# Testosterone replacement therapy



## crayzyMed (Nov 2, 2006)

> Testosterone May Boost Efficacy Of Antidepressants in Men
> Joan Arehart-Treichel
> Testosterone gel may produce antidepressant effects in men who are not responding to conventional medication.
> 
> ...





> Testosterone Gel Supplementation for Men With Refractory Depression: A Randomized, Placebo-Controlled Trial
> 
> Harrison G. Pope, Jr., M.D., Geoffrey H. Cohane, B.A., Gen Kanayama, M.D., Ph.D., Arthur J. Siegel, M.D., and James I. Hudson, M.D., Sc.D.
> 
> ...





> "Testosterone replacement therapy for hypogonadal men with SSRI-refractory depression
> Journal of Affective Disorders, Volume 48, Issue 2, Pages 157-161
> S.Seidma
> Abstract
> ...





> "Antidepressant-Induced Sexual Dysfunction Associated with Low Serum Free Testosterone
> 
> Presented by Alan J. Cohen, M.D.,
> Private Practice and Assistant Clinic Professor of Psychiatry, UCSF
> ...


Anyone have experience with TRD? Looks interesting.


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## VanDamMan (Nov 2, 2009)

I've thought about it. Hear a lot of good results. Supposedly you don't need this though until at least 30 when T-levels start dropping.


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## crayzyMed (Nov 2, 2006)

VanDamMan said:


> I've thought about it. Hear a lot of good results. Supposedly you don't need this though until at least 30 when T-levels start dropping.


For healthy people thats right, but people with social anxiety, depression etc could benefit from it on a much younger age.


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## euphoria (Jan 21, 2009)

Wouldn't dopamine raise testosterone? Being such an alpha-male neurotransmitter, heh.


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## kirribilli (Mar 9, 2010)

Good luck finding an endo who will put you on TRT if you'r labs aren't really really low, like under 300 T total, minumum -- no matter what your age.


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## karoloydi (Feb 18, 2010)

euphoria said:


> Wouldn't dopamine raise testosterone? Being such an alpha-male neurotransmitter, heh.


A raise in dopamine will result in a reduction of prolactin. A reduction in prolactin will result in an increase in testosterone.


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## podizzle (Nov 11, 2003)

im going to try 25mg of clomid to see if the increase in test helps SA. I'll log it when it gets here.


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## fredbloggs02 (Dec 14, 2009)

~Reminds me of that guy in Grand Theft Auto Brucie, who took Bull Shark testosterone. He also owned the "Brucies Alpha mail" postage company.


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## BearFan (Mar 22, 2008)

I have tried HRT, it was helpful, but I am chosing to discontiune due to potential long term effects, and there are many other things (such as exercise, supplements) than can stimulate testosterone naturally.


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## KurtG85 (Sep 19, 2008)

I noticed when I started taking propecia (which increases free testosterone levels), I became intensely more anxious, over emotional, impulsive, aggressive and had significantly less verbal fluency (basically exactly how I feel unmedicated; off of adderall). 

All of these things are pretty much exactly what triggers my social anxiety panic attacks. 

Oddly, I noticed that the natural talents I lose (or are lessened) when I take adderall, like my innate sense of rhythm, athletic ability and sex drive, all suddenly returned in force for the few days I was on propecia. It seems I have quite the paradoxical relationship with testosterone. I believe its reduction (by adderall) is actually a contributor to adderall's beneficial effects for me. Just sayin.


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## karoloydi (Feb 18, 2010)

KurtG85 said:


> I noticed when I started taking propecia (which increases free testosterone levels), I became intensely more anxious, over emotional, impulsive, aggressive and had significantly less verbal fluency (basically exactly how I feel unmedicated; off of adderall).
> 
> All of these things are pretty much exactly what triggers my social anxiety panic attacks.
> 
> Oddly, I noticed that the natural talents I lose (or are lessened) when I take adderall, like my innate sense of rhythm, athletic ability and sex drive, all suddenly returned in force for the few days I was on propecia. It seems I have quite the paradoxical relationship with testosterone. I believe its reduction (by adderall) is actually a contributor to adderall's beneficial effects for me. Just sayin.


Testosterone affects cortisol. The following study shows that low cortisol + high testosterone = aggression. Theres also one other thread that I made with lots of research that shows clear relationship between low cortisol and social anxiety. I strongly believe that everyone in this forum should have their cortisol levels checked, especially the ones with low blood pressure.

Read this:
http://www.journals.elsevierhealth.com/periodicals/bps/article/PIIS0006322306007980/abstract



> These results indicate a moderating effect of cortisol on the relationship between testosterone and overt aggression in delinquent male adolescents. Implications and directions for future research are discussed.


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## garch2010 (Aug 3, 2010)

Reasons why testosterone replacement can increase anxiety and impulsiveness:


Testosterone (or one of its metabolites) can decrease the sensitivity of the adrenal glands, meaning that for a given amount of ACTH (a hormone excreted by the pituitary gland in the brain) less adrenal hormones are produced, including cortisol. If the person's basal stress state can be characterised as one with elevated stress hormones (Norepinephrine, Epinephrine) with a blunted cortisol response, then testosterone supplementation can interfere with the body's stress negative feedback mechanism and result in increased stress hormones, especially the inhibition of stress hormone release via the sympathetic nervous system. Cortisol is produced by the adrenal glands (as well as other stress hormones) in response to ACTH. The increase in cortisol is fed back to the brain where it reduces the stress response by reducing the production of ACTH and via the nerve sympathetic nervous system to the adrenal glands. 
Testosterone replacement can blunt the cortisol response to ACTH. Without sufficient cortisol the ability of serotonin to inhibit glutamatergic activity in the lateral amygdala is greatly reduced. The amygdale is an area of the brain that is implicated in "flight or fight" stress response, in other words anxiety and panic attacks. 
Some of the metabolites of testosterone (namely estradiol and estrone) can increase the binding of cortisol via cortosol-binding globulin, making it unavailable for use as free-cortisol. Again, this can interfere with the negative feedback mechanisms required to suppress the stress response.
Some of the metabolites of testosterone (namely estradiol via aromatisation of testosterone) can inhibit the deiodinase enzyme pathway in the central nervous system and peripheral organ (the liver), reducing the availability of T3 via the inhibition of the conversion of thyroid hormone T4 to T3. The reduction of active T3 can result in the down-regulation of the serotonin 5HT receptors in the brain, increasing the sensitivity of the body's stress system.
One of the metabolites of testosterone (namely estradiol via aromatisation of testosterone) can increase glutamatergic activity in the brain. Too much activity and we perceive that as stress, anxiety and panic.
One of the metabolites of testosterone (namely estradiol via aromatisation of testosterone) modulates the serotonin 5HT system in a complex way. Initially it seems to up-regulate the 5HT system (good for lowering stress and anxiety), then a little later seems to down-regulate the 5HT system (bad for anxiety).
 
Men with more body fat are more likely to aromatise more testosterone to estrogen metabolites and experience the problems above. The aromatise enzyme is contained within fat cells.

Men with existing HPA abnormalities - blunted cortisol response to ACTH challenge, flat diurnal salivary cortisol profile, sub-clinical Addison's disease, adrenal insufficiency, chronic fatigue syndrome or any sub-clinical hypocortisolism condition are more likely to respond to testosterone supplementation negatively.

Men with existing thyroid abnormalities - either clinical or sub-clinical hypothyroid or hyperthyroid are more likely to respond to testosterone supplementation negatively.

To address these issued a full workup is required in the following order:


Adrenal profile evaluation
Thyroid profile evaluation
Androgen profile evaluation
Growth hormone profile evaluation
Neurochemical profile evaluation
 
Each of these needs to be evaluated in the above order and treated in this order.


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## Kari011 (Aug 2, 2010)

Testosterone injections work slowly, If you want to try you may have to give yourself a year before giving up.


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## LALoner (Dec 3, 2008)

Back when they were legal I tried hormonal precursors to help with my weightlifting. They are basically baby steroids. Anyway, it did pick up my mood a little and no, I didn't become angry or hostile. But I did swear more, my friends even asked me about it. But I wasn't angry, I was just swearing more than normal for some reason.


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## garch2010 (Aug 3, 2010)

It is a very interesting area of research, androgens and aggression disorders. Testosterone seems to act on the amygdala in a very specific way. It seems to attenuate the subconscious procedural-memory fear response associated with learned fear (avoidance behaviour), but does not seem to modify either the conscious fear response, nor positive affective behaviours stored within subconscious procedural-memory. In short it testosterone seems to "cap" the subconscious fear response, but not the pleasure response - at least in cases where the HPA is operating optimally.

- Garch


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## Bigbird (Feb 25, 2010)

karoloydi said:


> A raise in dopamine will result in a reduction of prolactin. A reduction in prolactin will result in an increase in testosterone.


Is this true that the reduction in prolactin is what helps increase testosterone levels?


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## garch2010 (Aug 3, 2010)

Prolactin inhibits LH and FSH release from the pituitary gland, so reducing prolactin should increase the release of LH and FSH and so testosterone production should increase from the gonads. If not, then it may be the case that you have high levels of cortisol which inhibits testosterone production by directly acting on the cells in the testes. 

- Garch


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