OperativeKlause Intro

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OperativeKlause
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OperativeKlause Intro

Unread post by OperativeKlause »

Hey all, thought I'd jump over here from r/PSSD; I've already made a few posts on there over the past couple of years, but I figured I would share my story on here in case anyone wants to discuss.

To summarize as briefly as possible:
*I'm a 30yo male in generally good health aside from mild obesity and high cholesterol

*Developed PSSD in mid-2020 after having taken Zoloft for ~6 months following an episode of anxiety and severe insomnia

*Symptoms are erectile dysfunction (typically can't get an erection without manual stimulation, generally doesn't last more than 30 seconds, easy to lose one even during sex/masturbation, no morning wood or spontaneous erections), lack of genital sensitivity (not completely numb, but definitely less sensitive than pre-PSSD), lack of libido/sexual or romantic interest (I'm only interested in sex and dating in the sense that I wish I could still feel interested, if that makes sense), emotional blunting (can't feel sad/cry, can't feel scared, can't really feel happy or content), anhedonia (don't really enjoy things to the extent I used to), brain fog/problems with memory and concentration, and inability to enjoy music (my favorite music is basically just noise to me now, in the same way that I don't feel attracted to people I once did).

*Since stopping Zoloft, I've been on several psychiatric medications, including trazodone and wellbutrin, none of which seemed to help or hurt my PSSD symptoms, even if they caused changes in my mood, anxiety/depression symptoms, etc.

*I've tried a wide range of supplements that haven't helped, including maca, tribulus, damiana, horny goat weed, methyl folate, neo40 (nitric oxide supplement), schisandra, B12, and various others I don't really remember.

*I've tried a few things that actually have helped to a degree; these are as follows:

**Rifaximin (antibiotic for SIBO); I got diagnosed with SIBO after u/lastround360's gut microbiome hypothesis inspired me to get tested, and I was prescribed rifaximin to treat it. To my shock, this absolutely did help my symptoms across the board over the course of a month, but unfortunately I couldn't take the antibiotic indefinitely, and all the benefits went away after stopping. Haven't been able to try it again since last year.

**Inositol; I took 1 gram about two months ago, and my ED symptoms improved immensely for about 12 hours. No further benefits with more or larger doses.

**Forskolin (herbal supplement); this actually helped my sexual symptoms more than anything else I've tried. Within a day or two of starting, I was getting erections much more easily, they were harder than they had been in years, my orgasms were stronger, and my mood and ability/willingness to socialize improved noticeably. After a week of continuous dosing, however, the benefits faded away, and I haven't been able to replicate that first success again as of yet.

*I recently started taking a hormonal approach under the supervision of a well-respected urologist in my area; he initially had me on a month of Clomid, which didn't really help (there were maybe slight, transient improvements during the first week or so, but by the end my sexual dysfunction and low libido were worse than before, and I felt depressed and lethargic). I've now been off Clomid for a few days, and will be getting some blood work done in a couple days; I'm hoping to move on to HCG or TRT as a next option, as I really didn't like how Clomid made me feel.

My thoughts on the stuff that's helped me are as follows:

*It's possible that the rifaximin helped me because it was treating my SIBO, but as of now I think it's more likely that it was affecting my hormones. There's a paper (see link:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8862550/) that shows rifaximin to have a significant effect on levels of thyrotropin-releasing hormone (TRH) in the brain. TRH signals the release of thyroid-stimulating hormone (TSH), and has been used clinically as a treatment for neuro-cognitive problems.

*Inositol is well-established to increase serotonin and dopamine receptors in the brain, which seems relevant and possibly explains why it helps some people (including me, if only briefly).

*Forskolin has a variety of effects, such as increasing testosterone levels, upregulating dopamine (D2) receptors, increasing cAMP (a second messenger involved in many cell processes), and mimicking the function of TSH in certain contexts. Any or all of these seem like they could explain why it helped me.

My background is in molecular biology, but I have very little expertise in neurochemistry, hormone metabolism, etc. As such, all I can really say at this point is: based on what's helped me, it seems likely that my PSSD symptoms have something to do with my hormone metabolism, and likely something to do with dopamine signaling.

I'd be very interested to hear any of your questions or comments on the above- unfortunately, until the ball really gets rolling on PSSD research, all any of us really can do is compare notes and draw hypothetical connections. Hopefully some of what I've shared will be useful/interesting to you guys.
Last edited by OperativeKlause on Mon May 29, 2023 6:55 pm, edited 1 time in total.
Leadtheway
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Re: OperativeKlause Intro

Unread post by Leadtheway »

Hi,
I've just read on BDNF (Brain-Derived Neurotrophic Factor) and it could play a role in dopamine circuits and could also be acted upon by antidepressants. Maybe a good topic to research.

Also, inositol is an osmolyte (a molecule that helps counter osmotic stress) and I believe it's on this basis that it could be interesting.
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HTH
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Re: OperativeKlause Intro

Unread post by HTH »

Welcome! What symptoms do you have that may related to SIBO?
Agree, doing things that possible elevate BDNF is a good way to start improving symptoms.

What happens when a psychiatrist and a hooker spend the night together? In the morning each of them says: "200 dollars, please."
OperativeKlause
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Re: OperativeKlause Intro

Unread post by OperativeKlause »

HTH wrote: Tue May 30, 2023 6:36 am What symptoms do you have that may related to SIBO?
Currently not much to be honest, I've had near-constant loose stools/diarrhea with occasional constipation for the past 3 years or so, but this seems to have improved in the past month. It could be that I've just managed to nuke my gut microbiome into submission at this point after all the things I've taken :lol: Still have cognitive issues and brain fog, which is a known symptom of SIBO, but that could just be my PSSD (assuming my PSSD isn't caused by SIBO, which is one hypothesis).
Leadtheway wrote: Mon May 29, 2023 11:08 am I've just read on BDNF (Brain-Derived Neurotrophic Factor) and it could play a role in dopamine circuits and could also be acted upon by antidepressants. Maybe a good topic to research.

Seems like as good a lead as any! I've recently been trying to exercise more, I'll work in some other things to try and increase my BDNF however I can. Do you have any recommendations?
Leadtheway
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Re: OperativeKlause Intro

Unread post by Leadtheway »

OperativeKlause wrote: Wed May 31, 2023 2:55 am Seems like as good a lead as any! I've recently been trying to exercise more, I'll work in some other things to try and increase my BDNF however I can. Do you have any recommendations?
Disclaimer: I might be biased on this one. Sometimes I wonder whether exercise benefits aren't mostly coming from water loss (and induced hyperosmolarity/"dehydration") and then rehydration, creating dehydration/rehydration cycles which in my unhorthodox views could be a good thing for a number of reasons.

That being said, I think "intermittent drinking" (here is a publication in the Medical Hypotheses journal about this concept of adopting water drinking patterns, https://pubmed.ncbi.nlm.nih.gov/27241263/) could be a way to boost BDNF:

Water supplementation affects the fluid intake and serum levels of BDNF among the elderly nursing home residents (https://pubmed.ncbi.nlm.nih.gov/35679810/)
The present study demonstrated that 7 d of water supplementation increased the water and the total fluid intake in elderly individuals regardless of dehydration status. Serum BDNF levels increased during dehydration and reverted to physiologic levels after appropriate rehydration.
The Effects of Fasting During Ramadan on the Concentration of Serotonin, Dopamine, Brain-Derived Neurotrophic Factor and Nerve Growth Factor (https://pubmed.ncbi.nlm.nih.gov/28713531/)
Our findings suggest that plasma levels of serotonin, BDNF and NGF were significantly increased during fasting month of Ramadan.
Ramadan is not only not drinking but also fasting of course.

BDNF could be linked to water homeostasis through vasopressin (Hold the Salt: Vasopressor Role for BDNF, https://www.sciencedirect.com/science/a ... 3115001187).
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