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Dopamine Questions & Concerns

Whats up guys,

Been dealing with ED & Low libido for about 2 1/2 years and i havent found a cause. I’ve moments of temporary relief but nothing that has been consistent.

I went down to CT last Monday to visit Thomas O’Connor of testosteroneology. He’s a very nice guy and on top of that really seems to know his stuff. I sent and came with additional blood work from the last 18 months. After getting to know each other a bit we delved into my blood work and my worse case scenario occured: nothing was conclusive.

I immediately was dejected and the feeling of being despondent poured out of me. He then proceeded to talk about my symptoms being in my head and due to depression. That I’m in a feedback loop of being depressed about my ed and my ed causing my depression.

I drove home after the appt and thought about the possibility of having psychological ED. However after doing some research and delving deep into my gut, i know for a fact its not in my head.

During the appt he did mention the possibility of it being neurotransmitter related and talked about how important dopamine is to the HPTA axis and for our overall health in general. That lead me to doing research on dopamine deficiency and i have plenty of the symptoms outlined. It would also explain, for example, why i would restart trt and id get that honeymoon phase only for me to return back to my baseline. I’ve also used mdma on and off for a good 6-7 months during my edm excursions during my very early 20s. I think its very possible I’ve messed or altered something with my dopamine receptors.

With all that being said. I’m on trt and I’m going to simplify things by dropping the hcg and aromasin for a couple of weeks and seeing how that works. However i don’t think that’ll change much.

I’m looking into Wellbutrin. It’s known to increase libido more often than not but i also know that everyones body is different and i may or may not find my answer in this drug. I’ll ask for a prescription and take it from there.

I’m also aware of apomorphine and its ability to help with ED, unfortunately the ED drug Uprima is only available in Europe.

Lets cut to the chase. Firstly does anybody have experience with Wellbutrin with or without trt and how it interacted?

Does anybody know how i can get my hands on uprima or apomorphine?

Is there anything i can do/take to help my dopamine receptors? Is there a long term cures?

The LAST thing i want to take is cabergoline and other prolactin reducing dopamine agonist. The risk of DAWS is too great of a risk in my opinion and would only be my failsafe option.

Thanks in advance for the assistance!

Cabergoline is not that bad if you take it in low enough dosage. I’m taking it now 0.125mg twice a week.

To be honest you cannot find alternative to this medicine and its the best available option if you need it. I’ve put ton of research because also I did not want to take it.

But on the other hand - have you measured your prolactine? if it is not too high for sure you do not want to take caber because you will crush it.

my prolactin is always towards the lower quarter of the range. I’ve never had a problem with prolactin.

How long have you been taking caber?

We’re the effects instant? and if i took it as a low dose like you, would i still tank my prolactin levels?

With low dose it will drop your prolactine little. It will do it in like 1-2 weeks.

I take it for 3 months.

To give you an idea - when I started my prolactine was like 370(top margin is like 320). In 10 days it was 280, and now 3 months later it is again 280. I need to take a bit more caber to lower it further but I start to get side effects like nervousness, drowsiness and so on. but just to mention Im EXTREMELY sensitive to all kinds of drugs and I even get side effects from some natural supplements!

THis is a serotonin thing. Ravers are known to supplement high dose 5-HTP after a binge to ameliorate the after effects. The 5-HTP (In high doses) causes a serotonin rush, but it’s short lived and burns out the production for a while. It also causes a dopamine deficit in the short term, as dopamine and serotonin are produced in balance and if your body gets pushed to produce one heavily it will not produce the other while it’s doing that. Tyrosine, mucuna pruriens (L-dopa), maybe B-6, will help dopamine if that’s a problem. So will having more free T, as you need free T to produce catecholamines.

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I have B complex, taking mucuna pruriens currently. I’ve done tyrosine on a few occasions as well. Unfortunately theyre not strong enough to stimulate the effects that are needed. I’m hoping to take Wellbutrin, or if that doesn’t work, something like caber on a temporary basis and eventually ween myself off and not need it anymore.

I’m on trt so free isn’t a problem. Before trt i always had high total test but habitually low free t for some reason.

Low free with high total is indicative of high SHBG. I have noticed that I react very differently to adderall since TRT. I am not covinced I was really ADD before, just low T maybe.

yup, and ive tried proviron and boron on separate occasions multiple times and it worked in terms of decreasing shbg. free test went up but no change in my libido function.

The problem is that hormonal symptoms line up concurrently with other systems that its truly hard to distinguish.

Do you know your current E2 numbers? I would say that most likely your E2 is too low. The symptoms are consistent with that, and the fact that you have been taking aromasin is significant in my saying it.

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my e2 has been as low as 15 and as high as 48 and nothing has changed in between.

Trust me when i say that I’ve tried everything under the sun and then some. I haven’t found anything that worked.

I remember doing hcg for the first time in feb 2018 after trying my hardest for months to get a doctor to prescribe it for an hpta restart. My first shot of 250iu had me feeling really good, felt social and had some libido. After that shot and from then on, I’ve had that experience from hcg again.

I did hgh for about 4 months staring in december 2018. from weeks 2-3 i had a 10 day period where i was 70% normal but it failed to uphold and i couldn’t get that same feeling back.

I’m down to my last few options at this point and trust that I’m willing to try and experiment with anything, provided I have a solid plan in place whilst being aware of the side effects.

If i could just have a good libido id be happy. At this point i dont need it to be thru the roof, I just need solid desire at the very least.

What’s your current dose?

100mg test e. Doing 250iu of hcg 3x per week. along with 12.5 mg of aromasin per week. Still tinkering as its only been a little over 3 months since I’ve been on trt.

Well, for starters, your dose is too low to give you what you want. Up it. You really shouldn’t need aromasin at 100 mg. What is your Total T at 100 mg? You feel good on the “Honeymoon” because you have more test flowing around then you’re getting now. Have you gone without HCG? Some guys suffer negative effects from it.

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I’m not sure. I started at 125mg and my test was:

TESTOSTERONE,FREE 274.6 H (35.0-155.0 pg/mL)
TESTOSTERONE,TOTAL, MS 1387 H (250-1100 ng/dL)

Per Dr. O’Connors recommendation, I’ll be going with out hcg and aromasin for a couple of weeks to a month and see how i feel.

And while thats true, there is still a dopamine rush that comes with being on higher levels of test.

I also want to remain fertile for the future. If i feel better without hcg, ill try and see if i can reincorporate it without the e2 spike.

Was that blood test at trough, or post injection? I don’t get those numbers at 200 mg a week. You can always add the HCG whe you want to be fertile, you don’t need to stay on it indefinitely just for that.

pre injection. This was done early in the morning and i made sure to withhold my injection to see what my base would be.

I’ve always questioned if i needed to even be on test. But its the only thing that allows me to operate with some efficiency. Without test especially my penis is useless, i’m lethargic as ever, i can’t concentrate nor handle multiple stimuli and i feel as weak as a one man could be.

Test doesnt fix the libido and ed issues and i know my energy could still be better.

Thats why my mind is venturing into dopamine. My blood shows things that are high and low, but nothing sever nor anything that genuinely illustrates what the clear problem is.

feel free to look at my latest bloodwork.
TOTAL GLUTATHIONE 752 (544-1228 uM)
OMEGA 3 (EPA+DHA) 2.1 (2.2-3.2)
OMEGA 6/OMEGA 3 RATIO 12.3 (5.7-21.3)
EPA/ARACHIDONIC ACID RATIO <0.1 (0.2 OR LESS)
ARACHIDONIC ACID 11.3 (5.2-12.9 %)
EPA 0.3 (0.2-1.5 %)
DHA 1.8 (1.2-3.9 %)
OSMOLALITY,SERUM 290 (275-295 mOsm/kg H2O)
MAGNESIUM 2.0 (1.5-2.5 mg/dL)
FIBRINOGEN ACTIV,CLAUSS FIBRINOGEN 237 (175-425 mg/dL)
FSH <0.7 L (1.6-8.0 mIU/mL)
LH <0.2 L (1.5-9.3 mIU/mL)
THYROID PEROXIDASE AB <1 <9 IU/mL
THYROGLOBULIN ANTIBODIES <1 < OR = 1 IU/mL
CERULOPLASMIN 31 (18-36 mg/dL)
VITAMIN C 0.7 (0.2-2.1 mg/dL)
TNF-ALPHA,HIGHLY SENSITIVE 0.54 L (0.56-1.40 pg/mL)
ESTRADIOL, ULTRASEN,LC/MS 51 H
DIHYDROTESTOSTERON,LCMSMS 64 (16-79 ng/dL)
TESTOSTERONE,TOTAL, MS 1387 H (250-1100 ng/dL)
TESTOSTERONE,FREE 274.6 H (35.0-155.0 pg/mL)
17-HYDROXYPROGESTERONE 40 (32-307 ng/dL)
VITAMIN A (RETINOL) 46 (38-98 mcg/dL)
IMMUNOGLOBULIN A 150 (81-463 mg/dL)
SEX HORMONE BINDING GLOB 41 (10-50 nmol/L)
WBC 2.9 L (3.8-10.8 Thousand/uL)
RBC 5.95 H (4.20-5.80 Million/uL)
HEMOGLOBIN 16.3 (13.2-17.1 g/dL)
HEMATOCRIT 49.5 (38.5-50.0 %)
MCV 83.2 (80.0-100.0 fL)
MCH 27.4 (27.0-33.0 pg)
MCHC 32.9 (32.0-36.0 g/dL)
RDW 15.3 H (11.0-15.0 %)
PLATELET COUNT 231 (140-400 Thousand/uL)
MPV 9.9 (7.5-12.5 fL)
TOTAL NEUTROPHILS,% 46.8 (38-80 %)
TOTAL LYMPHOCYTES,% 42.3 (15-49 %)
MONOCYTES,% 6.8 (0-13 %)
EOSINOPHILS,% 3.4 (0-8 %)
BASOPHILS,% 0.7 (0-2 %)
NEUTROPHILS,ABSOLUTE 1357 L (1500-7800 cells/uL)
LYMPHOCYTES,ABSOLUTE 1227 (850-3900 cells/uL)
MONOCYTES,ABSOLUTE 197 L (200-950 cells/uL)
EOSINOPHILS,ABSOLUTE 99 (15-500 cells/uL)
BASOPHILS,ABSOLUTE 20 (0-200 cells/uL)
ACTH,PLASMA 33 (6-50 pg/mL)
HEMOGLOBIN A1C 5.3 (<5.7 % of total Hgb)
COPPER 124 (70-175 mcg/dL)
MAGNESIUM,RBC 4.5 (4.0-6.4 mg/dL)
SELENIUM 142 (63-160 mcg/L)
ZINC 63 (60-130 mcg/dL)
VITAMIN B6, PLASMA 38.0 H (2.1-21.7 ng/mL)
VEGF,ELISA QNI VASCULAR ENDOTHELIAL GF <31 L (31-86 pg/mL)
HUMAN TGF BETA 1 (TGF-B1) 15460 H (344-2382 pg/mL)
VITAMIN B1 (THIAMINE), B 76 L (78-185 nmol/L)
VITAMIN E (TOCOPHEROL) AMD ALPHA-TOCOPHEROL 12.9 (5.7-19.9 mg/L)

Comp Metab Panel
GLUCOSE,FASTING 91 (65-99 mg/dL)
SODIUM 139 (135-146 mmol/L)
POTASSIUM 4.3 (3.5-5.3 mmol/L)
CHLORIDE 105 (98-110 mmol/L)
CARBON DIOXIDE 30 (20-32 mmol/L)
UREA NITROGEN 17 (7-25 mg/dL)
CREATININE 1.33 (0.60-1.35 mg/dL)
CALCIUM 9.4 (8.6-10.3 mg/dL)
PROTEIN, TOTAL 6.9 (6.1-8.1 g/dL)
ALBUMIN 4.4 (3.6-5.1 g/dL)
GLOBULIN 2.5 (1.9-3.7 g/dL) (calc)
ALBUMIN/GLOBULIN RATIO 1.8 (1.0-2.5) (calc)
BILIRUBIN,TOTAL 0.6 (0.2-1.2 mg/dL)
ALKALINE PHOSPHATASE 109 (40-115 U/L)
AST 37 (10-40 U/L)
ALT 28 (9-46 U/L)
EGFR NON AFR AMERICAN 73 >=60 mL/min/1.73m2
EGFR AFRICAN AMERICAN 85 >=60 mL/min/1.73m2

LIPID PANEL
CHOLESTEROL,TOTAL 175 (<200 mg/dL)
HDL CHOLESTEROL 62 (>40 mg/dL)
CHOLESTEROL/HDL RATIO 2.8 (<5.0 calc)
LDL-CHOLESTEROL 101 H (<100 mg/dL) (calc)
TRIGLYCERIDES 41 (<150 mg/dL)
NON HDL CHOLESTEROL 113 (<130 mg/dL) (calc)
GGT 10 (3-70 U/L)
IRON,TOTAL 75 (50-195 mcg/dL)
IRON BINDING CAPACITY 298 (250-425 mcg/dL) (calc)
IRON % SATURATION 25 (15-60 %)

TSH 1.34 (0.40-4.50 mIU/L)
T4,FREE 1.1 (0.8-1.8 ng/dL)
T3,FREE 3.0 (2.3-4.2 pg/mL)
LIPASE 46 (7-60 U/L)
FERRITIN 5 9 (20-345 ng/mL)
PROGESTERONE 0.5 (<1.4 ng/mL)
VITAMIN B12 510 (200-1100 pg/mL)
FOLATE,SERUM 13.4 (> 5.4 ng/mL)
CORTISOL (AM) 11.8 (4.0-22.0 mcg/dL)
INSULIN 3.0 (2.0-19.6 uIU/mL)
DHEA SULFATE 392 (85-690 mcg/dL)
HS CRP 0.8 mg/L
HOMOCYSTEINE 7.6 (<11.4 umol/L)
VITAMIN D,25-OH,TOTAL,IA 52 (30-100 ng/mL)
INTERLEUKIN-6(IL-6),SERUM <1.40 (<5.00 pg/mL)
PREGNENOLONE,LC/MS/MS 62 (22-237 ng/dL)
T3 REVERSE, LC/MS/MS 14 (8-25 ng/dL)
VIP <50 (<75 pg/mL)

Definitely drop the HCG and Aromasin. Allow your body to adjust to everything once you drop that. You’re putting your body through a roller coaster taking that shit.

Been on TRT for 3 months now. One month ago, I switched to daily subq 22mg and my libido isn’t necessarily through the roof as far as thinking about sex, but when me and my gf get started, it’s as if I took a handful of Viagra. It’s gnarly how crazy the erections are. I didn’t have that previous to daily dosing. The daily dosing keeps your blood levels higher and more stable. Don’t worry if your numbers are high on your blood work. What you’re after is treating your symptoms, not the numbers. Otherwise what’s the point of all this?

I’ve been on Wellbutrin for about a year and a half now. It was a super rough start up the first month and a half. I had anxiety, headaches & some other pretty heavy side effects initially. But it has been a game changer for me. I did very little in the libido department for me, but what it did for my state of mind was priceless. I became a much more well balanced individual once the side effects settled. It is what got me through the past year and a half before I started TRT.

You need a better TT:E2 ratio. 51 E2 is too low for 1387 TT.

“T/E2 balance plays a key role in the relationship between sex hormones and the risk of cerebrovascular disease. The balance between T and E2 may be more important than their absolute quantities. Extremely low T/E2 and inappropriately high T/E2 ratio can both harm the brain blood vessels.”

“Trend line analyses showed that T/E2 actually had a binomial linear correlation with the risk of cerebrovascular disease; its best protective effect occurred at values of 0.13–0.15, with an OR value extremely close to those of FT and FE2 (0.23 vs. 0.24–0.25).”

Here’s a calculator:
https://www.omnicalculator.com/health/t-e2-ratio

Your ratio comes out to 0.26. High.

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