What lab tests would you run if you had chronic anxiety for no apparent reason? I have already tested the basics, need more suggestions!
Been there, done that, not interested in xanax.Why don't you make an appointment to see your Doctor instead of trying to self-diagnose and treat yourself via an internet message board.
I would start with thyroid and adrenals, including saliva cortisol and urine catecholamines.Been there, done that, not interested in xanax.
Starting with above premise;Been there, done that, not interested in xanax.
12/07 Saliva Cortisol 8am: 7 ng/ml [13-24] LOWI would start with thyroid and adrenals, including saliva cortisol and urine catecholamines.
Serum Testosterone-Total 594 ng/dL [280-1100] WAS LOW BEFORE CLOMIDQuest:
Estradiol, Free, LC/MS/MS (36169X)
Testosterone, Free, Bio/Total (LC/MS/MS)
Genova:
Comprehensive Thyroid Assessment
Metabolic Analysis Profile
Genova:12/07 Saliva Cortisol 8am: 7 ng/ml [13-24] LOW
12/07 Saliva Cortisol 12pm: 5 ng/ml [5-10] LOW-NORMAL
12/07 Saliva Cortisol 4pm: 3 ng/ml [3-8] LOW-NORMAL
12/07 Saliva Cortisol 12am: 8 ng/ml [1-4] HIGH
2/07 Saliva Cortisol AM: 5.2 ng/ml [3.7-9.5]
2/07 Saliva Cortisol PM: 0.3 ng/ml [0.4-1.0] LOW
Urine Epinephrine 6.3 ug/gCr [day:8-12, night:1-3]
Urine Norepinephrine 31.4 ug/gCr [day:35-50, night:20-30]
Urine Dopamine 124.9 ug/gCr [day:110-175, night:80-120]
Urine Serotonin 75.1 ug/gCr [day:150-200, night:100-175] LOW
Urine GABA 1.6 umol/gCr [day:1.5-4.0, night:1-3] LOW
Urine Glutamine 400.8 umol/gCr [day:150-400, night:100-350]
Urine Glutamate 26.9 umol/gCr [day:10-35, night:8-20]
Urine PEA 236.6 nmol/gCr [day:175-450, night:125-300]
Urine Histamine 19.6 ug/gCr [day:10-20, night:5-15] HIGH-NORMAL
Serum DHEA-S 361 ug/dL [35-430] WAS LOW BEFORE SUPP
Serum TSH 1.740 uIU/mL [0.3-5.6]
Serum Free T3 3.4 pg/mL [2.0-4.2]
Serum Free T4 1.12 ng/dL [0.87-1.56]
Serum Reverse T3 351 pg/mL [90-350]
Serum Thyroglobulin AB <80 IU/mL [normal]
Serum Thyroid Peroxidase AB <20 IU/mL [normal]
Serum ACTH test [normal]
Serum Testosterone-Total 594 ng/dL [280-1100] WAS LOW BEFORE CLOMID
Serum Testosterone-Free 18.59 ng/dL [5-21] WAS LOW BEFORE CLOMID
Estradiol 28.5 pg/mL [0-56]
Thanks guys. As you can see, I have done much of this. I really do not want an SSRI, IMO its only masking the problem, and adds a bunch of new sides. I want to know the reason why I feel the way I do. My doctors are out of ideas for tests. My endo is useless, checked TSH, ACTH, said they're normal and I should just take xanax. My ND tells me to take tryptophan/5-HTP for low serotonin which I agree, helps some w/ sleep but not anxiety yet. Cortisol runs low, I don't see how that could cause anxiety, unless it's spiking up.
I will look into the metabolic analysis. What about some kind of amino/vitamin/mineral deficiency (NutrEval)? What about aldosterone causing some kind of elecrolyte imbalance? What about homocysteine to check methylation issues? Anything else, I am trying to cover all bases.
Gotcha. Now I need to convince my doctor to order the test. Any idea about non-insured cost?Genova:
Metabolic Analysis Profile
You will get a list of supplements to take,
name, daily dose, additional advice.
No need to involve your doctor in making basic guesses.
Unless your doc is top notch researcher,
results of the test will give you better advice that given by your doctor.
No offense intended here, but have you considered long-term psychotherapy. Regardless of the cause, you need to get in touch with your triggers.12/07 Saliva Cortisol 8am: 7 ng/ml [13-24] LOW
12/07 Saliva Cortisol 12pm: 5 ng/ml [5-10] LOW-NORMAL
12/07 Saliva Cortisol 4pm: 3 ng/ml [3-8] LOW-NORMAL
12/07 Saliva Cortisol 12am: 8 ng/ml [1-4] HIGH
2/07 Saliva Cortisol AM: 5.2 ng/ml [3.7-9.5]
2/07 Saliva Cortisol PM: 0.3 ng/ml [0.4-1.0] LOW
Urine Epinephrine 6.3 ug/gCr [day:8-12, night:1-3]
Urine Norepinephrine 31.4 ug/gCr [day:35-50, night:20-30]
Urine Dopamine 124.9 ug/gCr [day:110-175, night:80-120]
Urine Serotonin 75.1 ug/gCr [day:150-200, night:100-175] LOW
Urine GABA 1.6 umol/gCr [day:1.5-4.0, night:1-3] LOW
Urine Glutamine 400.8 umol/gCr [day:150-400, night:100-350]
Urine Glutamate 26.9 umol/gCr [day:10-35, night:8-20]
Urine PEA 236.6 nmol/gCr [day:175-450, night:125-300]
Urine Histamine 19.6 ug/gCr [day:10-20, night:5-15] HIGH-NORMAL
Serum DHEA-S 361 ug/dL [35-430] WAS LOW BEFORE SUPP
Serum TSH 1.740 uIU/mL [0.3-5.6]
Serum Free T3 3.4 pg/mL [2.0-4.2]
Serum Free T4 1.12 ng/dL [0.87-1.56]
Serum Reverse T3 351 pg/mL [90-350]
Serum Thyroglobulin AB <80 IU/mL [normal]
Serum Thyroid Peroxidase AB <20 IU/mL [normal]
Serum ACTH test [normal]
Serum Testosterone-Total 594 ng/dL [280-1100] WAS LOW BEFORE CLOMID
Serum Testosterone-Free 18.59 ng/dL [5-21] WAS LOW BEFORE CLOMID
Estradiol 28.5 pg/mL [0-56]
Thanks guys. As you can see, I have done much of this. I really do not want an SSRI, IMO its only masking the problem, and adds a bunch of new sides. I want to know the reason why I feel the way I do. My doctors are out of ideas for tests. My endo is useless, checked TSH, ACTH, said they're normal and I should just take xanax. My ND tells me to take tryptophan/5-HTP for low serotonin which I agree, helps some w/ sleep but not anxiety yet. Cortisol runs low, I don't see how that could cause anxiety, unless it's spiking up.
I will look into the metabolic analysis. What about some kind of amino/vitamin/mineral deficiency (NutrEval)? What about aldosterone causing some kind of elecrolyte imbalance? What about homocysteine to check methylation issues? Anything else, I am trying to cover all bases.
No offense taken. But SSRI's will be a very last resort for me. IMO there is a physiological reason for anxiety/insomnia, not all in the head. I think I'd rather live with the symptoms than add sexual sides etc. from a SSRI. That would bring on depressionNo offense intended here, but have you considered long-term psychotherapy. Regardless of the cause, you need to get in touch with your triggers.
While I understand your feeling that SSRIs are bandaids, it may be your only resort. While it's possible that hormonal rebalancing will quell some of your anxiety, I would remain open minded. I think you may be well served by trying hCG rather than clomid, which may serve to increase dopamine. I haven't heard many good things about clomid monotherapy. That said, your free-T is pretty good.
I don't have that much confidence in L-tryp and 5HTP. They may help you sleep, but they are usually not that affective for managing day-time anxiety.
Good luck and hang in there.
Metabolic Analysis Profile was my first Genova test.Gotcha. Now I need to convince my doctor to order the test. Any idea about non-insured cost?
I might do "The ONE" for $472... that's not bad for all you get.The ONE - Optimal Nutrition Evaluation - (Cost $472.01) bill dec/10/2007 consists of:
Metabolic Analysis
Amino Acid Analysis
Oxidative Stress Analysis
I smell that you may spring for few extra $$ and get the real McCoy.I might do "The ONE" for $472... that's not bad for all you get.
Thanks bioman, will do.In the meantime, try a little lemon balm and/or oat seed extract with your tryptophan doses. These have a nice, mild anti-anxiety effect with no other negative side effects (at least for me and most people). Lemon balm also re-establishes and enhances your sleep cycle.
Other super-simple things to add in just to ensure your body is getting what it needs to produce enough serotonin..folic acid upwards of 1-3 mgs per day, chromium 50 mg, and selenium. These all act as co-factors in nuerotranmitter function and production and from my experience, they can help a lot if you are low on them. All fairly cheap to boot.
No offense taken. But SSRI's will be a very last resort for me. IMO there is a physiological reason for anxiety/insomnia, not all in the head. I think I'd rather live with the symptoms than add sexual sides etc. from a SSRI. That would bring on depression
All that being said, I do occasionally take 25mg trazodone when I really need some help sleeping... works great with no sides except stuffy nose... it is not an SSRI... libido actually increases on it.
As far as clomid, it has brought my total T from 260 to 600, and free T from 6 to 18 in 2 weeks. I am not opposed to HCG in the future, but why take something suppressive before at least trying a SERM like clomid which may jump-start the HPTA.
I'm not discounting therapy... I'm sure it has helped a lot of people. In my case, I am not worried about anything, I just feel like I've had a few cups of espresso all the time. Wired and tired... like they say for adrenal fatigue, accelerator and brake on at the same time. Like the body is saying "hey something is wrong, find it". If I exhaust all physical tests, then only the mind is left.Plenty of anxiety IS of psychological/emotional origin. I used to have episodes of anxiety that would last for weeks, where I worried constantly, had difficulty eating and sleeping and felt like I was ready to jump out of my skin. I managed to keep myself distracted from it by being manically active and overworking, but eventually, coping in that way was beginning to really wear me out.
Higher T can act as a buffer for stress. It promotes dopamine production, the happiness neurohormone. hCG is anecdotally said to give a sense of wellbeing, for many. I think I would give hCG a chance. Unless you have an issue with injections (it's just an insulin pin), I dont see the big deal if you are going to take medicine (Clomid) in any event. And I think hCG has a cleaner side effect profile.No offense taken. But SSRI's will be a very last resort for me. IMO there is a physiological reason for anxiety/insomnia, not all in the head. I think I'd rather live with the symptoms than add sexual sides etc. from a SSRI. That would bring on depression
All that being said, I do occasionally take 25mg trazodone when I really need some help sleeping... works great with no sides except stuffy nose... it is not an SSRI... libido actually increases on it.
As far as clomid, it has brought my total T from 260 to 600, and free T from 6 to 18 in 2 weeks. I am not opposed to HCG in the future, but why take something suppressive before at least trying a SERM like clomid which may jump-start the HPTA.
You've done most of the tests, what are you taking? You def. need cortisol and possibly florinef as well. That and get the thyroid up and cranking. those two are huge as well as test.
until those 3 are straigthened out for at least 3 months, id hold off on anything else unless you just need a bandaid to get by.
Isocort is **** for your values. Its far too short acting, and kind of worthless for many of us 'far along'. Im guessing that is your crux of the problem. If the thyroid just pools in the blood, you'll still feel depressed (not in cells) but also feel hyper and thus anxious as well. Get on better cortisol support if you can.I'm taking isocort for cortisol. I thought my thyroid looked ok...
Two docs I've seen said no.Isn't the high rT3 a problem? I'm still learning but I thought I read that somewhere.
Yeah no crap...I suffer from anxiety/restless nerves and they wanted to put me on that as well. Not saying that's a stupid idea by any means but I am not interested either...too many mood fluctuations xanax can cause and I don't really care to become chemically addicted to a drug either...went with Atarax instead...Been there, done that, not interested in xanax.
SSRIs made my anxiety WORSE...I know everyone is different but one of the possible side effects of SSRIs is increased anxiety...and I found myself jumping over anything and everything...but other than that made me not give too shyts about anything...I wasn't happy, nor sad...just neutral about life. Some people actually dose an SSRI every other day to every other 3 days so not have the full sexual suppression but still had some benefits from the drug...some even do this to be able to last longer :thumbsup: hahaNo offense taken. But SSRI's will be a very last resort for me. IMO there is a physiological reason for anxiety/insomnia, not all in the head. I think I'd rather live with the symptoms than add sexual sides etc. from a SSRI. That would bring on depression
SSRIs made my anxiety WORSE...I know everyone is different but one of the possible side effects of SSRIs is increased anxiety...and I found myself jumping over anything and everything...but other than that made me not give too shyts about anything...I wasn't happy, nor sad...just neutral about life. Some people actually dose an SSRI every other day to every other 3 days so not have the full sexual suppression but still had some benefits from the drug...some even do this to be able to last longer :thumbsup: haha
And NO, I'll never take an SSRI again...
...I probably should have stated that I took it for depression but made my anxiety worse...Exactly, SSRI's are for depression, not anxiety. I have been taking my 25mg trazodone at night, and the anti-anxiety effect seems to last into the next day. It is a good script with few sides. This works for me until I get my metabolic testing done.
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