Exerpts from Dr. Braverman's newly released book., Serotonin and the pauses.

[chip douglas]

In his new book Dr. B. writes and I quote :

''A lack of serotonin will often cause depression and trigger the onset of other pauses. A lack of serotonin will :


1*Accelerate calcification, leading to osteopause.
2*Lower your sex drive, trigerring menopause and andropause.
3*Lower your testosterone, leading to andropause.
4*Lower your estrogen, progesterone, and triggering menopause
5*Weaken your immune system, leading to immunopause.
6*Accelerate skin aging or wrinkles and frown lines, triggering dermatopause.''



Now, the reason I'm posting this is I find confusing statements 2 and 3.

SSRI's inhibit the re-uptake of serotonin leading to higher Serotonin in the synaptic cleft. SSRI's have been used to treat depression, and their use have been linked to sexual dysfunction, namely inability to ejaculate, and lower sex drive.

Now can someone more knowledgeable then I explain to me how can serotonin lower one's sex drive, and lower one's testosterone, because it doesn't make sense to me as per the above regarding SSRI's use and side-effects.

The only reason I can see off the top of m head is that low serotonin increased percieved stress, and stress isn't conducive to a healthy sex drive.

But still I need explanation for the above quote from Dr. B.

Any thoughts ?

[HeadDoc]

are you working with Braverman? Hs "pause" model caused me to take a much more holistic approach to HRT than TRT. Some of Marianco's old threads on neurotransmitters and hormons may clarify this point. I recall putting a sticky on a few. Let me know if you cannot find them and I'll look this weekend.

[chip douglas]

That's kind of you HeadDoc. I'll look through the sticky in this forum, I guess I should find them on my own. If I don't I'll wave.

To answer your question : I'm one of his patient--went there last year and then had phone follow-ups, then stopped because the initial consult cost me in excess of $3500 + plus hotel stay for two days in Manhattan + plus the air fare. It was a very expensive consult I can tell you that.

Back then, if I had known about Dr. Marianco the way I do now, no doubt I would have seen him over Dr. Braverman. I think Dr. Braverman is a very good doctor per se, but he's too expensive to my liking and also felt it was impossible to get decent care with the flow of people there's at his clinic. One doesn't get much face time with Dr. Braverman, I can tell you that.

Thanks

[chip douglas]

Originally Posted by chip douglas

In his new book Dr. B. writes and I quote :

''A lack of serotonin will often cause depression and trigger the onset of other pauses. A lack of serotonin will :


1*Accelerate calcification, leading to osteopause.
2*Lower your sex drive, trigerring menopause and andropause.
3*Lower your testosterone, leading to andropause.
4*Lower your estrogen, progesterone, and triggering menopause
5*Weaken your immune system, leading to immunopause.
6*Accelerate skin aging or wrinkles and frown lines, triggering dermatopause.''



Now, the reason I'm posting this is I find confusing statements 2 and 3.

SSRI's inhibit the re-uptake of serotonin leading to higher Serotonin in the synaptic cleft. SSRI's have been used to treat depression, and their use have been linked to sexual dysfunction, namely inability to ejaculate, and lower sex drive.

Now can someone more knowledgeable then I explain to me how can serotonin lower one's sex drive, and lower one's testosterone, because it doesn't make sense to me as per the above regarding SSRI's use and side-effects.

The only reason I can see off the top of m head is that low serotonin increased percieved stress, and stress isn't conducive to a healthy sex drive.

But still I need explanation for the above quote from Dr. B.

Any thoughts ?

I spent the whole evening reading on the forum (Marianco's posting--this man is so interesing and reading him is captivating), and I cannot at all understand how Dr. Braverman can make claims that a deficit in serotonin can lower one's sex drive, and cause low testosterone.

Since 2+2 rarely equals 4 in the human body given it's unbelievable complexity, it would be most interesting to hear from M.D's on this forum, to comment on what Dr. Braverman claims. However Dr. Braverman is a medical doctor whereas I'm not, so what he said may very well have clinical relevance, although I cannot see how this can happen, UNLESS one has very low serotonin levels to begin with, and that stress is destroying his life, then it would make more sense, but this detail is never mentioned clearly, and no scientific back-up is provided to satisfy exacting readers like me.

[HeadDoc]

Braverman's Edge Effect was merely an introduction. Marianco has enlightened us the multivariate interaction of hormones and neurtransmitters. So, you are , of course, right that just siting one homone is not a satisfying answer. I wish there were available to us all a visual graph that would permit the exploration of "what if" statements on varying either hormones or neurotransmitters that would illustrate the effects.(is that a run-on sentence?). If that same graphic display would allow us to plug in baseline values of homones or adjustments, it could tell us alot about the neurtransmitters--even though they can not be directly measured at key sites in the brain.

[chip douglas]

But one thing seems to be well accepted, is that increased serotonin is not conducive to healthy sexuality. I take this from Marianco's posting, pharmaceutical drugs literature, and the number of poster all over the web reporting on sexual dysfunctions concurrent with the use of antidepressant medications.

From memory, I recall that Marianco has written that a little serotonin can help with sex drive by decreasing percieved stress, and that GABA is relevant to libido by modulating anxiety levels.

One of the supplements that has worked well in me with regards to libido is Valerian, but if I take too much, the libido is good but it inhibits orgasm. It also helps me get better sleep--I guess may mean deeper stage sleep as well.

I think Valerian (though I'll search Pubmed later on) acts primarily on melatonin and GABA receptor to increase the binding of GABA.


Sorry I went off on a tangent, but what i was saying is that after searching Pubmed this morning, all I have found regarding the relationship between Serotonin and Testosterone, is that increased serotonin tone from SSRI's often result in lower Testosterone levels--like Marianco stated many times, increased serotonin can lower dopamine, and that in turn will increase Prolactin release given it's dopamine that primarily control PRL. I also think that increased PRL (but i say this from memory so correct me if mistaken) will in turn inhibit the release of gonadotrophin hormones (FSH, LH), leading to lower T levels.

So Dr. Braverman would have to provide scientific back-up to his claims that decreased serotonin can bring about low sex drive and cause andropause.

Thanks for chiming in HeadDoc, I know you've been quite busy lately.

[HeadDoc]

it seems to me that you got all the pieces of the puzzle in place. I'd still like to have the multidimensional graphic to handle the types of questions that we raise. I don't work often enough in this model to recall all the pieces. Marianco does. As for me I have been majorly busy converting my practice to near paperless operation. About two months ago I was orphaned for the second time in ten years by specialty software that its developers could not fix.

In another week or two things should calm down for me. Thanks for noting this.

I'm also getting my aerobic act together. After getting a Vo2max assessment, I'm working on a five day a week program in addition to my usual lifting. Fatique has been an issue during this start up phase.

[chip douglas]

Oh yeah, the multidimensional graphic, would indeed be very useful to say the least...........I didn't comment about it earlier as it somehow escaped me at the time.

Best of luck to you HeadDoc in your restructuring and aerobics.

[Naturdoc]

I think we need to distinguish between synaptic levels of serotonin which are increased by SSRIs and systemic serotonin levels which I believe is what Braverman is relating as causing problems if they are inadequate.

[chip douglas]

I didn't mention it before, but yesterday this is what I thought might make a difference, however in his book, Dr. B doesn't state any difference between those. In fact he mentions that serotonin can be effectively raised by either HRT (rHGH), pharmaceutical drugs (SSRI's) and tryptophan. So he makes no distinction between elevation in the synaptic cleft as induced by SSRI's and more natural elevations such as with the use of Tryptophan.

Naturedoc : do you have any idea how low serotonin can bring about low sex drive and as far as to trigger andropause ? Any known scientific literature that would elucidate this to the best of your knowledge ?

Cheers

[chip douglas]

This afternoon I read this : http://fiddaman.blogspot.com/2007/01...serotonin.html

After reading this it's clear (as has been for a god while now) that the big three are involved in depression, namely : 5HT, Nepi. and DA.

However given the results of various reviews and committees on the efficacy of antidepressant drugs, and the placebo effect that some found between controls and drug fed group, I more and more wonder about the role of stress in the development of depression. I see lots of people stressed out, and I also see many people going to their doctor's office to have AD prescribed. Stress is rather pervasive nowadays, and while leading a life of no stress at all, simply is impossible, too much of it for sustained periods of time, seems to take it's toll on the neuroendocrine system.

There are a few theories of depression, and more and more think of it as heart disease, cancer and other disease state , as being multifactorial. I think the problem comes when one attemps to isolate an individual element and put the blame on it. Thanks to Marianco I think I have gained a better understanding of this holistic concept.

Anyway, it's my two cents from a good amount of reading here and elsewhere, and from personal observation of my own self, as well as others.

[bullmastiff]

Low serotonin could very well be a problem but high serotonin could also be a problem. The ssris may elevate serotonin to levels that are to high and thereby disrupt the other neurotransmitters and create sexual side effects. The new ad (emsam maoi) elevates serotonin, norepinephrine and dopamine and doesn't seem implicated so far in sexual side effects.

[Naturdoc]

Despite Braverman's opinion, I believe it is possible for SSRIs to maintain synaptic serotonin at the expense of total body stores that have multiple other functions and interalationships with hormones. I don't have references for this, only experience.

[HeadDoc]

I believe you are right. Marianco has told us that thisis one of reasons that measures of seratonin from blood or even spinal fluid are not be a true measure of seratonin at the synaptic level in the areas of the brain that would influence mood. That's why we can have a direct measure of hormones and their relevant direct action whereas the measure of neurotransmitters is indirect. Hence difficulty of knowing more directly the interaction between hormones and neurotransmitters.

[chip douglas]

Originally Posted by Naturdoc

Despite Braverman's opinion, I believe it is possible for SSRIs to maintain synaptic serotonin at the expense of total body stores that have multiple other functions and interalationships with hormones. I don't have references for this, only experience.

Would you be so kind as to expound some more on this, this is interesting.