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Originally Posted by DaVinci2 OK, my doctors aren't very helpful in this area. I mentioned that I was feeling very tired after I get my shot. Both doctors I talked with said the same thing "I've never heard of that happening so I don't know what to tell you." Then, I ask if it's possible (Over the las 3 weeks) that because of the hCG (Possible raise in E2) is causing panic attacks? Both have no idea.
Any advice on these 2 issues? |
I can't give you advice since you are not a patient.
However, I can give educational information about HCG (Chorionic Gonadotropin).
The issue of HCG and panic attacks is much more complex than what appears on the surface.
A partial account of the metabolic cascades involved is as follows:
HCG acts like LH (Luteinizing Hormone).
LH has several actions, such as:
1. It stimulates testosterone production from the testes
2. It stimulates the production of aromatase enzyme
3. It stimulates the production of Cytochrome P450sc enzyme
4. etc.
Testosterone has several actions, such as:
1. Increasing dopamine production in the brain.
2. Increasing OR Decreasing Thyroid hormone production.
3. Reducing ACTH production.
4. Directly reducing Adrenal hormone production.
5. Becomes Estradiol via Aromatase enzyme.
6. Becomes
DHT (Dyhydrotestosterone) via 5-Alpha-Reductase enzyme
7. Promotes insulin sensitivity.
8. Has antiinflammatory signaling functions.
9. Excessive Testosterone can result in an increase in anxiety depending on the metabolic cascades involved.
10. etc.
Aromatase Enzyme:
1. Turns Testosterone into Estradiol
2. etc.
Cytochrome P450sc enzyme:
1. Turns Cholesterol into Pregnenolone
2. etc.
Estradiol (and other estrogens) has multiple actions, including:
1. Acting as a Monoamine Oxidase Inhibitor in the brain
2. Reducing thyroid hormone activity by increasing production of Thyroid Binding Globulin from the liver.
3. etc.
Monoamine Oxidase Inhibitors (such as Estradiol) to varying extents:
1. Increase Serotonin levels
2. Increase Norepinephrine levels
3. Increase Dopamine levels
4. etc.
Serotonin:
1. Reduces the perception of stress - thus has an antianxiety effect.
2. Reduces norepinephrine production from norepinephrine neurons - contributing to its antianxiety effect.
3. Reduces dopamine production from dopamine neurons - if reduced excessively, this can increase anxiety
4. Has antiinflammatory signaling functions
5. etc.
Norepinephrine:
1. Is the primary signal for stress
2. Excessive Norepinephrine can result in anxiety or irritability/anger.
3. Has inflammatory signaling functions.
4. Can increase energy by promoting adrenal hormone production - if the adrenal glands are not fatigued excessively
5. etc.
Dopamine:
1. Promotes a sense of well-being, calmness
2. Deficiency in Dopamine production can cause agitation or anxiety, etc.
3. etc.
Thyroid hormone:
1. Promotes energy production, such as by increasing mitochondria production and thermogenesis.
2. Promotes steroid hormone production - increasing testosterone production - thus lowering thyroid hormone can reduce testosterone production.
3. Promotes IGF-1 production - which does most of the actions of growth hormone
4. Increases serotonine production
5. Promotes insulin sensitivity
6. Has antiinflammatory signaling functions
7. Deficiency in Thyroid hormone can result in anxiety or irritability/anger
8. etc.
Growth hormone/IGF-1 hormone:
1. Can promote a sense of calm and well-being - deficiency of which can result in a higher level of anxiety.
2. Has antiinflammatory signaling functions.
3. etc.
Adrenal Hormone production, includes:
1. Cortisol
2. DHEA
3. Progesterone
4. Testosterone
5. Pregnenolone
6. Adrenal cortex hormone production - particularly Cortisol - promotes energy production
7. etc.
Cortisol:
1. Promotes energy - via gluconeogenesis, etc.
2. Feeds back to the brain to reduce Norepinephrine production - resulting in reduction in anxiety.
3. Deficiency in Cortisol production can result in anxiety
4. etc.
DHEA:
1. Increases Dopamine production in the brain
2. Promotes insulin sensitivity
4. Has antiinflammatory signaling functions
5. Deficiency of DHEA can result in anxiety.
6. etc.
Pregnenolone:
1. Has a stimulant effect.
2. Excessive Pregnenolone production can result in agitation, tension, or anxiety.
3. etc.
Progesterone:
1. Has a calming, mood-stabilizing effect.
2. Deficiency in Progesterone can result in agitation, tension, or anxiety.
3. Has antiinflammatory signaling functions.
4. etc.
Insulin:
1. Excess insulin can reduce testosterone production.
2. Has pro-inflammatory signaling functions.
3. etc. etc. etc.
Immune System:
1. Deficient antiinflammatory signaling may promote anxiety
2. etc. etc.
Nutrition:
1. Certain nutrients are necessary to promote function across the nervous system, endocrine system, and immune system.
2. Deficiency of certain nutrients can promote anxiety in response to HCG as a result of dysfunction in these systems.
Thus, when HCG causes anxiety, the story is actually more complex than just the resulting increase in Estradiol.
1. If HCG increases Testosterone excessively, it can cause a cascade that results in anxiety - e.g. by decreasing thyroid function, decreasing adrenal hormone production, etc - particularly if a person is predisposed to anxiety such as by having hypothyroidism and adrenal fatigue.
2. If HCG increases Estradiol, it can cause a cascade that results in anxiety IF (a big if), Estradiol increases norepinephrine more than serotonin and dopamine, or if it results in significant thyroid hormone reduction (particularly if a person is hypothyroid and has adrenal fatigue).
3. etc. etc. etc.
The solution would involve examining all the involved systems and chemical messengers (neurotransmitters, hormones, etc) rather than just knee-jerk blaming only estrogen and attempting to reduce estrogen levels. The solution involves addressing the problems that are actually present (e.g. hypothyroidism, adrenal fatigue, excessive insulin, etc.) to reduce the risk of anxiety with HCG particularly when one wants to use HCG to preserve testicular size or to use HCG as a replacement for testosterone replacement therapy.
Reducing estrogen levels blindly can increase the risk of multiple problems including anxiety itself - such as when estradiol more strongly increases serotonin than norepinephrine in a person.
Lab tests and an exam would be necessary to help determine where the problem lies. Then solving the problem would not involve so much trial-and-error and guesswork.
Yes, HCG can cause panic attacks in susceptible persons depending on the functioning of the nervous system, endocrine system, and immune system - the sum of which I call 'the mind".
Dr. M
Re: Lithium's mechanism of action? 
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