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Suggest Treatment For Severe Depression
Question: M. Redman age 71 Bp 124/70/88
Of items tested B12 low B6 Low D3 low
Cortisol total 21 DHEA early morning 0.06 Afternoon 0.03
I owned two companies sold and fell into clinical depression some 30 years ago. Today I take Isocarboxazid and lithium medication. 10 years ago Thyroid problems still unsolved after three years. Finally my Cortisol and DHEA were tested (adrenal stress test) and found to be just a total of 13. At this time I also was diagnosed with Metastatic prostate cancer. Increasing my Cortisol caused my PSA to increase rapidly and we had to abandon the adrenal supplementation tablets. I am now in my ninth year with a psa of 1.2 – and apparently Less than 1% survive to this age
I guess the question I am asking is this
I think the low state of my adrenals is compromising my thyroid and I now feel so low I have no quality of life. I am seriously considering taking a very low dose of DHEA while taking frequent psa (to monitor my PSA) readings and adrenal stress tests. I have plotted the exponential values of my PSA over eight years and categorically there have been 6 basic foods/drinks which have caused PSA spikes immediately disappearing when I dropped these items from my diet.
I am in such a low state that I have little to loose that my intention is to start on a very low dose of DHEA I realise the potential lf raising my testosterone but there are mixed messages on this and it might alleviate my depression. Do you think this is the only realistic alternative open to me.
Many thanks XXXXXXX Redman
Ps I have Zoladex to curtail my Testosterone
Of items tested B12 low B6 Low D3 low
Cortisol total 21 DHEA early morning 0.06 Afternoon 0.03
I owned two companies sold and fell into clinical depression some 30 years ago. Today I take Isocarboxazid and lithium medication. 10 years ago Thyroid problems still unsolved after three years. Finally my Cortisol and DHEA were tested (adrenal stress test) and found to be just a total of 13. At this time I also was diagnosed with Metastatic prostate cancer. Increasing my Cortisol caused my PSA to increase rapidly and we had to abandon the adrenal supplementation tablets. I am now in my ninth year with a psa of 1.2 – and apparently Less than 1% survive to this age
I guess the question I am asking is this
I think the low state of my adrenals is compromising my thyroid and I now feel so low I have no quality of life. I am seriously considering taking a very low dose of DHEA while taking frequent psa (to monitor my PSA) readings and adrenal stress tests. I have plotted the exponential values of my PSA over eight years and categorically there have been 6 basic foods/drinks which have caused PSA spikes immediately disappearing when I dropped these items from my diet.
I am in such a low state that I have little to loose that my intention is to start on a very low dose of DHEA I realise the potential lf raising my testosterone but there are mixed messages on this and it might alleviate my depression. Do you think this is the only realistic alternative open to me.
Many thanks XXXXXXX Redman
Ps I have Zoladex to curtail my Testosterone
Brief Answer:
causes like vitamin defiiencies and depression should be adequatetly treate
Detailed Answer:
Good day,
Noted your concern and sorry to hear about your problems. DHEA will increase the level of testosterone which will favour the growth of prostate tissue ( including Metastatis tissue). Hence it is not recommended to use DHEA or testosterone supplementation. You need to discuss with both urologist and endocrinologist about the risk of rising PSA while on DHEA and if a consensus can be obtained, we could consider interval treatment with DHEA. However, i would discourage this.
ZOLADEX cause central pituitary/hypothalamus supression of hormones which evantually cause low levels of testosterone. However, when you take DHEA, adrenal gland and your testes will convert it to testosterone directly hence make Zoladex less effective.
I agree that, depression and low quality of life gets worsened by low levels of testosterone.But in view of metastatic prostate cancer, it would be logical to have low testosterone levels.
You havenot mentioned the units of cortisol. I presume it is mcg/dl. If AM cortisol is 13 mcg/dl, then it is a good value and rules out adrenal insufficiency.
There are several other reasons for your symptoms. Depression and Vitamin deficiencies itself can cause low quality of life. Before embarking on the DHEA treatment way, i would certianly request you to meet a psychiatrist and discuss about controlling depression. That itself would improve yor mood and quality of life. Besides, Vitamin B12 and D supplemants are harmless and please get a prescription of the same from your PCP.
Regards
Binu
causes like vitamin defiiencies and depression should be adequatetly treate
Detailed Answer:
Good day,
Noted your concern and sorry to hear about your problems. DHEA will increase the level of testosterone which will favour the growth of prostate tissue ( including Metastatis tissue). Hence it is not recommended to use DHEA or testosterone supplementation. You need to discuss with both urologist and endocrinologist about the risk of rising PSA while on DHEA and if a consensus can be obtained, we could consider interval treatment with DHEA. However, i would discourage this.
ZOLADEX cause central pituitary/hypothalamus supression of hormones which evantually cause low levels of testosterone. However, when you take DHEA, adrenal gland and your testes will convert it to testosterone directly hence make Zoladex less effective.
I agree that, depression and low quality of life gets worsened by low levels of testosterone.But in view of metastatic prostate cancer, it would be logical to have low testosterone levels.
You havenot mentioned the units of cortisol. I presume it is mcg/dl. If AM cortisol is 13 mcg/dl, then it is a good value and rules out adrenal insufficiency.
There are several other reasons for your symptoms. Depression and Vitamin deficiencies itself can cause low quality of life. Before embarking on the DHEA treatment way, i would certianly request you to meet a psychiatrist and discuss about controlling depression. That itself would improve yor mood and quality of life. Besides, Vitamin B12 and D supplemants are harmless and please get a prescription of the same from your PCP.
Regards
Binu
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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