T Nation

Panic Disorder Link with E2 and T?


#1

Hey guys.
I would really appreciate some help on this issue that I have.
I'm 26 now and I've been suffering from panic disorder with agoraphobia ever since I was 14 - when I hit puberty. That means that I can't go out more than a few blocks away from where I live.

What makes me wonder if this is a hormonal issue, is the fact that I've never had any issues as a kid, no problems, no abuse, no nothing. No trigger at all. Hitting puberty seems to be what unlocked it.

6 months ago I got a bloodwork done for an unrelated issue.
Here are my results:

FT3 6.03 / 3.1-6.8
FT4 14.22 / 12.0-22.0
TSH 1.46 / 0.27-4.20
Prolactin 419.2 / 86-324
Estradiol 181.4 / 28-156
Progesterone 1.79 / 0-5.3
Testosterone 9.64 / 9.0-27.8
DHEA-S 11.14 / 4.34-12.5
ACTH 21.080 / 4.7-48.8
4 androstenedione 7.790 / 1.22-11.00
17 alpha OH progesterone 2.887 / 1.52-6
Somatotropic hormone 0.11 / 0.10-5.92

Cortisol 231.0 ?
Cortisol 98.3 ?
Cortisol refference- 6am-10am 124.2-662.4 ; 4pm-8pm 49.68-179
(I don't know which Cortisol is which).

I've been on Lexapro 10mg + Klonopin 0.25mg daily, for the past 6 years.
From what I researched online, AD's can affect your prolactin and testosterone, as my bloodwork clearly shows. Still, I never managed to find a single article linking SSRI or benzos to high Estradiol?

If anyone can help me out with that, I would be really grateful.
Also, can you provide additional info regarding my hormonal panel that could link it to panic disorder ?

My endo didn't see anything wrong with my results (?!) and blamed the results on AD use.

What do you guys think ?


#2

Hey, your story sounds a lot like me; although my first panic attack was triggered from smoking marijuana in high school. During the last year of high school, my anxiety had gotten progressively worse and developed some agoraphobia, (I could travel away from the house but if I had a panic attack, I needed a quick path back to home so my travel was limited if there was traffic). This was all in 2003, and I was placed on Lexapro. I stopped taking the Lexapro in 2007 and it’s hard to say what triggered another attack in 2008. The professionals are saying that it was caused by my father’s heart attack a month prior but the day I had the attack, I drank two beers, ( I never drank before and don’t 'til this day; don’t like the taste.), I believe like the marijuana, this is what triggered the attack. Anyway, I began CBT, Cognitive-Behavioral Therapy with a great therapist and my issues are gone. I recently went on a trip to Miami and traveled across the Keys, (Long highway strip with no exit) and handled it with no problem. I usually taken my bottle of Xanax just in case, but I left it at the hotel on purpose!

Sorry for the long story. Anyway, I’ve read about how low testosterone affects mood and can lead to depression or anxiety. I also read one case report about a person have his anxiety symptoms resolved after TRT. Having said that, I think you are going about this the wrong way. I believe the key hormone at play is the decrease in testosterone, not estradiol. I know elevated levels of estradiol can lead to mood swings and irritability but I believe testosterone has more importance here. Maybe it could be the combination of low testosterone with high estradiol? I don’t know, I could be wrong here. Having said that and if my line of thinking is correct, estradiol is indirectly affecting symptoms of anxiety by interfering with testosterone production. If your anxiety is caused by a hormonal issue, it’s more likely due to testosterone by the increase in estradiol.

In my case, my testosterone was around the 200-300 levels and had an estradiol number of 62, (range 20-54). After taking an AI, my testosterone rasied to 638 and my estradiol decreased to 24.