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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by LostboyinNC34 on November 22, 2003, at 16:32:50
After six years of battling severe depression with minimal success, I finally had my first breakthrough recently. I have been formally diagnosed thru blood labwork as having hypogonadism (low testosterone). Ive recently been placed on testosterone therapy, 5 mg Androgel. Andro gel is an extremely easy to use drug and since Ive been on it, Ive been able to ditch my antidepressant zoloft.
I have been totally amazed at this, and quite frankly it took me by surprise. I recently had an ECT consult during which I was basically persuaded to not get ECT because I was not in a "psychiatric crisis" and my depression had become so chronic. I was told by the ECT doc that if I was looking for six months to a year of good health from a session of ECT, that he didnt think Id get it. He told me it was basically up in the air how long the ECT would last, basically he talked me out of it.
But he suggested I have a sleep study, which showed I was getting ZERO "deep stage sleep" ie; no stage four sleep whatsoever. NONE. Stage four sleep is the critical stage of sleep when your body rebuilds and a lot of hormones like testosterone and human growth hormone are released (if youre healthy that is). I didnt have any sleep apnea though.
Anyway, this guy suggested I try "androgens" in his words and my family doctor sent me for the blood tests recently...the second testosterone check in less than a year. Last time I was checked my T levels came back in the low normal range...technically OK but low normal. This time I FLUNKED bigtime. My total serum testostone levels were lower than a 60 year old man's T levels should be! And Im only 34 years old. I flunked total serum testostone and free serum testosterone (free serum T is a more accurate assessment of whether you have low T levels or not).
Anyway...Im just on Androgel and no antidepressants and feeling better than any antidepressant ever made me feel with the one exception of the MAOI parnate. Side effects are about nil. I have to have regular blood work done to monitor PSA, red blood cell count, liver function.
Anyway...I just wanted to get the message out to all the TRD men out there. If youve tried all these stupid monoamine drugs that dont work good, you are 30 or over, get your testosterone levels checked out. You might be surprised.
Testosterone is a GOOD antidepressant!
Eric
Posted by Larry Hoover on November 23, 2003, at 7:06:19
In reply to I have been diagnosed with testosterone deficiency, posted by LostboyinNC34 on November 22, 2003, at 16:32:50
> Anyway...I just wanted to get the message out to all the TRD men out there. If youve tried all these stupid monoamine drugs that dont work good, you are 30 or over, get your testosterone levels checked out. You might be surprised.
I did. I am low-T. There are two problems presented, however.
The first is in assessing the actual cause. Testosterone does not act alone. It is in a complex interplay with both its own precursors and metabolites, but also in feedback regulation with at least four other glands, and all *their* hormones. You didn't get low-T in your thirties via a random occurence, an act of God.
The second one is that androgen replacement therapy is by no means a standard treatment, in that there are no established guidelines for when to apply it, and what exactly to apply as treatment. For example, my own test was off-the-scale low by some standards, but low-normal by the one my own doctor wished to apply. Because of this, he would not order further tests (pituitary testing is indicated, but I'm not getting it). An anology to hypothyroid sufferers is probably fair; despite obvious symptoms consistent with the diagnosis, many hypothyroid subjects are denied treatment, or given inadequate treatment, due to the interpretation of hormone levels as falling within the "normal" range.
> Testosterone is a GOOD antidepressant!
>
> EricI sure hope so.
Lar
Posted by LostBoyinNC34 on November 23, 2003, at 8:58:31
In reply to Re: I have been diagnosed with testosterone deficiency » LostboyinNC34, posted by Larry Hoover on November 23, 2003, at 7:06:19
> > Anyway...I just wanted to get the message out to all the TRD men out there. If youve tried all these stupid monoamine drugs that dont work good, you are 30 or over, get your testosterone levels checked out. You might be surprised.
>
> I did. I am low-T. There are two problems presented, however.
>
> The first is in assessing the actual cause. Testosterone does not act alone. It is in a complex interplay with both its own precursors and metabolites, but also in feedback regulation with at least four other glands, and all *their* hormones. You didn't get low-T in your thirties via a random occurence, an act of God.
>Here in America, the doctors (if you have a decent one that is) will try to determine whether your testosterone deficiency is primary or secondary caused. Primary caused means the problem is directly in your testicles and your testicles are not working normally, not producing enough testosterone.
Secondary testosterone deficiency usually means there are some problems with the hypothalamus-pituitary gland sending out signals to your gonads to produce enough testosterone. Things that can cause secondary testosterone deficiency include pituitary tumors, etc. The only way doctors can determine all this stuff is if they give a battery of blood tests besides the usual free and total serum testostoterone, PSA and Complete Blood Count. They have to order pituitary tests, LSH, LH tests. You cant have a lazy or cheap doctor who cuts corners on lab tests and get an accurate assessment.
Go to the Androgel website it explains all this in specific detail and its a credible source of information regarding this subject.
> The second one is that androgen replacement therapy is by no means a standard treatment, in that there are no established guidelines for when to apply it, and what exactly to apply as treatment. For example, my own test was off-the-scale low by some standards, but low-normal by the one my own doctor wished to apply. Because of this, he would not order further tests (pituitary testing is indicated, but I'm not getting it). An anology to hypothyroid sufferers is probably fair; despite obvious symptoms consistent with the diagnosis, many hypothyroid subjects are denied treatment, or given inadequate treatment, due to the interpretation of hormone levels as falling within the "normal" range.
>Here in America, if you score low on testosterone testosterone replacement is "standard." Its very popular here. I dont know what its like in Canada, you guys seem to have a different system. I do know the testosterone gels and patches are VERY expensive here. Maybe thats why not being treated for it in Canada occurs..the cost. I dont know just a suggestion.
Eric
Posted by jodeye on November 23, 2003, at 16:25:47
In reply to Re: I have been diagnosed with testosterone deficiency, posted by LostBoyinNC34 on November 23, 2003, at 8:58:31
Hi LostBoy,
Did any doctor have a recommendation to increase stage four sleep?
Do you plan on having another sleep study to see if testosterone affected stage four sleep?
This is the end of the thread.
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