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I can’t answer your question but can tell you that, although I lost weight after starting adderall – due to decreased appetite – I have not seen significant body recompositioning.
I wish I did!!
@clloyd 1582 wrote:
Can you provide a link to what you read? I have taken Adderall for years but have lowered my dose. I do believe it has induced excess norepinephrine in me (more than I would have liked). I also believe that my body has come accustom to its stimulation of dopamine. OVerall, the drug has helped me focus and definitely helps adult ADD. I have not been able to get off completely though. There is some complexities that are too long to post (adrenals, etc.).
I would list individually, but there’s lots…I googled “adderall depletes neurotransmitters”.
I’m not really worried – and I think this is the point of drug holidays – but remember a lot has to do with the right dose. Too much of anything is no good.
For OP, I can also tell you that I used metoprolol when I had high BP years back (since TRT, I’ve lost about 40 pounds and have no need for meds!) and the drug made it virtually impossible to acheive an erection suitable for penetrative sex.
I would liken it to trying to have sex after about the tenth shot (not that I advocate that).
I understand this is a pretty common side effect for this class of medication, so make sure to consider that with your doc.
Also, I have been on Isocort for adrenal support for about a month and some change now, and it has made a difference for me. It wasn’t an abrupt change (like I had hoped), but I just generally started feeling better after about 3 weeks. I also found my response to caffeine was back, which is what alerted me that something changed.
So it’s definitely something to talk to your doc about.
@DrMariano 1034 wrote:
I did not state that HCG should be withheld.
HCG doesn’t falsely elevated estrogen. It actually increases estradiol production. This is not “false”.
As I recall, another registered member noted his physician recommended withholding HCG prior to lab measurements.
My answer is to not withhold HCG. Rather, it is to time the lab for the trough level of testosterone. And if needed, do a lab to determine a peak value of testosterone. The estradiol that is present is due to HCG but that is taken into account. It is not a falsely elevated estradiol. By not withholding HCG, I see what a person actually experiences. This is the most important reason for not withholding HCG.
In my own protocol for testosterone replacement using testosterone cypionate, with HCG used cosmetically to maintain testicular size, I modified Dr. Crisler’s method by having HCG taken at the same time as the testosterone injection (with an additional dose between testosterone injections if the injections are once a week for testosterone). This modification is done for convenience. From my point of view, when testosterone is given at an appropriate weekly frequency (e.g. twice a week or more frequently for those with short-half lives for testosterone cypionate, weekly and longer for those with normal or longer half-lives), the need to boost testosterone with a small HCG injection is not necessary.
When not withholding HCG (my preference), it is then a matter of timing the date of the lab.
Sorry doc, I must’ve misunderstood another post. Might have even been another doctor the poster was referring to.
I notice you mention using HCG to maintain testicular size. Do you think it also maintains baseline function? I have recently switched doctors and my new guy wants me to take a break from TRT to get a new set of baseline labs. He did tell me i would probably crash, though he expected it to be less because I had been doing hcg.
@DrMariano 936 wrote:
Congratulations. I am happy it helps you.
SSRIs increase serotonin signal duration. Increasing serotonin signaling (so long as thereis sufficient serotonin being reduced) can lead to decreased norepinephrine signaling (if dopamine isn’t reduced excessively by the increase in serotonin), which can lead to decreased pro-inflammatory cytokine signaling, which can help resolve hypothalamic-pituitary-adrenal axis dysregulation – if one doesn’t have other complicating factors. The main reason depression is generally better after several weeks – if one is lucky – with an antidepressant is this improvement in hypothalamic-pituitary-adrenal axis regulation. With improvement in HPA axis regulation, cortisol signaling improves, then thyroid signaling improves, and so on, until a person is hopefully in remission.
Notice that it is a long chain of events that has to occur, starting with the availability of serotonin production so that the SSRI can work in the first place via its primary mechanism. Since there are a lot of complicating factors that prevent this chain of events from being successful, there are many reasons antidepressants may only partially work or not work at all. Addressing these other factors – which are themselves often causes of depression – helps improve treatment outcome.
SSRIs are very useful medications in the psychiatric toolkit when one knows how to use them as part of an overall scheme of treatment.
That really is amazing.
And I have to tell you, I truly appreciate your approach of considering these illnesses as all part of the same system.
I also use a small amount of isocort and transdermal pregnenolone, which helps greatly. The pregnenolone started relieving the anxiety all by itself, the SSRI capped it off.
As an aside, when one is on a few different meds, do you think it makes sense to use a supplement like milk thistle or liv-52 to keep the liver up to par?
I don’t know how much load I’m putting on my liver with these meds as I don’t understand liver metabolism well, so I don’t even know if it’s much of a concern.
@DrMariano 901 wrote:
An SSRI may be useful depending on the patient’s circumstances. For example, does the person have a deficit of serotonin? How is the dopamine system functioning? How much in excess is norepinephrine? What is their iron level? How much serotonin is being produced? What is their tryptophan intake? What is the person’s level of sexual function? What is the person’s capacity to concentrate and remember things? How good is impulse control? How significant is environmental or psychological stress? What is the person’s age? How susceptible is the person to anticholinergic effects? What is the person’s weight and is the person trying to lose weight? What is the risk of the person committing suicide? Etc. There are a lot of variables to consider when considering an SSRI as a treatment.
The selection of medication (s) and class of medication (s) depends on the individual patient’s condition and situation.
I ask because my doctor put me back on prozac and not only is my anxiety greatly reduced, my fatigue seems less.
I don’t know if that’s a mental thing or not. When i first started taking it again, I was REALLY sleepy. After about a week, that seemed to reverse.
@gu3vara 840 wrote:
I heard similar thing with using transdermal DHEA and doing 24 urine test. Dr J says it make many elements artificially high in the analysis.
Why would I stop DHEA some days before testing, I will have no idea how much DHEA I’m absorbing?
I’d like to hear more from Dr. M on HCG and appropriate way of testing estrogens and testosterone, whether it’s from HCG monotherapy or not.
I believe transdermal DHEA can actually raise T levels, or at least moreso than oral DHEA.
@DrMariano 874 wrote:
If anything, the major target (which most psychiatrists do not realize since they don’t take endocrine function into consideration) of treating person with an antidepressant or mood stabilizer is correction of hypothalamic-pituitary-adrenal axis dysregulation.
Could an SSRI antidepressant be useful in this regard/ Or do you generally prefer another class?
@DrMariano 198 wrote:
DHEA:
For myself, I have found that the ultrasensitive estradiol is the most clinically useful test for estrogen signaling activity. This means whether or not estrogen is too high or too low in relationship to the other hormones, neurotransmitters, and other signals. This is particularly important for signals which are directly affected by estrogen: testosterone, thyroid hormone, serotonin, dopamine, norepinephrine.
Do you think the ultrasensitive assay is always accurate?
I have taken 5 tests since starting TRT, 3 have come back <2 mid week.
Do you feel the other assays are invalid?
@Shaolin 828 wrote:
Couldnt agree more, tried diazepam and was the only thing to help me with adrenal fatigue. But most of the day i was sedated,tired and sleepy Its not great help, just some vere urgent times or unbearable ones.
Dr. M you think there will be some guideline to treat adrenal fatigue conditions in the future??
Its a killer situationA benzo helped HPA dysfunction? how?
@charliebizz 831 wrote:
is it possible for one to treat low t3 based on symptoms and body temp.my last two blood test showed i have low t3 but i currently have no health ins. if i were to get my hands on say armour would i be able to treat it or is it somthing u must carefully moniter thru labs.
Possibly for a doctor, as I understand they used to treat thyroid this way before the advent of the TSH test.
But even a doctor today would want to monitor labs, and I wouldn’t want to treat myself – with or without labs.
Any ways to save for a single doc visit? free clinic?
@gu3vara 837 wrote:
I’m interested in that as well. If someone is taking HCG EOD, why not just measure E2 the day before the shot? HC levels should be pretty stable on such a schedule, so I don’t see estrogen spiking that much.
That’s my understanding, I might be wrong here.
I’m curious as to whether “artificially elevated” can translate into a difference in symptomology for a given E2 result (b/w a test/hcg and hcg mono pt), and the related mechanism.
Absolutely unbelievable. Great find.
I am excited about “where we are” with medicine. I think the next 20 years will produce some real neat stuff.
I’d also love to hear about how the pharmaceutical companies are making out with the ultra pure resveratrol.
@DrMariano 787 wrote:
Provigil (Modafinil)
At about $9 a tablet, it is a very expensive medication. One can get two Viagra pills for the price of one Provigil.
And have more fun with the former and a willing partner.
Where can I trade? Just kiddin’ 😀
