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Author Topic: Low Dose Naltrexone  (Read 16204 times)
lostmojo
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« Reply #15 on: August 23, 2010, 04:55:09 PM »

Wow - are you in one of those wonderful countries where you can get testosterone cream over the counter? I'm so jealous.

No I would need a prescription as far as I can tell before I can buy it. For all I know the testosterone cream I've ordered will be confiscated by customs when it enters the country, I hope not.
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michaelsad
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« Reply #16 on: August 23, 2010, 07:32:19 PM »

@nofun,  
is it safe for lostmojo to use 5-HTP instead of SSRI for experiementing a boost up of serotonin level ?
.......I recently tried it for a couple of months..........generally increased serotonin levels are believed to dampen sexual response.......if you really think you're serotonin deficient, I'd take a trial of 5-htp before an SSRI..............After a little further reading on testosterone replacement......... I've already started on HRT.........

I always have PE so I assume my serotonin level could be at the low level however I still dare not to take the 5HTP that i have bought because i understand that it will dampen sexual response, which is my main problem (not PE). So instead of taking 5HTP,  I am thinking of trying Ginkgo Biloba (I read somewhere that it enhances libido and sexual response).

Could you give me some opinion on Ginkgo biloba ?  Can i take this together with GABA?

The doctor I have seen only gave me a test on total t-level ( ~500 ) and not free t-level even i demanded for it.  I am still searching for a place in my country where i could do the reasonable set of blood test.  In the meantime, I have taken some natural approach to increase my (hopefully free ) t-level such as eating more peanuts, eye yolk, sleep more, Vitamin E and Zn supplements, ejaculate less frequently.  Seems help a little bit in sensation, ejaculation strength and volume.  

 
« Last Edit: August 23, 2010, 07:34:30 PM by michaelsad » Logged
lostmojo
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« Reply #17 on: August 25, 2010, 03:26:30 AM »

MichaelSad you have said previously that it was a specific physical act that you believe cause your AE. Could you please tell us what that was?

During a masturbation session (at 17,  40 years ago),  I attempted to delay ejaculation by,  upon reaching the point of no return,  contracting (may be relaxing)  the bladder/urethra muscle in the direction as if i was urinating.   I suddenly felt a sharp uncomfortable feeling that stopped me from continuing my hand motion.  I tried to continue masturbating but after a few hand strokes,  an uncomfortable feeling arose.  That masturbation session was never continued. From that moment onwards, I have had my orgasm lost.  

I had not lost my sex drive and pleasure sensation with sex (except orgasm).  I got married and have lived a normal life.

I am now facing some additional problems ---- my sex drive,  semen volume,  penile sensitivity and sex pleasure sensation  have decreased substantially over the last year.  

michaelsad, I brought this post over from the other thread because I think you are the only person who can recall a specific physical incident that led to AE.

Have you ever seen a urologist and/or neurologist about this? Not that they will necessarily have any answers but I think it is extremely important that you at least try. I have sent your description to my neurologist in the hope that it may mean something to him or some other specialist he knows.

Do you still feel "normal" pain, heat, cold etc in the genital area? Is it only sexual sensation that has diminished? If a single physical act can have you go from completely normal to losing orgasm (and eventually almost all sexual sensation) but retaining other sensory feedback then that seems to be outside of what anybody understands about nerves and sexual functioning.

Where you and I are now in terms of sensation is very similar. I did engage in somewhat rough masturbation when I was young and although I wasn't aware at the time of a single "act" when the damage was done I think it is possible that something similar happened to me as for you.

If any supplements are giving you any slight improvement I would be guessing that it is because they are "turning up the volume" on what little sensation you have left not actually addressing the underlying cause. Not that years of functioning differently may not have caused some other imbalance to happen.
« Last Edit: August 25, 2010, 04:18:31 AM by lostmojo » Logged
NoFun
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« Reply #18 on: August 25, 2010, 04:26:56 PM »

michaelsad, I brought this post over from the other thread because I think you are the only person who can recall a specific physical incident that led to AE.
Yeah, it certainly sounds like you might have injured something. There are valves in your tubes that open and close to control ejaculation. I would think that it is possible to damage them, and their associated nerves, in a way that prevents orgasm, particularly if too much pressure gets built up in the system. But maybe you're not really injured, and it's an ejaculatory duct obstruction problem? Some cyst or stone got jammed somewhere?

I'd think that's something worth talking to a urologist about. They're the experts on the mechanical aspects.

But work on regaining sensitivity and libido too, since you've only recently lost them.

On Gaba and Gingko, strangely enough, there is at least an indication they are counterproductive. Apparently Gingko is a GABA_A antagonist. I wouldn't get too worked up over this, but technically, there appears to be a reason not to take them together. I don't see you hurting yourself, and Gingko is supposedly good for increasing blood flow to the brain. Honestly, I've never heard of gingko making a big difference either way.
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researcher
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« Reply #19 on: August 25, 2010, 08:29:14 PM »

i did not notice any feelings of improvement on ginkgo. i felt nothing from it. but i dunno thats just me.
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michaelsad
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« Reply #20 on: August 26, 2010, 08:06:15 PM »

Yes nofun, I have been disappointed by doctors many many times but still haven't visited a urologist.  It should be one of my action plan.  

I am not the only one who have triggered AE by a single incident.  I read in some forum that someone complained he lost his orgasm ability (very similar to mine) after following a female "expert" teaching "achieving male multiple orgasm" in TV. He followed her advise and end up with no more orgasm.  Unfortunate that I could not find this forum message again since i read it the first time. I hope this person can find this forum and share with us his story.

I found very recently that obstinence ( to me,  it means a reduction from 2-3 ejaculations per week to 2-3 per month) can increase my ejaculation strength and volume.  This eliminates the possiblity of duct obstruction and retrograde ejaculation.

A neurologist might be appropriate too because I've got an impression that my AE trigger incident could have established in my brain an undesirable feedback mechanism where just before orgasm, a signal will be sent to a set of muscle and valves asking it to resist any external stimulation (since my body was told once by me that I don't want orgasm).  Thanks lostmojo in sending my case to your neurologist.    

I think my pain/cold/hot penile sensations are normal.  I believe my lost of sexual drive and sensation is a gradual slow process caused by aging.  The lost had became drastic last year.  This could be due to prostatitis.  My prostatitis was over and together with supplements,  my sexual sensation is regaining slowly.      

My GABA-plus experiement gives me some hope because not only it enhances my weak sexual sensation (lost last year),  it seems it can affect the undesirable feed-back circuit and have allowed me to achieve 1/10 of an orgasm (lost for 40 years).

Thanks nofun and researcher for your information re ginkgo.
« Last Edit: August 26, 2010, 08:08:21 PM by michaelsad » Logged
NoFun
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« Reply #21 on: August 27, 2010, 03:39:07 AM »

I know a number of folks mark the beginning of their problems to SSRI use. I came across a few interesting articles showing a relationship between opioid antagonists like naltrexone and SSRI tolerance effects.

First, a post from Yahoo SSRIsex group, for people with SSRI sexual dysfunction:
Quote
Either Naltrexone (regular dose) or Low Dose Naltrexone (LDN) may be worth a
shot. Several people on this site have tried Naltrexone with good results. They
didn't report that it cured them, but it helped some with libido. Also, on the
Yahoo Group for LDN, may of the members discuss a resurgence of libido (using
LDN) that was blunted by Multiple Sclerosis or Fibromyalgia.

An abstract talks about SSRIs used as analgesics, and patients developing tolerance over time, where the tolerance effect was reversed with use of naloxone, another opioid agonist.

http://content.karger.com/ProdukteDB/produkte.asp?Doi=72662
Quote
Selective serotonin reuptake inhibitors (SSRIs) have been used clinically as co-analgesics in various devastating painful conditions. Upon chronic treatment tolerance develops to their analgesic effect, which is often refractory to increasing dose. Although modulation of serotonergic pathways considerably explains their clinical efficacy, numerous reports nevertheless indicate the direct/indirect role of the opioidergic pathway in SSRI-induced analgesia.

... Thus, in ultra-low doses, naloxone paradoxically enhances SSRIs-induced analgesia and reverse tolerance through spinal and peripheral action. These effects of opioid antagonist naloxone on SSRIs-induced antinociception may have an implication in refractory cases upon chronic use of SSRIs as co-analgesics.

And some doctor bulletin board had a couple of docs talking about interactions between naltrexone and SSRIs. With a little more search, it seems that naltrexone has a reputation for combating SSRI poop out.
Quote
Date: Fri, 16 May 1997 09:20:19 -0700 (PDT)
From: ferrell@cmgm.stanford.edu (James Ferrell)
Subject: Naltrexone for SSRI poop out

Lee Dante wrote, in part:

    This phenomena of the SSRI "poop out" can usually be reversed by adding 25 mg of naltrexone (marketed in the US as Revia), usually on top of supper to avoid transient nausea. In anywhere from two weeks to five of once daily dosing the SSRI regains the full effect and often is perceived as working better than it did at first. I have done this in over forty cases where this has been most gratifying. At this dose of naltrexone the incidence of side effects is very low, and the improvement is sustained over a period of years. It has been the end of poop out in my practice.

Do SSRIs have an effect on opioid systems, promoting opioid release, which eventually causes downregulation of opioid receptors? Is that the mechanism by which they cause lasting sexual dysfuntion?

So now we've got indications that naltrexone stimulates GNRH release (and therefore testosterone), reverses sexual dysfunction in heroin addicts, reverses tolerance effects in SSRI patients, and increases orgasm intensity.

Maybe opioid receptor downregulation is a common pathway for lasting sexual dysfunction, and can be reversed by naltrexone.


« Last Edit: August 27, 2010, 04:05:28 AM by NoFun » Logged
NoFun
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« Reply #22 on: September 10, 2010, 05:51:16 PM »

Some articles on naltrexone and learned helplessness.

http://www.ncbi.nlm.nih.gov/pubmed/1319586
Reduction of learned helplessness by central administration of quaternary naltrexone.

Abstract:   Prior research has established that escape impairment resulting from prior inescapable shock (IS) could be reversed by the peripheral administration of the opiate antagonist naltrexone...


http://www.ncbi.nlm.nih.gov/pubmed/6308695
Opiate antagonists overcome the learned helplessness effect but impair competent escape performance.

Rats exposed to inescapable shocks exhibited deficiencies in learning to escape shock in a novel situation 24 hours later (learned helplessness). Opiate antagonists (naloxone or naltrexone) blocked the learned helplessness effect, allowing efficient escape performance on the subsequent test.
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lostmojo
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« Reply #23 on: September 21, 2010, 02:25:30 AM »

I won't find out the results for a while (prob not till I see the neurologist again late next month) but I have had the following tested:

DHEAS; FSH; LH; Oestradiol; Prolactin; SHBG; Testosterone; Free Testosterone; DHT; PSA.

I think NoFun will be happy with that list.

I see the urologist this week, apart from my own history I will definitely be taking the description from michaelsad of what happened the day his orgasms stopped.
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michaelsad
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« Reply #24 on: September 21, 2010, 11:56:49 PM »

Tons of thanks to you, lostmojo : )
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NoFun
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« Reply #25 on: September 22, 2010, 12:57:02 AM »

I have had the following tested:
DHEAS; FSH; LH; Oestradiol; Prolactin; SHBG; Testosterone; Free Testosterone; DHT; PSA.
I think NoFun will be happy with that list.
I'll be even happier when you post your results to the poll.  Smiley
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NoFun
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« Reply #26 on: September 22, 2010, 12:58:38 AM »

Going in to the Doc to schedule blood tests and see about a prescription for low dose naltrexone.
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lostmojo
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« Reply #27 on: September 23, 2010, 07:01:00 AM »

Well things are starting to get more interesting. I saw the urologist today, interesting guy, very open minded. He heard my history, some of my/our theories, what I have tried.

He thinks it is unlikely I have a hormonal problem (and yes NoFun I will post my latest blood test results when I have them  Cheesy). He's done the basic examination, my pelvic floor is neither too tense nor too relaxed, both of which can be problems. There does not seem to be anything wrong with my prostrate.

He thinks it extremely unlikely that I have any sort of plumbing problems. He said ejaculatory duct obstructions can occur but when they do they block everything so it's pretty obvious if you have one. He's never heard of the opposite, that is a valve that won't shut when it should, that is preventing sufficient build up for pleasure. He thinks it unlikely that the MRI I had done will show up anything unusual.

He thinks the lack of wet dreams amongst us is not significant, that is it is not an indicator at all. He's heard of the studies that we have that show them to be very common. He says that is not true as a whole, that it is very common for guys with normal sexual function to have none or very few wet dreams.

He does not think herbs and/or supplements are likely to improve anything. He does not think taking testosterone would change anything (regardless of what the blood tests say). I gave him the text of michaelsad describing what happened to him. Although he has not heard of a similar story he does not doubt that it took place and that something physical "broke".

The way he described it is that he thinks what has gone wrong with me (and michaelsad) is that we have a problem in the nerve circuitry. He compared it to a computer crashing, I think that is a good analogy. He said that there is so much we don't know and that things can happen that throw the whole system out of whack. The real issue is what can be done to make it right again, no easy answers here unfortunately.

He thinks that my initial rapid decline in touch sensation and orgasm sensation was due to a breakdown in the system. He puts down the fact that I have declined a little bit more in the last 25 years or so to the normal aging process, I think that makes sense.

What was extremely interesting to me was that he did not doubt that something physical may have gone wrong with me even though I am the first person he's seen with this specific problem. The reason for this is based on his experience with patients with bladder problems, apparently this is what the majority of his patients have. He told me that he has seen numerous people who have bladder control problems and yet none of the normal tests show up any physical problems that could cause it. He again put this down to a breakdown in the circuitry and said my type of problem is closely related. Perhaps this is another avenue of research for us, that is people with urinary control issues and no apparent physical cause.

He does not think that SSRIs are a good first choice to experiment with. He was interested in Naltrexone and thought it could be worth a try (if NoFun gets some I can't wait to hear what happens). I can probably get him to prescribe me some another time but for now he has given me a Viagra prescription! The plan of action is take half a tablet on a day of sexual activity, at least half an hour before hand (the effect will last for at least 4 hours) and see if anything feels any different. He also recommended a psychologist who specializes in sexual disorders just in case there is anything there that might help, this guy does hypnosis which I love the idea of but I think I am one of those people who can't be hypnotized (based on previous dabbling).

We also talked about drugs that can have "opposite" effects. I told him about a guy I knew who had lost the ability to orgasm, he was prescribed Cialis which fixed the problem. Often Cialis (along with Viagra) is prescribed to slow down sexual response but in this case it had the opposite effect, he said this is a not so uncommon thing for drugs to work this way. Don Tolman (a natural health guru) thinks that people may have food allergies because the food contains components that their body actually needs more of, this is rather contrarian and illogical, but I think there's a good chance he's right.

Ok lots of stuff here to ponder, I look forward to your feedback.
« Last Edit: September 23, 2010, 07:18:11 AM by lostmojo » Logged
NoFun
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« Reply #28 on: September 23, 2010, 06:09:08 PM »

He thinks it is unlikely I have a hormonal problem (and yes NoFun I will post my latest blood test results when I have them  Cheesy).
...
He thinks the lack of wet dreams amongst us is not significant, that is it is not an indicator at all.
...
The way he described it is that he thinks what has gone wrong with me (and michaelsad) is that we have a problem in the nerve circuitry. He compared it to a computer crashing, I think that is a good analogy.
...
He thinks that my initial rapid decline in touch sensation and orgasm sensation was due to a breakdown in the system.
...
He told me that he has seen numerous people who have bladder control problems and yet none of the normal tests show up any physical problems that could cause it.
...
He was interested in Naltrexone and thought it could be worth a try (if NoFun gets some I can't wait to hear what happens).
...
I can probably get him to prescribe me some another time but for now he has given me a Viagra prescription! He also recommended a psychologist who specializes in sexual disorders just in case there is anything there that might help,
Looking forward to seeing your blood test results.

I don't agree that the lack of wet dreams is unrelated and not significant. The stats I had, showing that in the US, only 17 percent of men have never had wet dreams, and in Indonesia, the number is only 3%, makes it extremely unlikely that our 58% is due to chance alone, and is entirely unrelated to our problem. Sure, few men with no wet dreams also have AE, but all those with AE (except 1, who may have been joking), are significantly below the average. It is not credible that that was due to chance alone.

But I agree with you that urological disorders are another avenue we should look at. I'd include wet dreams in that category, by the way. And bedwetting. How do our urological circuits work differently than most people?

I agree with him, that it is something wrong with our circuit, but the question is, what controls the functioning of the circuit?

Let's rule out magic. Then what? Physical injury? I think we would have compared notes on that by now. For those of us who started out young, like me, it is probably not neurodegenerative. It might have been developmental, where the circuits weren't properly built in the first place, but that doesn't explain those who acquired it later in life, or very suddenly.

Hormones control the development of sexual characteristics,  the initial building and continued maintenance of the circuits, while neurotransmitters control the in the moment firing.

Either our circuits were not properly built or maintained, which points more to hormones, or our neurological thresholds are just out of whack, which points more to neurotransmitters.

I doubt it could be just in the moment lack of enough neurotransmitters, since that should be variable enough to allow us to sometimes work. Probably not just hormones too, since hormone replacement therapy hasn't done the job.

But maybe a combination of the two - hormones and neurotransmitters. Given how closely related those can be, particularly with hormones and dopamine or opioids, that is probably a good bet, and why either therapy fails on its own. I've tried the dopamine route, along with a number of others. But I don't think that anyone has tried the opioid route yet. That's what makes Naltrexone so interesting. 

Likely, we have to rebuild our circuits for a while before there is any possibility of working, and that's why I think hormones are job 1. Get our hormones to good values, instead of just "in range", and do it for months, so that we can heal and rebuild our circuits. Then maybe, some in the moment neurotransmitter adjustments would have a chance to work.

Just talked to Walgreen's, and my Naltrexone should be ready sometime tonight around 11. Maybe I can try it tonight. Woohoo!

On your doc, It's good that he thinks something real is wrong, but his analysis and prescription so far are not terribly encouraging to me. He thinks we have a bad circuit, but has no theory on what controls the circuit. He offers Viagra and sexual counseling. I think any of us with erectile difficulties have already tried Viagra, without results. Maybe the guy is a little more interested and open minded, but that is the standard "don't know, don't care" prescription that a GP throws at any sexual dysfunction.

I don't mean to be a downer. At least he sounds open to trying things if (when) Viagra fails to help. That is the best we can realistically hope for. I lucked out finding a doc willing to at least try things. Unfortunately, he is moving to a new clinic over an hour away, but at least I got a few prescriptions out of him before he moved on.
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researcher
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« Reply #29 on: September 23, 2010, 07:14:26 PM »

thx guys for the update keep it up
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