T Nation

Can TRT Deplete Your Serotonin?

Hey there,

I was on TRT for just five weeks in 2011 and it was a disaster, as you can see from this lengthy message wrote at the time:

http://www.allthingsmale.com/forum/showthread.php?17730-Why-has-Testogel-caused-brain-fog-depersonalisation-etc-(PLEASE-HELP)

The depersonalization and brain fog remain to this day, along with some of the other symptoms that most likely reflect a highly sensitised central nervous system.

I recently came across this old article:

Anabolic steroids may lead to violence
Friday, 21-Nov-2003 11:40AM PST

Story from United Press International
Copyright 2003 by nited Press International (via ClariNet)

BOSTON, Nov. 21 (UPI) – Anabolic steroids may have long-term effects on players’ behavior and aggression long after they stop abusing the performance enhancing drugs.
NewsVantage â?? Just all the news you want, with all the depth you need.

Northeastern University psychology professor Richard Melloni, with funding from the National Institutes of Health, recently found evidence that long after steroid use ends it can produce long-term aggression, the university said Friday.

Melloni has been studying how steroids used during adolescence may permanently alter the brain’s ability to produce serotonin. Adolescent Syrian hamsters, given their similar brain circuitry to human adolescents, were administered doses of anabolic steroids and then measured for aggressiveness over certain periods of time.

The researchers initially hypothesized steroid use during adolescence might permanently alter the brain’s chemistry and a person’s tendency toward aggression long after use has stopped.

Their most recent findings, published this week in Hormones and Behavior, enabled them to confirm this hypothesis and conclude there is indeed a lengthy price – namely long-term aggression – to pay for drug abuse even after the ingestion of steroids ceases.

“We know testosterone or steroids affect the development of serotonin nerve cells, which, in turn, decreases serotonin availability in the brain,” Melloni says.

As I was 19 years old during the time of TRT, and arguably still in adolescence, depending on your personal age criteria, do you believe it is possible that the testosterone permanently messed up my serotonin levels, hence why many of the negative effects failed to disappear once treatment was ceased?

A lot depends on whether testosterone via androgel is an actual steroid or not (it’s hard to find a clear cut answer on this, it’s certainly a steroid hormone but whether that’s the same thing is unclear to me…)

The reason this is important is because I still need to fix my testosterone levels somehow, and even risk TRT again, so your thoughts would be greatly appreciated.

Also, if anyone has any ideas how to fix a hypersensitive nervous system, bearing in mind that I can’t tolerate supplements well any more, that would be great! :smiley:

Thank you guys.

I think you and I may be dealing with some of the same issues. I’d love to chat using the PM here, as I think my I have both testosterone and serotonin issues.

Jimbo4, when I read that article, I get the impression it’s talking about being exposed to steroids over a long period of time during development. Sort of like the way being malnourished for a long period during childhood could permanently stunt a child’s growth.

Not a lot of development occurs in a 5 week period, especially at the age of 19. I’m doubtful that you’ve been effected by the phenomenon discussed in the paper. I’m not doubting your symptoms at all, or minimizing your situation, I just think it unlikely to have been caused by TRT.

As far as serotonin depletion, you can increase your levels quickly with 5-Hydroxytryptophan (aka 5-HTP). It’s a naturally occurring amino acid which is readily available at health food stores. You’ll see results within hours to days.

Thank you for the replies. Hopefully you’re right Feisty - I’m positive that the testosterone therapy overstimulated my CNS, as the long-term symptoms I’ve experienced are very similar to those who have had bad reactions to SSRIs or Benzos, but the serotonin idea was more of an add-on theory which hopefully has no basis in reality. As for 5-HTP, I’m on Zoloft at the moment so can’t combine the two, but I have given great consideration in the past to quitting my current medication and using that as an alternative. Still might do at some point. Thanks for the suggestion.

John, I’m more than happy to talk on here and have sent you a PM accordingly. I look forward to hearing from you.

Like a lot of guys here ( I would think), I have a pretty long story and don’t want to bore everyone, so I’ll stick with the broad strokes. I had taken SSRI’s since 2006, on and off, for OCD. I had the usual side effects, (fuzzy head, inability to orgasm) but it was tolerable enough and when I would periodically stop taking them, I’d feel normal after a day or two. The libido issues were more than just difficulty ejaculating, though.

Sex was less desirable and I was less, let’s say… assertive… in bed. Normally I wouldn’t go into detail like that, but it’s relevant to my current problems. I didn’t pay attention to it at the time, because when I stopped the meds, I’d feel fine. So I took a new SSRI in the summer of 2012 that just devastated my body. Problems persist today, after stopping taking it after only a few weeks.

Saw lots of docs, couldn’t find anything wrong, yadda, yadda… Ok, so cut to 2013, one of the few things they’ve been able to find that actually was wrong with me was my testosterone and Vitamin D levels. I just started androgel today, actually. My levels were below 200 on my last test. But back to the serotonin issue, libido-wise, my body feels basically the same now as it did when I was on SSRI’s. It would stand to reason that there is some link between serotonin and testosterone… I also suffer from “brain fog” and dry mouth in the mornings, which I have no explanation for but is similar to my experience with SSRI’s.

You also mentioned a “highly sensitised central nervous system”, which is something one doctor mentioned to me. He thought it was something called C.S. (central sensitization). It wasn’t something I was familiar with but it sounds like you may be. I have a few reasons to doubt his diagnosis, but for the sake of brevity I’ll leave that out of this post. My issues seem to stem from malabsorption, and it seems that the SSRI played a role in damaging my gut. I don’t know if low T is a cause or effect at this point, but I’m giving it a shot.

That was a bit of a rambling response, but that’s mostly due to the fact that I have more questions than answers. I see that people have listed SSRI’s as damaging to male hormones in the sticky thread, but I was unsure of which hormones they referred to, or how exactly they damaged them.

Hi John,

Just need a bit of extra detail about your SSRI use:

  • Which SSRI were you taking intermittently from 2006 onwards, and which was the new one you were prescribed in 2012?
  • When you’ve stopped taking an SSRI, have you always weaned off slowly, or have you ever just stopped the medication cold turkey?
  • Have you noticed that seemingly harmless supplements make you feel extremely anxious nowadays? (e.g. B-vitamins, fish oil).
  • Had your testosterone levels ever been checked before using SSRIs?
  • Low libido notwithstanding, what is your mood like nowadays? Do you feel other symptoms of excess serotonin such as good mood but fatigue and lack of motivation? (Kind of like you feel too content to get things done?)
  • Have you noticed any physical or mental changes since beginning androgel? (It often takes a couple of days for anything noticeable to occur, so it’s OK if there’s nothing to report).

Thanks.

Why were you put on TRT in the first place at 19? If there were problems that predated and prompted TRT, maybe it is not entirely TRT that is to blame.

The TRT is definitely to blame, I guarantee that if you had experienced the changes I did during treatment and post-treatment then you would agree.

I was put on testogel because of fatigue, low mood and poorly functioning libido. I had several testosterone readings taken, the highest was something like 280 and the lowest was 70 (this was the final result before beginning treatment).

[quote]Jimbo4 wrote:
The TRT is definitely to blame, I guarantee that if you had experienced the changes I did during treatment and post-treatment then you would agree.

I was put on testogel because of fatigue, low mood and poorly functioning libido. I had several testosterone readings taken, the highest was something like 280 and the lowest was 70 (this was the final result before beginning treatment).[/quote]

Okay, people certainly can have idiosyncratic reactions to changes in hormones, but I would doubt the serotonin theory. Are your problems improved with Zoloft? I am surprised you were put on an SSRI despite a complaint of poor libido - were you diagnosed with major depression or is this an “off-label” use? Zoloft kills most people’s libido. THere are studies that estimate the incidence of sexual side effects from SSRIs to be 70%, and other studies estimate 90% of people on SSRIs to have sexual problems.

The problem of SSRIs and sex have nothing to do with testosterone levels, by the way. You can have perfect testosterone and SSRIs will still kill your sex drive.

Seeknok- could you elaborate on that last sentence a bit? I saw in another thread you said SSRI’s, ADHD meds and Acne meds can be damaging to male hormones. Which hormones did you mean? I took all of those and would interested in hearing your insight.

John- I’ll repost your questions and answer them below:

  • Which SSRI were you taking intermittently from 2006 onwards, and which was the new one you were prescribed in 2012?

I was on clomipramine mainly, very briefly tried zoloft and lexapro. The 2012 med was Viibryd.

  • When you’ve stopped taking an SSRI, have you always weaned off slowly, or have you ever just stopped the medication cold turkey?

I was never good with tapering, honestly. It was never a problem until Viibryd, however. I had a terrible reaction and quit cold turkey, which only made things worse.

  • Have you noticed that seemingly harmless supplements make you feel extremely anxious nowadays? (e.g. B-vitamins, fish oil).

Eh, not really. I will say though, certain things have given me bouts of anxiety, like coconut oil and various other herbal supplements. It’s not bad, and it doesn’t happen with every supplement, but I suppose I have experienced some anxiety, yes.

  • Had your testosterone levels ever been checked before using SSRIs?

No, and I wish I had. That info would be very helpful.

  • Low libido notwithstanding, what is your mood like nowadays? Do you feel other symptoms of excess serotonin such as good mood but fatigue and lack of motivation? (Kind of like you feel too content to get things done?)

Well, I’m quite depressed, mostly due to my health problems. But, (and this is the weird part) my OCD symptoms are almost totally gone. The brain fog has taken its place. In some ways it seems like my depression and lack of OCD symtpms would point towards low serotnin, but other symtptoms like diherrea and brain fog and sun sensitivity, dry mouth, point to high levels. I’ve had it tested and been told the numbers were normal. I will add though, whenever I try a new diet or medicine, I usually feel much better for a few days, and when that happens, my ocd symptoms come back. At this point, I’d welcome their return.

  • Have you noticed any physical or mental changes since beginning androgel? (It often takes a couple of days for anything noticeable to occur, so it’s OK if there’s nothing to report).

This is my 2nd day, and I’ve noticed some changes, yes. Erections are easier to come by, although still not totally normal. I had a bit more energy. Other than that, no major differences, but I’m not sure how long Androgel typically takes to work.

[quote]seekonk wrote:

[quote]Jimbo4 wrote:
The TRT is definitely to blame, I guarantee that if you had experienced the changes I did during treatment and post-treatment then you would agree.

I was put on testogel because of fatigue, low mood and poorly functioning libido. I had several testosterone readings taken, the highest was something like 280 and the lowest was 70 (this was the final result before beginning treatment).[/quote]

Okay, people certainly can have idiosyncratic reactions to changes in hormones, but I would doubt the serotonin theory. Are your problems improved with Zoloft? I am surprised you were put on an SSRI despite a complaint of poor libido - were you diagnosed with major depression or is this an “off-label” use? Zoloft kills most people’s libido. THere are studies that estimate the incidence of sexual side effects from SSRIs to be 70%, and other studies estimate 90% of people on SSRIs to have sexual problems.

The problem of SSRIs and sex have nothing to do with testosterone levels, by the way. You can have perfect testosterone and SSRIs will still kill your sex drive.
[/quote]

Oh yeah, I doubt the serotonin theory too, at least in terms of testogel disrupting natural production long after cessation of treatment. It was just a theory that came to me the other day - the worn out CNS is the issue as far as I’m concerned. It’s just unfortunate that there doesn’t appear to be any medication that can address this issue as it’s such a broad one.

The Zoloft has improved my mood to some extent, but it hasn’t been a magic bullet. The trouble is I don’t wish to raise my dosage any higher than the current 100mg, because whilst it would likely make me more relaxed, every time I step it up the brain fog gets worse. The GP diagnosed me with depression/anxiety, but it just seemed like a trademark cop-out for not being able to explain why the testosterone messed everything up so badly. Libido hasn’t been influenced by the SSRI, funnily (and happily!) enough.

Yes, thankfully testosterone is rarely affected by SSRI use - I’m guessing lowered dopamine is the main cause of libido problems?

Thanks for your help by the way.

John, I think the lack of tapering SSRIs has caught up with you, and am convinced that your problems are due to a highly sensitised central nervous system. I would recommend you check out Paxil Progress forum and the following link for useful information on what to do to give your body the best chance to return to homeostatis:

http://www.antidepressantsfacts.com/reaction.htm

Supposedly safe herbal remedies are often the worst supplements to take for people in your condition, I can attest to that. Coconut oil has the same effect on me as it raises dopamine, which is frequently too high in sensitive individuals, and lowers serotonin. High protein/low carbohydrate diets have the same effect, so I strongly recommend you eat more of the latter if you aren’t already doing so.

Keep us posted on how TRT goes for you as it could well provide major clues as to your testosterone/serotonin balance was beforehand and how it is now. Good luck.

I think there’s a strong chance that you’re right about the highly highly sensitised central nervous system. The were a few reasons why I doubted the doctor who made the diagnosis, however. The first is that, according to him, there’s really no test to confirm the condition, it’s just eliminating other possible causes. He also attributed my muscle weakness/loss to de-conditioning, and frankly, I think he’s wrong. It happened far too suddenly, in my view. Also, one of the consistent symptoms I’ve had is diarrhea, along with the inability to loose weight. He said I couldn’t loose weight because I wasn’t exercising enough, which may be true, but my diet is clean, and I still actually gain weight.
I told him that when I try new diets or medications, with many of them I feel great for the first few days. ALl of my symptoms dramatically improve. He attributed this to the placebo effect. Now, I can understand why he would think that, but it’s not the case. He dismissed this because it wouldn’t have been consistent with his diagnosis, in my opinion. He was a bit arrogant and dismissive of what I considered to be valid points, and he didn’t give me any ideas in how to treat this, so I didn’t really run with this possibility.

Having said, I’m not ruling out what he said and really do value your thoughts and opinions. I just listed that to give you an idea of my attitude/mindset after receiving that diagnosis. I think one of three things happened:

1- highly highly sensitized central nervous system

2-SSRI somehow lead to massive gut dysfunction and malabsorption, which I’m suffering from but can’t determine why. Stool samples have shown abnormal fat absorption.

3- Low T.

In addition to the low T numbers, I’ve also experienced hot flashes and incredibly slow healing on cuts/scabs. The doctor who brought up C.S. dismissed TRT and flat-out said it would give my prostate cancer. I felt I had enough of the symptoms to give it a shot.

I don’t want to hijack your thread, though. Would you want to maybe email back and forth? Not to be too creepy, it’s just that I don’t want to dominate your thread with news posts, and there’s very few people who have experience with this. It might be useful to pool our info.

For SSRIs the lowest dose is the best dose. So for prozac, normally taken around 20mg, the best starting dose might be best taken at 5mg and may produce no side effects. Now if you are severely depressed, and 20mg helps you, side effects do not outweigh benefits. The higher the dose, it could affect other systems such as dopamine.

I actually found Imipramine, the oldest anti depressant, at 25mg a day to help me a lot and had no side effects (including sexual). It is an SSNRI. I also took choline with it to mitigate anticholinergic side effects (which were unnoticeable at this dose, a higher dose they were there).

For brain fog, the best thing I ever did for my brain was Piracetam, around 3200mg/day with 900mg of choline. I’ve tried other nootropics (including the racetams and selegiline, gingko, etc) and they all didn’t do what Piracetam did.

Higher T = higher dopamine. I suppose in some it could work in reverse of an SSRI. SSRI sexual dysfunction is caused unbalancing serotonin and dopamine. If you’re on Zoloft add Requip and you’ll have great sexual function for a few days until your receptors adjust.

All of those drugs really aren’t the answer. Receptors desensitize and you’re back to where you started. The answer appears to be Ketamine but the treatment is still somewhat crude. In a few years there will be a nasal spray form of Ketamine that is going to be a life saver.

Any update? Going through similar issues. Would love to chat.