Depression and Low Free T
- 12-31-2007, 04:47 AM
Depression and Low Free T
I have posted quite a bit over at Meso. However, cant post there anymore as I live in Dubai and the govenrment blocks that website now :-(.
Anyway for the past 3 years I have seen about 10-15 different endos and urologists. I had no libido, brain fog, irritability, no focus, felt down quite a bit. My blood work was all normal (I could post it all, but there are literally hundreds of results) except free testosterone which was around 50pg/ml (49-150). Total testosterone was normal at the around the top of the range 900mg/ml (250-1048)
Not one single endo or urologist could explain this to me (E2 was low normal, so it wasnt that)
I finally after 3 years was reading that depression can cause low free T in some cases. I went to see a phsych. He diagnosed me with major depression.
I have been on Cymbalta now for 2 months. I feel so much better and free T is now 123pg/ml.
I just wish someone could have told me about this earlier, I would not have to suffer like I did for 3 years. Just posting this incase anyone is suffering similar circumstances/symptoms.
- 12-31-2007, 08:08 AM
Glad to hear you feel better.
Do you think the Cymbalta raised your free testosterone?
Someone more knowledgeable than I will chime in, but free T is T that is not bound by SHBG or albumin.
There is a calculator here:
Do you know if those two levels have changed?
Do you know if your Total T has changed? Some antidepresants are thought to lower total T. Be interesting if you found one that raises free T.
- 12-31-2007, 11:11 AM
Very interesting. I have been on TRT for weeks, yet still have depression.
I wonder what to do. I've been on TRT for several weeks now and really don't feel any differently. Awaiting most recent blood work/results as 1-2 weeks into it saw T at only 427 or so.
Can't shake the persistent feelings of malaise and being "down". I hesitate to even think about another drug, but the poster's comments on cymbalta have me slightly intrigued.....
Get your FreeE2 (0.45 - 0.6)
Get your Free DHT ~(6.5 - 7.5)
Get your FreeT3 on a top or real close to the top
Hold that for 6-9 months
If you are anything like me, you should be much hapier person by then.
It is only four numbers, you can do it.
After that we will talk about the other 196 and how to get them in right place.
Happy New Year
this calculator will give you precise numerical values that you can also read from dr Shippen's chart
my post #41
Jan's BloodTest April13/2007
That calculator is not to be used for BAT, wrong results.
Good points, but how does one raise DHT? Mine has always been crappy
I next speak to him in about 2 weeks and will raise these issues again as well as the puzzling lack of testing for free T. In the interim, how does one raise DHT?
Oh, and a most Happy New Year to you as well! You're definitely one of the most helpful and informed people here!
you raise dht with t-gel...which is one reason dr. j prefers it. but if your thyroid is messed, it wont absorb. catch 22 eh?
Ah- Is DHT raised by applying gel to the genitals as I recall reading?
Is topical application of a gel the only way to boost dht? Gotta say, this whole process is getting irritating and far too lengthy. I am starting to more than a little envy guys were were down, slapped on some T and felt great. Does the process of seemingly endless experimentation ever end and a decent result finally achieved?
To further confuse the issue:
Frankly IMO depression and andropause both exist. Both have some cross over in symptoms. Some people may one or the other or even both! IMO there are two essential points to take from this
As a provider treating either condition look for other causes. i. e. if you are a provider treating depression in a male consider doing Total and free t and estradiol levels as part of the depression workup. Make sure that you have a well set differential diagnosis.
For the patient be open to the possibility that there may be other causes for the symptoms. For the patient ask the doc why or why not he thinks you fit the diagnosis. Docs are generally there to help the patient. Polite friendly discussion is almost always welcomed by a treating physician since it makes you co-partners in your care.
Some questions for you:
1. What is several weeks?
2. What does your protocol look like now?
3. How long have you been on said protocol?
4. What preceded current protocol?
5. Have you had thyroid checked (the constellation of symptoms for thyroid/low-t/depression all crossover).
Yes, this can be a pain in the rear. I can tell you that 3 weeks into the shots and my stamina is up, sex drive is up (with consistent morning wood).
But I was high DHT to begin with (just over top of range) with low test. Transdermals did nothing other than raise DHT (and lower T) and my thyroid function is good. Not optimal, but if I don't need to treat it, great.
If you're low DHT and on shots, have you considered both?
When I was on trasdermals and not feeling much (went through a brief period of well being), my thought was to switch to injects and if that didn't improve depression, scale back to zero and start with antidepressants again.
I can tell you that so far I have noticed a difference on the injects. For this to be a "win" for me, I need to be a hair more "up" and not to have to tinker.
I am hoping that just a little more T and I'm done. I also don't "feel" like I have an estrogen problem and I'm only doing weekly shots. If I can end it there, I'm a happy guy.
Stick with it, exhaust all possibilities and you've got no "what ifs" if it didn't work. We're right here with you.
If it helped some, you may keep your T shots and slap some Androgel on your scrotum.
If not, there is DHT cream ask your doc for it.
My experience with T cream was weak, low TT low DHT increases.
I suspect Androgel's tendency to jack up DHT is because it uses lots of skin area. Genital/anal area are probably the best for raising DHT.
Bottom line, watch the four numbers I gave you, make whatewer you have to, to get it where they should be.
SHBG and Free testosterone have remained basically the same. The only thing that has changed since taking Cymbalta has been a dramatic increase in free test.
FreeT tests are bogus.
the Quest Testosterone test that I recomend have a FreeT in its results. It is calculated not assayed.
good luck getting off cymbalta. i honestly wish you the best when u feel like stopping it. even to see kinda what it's like, after ur on it for months, trying skipping a day or two and the feeling of gravitational distortion and brain zapping are the among the few things that EVERYONE trying to stop has gotten. I have tried tapering off ever so slowly (even using a scale) and the physical and mental pain, grief and agony is the worst experience you will ever have felt in your entire life. It did me wonders at first at a low dose of 30mg, then after your body keeps changing with it and the effects really kick in, you don't care about ANYTHING. You don't even care about waking up. Nothing will bother you and believe me, this drug is relatively new and EVERYONE trying to get off of it is experiencing what is like Effexor withdrawal, mutliplied by about 10000000.
Freedom means nothing here.
this is what to expect. i'm not exaggerating at ALL:
This is my second entry as my first did not show up. If the first entry shows up, please disregard this. I was on cymbalta for 4 months to treat depression. Within the first 2 weeks I was experiencing the common side effects. By the beginning of the 4th month I was experiencing the unlisted, rare side-effects...including extreme jaw pain, insomnia. I weaned off the cymbalta creating full fledged withdrawals. I was completely off the med, but was forced back into weaning. I'm currently on 10mg per day - home-made capsules since cymbalta's lowest dose is 20mg. I'm in my 3rd month of major withdrawals which have not eased up. Withdrawal symptoms include major brain zaps, flu-like symptoms, pin point pains throughout my body almost like fibromyalgia, withdrawal induced depression, night terrors -- though I already suffer from night terrors, the withdrawals have made them dangerous. Other withdrawal effects include audio hallucinations, and the feeling of the brain not connected to the body.
Freedom means nothing here.
Please for your own sake, find a doctor (a few doctors) that specialize in drug cessation/withdrawal and also search for a good inpatient rehab. I am honestly not one to look for things to point the blame at, although being as anti-drug as I was, I did not care what I used to remedy the zombie-like side effects and terrible quality of life that this med has caused. Yes this med. After getting my hands on methamphetamine as a last ditch effect to get my somnolent ass out of bed at a hotel before the staff kicked my out, I realize that even methamphetamine withdrawal was a walk in the park compared to this.
I wish to provide a response to those who have taken cymbalta for only a few weeks or month and report it to be "sunshine in a bottle". The true character of this drug comes only after months of use. Scores of people say the same thing: it was great at first, then something went wrong. I am in this group. They return to their doctor and the dose is increased. Shortly thereafter, a person begins to know there is a problem. We all know the music of our bodies and are acutely aware of what substance is causing a problem and the problems it is causing. For cymbalta it simply quits working and then causes the problems. Once you figure it out, and decide to quit its use, its too late. Instinctively, you know if you continue its use you will die; but you cannot simply stop its use. The withdrawal is pure HELL, and it does not seem to matter much if you slowly taper the dose.
Freedom means nothing here.
If you're saying it's WAY worse than effexor, I couldn't even begin to believe it. That's BAD.
Effexor was awful enough. Felt like I had a flu, I was dizzy, tingled everywhere, etc... I had to switch to another antidepressant as an "interim" drug to get off it.
I went effexor-prozac-off. The effexor to prozac wasn't bad, nor was prozac to off.
I think saying that these meds should never be used is a dangerous thing. Some people need them, but they are not meant for nearly as many people they are currently pushed on.
Serious depression can be a serious thing, as is bipolar disorder, schizophrenia and other mental disorders.
The down times for me occur when I feel physically lousy. AFTER i feel bad for two days, I feel emotionally bad.
When my body temp is above 98.0...I feel emotionally great, I think this is all based on low metabolic energy.
hey guys, glad to see you guys again in the forums. I'm sure that if any of you guys read my posts and whatnot, you'd notice that I have a lot of stupid moments and that this forum/website is probably the only documented record of the choices I've made as far as what I have ingested and whatnot. I don't think it's pathetic like some may, but this forum is maybe my only outlet to share exactly what the hell is going on.
I've had my share of issues as I'm sure everyone has, but I'll try to recap everything in a nutshell of what lead up to the decisions and mistakes I've made.
I grew up in a middle-upperclass family and never really had to worry about much as far as money or anything. I was pretty much a class-clown through elementary school and when middle school and high school came along I had severe integration anxiety and could not fit in. I pretty much got the **** kicked out of me on a tri-weekly basis and any day that went by without getting **** I thought of it as a blessing. Since the age of 16 I started lifting weights and then the summer when I came back as a junior I had put on some decent size and a little more height (gained about 30 lbs) and was no longer a target for torment. Senior year I was 6' and 180 lbs and I kept trying to get bigger. Eventually I passed the point of my goal and started getting severe self-image issues and having severe depression problems and then started having problems with diet pills and eating constantly 'low-carb'.
Anyhow... amongst the short version... much more has happened but after moving back to NJ from Los Angeles, I felt like a failure and was pretty much a vegetable from having a major-depressive episode and mononucleosis. I was willing to take anything to just get better. Alas, Cymbalta!
At first it was utterly fantastic! I couldn't get upset by ANYTHING! I used to brag that I couldn't become depressed. Then my energy levels started dropping and I began not caring about much of anything. After 3 months, I really didn't give a crap about anything at all.
I quit my job all of a sudden and was tired of putting up with my parents who are great people, but difficult to get along with as my dad is a cop with some anger issues to say the least.
I couldn't stop the lethargy and weight gain from the Cymbalta so I kept trying to counter it with loads of supplements, although at the time I didn't know what it was. Anyhow... the first time I missed a dose, I felt like I was in a hurricane and could barely stand. My doctor said there were no withdrawal symptoms. He lied. I became getting more emotionally numb and lethargic and finally after a series of crises, I started looking into cymbalta and went to a new psych. I tried weaning off of it...
Used a digital scale to drop from 30 to 25 mg. Day 4 I caught the flu and could not get up to take a piss. Worst pain and agony I've ever felt in my life. I swear that I am in such agony that all I want is to surrender all that's left of my possessions, check into a rehab/detox and upon discharge live my life helping others with similar problems. Sounds like b/s maybe, but I've never felt this way before.
Anyhow... all I can say for those who feel depressed and have other similar psychoses, take charge of your life and utilize a support group and a therapist. In my own personal opinion, it's better to go to narcotics anonymous before taking an anti-depressant. I know that some have had success and that some people can get off without much sides, but I can say for Cymbalta for SURE, that NO ONE who started has been able to stop without utterly, torturing side effects. I tried to overcome to discontinuation syndrome with will-power and whatnot, "come on Kyle, you can beat this... break out of it and survive! etc" But this compound will take the will-power right out of you.
Before taking Cymbalta, I had no problem turning down a drug. I despise drugs to be honest with you. I just didn't give a crap anymore and I've really made some piss-poor choices multiplied by 100.
Freedom means nothing here.
Thanks Force. That is exactly the impression I had of anti depressants but did not realize coming off of them can be so difficult.
I can not believe DRs are trying so hard to push these on me and others. They have no soul.
However, it is also a much easier answer for the doc. As you can see here, the hormones are challenging to diagnose/get right.
This requires more effort and more knowledge than most Dr.'s have. The sticky at the top of this forum on how to find a doctor is there for a reason: It's commonly needed. I am on my 3rd doc who I am now happy with. Really you need to become your own expert as well as find a knowledgeable doc to work with.
FOG, I would have suggested Welbutrin first over the other stronger SNRI's. I think it's also prescribed more for people with temporary depression. I think the other drugs are more for people with long term needs, but also Welbutrin is a great choice for one who wants low sides. In more cases than not, I think it even has a positive effect on libido and lower cases of somnolence.
Also, people taking supplements when taking anti-depressants really need to be careful. There can be a problem with having too much seratonin...taking things like 5-HTP or tryptophan alongside these drugs can be dangerous. A lot of supplements out there can have an effect on neurotransmitters and when coupled with these drugs, can cause serious interactions.
I agree with all of you guys with a lot of key points made here. I really think that some people do need medicine to correct certain chemical imbalances. Indeed.
Why is the system of correction merely 'trial and error'? Psychiatrists don't know what chemicals need to be corrected and don't even know much about the patient before being so apt to start writing that script.
If one doesn't work, let's up the dose... if that doesn't work, let's switch over to a different one... if that doesn't work we'll up the dose of that... if that doesn't work, maybe we'll try another class of meds... oh great, this works but it causes insomnia... let's have you try taking the dose before bed and here's a script for seroquil for your newly found insomnia... oh you don't wake up rested? let's get you off seroquil and onto ambien CR...
WHEN does it end?????????
Certain medicines are great. YES... we can all agree on that. There are some that have NOT been tested enough and are NOT safe that are out there that shouldn't be. My mother had a doctor prescribe Effexor for her fibromyalgia pain and depression and said it's fine to get off of it when she wants. She tapered off for over half a year and it was half a year of non-stop ER visits and idiot doctors telling her that the scans and tests show nothing, therefore it is nothing... but here's some pain meds in the meantime.
I can't even get into a rehab for discontinuation syndrome, because every doctor is in denial that there is such a thing. Everyone seems so quick to diagnose me over the phone and say, "it's clear that Cymbalta isn't helping with your depression and let's try switching you to another med." I have to make up some other story just to get insurance to cover me for rehab.
Freedom means nothing here.
In case anyone is interested in my story: I tried weening off effexor with great difficulty. I went down to the smallest dose possible and then finally came off it completely. I got all the same symptoms ppl complain about, brain zaps, feeling of distortion, etc etc..
I read some support forums and read someone posting about doing a 2-week herbal cleanse. I tried it and it seemed to really help. My withdrawl symptoms were all gone within 2 weeks. I think it definately sped up the process.
Gutterpump, can you enlighten me with what herbal cleanse you used and how you weened off the medicine concurrently with the cleanse? What exactly did you do? Thanks Gutterpump.
Freedom means nothing here.
I think I had quit the effexor a week prior to starting, and the symptoms ended shortly after the cleanse (I think) or maybe during the cleanse. I just stuck it out and stayed in my house when I was not at work and let it ride it's course. It's basically traces of the drug leaving the system (from what I've heard) and it's completely counter-productive to fall back into taking a tiny dose here n there to ease the issues.
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