callin marianco and swale please!!

[HeadDoc]

[quote=marianco]Yes!

And to have romance, we have to be able to produce adequate amounts of the hormone, Oxytocin.

Unfortunately, if a person grew up neglected, such a person may not be able to produce enough oxytocin. Sometimes optimizing the hormones may restore this.

[HeadDoc]

Marianco, please excuse me for altering your post. I hit the wrong button some how. Anyhow, with regard to romance and oxytocin, I wonder if the application of secure attachment may correct the situation. It took Harry Harlow's monkeys five generations to compensate for their early traumas. My wife and I socialize kittens born to feral mothers. We have varying degrees of success. These cats have taught me quite a bit about adrenal functioning and "releasing" or desensitization therapies for taumatized people.

[thebigEZ]

Is there any good way to raise oxytocin in men. I am curious on what yall's thoughts are on injectable oxytocin.

[marianco]

Originally Posted by thebigEZ

Is there any good way to raise oxytocin in men. I am curious on what yall's thoughts are on injectable oxytocin.

Oxytocin has to be raised indirectly using psychological interventions or optimization of other neurotransmitters/hormones such as estrogens, progesterone, cortisol, testosterone, dopamine, etc. Oxytocin is meant to have variable levels depending on the circumstance. Keeping Oxytocin raised would only create problems, some of them potentially lethal. Oxytocin further lasts only minutes, making constant elevation a problem with externally applied oxytocin.

[marianco]

Originally Posted by HeadDoc

Marianco, please excuse me for altering your post. I hit the wrong button some how. Anyhow, with regard to romance and oxytocin, I wonder if the application of secure attachment may correct the situation. It took Harry Harlow's monkeys five generations to compensate for their early traumas. My wife and I socialize kittens born to feral mothers. We have varying degrees of success. These cats have taught me quite a bit about adrenal functioning and "releasing" or desensitization therapies for taumatized people.

Trauma (including neglect) is like getting branded with a hot iron. Some permanent damage is done.

I think psychological interventions such as secure attachment interventions or true dialectical behavioral therapy may help compensate or correct the problems. This is tempered however by limitations in providing intensive therapy over a prolonged period of time. Also, underlying neuroendocrine problems which predispose a person to trauma - such as hypothyroidism and adrenal fatigue - need to be addressed to help gain a fuller recovery.

I do not think psychiatric medications or hormonal treatments will fully treat the problems involving trauma. Psychological interventions are necessary to improve a person's skills in mindfulness, self-nurturing, relationships, problem solving, distress tolerance, etc.

An analogy to cars I often use is for what I do medically (apart from therapy) is that I am the mechanic while the therapist is the driving instructor. No matter how well tuned a car is, if the driver is not well trained, the driver can still crash.

[ironaddict69]

marianco, your by far the wisest doctor ive been in contact with.
where do you practice?
would you put someone with a morning cortisol of 16 (8-25) on cortef?
my dr. wont, and i know i need it. my adrenals are effed.

[marianco]

Originally Posted by ironaddict69

marianco, your by far the wisest doctor ive been in contact with.
where do you practice?
would you put someone with a morning cortisol of 16 (8-25) on cortef?
my dr. wont, and i know i need it. my adrenals are effed.

Please read my profile.

I would place a person on cortef or other adrenal treatments if the diagnosis of adrenal fatigue or adrenal insufficiency can be established. A single morning cortisol of 16 is only one clue and cannot establish a diagnosis. More information is necessary from other labs and the history and physical exam.

Cortisol (hydrocortisone or Cortef) is not the only glutocorticoid that can be used as part of an adrenal treatment. Cortef, for example, has some mineralocorticoid activity (e.g. it retains salt), which may not make it the best treatment in a person with significant hypertension, without other compensitory medications to lower blood pressure. Cortef also has a short half-life - which makes it difficult for teenagers or college-age students to adhere to treatment. An artificial glutocorticoid steroid in these cases and others may then be an option. Methylprednisolone, for example, has almost no mineralocorticoid activity and a long-half life. Prednisolone is another long lasting glutocorticoid with similar activity to Cortef. These are much more potent than Cortisol and thus need to be used in much smaller doses. They cannot be easily used when one needs to adjust glutocorticoid dose quickly or frequently - for example, when I add additional doses to be used as needed, or when fine tuning needs to be done. When small or rapid changes are needed, Cortef is still best because the half-life is so short. The treatment with these and other alternatives still has to be customized to the person.

[ironaddict69]

so what tests exactly would you run?
the ACTH test?
any other ones?
im asking because im going to request them.
so you keep people on their cortisol medication, or do you take them off after a few months and have them go onto isocort?

[marianco]

Originally Posted by ironaddict69

so what tests exactly would you run?
the ACTH test?
any other ones?
im asking because im going to request them.
so you keep people on their cortisol medication, or do you take them off after a few months and have them go onto isocort?

Tests for adrenal fatigue and associated conditions include: Cortisol AM, Cortisol PM, DHEA-s, progesterone, fasting glucose, electrolytes (sodium, potassium, bicarbonate, chloride), albumin, BUN, creatinine, total testosterone, Free T3, Free T4, TSH, hemoglobin A1c, fasting insulin. Additionally it is useful to do saliva tests for Cortisol four times in a day, and DHEA two times in a day; and urinary neurotransmitter testing (serotonin, dopamine, GABA, norepinephrine, epinephrine, glutamate, histamine (when available)).

There are numerous options for treating adrenal fatigue. I customize the treatment to the person. Isocort can become extremely expensive when it has to be used in high doses, for example. It also has to be paid out-of-pocket. Hydrocortisone and other glutocorticoids can be inexpensive, generic, and covered by health insurance. Treatment will depend on numerous factors including the patient's needs, their ability to afford treatment, their ability to adhere to treatment (e.g. short-acting glutocorticoides such as hydrocortisone/cortisol are more difficult for college-aged adults to use), etc. Some conditions such as severe hypertension may rule out the use of hydrocortisone. An alternative may need to be used.

Whether or not a patient continues their adrenal fatigue treatment depends one the treatment of associated conditions such as thyroid problems, age-related DHEA decline, testosterone deficiency. It also depends on whether or not the person can improve their psychological skills to adapt to stress, whether or not the person can modify their environmental stresses, whether or not the person can resolve the problems caused by past trauma, etc. For example, if a person can change their lifestyle to reduce stress enough that the adrenal glands can fully recover, then they may not need continuous treatment. Some people cannot escape extreme stresses - for example, people who have had severe childhood trauma and live in poverty. These people may need lifelong treatment. Some people can stop treatment one day, some people can't. The treatment depends on the person and their circumstances.

[ironaddict69]

marianco, do you know a direct way to lower progesterone?
whats the highest dose of armour youve ever had somebody on? i hear for some it takes up to like 10 grains.
im just curious, not that im addressing my thyrod and adrenals with isocort, im wondering how to lower progesterone. its the only thign outta wack and its ruining my sex life.