HRT or bupripion to increase testosterone and dopamine?
- 09-19-2012, 03:41 PM
HRT or bupripion to increase testosterone and dopamine?
I'm a 37-year-old guy that's suffered from tiredness for some ten years, but it's been getting Really bad during the last few years. It's been really eating most of the pleasure from my life and it's affecting my career drastically. When I wake up in the morning I feel more or less tense and like I haven't slept much at all. During the daytime I feel like wanting to fall asleep (however, I just can't nap easily at all) and I've got no motivation or energy. I used to have a promising career, but nowadays I don't have the energy to do anything about it.
I also suffer from brain fog, my memory's got bad, I've got low libido and I've also got some ADD like features (trouble concentrating, always feel like being in a rush to some other situation, place or whatever etc.). My muscles get tired pretty easily and altogether I just feel lousy.
A few months ago I got a sleep study done, where it was found out that I wake about 13 times per hour (RDI 13), almost all being related to flow limitation (no apneas or hypopneas). Then I went to an endocrinologist and had various tests done. The main thing I noticed was total testosterone, which was 8.5 nmol/litre (ref. 10-38). TSH was 0.94 (0.3-4.5) and T4-V 17 (10-21). My cholesterol was 6 (ref. under5) and glucose 5.9 (4.2-6), SHBG being in the middle of the scale (just got it over the phone and I can't remember the exact value, I think about 25). I haven't received the cortisol results yet. Prolactin was 245mU/l (70-300).
The doctor was nice and listened to me carefully, but he didn't want to check my E2 levels, he just said that I can't have too much estrogen in my body because I don't really have manboobs. For some reason LH and FSH weren't checked either. I also wanted to have e.g. iron, magnesium, PTH, VitD, folate and possibly DHEA checked, but the doctor didn't think those would be needed. I've had my testosterone checked a few times before (the last one being five years ago) and it's been within the normal range but just barely. Only now I realize that someone of my age should probably have higher values. My prolactin has always been elevated, usually around 280-330 but once over 400.
Then I saw another sleep doctor that told me there wouldn't be much that could be done. He said he thinks my dopamine receptors aren't working correctly or there isn't enough of them and suggested bupripion. Besides giving me energy, it could help with my moderate ADD symptoms and some restless legs syndrome that I've got. The doctor recognized my low test values but said it would be a milder and more natural way to address the problem by adding dopamine. Then I could have my testosterone checked to see if extra dopamine has got it up as well (due to the link between testosterone and dopamine). Now finally to the question that I'd really really need help with:
For someone with my symptoms (terrible quality of sleep, overwhelming tiredness, low libido, lack of motivation etc.), do you think I'd be better to go for HRT (which should also increase dopamine) or bupripion (which would hopefully increase testosterone)? Do you think with someone this low a testosterone adding dopamine will not be enough? There are several factors to consider, I was told low testosterone weakens the quality of sleep, but added testosterone may also worsen nasal problems at night. I've also got some tinnitus (which is manageable the way it's been) and I don't know if one of these methods might get that stronger. Maybe I'll worry about that only it it gets a lot worse after the treatment. I guess one option would also be to have a medication to lower prolactin (and thus increase dopamine) but I suppose my prolactin values aren't high enough for that?
If I start HRT (or bupripion), I should probably have some of my levels checked (E2, LH, FSH)? Any other things that I should check before staring HRT/bupripion?
I really hope some of you read this long message through and can hopefully share your knowledge and ideas! I'm sure you already saw it by reading this message, but I can't emphasize how important this all is to me!!! I really want my life back, now there's finally been some progress so I'm at least somewhat hopeful, but I really need help with my choices, lab tests etc. Thank you so so much!!
- 09-19-2012, 04:19 PM
Article I wrote.
How can one have proper B-12 in the serum with good CBC, but still be deficient? The answer is simple. There are 4 forms of b-12. The first form is cyanocobalamin which is usually found in multivitamins and can be toxic to people who do not have the ability to break down cyanocides which are toxic to the body. Second form is hydroxocobalamin which is the form which is preferred in people who have specific mutations. This form of b-12 can be broken down into the adenosylcobalamin or methylcobalamin. Adeno b-12 is used to drive mitochondrion function, CBC as well as to breakdown certain proteins. Adeno b-12 is also the form stored longest in the. Finally type of the most important b12 is the methyl b-12. This b-12 is needed to help methylate toxins from the body, formation of neurotransmitters, help cells communicate properly. Methyl b-12 is the shortest acting b-12 where as the longer active form adenosylcobalamin function can show up longer in the blood by representing the proper reading on a CBC. When a Dr looks at a CBC and see everything is normal this does not rule out a possibility of a methyl b-12 deficiency. Serum b-12 which are elevated when supplementation is not used is a representation of the body not being able to convert the b-12 into the proper forms. Elevated b-12 may also represent a Small intestinal bacterial infections.
My email was flooded from parents of a children with ASD (autistic spectrum disorders)
- 09-19-2012, 04:41 PM
Thank you so much for your reply, The Matrix! I live in Scandinavia and it's late here so I can only reply quickly.
I've read a bit about the neurotransmitter testing. It's very interesting but I guess it's also a bit controversial topic, some saying it may not give a good enough picture of what's going on in the brain. Some other people seem to trust it a lot so I don't know. I also don't know if it's possible to get it checked where I live, I should probably try to find out if it can be done by mail, although I think it may take too long for the package to the to the lab unless they are located here in Europe.
What you said about B-12 is very interesting. But do you really think too low B-12 (some of the B-12 forms you mentioned) figures could explain this big symptoms? If I do manage to get my neurotransmitters tested, I suppose there's quite a few tests to chose from so any suggestions for this? How about checking the different forms of B-12, how can this be done (I suppose this could be found out by some googling which I may do tomorrow after getting some "sleep" first; unfortunately in my case I have to use the quotation marks ). Thank you again!
09-19-2012, 05:30 PM
I.am actually meeting.with the vp of.neuroscience in 2 weeks to see if we can make.it available internationally .Originally Posted by tstudio
B12 as functional deficiency is present in majority of cases people.have.no.clue.
09-20-2012, 07:05 AM
09-23-2012, 04:50 AM
Dude, get tested for Candida if you can (not all Doc's acknowledge it can be an issue). I have just done 2 years of hell due to excess yeast in my body.
The early warning signs were identical to what you have going on. I tried to carry on to the point of being bed ridden for 4 months (Doc's told me all tests checked out as normal).
I discoverered my low T myself, after looking on this forum...... In my case it was a knock on from the Candida.
There is a real good chance it could be something else causing your issues. But, having read you post, it gave me déjà vu, everything was identical to what I had 2 years back (even age).
Good luck bro getting to the bottom of things. If you want any more info just ask. I'm not on here that often, so may be slow to respond.
P.S google.... Candida spit test..... That may give you a clue about the yeast being an issue or not.
09-23-2012, 12:05 PM
Candida spit test is a fallacy.
I prefer evaluation from a OAT, nutreval, or Ion test from metametrix. You find it indirectly not directly. When it comes to the GI issues I am one of the best around...
Future of medicine is here just the traditional medicine has no clue or is in total denial. Why our healthcare system is up creek with out a paddle. I have been planting seeds past year. They are finally starting to sprout to make a huge impact on our health care. It all goes back to what I have been suggesting for nearly a decade. Its all about detoxification...
09-23-2012, 03:06 PM
Thank you guys for your replies! I'd never thought about the possibility of candida. Even though it naturally is possible my problems derive from something else, it's interesting how the symptoms sound so similar to what I'm experiencing. I've sometimes thought that I may eat too much bread, which obviously may make candida worse, and I've had some yeast problems in my groins (if that's the proper word for what I mean). So wether that's the main problem for me or not, it's definitely worth checking.
So Stevieg, what have you done to try to get rid of Candida? How much has it helped, I mean how would you describe the changes? You said you discovered the low testosterone yourself, what do you mean by that? You started to suggest that and then went to lab tests? Have you checked your T levels after treating Candida? Thanks so much (also Matrix) for offering to help me by sharing your knowledge and experiences!
09-23-2012, 03:46 PM
90% of your neurotransmitters are produced in the GI tract. Pathogens such as clostridia, klebsiella, and pseudomonas turn your tyrosine and tryptophan in to neurotoxins. Where ever there is candida there are co infections such as one mentioned above.
Remove the stress and HPTA may start to fire up. I have had cases of this. Why you find the root cause and address it according.
09-23-2012, 04:07 PM
Forget candida, which is a new age wild goose chase. Get tested for celiac, which is a) real and b) linked to all sorts of bad autoimmune stuff. BT, DT, life got better in a hurry.
09-23-2012, 04:55 PM
09-23-2012, 07:21 PM
09-23-2012, 08:32 PM
The spit test was a very good indicator for myself. If symptoms were bad, so was the test.
I'm still dealing with it Matrix, so, any further knowledge or opinions on how to bring my GI tract back into balance would be very welcome and appreciated.
And, yes, i agree detoxification helps.
09-23-2012, 09:30 PM
tstudio, I too had jock itch.......i chose to ignore things for as long as i could, and then eventually, treated the itch with an anti fungal cream. Creams will only treat what you can see on the surface. If it is Candida overgrowth, there is a lot more to correcting things than just this.
What improved my symptoms:
Taking all carbs out of my diet (beer included,lol), detoxing, replenishing good bacteria to balance my gut flora (probiotics).
The road can be a fairly long and frustrating one, so, you also need bull strong determination and a positive outlook.
Changes are huge, i am able to carry on as normal pretty much (just have a few issues with memory sometimes, and concentration). But can safely say, these sides are getting less with time.
There is no magic pill, so don't be fooled by any fad's or quick fixes. It's all about, getting the crap out of your system and rebalancing things.......if there is an underlying factor (which i'm sure there is), i'm yet to find it for myself.
A change in diet will bring massive changes.....google a Candida Diet. Stay away from any type of carb where possible (including yoghurt and kefir).
Introduce your new diet over a week or so.......if you eliminate all the food sources for Candida at once, you can will feel very sick (depends on the severity).
A good way to describe my symptoms when it was less severe, was like a Hangover.
Excess yeast does create a hangover of type........
As the yeast ferments (feeds), it creates a by product called Acetaldehyde (Ethanol). Acetaldehyde is then metabolised by the liver, this in turn brings on that hangover feeling (usually worse in the mornings). Over time, the knock on effect starts to effect other parts too. Think about how we get brewers droop (alcohol induced). Over time Candida will effect Testosterone levels.
Yes, I did have some lab work done.
My total T was at 320 and my free was also low. I have now managed to get those into the higher ranges.
My battle with Candida still go's on.........take my foot of the pedal diet wise and things go down hill!
Seriously bro, have a good look at your diet, balancing your gut flora......and, look into every way possible to detox.
Also, have a serious read up on Virgin Coconut Oil too......that stuff is awesome, and really good for shifting some of that excess yeast.....keep things as natural and clean as you can for a good while.
09-24-2012, 07:16 AM
If you detox you can not heal...simple as that
Incase of mold toxicity in ability to detox can kill you.
I have people on verge of possible dying with this..Its no joke.
It took me close to a year to understand genetic pathways. Past few months, I have been using these in my practice People with mold, lyme, CFS, FM , adrenals, dysbosis, autism and other immune system issues finally making progress.
Next month I meet with head of multiple departments of the largest non profit cancer center in America to discuss possible integrating this into programs. There are only about small hand full of people who are now using this, but there will be a huge explosion in the next year. This is the perks of being in the shadows. Never know what is around the corner..
10-09-2012, 12:35 AM
Being there and willing to help
Hi, I have read your message and and feel I can offer some insights based on my experience; I was your age when my problems started low libido, Ed, and many of the same symptoms that you have described. Way back then, nearly 30 years ago, HRT was in the prehistory, and really not much was known about the subject, so it was very hard to find a doctor that was actually knowledgable on the subject and thus able to help.
I have tried Bupropion, and HRT, and based on your age and background, I suggest you get started with Bupropion ; the rationale is the following, at your age, most likely you are or will look forwards to having kids. If that is the case, HRT is not a good idea, as it will eventually cause atrophy and render your testicles inoperative as well as a host of other side effects, such as baldness and a for life dependency on testosterone from external sources.
Bupropion, will probably take longer to increase testosterone, and may not help you to reach as high a reading as externally applied testosterone, but it will have a positive effect on your libido, and thus could be an acceptable and viable option. It really worked for me.
Additionally, prolactine may need to be reduced via a low dosage of Dostinex, which has little to none side effects and a direct role in increasing testosterone and libido as it is a dopamine agonist.
Lastly, do feel free to contact me for any further sharing of my own experience with both approaches to the same problem.
02-13-2013, 12:30 PM
Thank you again guys for your replies, also to gellesar for offering to help me! I'm sorry to come back so late but here I am with an update to my situation. Since my testosterone level was so low my doctor offered me TRT. I knew I wouldn't be ready to stick with that for the rest of my life yet, but I decided to try it for a month to see if it would fix my problems. Even though it did help a bit, it didn't do nearly as much as I expected. On the other hand, after the month I checked my T levels (the following morning after applying gel about 22h earlier) and the number was lower that ever before (less than 2/3 of the miminum value, which is way too low for someone of my age and actually for anyone). The interesting thing is that in some ways I've found that DHEA seems better for me. I just ordered magnesium oil in order to try to raise DHEA levels that way.
I also tried bupropion for a few days, but it seems to affect my sleep negatively and cause me some tinnitus. I also tried Pramipexole, but got so tired and felt like a mess so decided to quit it after a few days. I've read about cabergoline and I think that's about the last dopamine agonist I'd like to try, but the problem is that obviously they don't even sell the stuff in my country (which is quite pathetic really).
As for candida, I think there is a great chance that might be affecting me. I also took the spit test, which showed some signs of candida. Tomorrow I'm seeing a new endo so I'll ask to have a lab test for candida. After that I'll do my best to get rid of it, which will obviously be a long battle.
I also got the rest of my lab results. I'm writing from the train so I don't have them with me, but DHEA was fairly low (about 1/3 between the min and max value), vitamin D was reasonable (but under what many people consider the real minimum value) and B12 was low, but clearly within limits, which are obviously way too low. The interesting thing is that B12 seems to help with fighting candida as well, so I've started supplying with strong B12, B6 and folic acid supplements (by the way, thanks for the very interesting info about vitamin Bs, Matrix). As I guessed, my cortisol levels were high (but just under the max value) as well.
Since I see a new doctor tomorrow and will have some more lab tests, I'd love to hear your opinions on what tests I should still have. Maybe at least these:
Cortisol 24h panel?
Ferritin (saturation index or what ever that's called)
Free T3 and Free T4 (I've only had my total T4 checked)
Any other ideas? I'm willing to do all I can to get my health under control and I'll keep you updated on how things proceed. Thank you so much!!
02-14-2013, 08:35 AM
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