS, Elliott JA. Opioid-induced androgen deficiency (OPIAD). Pain Physician. 2012 Jul;15(3 Suppl):ES145-56.
Deyo, R.A., Smith, D.H., Johnson, E.S., Tillotson, C.J., Donovan, M., Yang, X., Petrik, A., Morasco, B.J., Dobscha, S., Prescription Opioids for Back Pain and Use of Medications for Erectile Dysfunction,
Spine, Volume 38 – Issue 11 – p 909–915.
Eden, K.J., and Wylie, K.R. (2009). Quality of sexual life and menopause. Women’s Health, 5 (4), 385-396.
Nappi, R.E. et al., (2006). Clitoral stimulation in postmenopausal women with sexual dysfunction: A pilot randomized study with hormone therapy. European Menopause Journal, 55, 288-295
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проверить свои usdt на чистоту
Проверка данных кошельков за присутствие подозрительных денег: Обеспечение безопасности вашего криптовалютного активов
В мире цифровых валют становится все значимее все более необходимо гарантировать защиту своих финансов. Каждый день жулики и криминальные элементы создают новые подходы обмана и мошенничества и кражи цифровых денег. Один из существенных инструментов обеспечения безопасности является проверка кошельков кошельков на выявление наличия неправомерных средств.
По какой причине так важно и проверить свои цифровые бумажники?
Прежде всего, вот это обстоятельство важно для охраны своих денег. Многие из пользователи рискуют потери денег их финансов из-за недобросовестных схем или краж. Проверка данных кошельков для хранения криптовалюты способствует предотвращению обнаружить в нужный момент подозрительные манипуляции и предотвратить возможные убытки.
Что предлагает вашему вниманию наша фирма-разработчик?
Мы оказываем послугу проверки данных электронных кошельков для хранения криптовалюты и транзакций средств с намерением обнаружения начала средств передвижения и выдачи подробного отчета о результатах. Компания предлагает программа анализирует данные пользователя для определения подозрительных действий и оценить риск для того, чтобы личного криптовалютного портфеля. Благодаря нашей проверке, вы будете в состоянии предотвратить с регуляторами и защитить от случайного участия в нелегальных операций.
Как проводится процесс?
Компания наша организация работает с ведущими аудиторами фирмами, например Certik, с тем чтобы обеспечить гарантированность и адекватность наших анализов. Мы применяем современные и методы проверки данных для выявления наличия опасных манипуляций. Личные данные наших пользователей обрабатываются и сохраняются согласно высокими стандартами безопасности.
Важный запрос: “проверить свои USDT на чистоту”
В случае если вы хотите проверить чистоте личных USDT кошельков, наши специалисты предоставляет возможность бесплатной проверки первых 5 кошельков. Просто свой кошелек в нужное место на нашем онлайн-ресурсе, и мы предоставим вам подробный отчет о статусе вашего кошелька.
Обеспечьте защиту своих финансовые средства сразу же!
Не подвергайте себя риску оказаться в жертвой мошенников криминальных элементов или попасть неприятном положении незаконных действий с ваших деньгами. Доверьте свои финансы специалистам, которые смогут помочь, вам и вашему бизнесу обезопасить деньги и избежать. Примите первый шаг к защите обеспечению безопасности своего криптовалютного финансового портфеля прямо сейчас!
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Проверка USDT для нетронутость: Каким образом защитить свои электронные средства
Постоянно все больше индивидуумов обращают внимание в безопасность личных цифровых активов. Ежедневно мошенники разрабатывают новые подходы кражи криптовалютных денег, или владельцы цифровой валюты оказываются жертвами их интриг. Один подходов защиты становится проверка кошельков для наличие незаконных денег.
Для чего это важно?
Прежде всего, для того чтобы защитить свои средства от обманщиков и украденных денег. Многие инвесторы встречаются с потенциальной угрозой убытков личных средств в результате мошеннических сценариев или грабежей. Осмотр бумажников позволяет выявить непрозрачные транзакции и предотвратить возможные убытки.
Что мы предлагаем?
Мы предоставляем услугу тестирования электронных бумажников а также транзакций для обнаружения источника денег. Наша технология исследует данные для выявления нелегальных действий а также оценки риска вашего портфеля. Благодаря этой проверке, вы сможете избегнуть проблем с регуляторами и также защитить себя от участия в незаконных операциях.
Как это действует?
Наша фирма работаем с лучшими аудиторскими фирмами, такими как Halborn, с целью предоставить аккуратность наших проверок. Мы применяем передовые технологии для обнаружения опасных транзакций. Ваши данные обрабатываются и хранятся в соответствии с высокими нормами безопасности и конфиденциальности.
Как проверить свои Tether в нетронутость?
В случае если вы желаете убедиться, что ваши USDT-кошельки нетронуты, наш подход предлагает бесплатную проверку первых пяти кошельков. Просто вбейте место личного кошелька в нашем сайте, и также мы предоставим вам детальный отчет об его статусе.
Защитите свои активы уже сейчас!
Не подвергайте риску подвергнуться обманщиков либо попадать в неприятную ситуацию по причине незаконных операций. Обратитесь за помощью к нам, для того чтобы сохранить свои электронные активы и избежать проблем. Совершите первый шаг к сохранности вашего криптовалютного портфеля уже сейчас!
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Проверка кошельков для хранения криптовалюты за присутствие незаконных средств: Защита вашего цифрового активов
В мире электронных денег становится все более необходимее соблюдать защиту своих финансов. Ежедневно мошенники и злоумышленники разрабатывают совершенно новые способы обмана и мошенничества и воровства электронных финансов. Один из существенных способов обеспечения является проверка данных кошелька за присутствие подозрительных средств.
По какой причине так важно проверить собственные цифровые кошельки для хранения электронных денег?
В первую очередь это обстоятельство обязательно для защиты личных финансовых средств. Многие инвесторы находятся в зоне риска утраты их денег в результате непорядочных планов или краж. Проверка данных кошелька помогает предотвратить своевременно выявить непонятные операции и предотвратить.
Что предлагает вашему вниманию наша организация?
Мы предоставляем сервис проверки кошельков криптовалютных кошельков для хранения криптовалюты и транзакций средств с задачей выявления начала средств передвижения и предоставления детального доклада. Наши система анализирует информацию для обнаружения подозрительных операций средств и оценить риск для своего портфеля активов. Благодаря нашему анализу, вы можете предотвратить возможные с регуляторами и обезопасить от непреднамеренного вовлечения в незаконных действий.
Как осуществляется процесс?
Организация наша организация работает с известными аудиторскими организациями структурами, как например Certik, для того чтобы дать гарантию и правильность наших проверок кошельков. Мы внедряем новейшие и методики проверки данных для идентификации подозрительных действий. Данные пользователей наших клиентов обрабатываются и хранятся в соответствии с высокими стандартами безопасности и конфиденциальности.
Ключевой запрос: “проверить свои USDT на чистоту”
Если вас интересует проверить чистоте ваших кошельков USDT, наши специалисты оказывает шанс бесплатную проверку наших специалистов первых пяти кошельков. Просто введите адрес своего кошелька в нужное место на нашем сайте, и мы передадим вам подробный отчет о состоянии вашего счета.
Обеспечьте защиту своих финансовые средства в данный момент!
Не рискуйте попасть пострадать хакеров или оказаться неприятной ситуации из-за незаконных действий с вашими собственными финансами. Обратитесь к профессиональным консультантам, которые помогут, вам и вашим финансам обезопаситься криптовалютные активы и предотвратить. Сделайте первый шаг обеспечению безопасности вашего криптовалютного портфеля активов сразу же!
чистый usdt
Тестирование Tether для чистоту: Как обезопасить свои криптовалютные средства
Все больше пользователей придают важность для секурити своих криптовалютных активов. Каждый день мошенники изобретают новые способы хищения криптовалютных средств, и также владельцы цифровой валюты являются жертвами своих интриг. Один методов охраны становится проверка кошельков для присутствие незаконных средств.
С каким намерением это потребуется?
Прежде всего, для того чтобы защитить свои средства против шарлатанов или украденных монет. Многие вкладчики сталкиваются с риском убытков своих активов по причине мошеннических сценариев или грабежей. Осмотр кошельков позволяет выявить сомнительные транзакции или предотвратить возможные убытки.
Что наша команда предлагаем?
Наша компания предлагаем услугу проверки криптовалютных кошельков и также операций для выявления начала средств. Наша платформа анализирует данные для определения нелегальных транзакций и также проценки опасности для вашего портфеля. Из-за данной проверке, вы сможете избегать проблем с регуляторами и также защитить себя от участия в противозаконных операциях.
Каким образом это работает?
Наша команда сотрудничаем с первоклассными аудиторскими агентствами, наподобие Cure53, для того чтобы обеспечить точность наших проверок. Наша команда применяем новейшие технологии для выявления опасных транзакций. Ваши данные обрабатываются и сохраняются в соответствии с высокими стандартами безопасности и приватности.
Как проверить свои Tether в прозрачность?
При наличии желания подтвердить, что ваша Tether-бумажники нетронуты, наш сервис предлагает бесплатную проверку первых пяти кошельков. Просто введите положение вашего бумажника в на нашем веб-сайте, и также мы предоставим вам детальный отчет о его статусе.
Обезопасьте ваши фонды сегодня же!
Не подвергайте опасности попасть в жертву мошенников или оказаться в неприятную обстановку вследствие незаконных операций. Обратитесь за помощью к нашему агентству, с тем чтобы сохранить ваши криптовалютные активы и предотвратить проблем. Примите первый шаг к сохранности вашего криптовалютного портфеля уже сегодня!
Проверка USDT в чистоту: Каковым способом обезопасить личные цифровые состояния
Все более людей обращают внимание к надежность своих электронных активов. Ежедневно шарлатаны придумывают новые методы разграбления цифровых денег, или держатели электронной валюты становятся пострадавшими их афер. Один техник обеспечения безопасности становится тестирование кошельков в наличие незаконных средств.
С каким намерением это необходимо?
Преимущественно, для того чтобы защитить свои средства от обманщиков и также украденных монет. Многие инвесторы встречаются с потенциальной угрозой утраты своих средств по причине мошеннических схем или краж. Проверка кошельков помогает обнаружить непрозрачные действия и предотвратить потенциальные убытки.
Что мы предоставляем?
Мы предоставляем подход проверки цифровых кошельков и также транзакций для выявления источника средств. Наша технология анализирует данные для выявления нелегальных операций и также оценки риска вашего счета. Из-за этой проверке, вы сможете избежать проблем с регуляторами или защитить себя от участия в нелегальных переводах.
Каким образом это работает?
Мы работаем с ведущими аудиторскими компаниями, например Halborn, для того чтобы обеспечить точность наших проверок. Мы внедряем современные технологии для определения опасных транзакций. Ваши данные обрабатываются и сохраняются согласно с высокими стандартами безопасности и конфиденциальности.
Как проверить личные Tether в нетронутость?
При наличии желания убедиться, что ваша USDT-кошельки чисты, наш сервис обеспечивает бесплатную проверку первых пяти кошельков. Просто вбейте положение своего кошелька в на сайте, или мы предоставим вам подробный отчет о его положении.
Обезопасьте вашими активы уже сейчас!
Не подвергайте опасности подвергнуться обманщиков или оказаться в неблагоприятную обстановку вследствие незаконных транзакций. Свяжитесь с нашему агентству, для того чтобы защитить свои криптовалютные средства и предотвратить проблем. Предпримите первый шаг к сохранности вашего криптовалютного портфеля уже сейчас!
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Тестирование Tether для чистоту: Каким образом обезопасить свои цифровые состояния
Все больше людей придают важность к безопасность собственных электронных средств. Постоянно дельцы разрабатывают новые подходы кражи криптовалютных средств, и также владельцы электронной валюты являются страдающими своих интриг. Один из подходов обеспечения безопасности становится тестирование кошельков в наличие нелегальных средств.
Зачем это полезно?
Преимущественно, чтобы защитить свои активы от шарлатанов и также украденных монет. Многие вкладчики сталкиваются с вероятностью потери своих фондов по причине обманных схем либо краж. Анализ кошельков помогает выявить непрозрачные транзакции и предотвратить возможные убытки.
Что наша группа предлагаем?
Мы предлагаем услугу анализа электронных кошельков и транзакций для определения происхождения фондов. Наша система исследует информацию для выявления незаконных операций и проценки риска для вашего счета. Из-за этой проверке, вы сможете избежать недочетов с регуляторами или обезопасить себя от участия в незаконных переводах.
Как это действует?
Наша фирма сотрудничаем с передовыми проверочными компаниями, наподобие Certik, с целью обеспечить аккуратность наших проверок. Наша команда применяем передовые технологии для выявления опасных сделок. Ваши данные обрабатываются и хранятся согласно с высокими нормами безопасности и конфиденциальности.
Как выявить собственные USDT в нетронутость?
При наличии желания подтвердить, что ваши USDT-кошельки чисты, наш подход предлагает бесплатное тестирование первых пяти кошельков. Просто вбейте положение личного бумажника в на нашем веб-сайте, а также мы предоставим вам детальный доклад об его статусе.
Охраняйте ваши средства уже сейчас!
Не подвергайте опасности подвергнуться дельцов или попасть в неприятную обстановку вследствие незаконных сделок. Обратитесь к нашему агентству, с тем чтобы защитить ваши электронные средства и предотвратить проблем. Примите первый шаг к безопасности криптовалютного портфеля прямо сейчас!
usdt и отмывание
Тетер – это стабильная цифровая валюта, привязанная к валюте страны, подобно доллар США. Это делает ее в особенности популярной среди инвесторов, так как она обеспечивает стабильность курса в в условиях неустойчивости рынка цифровых активов. Однако, подобно любая другая тип криптовалюты, USDT подвержена риску использования для скрытия происхождения средств и финансирования незаконных операций.
Промывка средств путем криптовалюты становится все более обычным способом для того чтобы обеспечения анонимности. Используя различные приемы, мошенники могут попытаться отмывать незаконно завоеванные деньги через сервисы обмена криптовалют или миксеры, с тем чтобы совершить их происхождение менее прозрачным.
Именно для этой цели, анализ USDT на чистоту оказывается весьма необходимой практикой защиты для того чтобы участников криптовалют. Имеются специализированные услуги, которые выполняют анализ транзакций и бумажников, чтобы идентифицировать ненормальные операции и противоправные источники средств. Эти услуги содействуют владельцам предотвратить непреднамеренного участия в финансирование преступных деяний и избежать блокировки счетов со стороны контролирующих органов.
Проверка USDT на чистоту также как и предотвращает обезопасить себя от возможных убытков. Владельцы могут быть убеждены в том, что их капитал не ассоциированы с незаконными операциями, что соответственно уменьшает вероятность блокировки счета или лишения капитала.
Таким образом, в текущей ситуации возрастающей сложности криптовалютной среды важно принимать шаги для гарантирования безопасности и надежности своих активов. Проверка USDT на чистоту с использованием специальных услуг является одним из способов противодействия отмывания денег, обеспечивая владельцам криптовалют дополнительный уровень и защиты.
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Adhering to Search Engine Algorithms
Today’s backlink positioning methods are finely tuned to align with search engine algorithms, which now emphasize link high quality and significance. This guarantees that hyperlinks are not just numerous but significant, guiding users to useful and relevant content. Site owners should emphasis on integrating hyperlinks that are contextually proper and enhance the overall content high quality.
Advantages of Using Clean Contributor Bases
Utilizing current donor bases for backlinks, like those handled by Alex, offers substantial advantages. These bases are regularly refreshed and consist of unmoderated sites that don’t attract complaints, making sure the links positioned are both impactful and agreeable. This strategy assists in keeping the effectiveness of links without the risks connected with moderated or problematic assets.
Only Authorized Sources
All donor sites used are sanctioned, keeping away from legal pitfalls and sticking to digital marketing requirements. This determination to using only authorized resources ensures that each backlink is legitimate and reliable, thereby building trustworthiness and trustworthiness in your digital presence.
SEO Impact
Skillfully positioned backlinks in weblogs and comments provide greater than just SEO benefits—they boost user experience by connecting to relevant and high-quality articles. This technique not only meets search engine conditions but also engages end users, leading to better visitors and improved online proposal.
In essence, the right backlink strategy, particularly one that utilizes refreshing and dependable donor bases like Alex’s, can transform your SEO efforts. By focusing on high quality over volume and adhering to the most recent requirements, you can guarantee your backlinks are both powerful and effective.
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טלגראס תל אביב
קנאביס הנחיות: המדריכים המלא לסחר קנאביסין דרך המסר
טלגראס הנחיות היה אתר רשמי מידעים והדרכות להשקיה קנאביס על ידי האפליקציה הפופולרית הטלגרמה.
האתר רשמי מספקת את כלל המידע הקישורים הידיעתיים והמידע המתעדף לקבוצות העוקבות וערוצים המומלצים מומלצים לקניית פרחי קנאביס בטלגרם במדינה.
כמו לצד זאת, האתר מספק הסבר מפורטת לאיך להתארגן באמצעות בהשרף ולקנות קנאביסין בקלות הזמנה ובמהירות רבה.
בעזרת המסמכים, גם משתמשי משתמשים חדשים יוכלו להירשם לעולם ההגראס בטלגרם בדרך בטוחה לשימוש ובטוחה.
ההאוטומטיזציה של טלגראס מאפשר להמשתמשים ללבצע פעולות המבוצעות שונות כמו כן השקת שרף, קבלת תמיכה תמיכה, בדיקת והוספת ביקורות על המצרים. כל זאת בדרך נוחה ופשוטה דרך האפליקציה.
כאשר כאשר נדבר באמצעים שלמות, השרף מפעילה בדרכי מוכרות כמו מזומן, כרטיסי אשראי ומטבע קריפטוגרפי. חיוני להדגש כי יש לבדוק ולוודא את המדיניות והחוקים המקומיים באיזור שלך לפני התבצעות רכישה.
הטלגרמה מציע יתרונות מרכזיים כגון פרטיות והגנה מוגברים, התקשורת מהירה וגמישות גבוהה מאוד. בנוסף, הוא מאפשר גישה להקהל עולמית רחבה ומציע מגוון של תכונות ויכולות.
בסיכום, טלגראס כיוונים הוא המקום המושלם ללמצוא את כל המידע והקישורים הנדרשים להשקיה פרחי קנאביס בדרך מהירה, בבטוחה ונוחה מאוד דרך הטלגרם.
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