Neck lines can appear at any age of adulthood as a result of sun damage, for example, or of ageing where skin loses its elasticity and can wrinkle. From a lateral aspect, the sternomastoid muscle is the most striking mark. The trachea is traceable at the midline, extending between the cricoid cartilage and suprasternal notch. Arteries which supply the neck are common carotid arteries, which bifurcate into the internal and external carotid arteries. The head and neck get the majority of its blood supply through the carotid and vertebral arteries. In addition to nerves coming from and within the human spine, the accessory nerve and vagus nerve travel down the neck. Sensation to the front areas of the neck comes from the roots of the spinal nerves C2-C4, and at the back of the neck from the roots of C4-C5. Here, we have addressed four issues caused by low testosterone in men. That being said, it is important to recognize the possible problems to remain on top of your health. The issues caused by low testosterone may not always have an obvious connection. Issues caused by low testosterone are important to recognize in order to prevent them from causing further problems. Testosterone is known to play a significant role in muscle development and maintenance. I’ve seen various influencers on social media, who typically have no formal training or education in science or healthcare, promoting the idea Noticing these issues in your own life but unsure if they are linked to low testosterone? It is important to be able to identify issues caused by low testosterone. It is worth noting here that the combination of issues caused by low testosterone can come together to create even more problems. Preventing a good night’s rest can make the following days full of fatigue and low levels of energy. Here, it is important to note that fatigue can even come from the accumulation of more body fat as a direct result of the low muscle mass as well. We will examine potential associations between baseline total and free testosterone with demographic and health related characteristics and psychiatric medication usage. In a cohort of 45 hypogonadal men with diffuse musculoskeletal pain we found a negative correlation between the duration of pain in years and baseline total testosterone values. We had few subjects who were evaluated after at least 3 months of testosterone replacement therapy, and we did not differentiate between subjects based on their post treatment testosterone concentrations. Benzodiazepine use may have mixed effects on serum testosterone concentrations depending on duration of therapy.29–31 Our review did not include analysis of the duration of psychiatric medication use; therefore we do not know the chronicity of benzodiazepine use in each patient. In our case series of hypogonadal men with diffuse pain, we found a negative correlation between the duration of pain in years and baseline total testosterone values, but no significant correlation with baseline free testosterone values. There is limited evidence that men taking commonly used psychiatric medications have lower testosterone.19,20,22–32 In our review, we found that 31.3% and 25% of the men using any psychiatric medication were in the lowest quartile of total and free testosterone, respectively; however, the relationships between total or free testosterone and degree of hypogonadism failed to reach statistical significance. Overall there was no significant difference in testosterone concentrations between users and non-users of psychiatric medications. We also did not find a significant change in self reported pain score after hormone replacement therapy; however, many of these patients were lost to follow-up or did not have post-replacement pain scores, thus data are not sufficient to fully evaluate the impact of testosterone replacement therapy on pain. Spearman correlation coefficients were determined to show the relationship between variables of interest and baseline serum total and free testosterone values (table 2). None of the subjects had been previously treated with testosterone replacement therapy.
