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Suggest Treatment For Adverse Effects Of Androgens On Bone Growth

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Posted on Tue, 4 Aug 2015
Question: Dear Doctor,

I read that androgens cause bone growth. i took a derivative of androgen called oxandrolone to promote growth. Now i feel sad because maybe this oxandrolone caused my face bone and jaw to grow also...and face is permanent. Means permanent effect.

Or does face bone turn over rapidly ? in other words, none of the bone is present now that was present at 14?)
doctor
Answered by Dr. Mahesh Kumar T S (1 hour later)
Brief Answer:
adverse effect of androgens, investigations, consult oral physician

Detailed Answer:
Thanks for your query. I have gone through your query.
As far as the bone growth is concerned following androgen therapy, It can be because of the adverse effect of the steroid you have taken. Basically the excessive bone formation will not occur following steroid therapy, it results in bone resorption but the muscle overlying these bones can be enlarged or even fat deposition or puffyness of face can occur. Nothing to be panic, consult a oral physician and get yourself.
We need to rule out the odontogenic causes resulting in facial deformity. So you need to get some radiographs like OPG and PA views done to confirm the diagnosis.
You need to consult an endocrinoogist and take an opinion to confirm the diagnosis.
These are the possible causes and diagnosis based on your description of the lesion. If you can upload the images of the face, I can give clear diagnosis and we can further discuss on it.
I hope i have answered your query. If any queries are there, reply me back. Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mahesh Kumar T S (1 hour later)
i do not have facial deformity , its normal. im just upset that the steroids contributed in acheiving this normal - unless all the bone from 14 years of age has already been turned over and replaced??

thanks
doctor
Answered by Dr. Mahesh Kumar T S (13 minutes later)
Brief Answer:
bone thinning secondary to steroids.

Detailed Answer:
Thanks for your feed back.
The facial bones may grow up to around 18-20 years of age. But it will not get reduced in size or increase in size unless there is pathology. There is nothing called turn over of the bone and replacement. The steroids can cause osteoporosis or thinning of bone. So you need to consult a oral physician and get a radiographic investigation done to confirm the diagnosis. If there is osteoporosis or thinning of bone, then you need to stop taking steroids.
I hope i have answered your query. If any queries are there, reply me back. Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Mahesh Kumar T S (49 minutes later)
Thanks,

I thought steroids have protein synthesis effects in tissues...and since the bone is a tissue it must also be affected?
doctor
Answered by Dr. Mahesh Kumar T S (6 hours later)
Brief Answer:
remodelling of bone, increase in thickness of bone

Detailed Answer:
Thanks for feedback.
The steroids can have a protein synthesis effect but it is not similar to the mechanism in case of bone. The bone can remodel but it cannot grow further. The androgens can increase the density of the bone by increasing the osteoblastic activity and decreasing the osteoclastic activity. This can result in some periosteal reaction and result in bone growth. But in case of other steroids, there will be bone resorption.
Even though bone is a tissue, the bone cannot be grown further, only remodeling can occur. The other possible cause for the bone growth can be the increased muscle thickness or bulk which is a result of androgens. This increased muscle mass creates or applies more forces on the bone in response there will be remodeling process in bone resulting in over growth of bone.
So consult a oral physician and get your blood investigations and interleukin and growth factor levels checked by an endocrinologist to confirm the diagnosis.
I hope i have answered your query. If any queries are there you can reply me back.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Mahesh Kumar T S (3 days later)
dear Dr. XXXXXXX

was there any effect on my facial muscles? or ist he treatment considered to weak at the dosage to affect facial muscles? thanks
doctor
Answered by Dr. Mahesh Kumar T S (4 hours later)
Brief Answer:
Increase in muscle mass, steroids

Detailed Answer:
Thanks for your feed back.
Yes, the steroids have effect on muscles. It increases the muscle bulk or mass. This increase in the muscles mass results in increased strain over the bone underlying or to which the muscle is attached. So in response to these forces the bone remodels and increases in size. So the bony changes can be direct effect of steroids on bone or it can be indirect effect through muscles of the face. Since you have taken the treatment for 3 months, it is sufficient to result in changes in the muscle mass.
I would like to tell you some thing, please be clear in your question and what you are expecting? If you can ask the question or problem clearly I can give you the answer to the point.
I hope I have answered your query. If any queries are there reply me back.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Mahesh Kumar T S (23 hours later)
ok i have one final followup query,

whats the rate of chondrocyte turnover in pubertal boy ie age 15?

how much percent annually ? many thanks
doctor
Answered by Dr. Mahesh Kumar T S (20 hours later)
Brief Answer:
12-24week, There are no data regarding life span of chondrocytes

Detailed Answer:
Thanks for your feedbacki.
As far as the chondrocyte turn over is concerned, there are no exact reports till date have been reported till date. But few reports have shown that it may vary from 12-24weeks. But as per the literature the chondocytes will mature and form cartilage. At puberty these chondrocytes will mature and form cartilage and ends its life. If there is any destruction of the cartilage, then the cartilage cells will migrate from the neighbour region and form chondrocytes. So any damage to these chondrocytes during or before puberty, it will result in arthritis or joint related problems.
There are no data about the annual turn over rate of the chondrocytes.
I hope i have answered your query.
Take care.
Note: Find out which dental treatment will work best for your teeth. Ask here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Mahesh Kumar T S

Dentist, Oral and Maxillofacial Surgery

Practicing since :2007

Answered : 3377 Questions

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Suggest Treatment For Adverse Effects Of Androgens On Bone Growth

Brief Answer: adverse effect of androgens, investigations, consult oral physician Detailed Answer: Thanks for your query. I have gone through your query. As far as the bone growth is concerned following androgen therapy, It can be because of the adverse effect of the steroid you have taken. Basically the excessive bone formation will not occur following steroid therapy, it results in bone resorption but the muscle overlying these bones can be enlarged or even fat deposition or puffyness of face can occur. Nothing to be panic, consult a oral physician and get yourself. We need to rule out the odontogenic causes resulting in facial deformity. So you need to get some radiographs like OPG and PA views done to confirm the diagnosis. You need to consult an endocrinoogist and take an opinion to confirm the diagnosis. These are the possible causes and diagnosis based on your description of the lesion. If you can upload the images of the face, I can give clear diagnosis and we can further discuss on it. I hope i have answered your query. If any queries are there, reply me back. Take care.