This article is Part Two of a series. Click Here for Part One. In the past, Jim had seen a number of doctors including an internist, a hematologist, and an endocrinologist. This is Clomid Stimulation Test failure, indicating Clomid is not a suitable treatment. Next, most endocrinologists will order an MRI scan of the pituitary gland and brain to rule out a pituitary lesion.
This was done and the MRI scan was normal. The failed Clomid Stimulation Test is virtually diagnostic of hypothalamic dysfunction, representing a complex condition with dysfunction of all hormonal systems in the body. Jim told his story of many years of markedly reduced libido, anxiety, panic attacks, and chronic fatigue unrelieved by sleep. Clubbing on Ecstasy Courtesy of Wikimedia Commons Ecstasy MDMA is a chemically modified synthetic amphetamine drug that floods the brain with serotonin and dopamine, the two major neurotransmitters.
This damage may or may not be reversible.
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Examination of brain photomicrographs of monkeys given MDMA reveals loss of serotonergic axons in the hypothalamus, with some abnormalities persisting for seven years. Many of these Post-MDMA, post-Ecstasy members of Generation E are now suffering from low testosterone and other symptoms of hypothalmic dysfunction with chronic fatigue and fibromyalgia.
They may find it difficult to find a physician who has the knowledge and experience to help them. As noted by Michael H. Upper image: Chemical structure of MDMACourtesy of Michael H. Baumann in Psychopharmacology Berl.
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Nonetheless, long term SSRI antidepressant use can potentially induce the same neuronal defects and chronic brain changes as those found with MDMA usage. There are many others. This is a perfect example of an abusive medical practice that should be halted, and reveals a medical system gone wrong.
Many of these unfortunate victims are on combinations of drugs such as SSRI antidepressants, amphetamines Vyvanse ,lisdexamfetamine, Adderal, Ritalin and Benzodiazapines Xanax, Klonopin and Narcotics such as Oxycontin and Vicodin, etc. Some are also chronic alcohol rs. In some cases, a drug rehabilitation facility is required during the drug withdrawal phase. The ACTH stimulaton test is limited and does not evaluate the HPA axis.
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A better testing choice is the Metyrapone test.
Unlike ACTH which requires an injection, the metyrapone drug can be given PO orally. The metyrapone test is superior to the ACTH stimulation test because evaluates both hypothalamic and adrenal function. HCG stimulates testicular production of testosterone without impairing fertility, and is therefore a preferred treatment in the er age group. He was also given a small dosage of natural thyroida half grain tablet daily.
Additional treatment protocols were also given as outlined by Dr. Jim had hypothalamic damage from MDMA drug use which caused his low hormone levels and chronic fatigue. LH and FSH then travel to the testicle to stimulate testosterone LH and sperm production FSH.
Chronic recreational drug use with Ecstasy. For Part Three, Click Here Low Testosterone From Pain Pills by Jeffrey Dach MD Dr John Crisler on HCG for Symptoms of Low Testosterone Low Testosterone Diagnosis and Treatment by Jeffrey Dach MD More articles on Low Testosterone, Diagnosis and Treatment Click Here for excellent discussion of pathophysiology of hypothalamic pituitary axis.
Patients were also given fludrocortisone if they had signs of neurally mediated hypotension. Treating chronic fatigue syndrome and Fibromyalgia BY KENT HOLTORF, MD An overwhelming amount of peer-reviewed medical literature documents pituitary and hypothalamic dysfunction in CFS and FM patients.
Overnight Metyrapone Test — Clin Endocrinol Oxf. The overnight single-dose metyrapone test is a simple and reliable index of the hypothalamic-pituitary-adrenal axis.
Fiad TM, Kirby JM, Cunningham SK, McKenna TJ. The ACTH stimulation test examines adrenal responsiveness but may not examine the entire hypothalamic-pituitary-adrenal HPA axis and requires parenteral administration. The cortisol response to hypoglycaemia provides an index of activity of the entire HPA axis but is demanding for patients and medical staff. The aim of the present study was to examine the performance of the overnight single-dose metyrapone test as it provides a simple alternative test for HPA axis function.
One hundred per cent concordance between the metyrapone, the ACTH and the hypoglycaemia test was seen in patients with primary adrenal insufficiency. The ACTH stimulation test should not be used for patients suspected of having secondary adrenal insufficiency.
Evidence for and pathophysiologic implications of hypothalamic-pituitary-adrenal axis dysregulation in fibromyalgia and chronic fatigue syndrome. Demitrack MA, Crofford LJ. Abstract Chronic fatigue syndrome CFS is characterized by profound fatigue and an array of diffuse somatic symptoms. Our group has established that impaired activation of the hypothalamic-pituitary-adrenal HPA axis is an essential neuroendocrine feature of this condition.
The relevance of this finding to the pathophysiology of CFS is supported by the observation that the onset and course of this illness is excerbated by physical and emotional stressors. It is also notable that this HPA dysregulation differs from that seen in melancholic depression, but shares features with other clinical syndromes e. How the HPA axis dysfunction develops is unclear, though recent work suggests disturbances in serotonergic neurotransmission and alterations in the activity of AVP, an important co-secretagogue that, along with CRH, influences HPA axis function.
Results of that work are consistent with the view that patients with CFS have a reduction of HPA axis activity due, in part, to impaired central nervous system drive. These observations provide an important clue to the development of more effective treatment to this disabling condition.
The Neuroendocrinology of Chronic Fatigue Syndrome. Hypothalamic-pituitary-adrenal axis function in chronic fatigue syndrome. Van Den Eede F, Moorkens G, Van Houdenhove B, Cosyns P, Claes SJ. Source Department of Psychiatry, University Hospital Antwerp, Edegem, Belgium. Abstract There is evidence for a hypofunction of the hypothalamic-pituitary-adrenal HPA axis in a proportion of the patients with chronic fatigue syndrome CFSdespite the negative studies and methodological difficulties.
In this review, we focus on challenge studies and on the role of the HPA axis in the pathogenesis of CFS. Mild hypocortisolism, blunted adrenocorticotropin response to stressors and enhanced negative feedback sensitivity to glucocorticoids are the main findings.
Several underlying mechanisms have been proposed. Currently, it is a matter of debate whether these disturbances have a primary role in the pathogenesis of CFS. However, even if the HPA axis dysfunctions are secondary to other factors, they are probably a relevant factor in symptom propagation in CFS.
Clomiphene testing evaluates both hypothalamic and testicular responses and may lead to most thorough evaluation of the HP axis. Clomiphene has been successfully used in the Lahey Clinic for sexual dysfunction in borderline low testosterone cases Andre Guay references ———————————. Written by: Jeffrey R. Guay AT, Bansal S, Hodge MB Section of Endocrinology, Lahey Clinic Medical Center, Burlington, Massachusetts. Twenty-one men with erectile complaints who were found to have a low level of serum testosterone without a reciprocal elevation of the serum levels of luteinizing hormone were evaluated to identify whether the defect was of hypothalamic or of pituitary origin.
Patients underwent a luteinizing hormone LH -follicle-stimulating hormone FSH -releasing hormone stimulation test that showed a normal but sluggish increase in LH and FSH levels, thus ruling out a pituitary defect and suggesting a suprapituitary abnormality. This was confirmed when, in response to clomiphene, patients had a normal increase in gonadotropin and testosterone levels.
Although the basal as well as clomiphene and gonadotropin releasing hormone-stimulated levels of total testosterone and gonadotropins were identical in men less than and more than fifty years old, the elevation of free testosterone levels in response to clomiphene was higher in patients er than fifty. This suggested that although the primary abnormality found in these patients is altered secretion of gonadotropin hormone-releasing hormone from the hypothalamus, an age-related decline in the responsivity of Leydig cells to LH may make it more manifest in older patients.
Elevation of testosterone levels from a subnormal to a normal range in response to clomiphene administered for seven days suggests that the defect is functional and reversible and that the drug may be useful in treatment of sexual dysfunction in this group of patients. Clomiphene increases free testosterone levels in men with both secondary hypogonadism and erectile dysfunction: who does and does not benefit?
Guay AT, Jacobson J, Perez JB, Hodge MB, Velasquez E. Abstract Secondary hypogonadism is more common than primary gonadal failure and is seen in chronic and acute illnesses. Although testosterone has a role in erections, its importance in erectile dysfunction ED has been controversial. Hypogonadism produced by functional suppression of pituitary gonadotropins has been shown to correct with clomiphene citrate, but with a modest effect on sexual function. We wondered if longer treatment would produce improved results.
Decreased responses also occurred in men with diabetes, hypertension, coronary artery disease, and multiple medication use. Since these conditions are more prevalent with aging, chronic disease may be a more important determinant of sexual dysfunction.
Men with anxiety-related disorders responded better to normalization of testosterone. Assessment of androgen status should be accomplished in all men with ED. For those with lower than normal age-matched levels of testosterone treatment directed at normalizing testosterone with clomiphene citrate is a viable alternative to giving androgen supplements. By Damian Thompson Health and lifestyle Last updated:. It also works on dopamine levels, which accounts for the energy and stimulation.
Neuronal recovery occurs over several months in laboratory rats, whereas monkeys and primates show only partial recovery even after an extended period Ricaurte et al. Nakagawa T, Kaneko S. Source Department of Molecular Pharmacology, Graduate college of Pharmaceutical Sciences, Kyoto University, Yoshida, Sakyo-ku, Kyoto, Japan.
Abstract Psychostimulants including amphetamines and cocaine, opioids including morphine, and some recreational drugs share the ability to cause drug dependence and addiction.
Although these drugs of primarily act on distinct molecular targets, such as monoamine transporters or receptors, they finally converge to common neural pathways. Several lines of evidence suggest that their chronic treatment leads to the enhancement of the mesocorticolimbic dopaminergic neurons from the ventral tegmental area VTA to the nucleus accumbens NAc and the medial prefrontal cortex mPFC and leads to abnormal glutamatergic function from the mPFC to the NAc and VTA.
The neural adaptation of dopaminergic-glutamatergic system is considered to be critically implicated in neuropsychotoxic effects of these drugs of . In addition, recent studies suggest that the serotonergic neurons from the raphe nuclei to limbic areas modulate the mesocorticolimbic dopaminergic-glutamatergic system and participate in the neuropsychotoxicity.
A Illustration of mesocorticolimbic dopaminergic and glutamatergic system. Each of three slices is arranged so that they contacted each other. Consequently, damage to the central serotonergic system could be theoretically followed by disturbances in different fields such as psychological well-being, neuroendocrine secretion, vegetative functions, processing of sensory stimuli, sleep architecture, and cognition.
J Neurol Neurosurg Psychiatry. Preliminary evidence of hippocampal damage in chronic users of ecstasy. Source Graduate college of Neurosciences, Department of Radiology, Academic Medical Center, Amsterdam, The Netherlands. These data provide preliminary evidence that ecstasy users may be prone to incurring hippocampal damage, in line with previous reports of acute hippocampal sclerosis and subsequent atrophy in chronic users of this drug. Cortisol release is increased by stimulatory factors, including physical activity, thermal stress and stimulant drugs.
Nonpharmacological research has shown how cortisol is important for psychological aspects such as memory, cognition, sleep, impulsivity, depression and neuronal damage. Conclusions: The energizing hormone cortisol is involved in the psychobiology of MDMA, probably via its effects on energy metabolism. Acute cortisol release may potentiate the stimulating effects of MDMA in dance clubbers.
Chronically, cortisol may contribute to the variance in functional and structural consequences of repeated ecstasy usage. Is it just the ultimate party high, or a postmodern cure that eases spiritual emptiness, rancorous individualism, alienation and lack of community?
These serotonergic deficits are observed in various regions of rat forebrain, including frontal cortex, striatum, hippocampus, and hypothalamus. Drugs and HPA axis. Istituto Auxologico Italiano, Ospedale San Luca, IRCCS, University of Milan, Milan, Italy. This paper outlines the interferences of the most widely used drugs with hypothalamo-pituitary-adrenal function and the related laboratory parameters, with the purpose of providing practical help to clinicians during testing for hypo- or hypercortisolemic states.
Dickerson SM, Walker DM, Reveron ME, Duvauchelle CL, Gore www.urbanmessenger.orgon of Pharmacology and Toxicology, The University of Texas at Austin Reproductive function involves an interaction of three regulatory levels: hypothalamus, pituitary, and gonad.
The primary drive upon this system comes from hypothalamic gonadotropin-releasing hormone GnRH neurosecretory cells, which receive afferent inputs from other neurotransmitter systems in the central nervous system to result in the proper coordination of reproduction and the environment. We quantified hypothalamic GnRH mRNA, serum luteinizing hormone concentrations, and serum testosterone levels as indices of hypothalamic, pituitary, and gonadal functions, respectively. The results indicate that the hypothalamic and gonadal levels of the hypothalamic-pituitary-gonadal axis are significantly altered by MDMA, with GnRH mRNA and serum testosterone levels suppressed in rats administered MDMA compared to saline.
Furthermore, our finding that hypothalamic GnRH mRNA levels are suppressed in the context of low testosterone concentrations suggests that the central GnRH neurosecretory system may be a primary target of inhibitory regulation by MDMA usage. Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician — patient relationship. Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.
Links to this article: Part One of this series. This article may be reproduced on the internet without permission, provided there is a link to this page Pingback: Clomiphene Clomid Adverse Side Effects Part Three by Jeffrey Dach MD – Jeffrey Dach MD I think the main reason why so many people today have problems with endocrine function and sub- or infertility is they were prenatally exposed to high doses of artificial sex hormones, mainly in the course of treatment aimed at preventing miscarriages with either diethylstilbestrol or progestins.
Similar effects of androgenization on reproductive function have been described in other species. Progestins were and are widely used in pregnancy, so there must be a lot of women around with reproductive problems due to prenatal progestin exposure.
Is it the cause of polycystic ovary syndrome I wonder? All in all there seems to be a colossal unrecognised problem with the use of these substances in pregnancy! Bioidentical Hormones Natural Thyroid. Skip to primary content Skip to secondary content Home. The Importance of BioIdentical Hormones. The Safety of Bioidentical Hormones. Bioidentical Hormones Prevent Arthritis. Bioidentical Hormones Found Beneficial After Hysterectomy. Bioidentical Hormone Estrogen Prevents Heart Disease.
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For Part Three, Click Here. Clomid Stimulation Test Failure. Next — Rule out a Pituitary Lesion with MRI Scan. Hypothalamic Dysfunction — Chronic Fatigue. Clubbing on Ecstasy Courtesy of Wikimedia Commons. Ecstasy MDMA is a chemically modified synthetic amphetamine drug that floods the brain with serotonin and dopamine, the two major neurotransmitters.
The Agony of Ecstasy — Inhibition of the Hypothalamic Neurosecretory System. Left image : Ecstasy MDMA TabletsCourtesy of the DEA and WIkimedia Commons. Long Term SSRI Anti depressants and Hypothalamic Damage.
MDMA, the Turbo SSRI. Polypharmacy and Hypothalamic Dysfunction. In my office practice, we will frequently see patients on multiple psychoactive drugs prescribed by the primary care physician, internist or psychiatrist. Treatment of Hypothalamic Dysfunction. ACTH Stimulation, Metyrapone Test, Clomid Test. Endocrinologists commonly use the ACTH stimulation test to diagnose adrenal insufficiency. HCG and Gonadal Axis Treatment.
The low testosterone level can be successfully treated with an LH analog called HCG human chorionic gonadotropin readily available at most pharmacies. What is Happening in this Patient?
Articles with related interest:. Dr John Crisler on HCG for Symptoms of Low Testosterone. Low Testosterone Diagnosis and Treatment by Jeffrey Dach MD. More articles on Low Testosterone, Diagnosis and Treatment. Click Here for excellent discussion of pathophysiology of hypothalamic pituitary axis. Hypothalamic Dysfunction- chronic fatigue, low T, Adrenal fatigue, Low thyroid.
Treating chronic fatigue syndrome and Fibromyalgia BY KENT HOLTORF, MD. An overwhelming amount of peer-reviewed medical literature documents pituitary and hypothalamic dysfunction in CFS and FM patients.
Ann NY Acad Sci. Clomiphene test for hypothalamic dysfunction. I totally agree with the author that diagnosis should established before treatment. A robust response which I frequently find insures that the hypogonadism is NOT due to hypothalamic dysfunction that may be due to drugs, disease, lifestyle, alcohol, stress, depression, aging, etc. Clomiphene has been successfully used in the Lahey Clinic for sexual dysfunction in borderline low testosterone cases Andre Guay references.
Effect of raising enenous testosterone levels in impotent men with secondary hypogonadism: double blind placebo-controlled trial with clomiphene citrate.
Int J Impot Res. Ecstasy MDMA and stimulant amphetamines METH and AMPPI are popular drugs of and they are neurotoxic in studies.
The Ecstasy Generation — Slowly but surely, Ecstasy is becoming the drug of choice for the millennial era. Long Term Adverse Effects of MDMA. Long term Damage of MDMA similar to SSRI s. The recreational drug ecstasy disrupts the hypothalamic-pituitary-gonadal reproductive axis in adult male rats.
Dickerson SM, Walker DM, Reveron ME, Duvauchelle CL, Gore www.urbanmessenger.orgon of Pharmacology and Toxicology, The University of Texas at Austin. Reproductive function involves an interaction of three regulatory levels: hypothalamus, pituitary, and gonad. Web Site and Discussion Board Links:. Disclaimer click here: www.urbanmessenger.org. Part Two of this series : www.urbanmessenger.org. This article may be reproduced on the internet without permission, provided there is a link to this page.
Pingback: Clomiphene Clomid Adverse Side Effects Part Three by Jeffrey Dach MD – Jeffrey Dach MD. I think the main reason why so many people today have problems with endocrine function and sub- or infertility is they were prenatally exposed to high doses of artificial sex hormones, mainly in the course of treatment aimed at preventing miscarriages with either diethylstilbestrol or progestins. Early progestins such as norethisterone were actually derived from the testosterone molecule.
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