Are Hormones Useful in the Treatment of Tendinopathies?

Tendinopathy, also known as tendonitis, is the breakdown of collagen in a tendon leading to inflammation, and pain with movement. It is usually treated with NSAIDs, rest, and physiotherapy. But researchers have been trying to study the use of hormones for the treatment of tendonitis. This idea to use the hormones struck them as they noticed the tendon damage in certain hormone disorders like hyperparathyroidism, hypercortisolism, acromegaly, and so on. Researchers studied the response of mice with tendinopathies when being injected with these hormones’ and came to the following results.

achiles tendon

Achiles Tendon

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Estrogen

Estrogen, through relaxin, has shown to increase the frequency of ACL ruptures in female athletes especially. However, when it was used to treat tendon disorders, researchers found that it actually has an inhibiting effect on collagen synthesis. In a disease of collagen breakdown, that is not beneficial. Overall, they concluded that both increase or decrease of Estrogen has a negative or null effect on the treatment of tendonitis.

Testosterone

Many studies show the presence of testosterone receptors in tendons. Researchers found that an increase in dihydrotestosterone level increases the proliferation of tenocytes, hence proving to be of some therapeutic use in tendon disorders.

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Thyroid Hormone

TH, just like testosterone, has an effect on cell proliferation but in a dose-dependent manner. Adding on to that, they also counteract apoptosis of cells. These effects occur in the presence of TH. Low or absent TH has a negative effect, with hypothyroidism causing several musculoskeletal disorders, such as rotator cuff injury.

Parathyroid Hormone

Researches already knew that PTH plays an important role in calcium homeostasis and the treatment of bone disorders. However, they tried to study the effect of PTH on bone-to-tendon or tendon-to-tendon therapy and they couldn’t reach any specific result showing its benefits in the long run.

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Glucocorticoids

Glucocorticoids present an interesting issue for the researchers. They are extremely efficient at treating inflammation in certain conditions like De Quervain’s but not so beneficial in other diseases. Not just that, researchers also found that, in the long run, the effects of GC are actually detrimental to tendons.

HGH/IGF 1

Many studies have proven the benefits of HGH/ IGF 1 complex, but researchers focused more on IGF 1 injections alone and found them to be of extreme importance. IGF 1 showed promising results in tendon healing. They also hypothesized that HGH injections alone lead to an increase in the IGF1 levels and hence also affect tendon healing positively. In their study, they also proved that HGH could facilitate the rehabilitation process.

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In conclusion, researchers have demonstrated great potential for the use of hormones as therapeutic agents in tendon disorders. Although, more extensive research and clinical models are required for it to become the gold standard.

References

Therapeutic use of hormones on tendinopathies: a narrative review

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