Posted by Marc Boucher on March 24, 2007, at 14:59:04
In reply to Re: Who among you know a lot about neurotransmitters ?, posted by Phillipa on March 24, 2007, at 10:06:56
Ok, first off thanks guys for chiming in, I really appreciate.
Ok, it's going to be a long posting, because I've gathered data, test results and questions over more than a year now. I'll try to be as accurate as it is humanly possible.
Before we engage in this discussion, I want you to know that my main issue is very low sex drive, Or what I think is low sex drive--at this point in time, I'm wondering whether it is low sex drive or low arousal. You'll get to understand why below. But what you have to keep in mind all along is that libido is the reason I consulted with Dr. Eric Braverman a year ago, and still is the reason I'm here today.
I'm now 34 and will turn 35 in a few days. I'm 5'7'', 165 lbs. I do not have high blood pressure, no diabetes, or other such diseases. I've been with the same woman life companion for 11 years now. My low sex drive issue began roughly at age 26, so it's been going on for a good while now--needless to say that it's substantially decreased my quality of life. Before I met my girlfriend and in the first months after meeting her, my sex drive was still through the roof, but then i began to fear she'd cheat on me. This wrong and recurrent thought pattern came about i imagine because of insecurity (I've always been insecure),as my girlfriend is toned and good looking, so I figured bunch of guys would attempt hitting on her, and most importantly because my sex drive was so very high that I'd come to believing that hers was alike mine, and that's in part what triggered the insecurity in me. So in order to build up a sense of security, I started to talk to her about that constant fear I harbored. That was the thing to do instead of bottling up tight inside. However it became truly obsessive, up to a point where I cannot even attemp to number the amount of coversations I initiated on this topic ; it must be in the 100's of conversations. I'd often start such discussions at bedtime where no tv no nothing was acting as a cause for distraction. Mental exhaustion would often cause me to fall asleep before I could hit a point in the conversation where my security meter would go : ''ok, I'm satisfied, you can go to sleep''. At this point I still had a sex drive but it was beginning to wane. This thing about insecurity lasted for a year, and then I was compelled to find new work. I did find new work, and that in a very short timeframe, but I hated the place with a passion, so much so that after being there for 2 weeks only ; worrying about my relationship issue while at work, and fretting over work related issue while being at home, I collapsed. My sex drive went from 10 to 0 in a few days, my energy was shot, whereas I would be quite strong prior to that event. My short term memory was no more, and I would feel sleepy and drowsy after the noon meal. I would also pass a lot of urine, but wasn't any thirstier than usual though. At some point i thought I'd contracted diabetes, because I was having lots of simple carbs back then. But my test results would all come in fine. Eventually I had to quit that job, and I was happy thinking that after appropriate rest the sex drive would make a strong come back, but mistaken I was.
I recall telling my girlfriend months after I quit that job that it felt as though my nervous system was stuck in the fight of flight--I'd have walks in the woods that fall, figuring it would ease the tensions, but it's actually made it worse, because I'd focus intently at all the sounds one would normally expect to hear in the forest, especially during the fall season. Eventually those walks were not helping at all. I was tense the whole time. so months weeks, month and years went by and I still didn't experience any return of the strong sex drive I'd have. I went to make alternative healers but none could help. I also have to mention that the energy normalized after 4 years mark, after I had this liver tonic : http://www.vitacost.com/FloraFloradixGallexierHerbalBitters
So this is what brought the energy back up and that in a very short time.
Short term memory and libido have improved ever so slightly in the last year--memory has improved more than libido I must say.
Now that you know more about how it all came about, I'll go down to the nitty gritty of what I call my sex drie issue.
For a time, I was able to exchange emails with a retired researcher in endocrinology friend of mine (now he's too busy to do so), and after much exchange he told me that what I had wasn't a real low sex drive, as one who truly has a low sex drive doesn't focus so intently on getting the his sex drive back--my obsession over sex drive for the last years, caused him to think that my sex drive wasn't so low to beging with. I've pondered over this for some time now. It's true that my motivation to recover my sex drive is up there !
**So my first question is : can one have a true low sex drive, yet want it back so much at the same time ?
Now, last year I called Dr. Eric Braverman's clinic down in Manhattan, and made an appointment with him. I went there, spent $3500 and got a lot of tests--although some of the tess he uses are the kind that have not yet made it in the medical community. So are they accurate or not ? Beats me ! So he diagnosed me with Dysthymia and ADHD--he said that the ADHD wasn't a true case and was from the Dysthymia driven anxiety. Although as a kid teachers would call home to let my parents know that I was having a hard time paying attention, was falling behind in my homework assignement. I had a hard time sitting still, and still do to this day. Dr. may or may not be right, as i know there can be many causes for ADHD.
What I didn't appreciate is that Dr. Braverman has prescribed 20 mg Paxil first thing in the morning, and 0.5 mg Klonopin at bedtime. Klonopin, well that I could understand as it can help with libido in some, but Paxil !?! I've yet to hear from someone who's sex drive improved on Paxil. He also prescribed natural supps, namely :
Brain calm (2 caps at breakfast and bedtime) : http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,1.html
Brain energy (2 caps at breakfast) : http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,2.html
Brain mood (1 caps. at dinner) : http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,4.html
Brain memory ( 1 caps at breakfast and dinner) : http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,3.html
**CES : 1 hour before bed. http://www.cesultra.com/
**Magnesium 470 mg at breakfast and dinner
**Zinc 20 mg at breakfast and dinner
**Cernilton`2 caps at lunch. http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,10.html
**prostate formula (I think he prescribed that to me because I have vertex MPB, and he said that most of his prostate cancer patients are bald). http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,30.html
**Tryptophan 1000 at bedtime.
**Citrinate/citrin & chromium : 1 caps with each meal. http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,12.html
**Vitamin E 400 i.u-- 1 gel caps at breakfast and dinner. http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,16.html
**CLA : 1 caps at breakfast and dinner--to help lose fat. http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,46.html
**fish oil : 1 gel caps at breakfast and dinner http://www.totalhealthnutrients.com/ph/catalog-product-detail;catalogproducts,34.html
**He also prescribed 50 mg DHEA in the morning, but I refused to take it because my DHEA-S is fine. I don't see what benefit it would be to supplement any hormone which is not low to beging with.
Now, I haven't followed his protocol at all. Why ? Because I don't feel the diagnosis was accurate enough. Dysthymia is a rather vague diagnosis, as it can involve brain neurotransmitters and hormones. Most psychiatric diagnosis tend to exclude the etiology of disease. An analogy is that middle-aged man often have Dysthymic disorder, and this can be traced to decreased Testosterone. I know for a fact that major depression has been linked to disruption of the HPTA (CRH, receptors etc...)
I've been a bundle of nerves all of my life, yet my sex drive was through the roof, until 8 + years ago, as I outlined above.
I've consulted many more M.D.'s since after I met with Dr. Braverman, including an endocrinologist last summer. I also had a heck of a lot of blood tests performed. Even last week a new lady doctor sent me to have the whole array of tests other doctors had prescribed to see where things are standing now.
One of the M.D.'s I've seen told me that my 24-Hour urinary Cortisol was low, and that was why my sex drive was low--while it is true, my very recent blood cortisol (from last week) are not low, here they are :
Consider that I'm Canada, and units might not the the same as in the U.S., however I provide the ref.range.
Cortisol (8 hours) 623 (160-700) nmol/L
Cortisol (16 hours) 330 (50-500) nmol/LIt looks fine, as it reflect the morning peaks of Cortisol which is higher than that of late afternoon.
=================================================
All of last week hormone test results are not in yet, but yesterday my primary care provider called me to let me know that those which have come in so far are fine--she said that my Estradiol was right where it should be, my Bioavailable testosterone has even gone up by 3 points, and my total Testosterone has gone up slightly too. My homocysteine was fine as well as fasting blood sugar. I however haven't yet seen those results, but will have someone make a printout of those on Monday, so I can review them myself, just to make sure I'm not given the : you're-in-the-range-so-you're-normal kind of diagnostic.
=================================================
**Sexually speaking I serotonin seems to have a role to play in delaying ejaculation through keeping Norepinephrine under control to some extent, given that it's a burst of Norepi. that triggers ejaculation.GABA seems to be more relevant in sex drive than is Serotonin, through lowering anxiety. I'm so used to be anxious that it's come to a point where I don't even know whether I am or not. I know that GABA is supposed to moderate the firing of excitatory neurotransmitter neurons--balancing them out.
Dopamine : this is the one which is most often tied to sex drive--testosterone does increase brain dopamine--i think the relevance of dopamine in sex drive is in the Mesolimbic area. I also know that when dopamine is high Prolactin is low, and vice versa. Prolactin inhibits the release of Gonadotropins, thus contributing to lower T levels. At Pathmedical, I had BEAM (Brain Electrical Activity Mapping) done, and it showed that I had a slight decrease in Dopamine, but I was then told by a psychiatrist that it is not possible to measure neurotransmitters levels through a BEAM.
Now there's also Ach (Acetylcholine) which is the one neurotransmitter I've wondered about ; that is whether I'm deficient in this one instead of dopamine. That is because at times mentally speaking I feel like having sex, but you know this systemic sense of arousal that one usuallly get when exited, well, I don't get it anymore, or at least I hardly ever feel that. So when referring to low sex drive, that is what I mean ; this overall sense of arousal.
**I've found a few foods to help with the low sex drive : eggs, and plain low-fat yogurt. Now those are choline rich.
**Dietary supplement wise, I've found : fish oil to consistently help rev up sex drive. Valerian has helped too, as well as grape seed extract, and theanine.
What I want is to find out what is the root cause of my issue--that is however wishful thinking to a large extent, but I'd like to get as close as possible to the etiology.
**While I don't drink coffee, I recall that one evening I'd french vanilla coffees and it made me quite horny--that was 2 years ago, and haven't tried it out since then.
**Another clue against low sex drive, and that all M.D.'s I've talked to about it have had a tough time making sense of, is that although I complain of low libido, I've kept masturbating daily at the rate of 1-2/day. I've thought that to me it was either a way of easing my mind, OR as a way of proving myself I'm still potent, although we all know that I'm not my old self. I usually do not have any problem getting an erection WHEN I feel like having sex--otherwise it will take a long time to get it up.
**I do not have blockages down there, because at Pathmedical I was performed a penile Doppler, and all is fine as far as blood flow down there.
**My last Total Testosterone from last summer was : 406 ng/dl which is borderline low. The blood test results from pathmedical showed an even lower T, but God was I stressed out while being on location--it was in a totally new environment, had to catch a plane, and believe it or not I'd never boarded a plane before, and then an hour later find myself at Laguardia airport......I felt like home alone in New York :-), although the plane experience was fun, it was still a psychological stress. Androgens are not to vary quite a bit during the day--they're not as Hemoglobin which is very steady as opposed to androgens. So all in all, I was very much stressed while at Pathmedical, and my total testosterone provided evidence of it--I scored very low at 184 ng/dl, but of course two weeks later it was back up at : 406 ng/dl. I was back from NYC and my stress levels had lessened to a more usual one, so as a result my T went back up, although not up to what I should be at for my age group. I should at least be 650 ng/dl at age 35, though in the 800's would be more like it.
My last Prolactin from last July came in at :
**Prolactin H 16.6 (4.0-15.2)
Some think it is too high, while most say that it's now so high as to cause low libido.
**E2 was at 25 pg/ml, which is supposed to be fine. But then it was a 17-B estradiol test, and not a sensitive E2 test. So some have argued it could still be too high.
**TSH came in at : 1.54
My thyroid anti-thyroperoxidase came in at : 12 out of a range of : negative <45
suspicious : 45-65 K/U/L
Positive > 65 kU/L
So obviously, I'm doing fine here.
**My FT4 came in at : 20.3 ( 12.0-22.0) pmol/L
**I had asked my primary care provider to also perform FT3 but the lab where those tests are sent I was told don't perform the FT3 when the FT4 is fine.
=================================================I may have forgotten to mention important details, but will add them up should any occured to me after I hit the post button.
I'd like to have your opinion on what neurotransmitters are at the root of my sex drive issue, or at least what I call a sex drive issue.
Of course there are way more than just those common four neurotransmitters we're talking about here. Opioids, neuropeptides, CRH, glutamate etc...making the whole picture pretty darn hard to figure out.
Thank you very much all,
Marc
poster:Marc Boucher
thread:743613
URL: http://www.dr-bob.org/babble/20070320/msgs/743729.html