Dopamine Upregulation post

Hello all,

Brooks sent me to this forum and I am thankful for his help. Have done a lot of reading the last 2 weeks but have not posted yet.

I wrote to Area-1255 on Ray Peat today, but I'll post here too. I'll basically sum up what I've had going on as quickly as possible. Basically copy and pasting what I wrote to him today and editing haha.

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About me: I am 28 years old, I had adrenal fatigue low cortisol issues for 3 years that I basically fixed to a degree with allthingsmale.com CHILLN's protocol of pregenolone and t3 between April and October. I got great by August after starting TRT with cream in July.

Obviously, I worshipped the guy CHILLN. He taught me everything, I spoke to him almost everyday via messaging. Come October when I started losing hair very quickly, he was just pretty adamant I was going to lose my hair no matter what unless I used some sort of DHT blocker. He used beta sitosterone in extremely high dosages and said finasteride is basically the same thing. He ended up with permanently low DHT and said he was perfectly fine with it.

Me being basically brainwashed by the guy, did a little research, saw that Dr. Romeo Mariano, Dr. Thierry Hertoghe; two doctors I really respected after reading a ton of their work the last few years- really were fine with blocking DHT and thought too much was bad. Chilln, those two and the fact that I was very well at 24 years old with T in 800 range, and DHT being low 20 range (I was thinking well I was naturally low DHT, now I am super high from this cream).

All of the above led me to trying to finasteride for first 2 weeks of November. I was actually great on it for a week at first then started having a few cortisol crashes, stopped it after 2 weeks. I got better by Decemeber but come December 10th I started literally having symptoms of serotonin syndrome and below you can see how badly I started handling stress.

I was in the worst spot I had ever been completely incapable of handling stress unless I use a 5-HT2c antagonist while boosting dopamine receptors.

To describe how poorly I was handling stress, look at these cortisol results. This was before any medication just on TRT still.

8am 16 (13-24)
Noon 20!!!! (5-10) until this point of day I was seeing systolic blood pressure in 130 range
530pm -4 (3- During afternoon blood pressure would shoot up to 150-160 range (obviously adrenaline
10pm 3 (1-4) Couldn't sleep at night. Cortisol/adrenaline rising at night for sure

A week of cyproheptadine and Lisuride left me feeling pretty decent. Just didn't love all the serotonin blockage as it depersonalized me. I definitely didn't feel the dopamine that I feel now -->. Currently on abilify, one 5mg dose 3 days ago. Half life is forever on this stuff. I am handling stress great, but the restlessness is absolutely horrible. I know this is not the healthy way of fixing this even at a very low dose as I am seeing people with success at .5mg to 1mg.

More than anything, I believe I really just need to upregulate the dopamine receptors. I believe I just caused a major imbalance of serotonin to dopamine with FIN. I believe I already had this imbalance before, but this just heightened it.

Libido and erection quality really have not dropped much. Sleep has been horrible so been on and off with night erections and wake ups, but I am not majorly concerned with that. I am hugely concerned with stress tolerance as you can see above by the cortisol graph.

I can't handle stress. I believe upregulating the dopamine receptors with advice you gave in this thread below would be amazing.

https://area1255.blogspot.com/2015/05/how-to-preventreverse-dopamine-receptor.html

After doing some more reading, it seems like Tianeptine can take the place of abilify. Also looks like Tianeptine can regulate CRH-ACTH- Cortisol axis. Phenyl-Piracetem and the herbs/vitamins could only help.

https://www.tianeptine.com/

Let me know what you guys all think. I am cautiously optimistic, but you guys very well may help save my life. It is horrible right now on abilify, I cannot take this restlessness. Before abilify, that cortisol result shows the whole picture.

Any advice would be much appreciated.

I am currently trying to order PhenylPiracetem and Tianeptine. I noticed in Area1255's link that he posted phenypiracetam hydrozide. Do we need the hydrozide? I know this is more expensive, but I am very happy to pay it if its what I need.

Please any help would be amazing. I am twitching my ass off at work because of this f wording abilify. I hate the stuff.

@Bruschi11, please write your last reply from RPF on here as they are being noisy and there are issues with the account over there.

Sorry I didn't notice this. Gotta be on this forum more. I will write what I did to you shortly.

Doctor tried to reset cortisol production line as we have in the past with Hydrocortisone as I suggested like an idiot... Went horrible with serotonin syndrome type symptoms today. Cyproheptadine afterward got my brain balanced and blocked the crazy cortisol spike at 5pm. I went high on HC- like 20mg yesterday 30 mg today. Definitely just promoted serotonin like crazy.

I realize this isn't going to be easy. This is going to be first fixing the brain which hopefully corrects the endocrine system. DHT is fine its actually high right now. Testosterone is converting to DHT so we know this isn't really a "post finasteride" permanent no DHT issue. I actually have too much libido at times. I am not worried about that at all.

Circadian rhythm, cortisol production (spikes under any stress at all and before bed), and fixing the neurotransmitter regulation in the brain and body is my issue. I truly believe I just have way way too much serotonin bouncing around.

Currently, abilify, which made me very restless, is coming out of my system. It has been 5 days since my 5mg dose. Half life is about 75 hours and we are looking at 125 hours now. Cyproheptadine (8hr half life) will be coming out of system for most part by tomorrow morning. I am going to be waking in a pretty bad position.

Right now, my plan is starting tieneptine tomorrow standalone as abilify removes itself from the situation. I totally get it, it's probably too weak by itself. But we need to see what it can do by itself. If it can balance serotonin/dopamine and help control HPA axis like cypro/ Ritanserin have to at least a small degree, we may be at the start of something.

I realize if it does not work, tianeptine with Ritanserin or Metergoline will have to be a long term thing. Blocking the serotonin receptors is not something I really want to do as I do not want to cause upregulation, but I realize I cannot be in high stress high cortisol states any longer as we both know that is just going to make things worse as we saw today.

I have a lot ahead of me. Your help is going to be needed I know that and am so appreciative of your work.

One big thing I am considering right now is moving from testosterone cream to testosterone injections.

I know DHT is an issue. But I am more worried about the brain and receptors here than DHT. While androgens are going to be huge for me, I almost want to lower them now while I heal the brain.

Would you agree with this?

What do we think about agomelatine as the source for blocking cortisol? Seeing it helps with sleep is huge.

Maybe a combination of agomeltatine, tianeptine while leaving the rest of the serotonin receptors at be, while doing what I can do increase dopamine receptor density, blocking the creation of serotonin with feverfew and lycine perhaps.

I really believe I just need to get the dopamine receptors back to a good place. I basically went through a one month "serotonin syndrome". It seems like these serotonin receptors are everywhere and dopamine receptors are not to be found.

Didn't realize the half life of agmelotine was only 2.3 hours. Maybe it could help with sleep. That is a major issue right now.

Tianeptine went into system for first time about 15 minutes ago. Definitely feeling its effects on dopamine.

Cyproheptadine was coming out of system from dose before bed last before this dose. I was having horrible anxiety before taking tianeptine (20mg). While anxiety is still apparent, I am far more relaxed. I believe the ability of tianeptine to actually relax me may be the most important thing for a long term cure. Realize this is going to take time. I may need to use cypro (eventually metergoline when it comes in mail) with this for the time being until the serotonin syndrome symptoms really start reducing.

I am a bit worried about taking phenylpiracetam with this. I just know that I do not want to give myself more anxiety at all. I know that it is stimulating. Should I stay away from this for now? Give tianeptine a few days then throw it in?

I got some bloodwork back and it confirmed what I already believed.

Tryptophan was on the high end of the bloodwork. I've believed I had a serotonin issue here and it looks true to me.

Tianeptine seemed to lower cortisol quite a bit in combination with cyproheptadine one day 1. I tried tianeptine alone on day two, but cortisol started rising pretty highly. A tianeptine dose seemed to lower it a little bit around 7pm yesterday but not enough. Cyproheptadine was needed.

Really seems like this is all serototonin/high cortisol causing the issues. When cortisol gets too high, my adrenals essentially burn out and stop producing cortisol. They essentially will just produce adrenaline.

So you are thinking long term usage of cyproheptadine or metergoline to keep cortisol down will fix this excess serotonin in the blood issue correct? Tianeptine is definitely helping here but cannot be the standalone until I relieve myself of this serotonin toxicity.

I'm also considering lysine/arginine and feverfew.

It's been a couple days now. Really looking for some advice. Please help, I am pretty desperate.

I will be seeing neuroendocrinologist Dr. Alan Jacobs in New York City next week to help me out here. My doctor I saw last week was horrible. This is very serious at this point.

Will say tianeptine has increased libido through the roof though so androgen insensitivity I think is out of the picture here.

In a tough spot here. Jacobs doesn't even believe in cortisol. Doesn't think it has much to do with the endocrine system at all.

It is the most important hormone in the body we all know this.

Libido still great and e quality too. I have a post finasteride syndrome different than the average folk. I have kept cortisol low all week with serotonin blockers and Ativan today. I'm going to see what happens tomorrow coming off of Ativan.

I have bloodwork back showing tryptophan on the high end of the range. This could mean this is all a serotonin problem right?

Really need some help if possible. Going through hell right now. Maybe RP board is easier?

I'm going back on the gel once some T-CYP runs out of my body. Would you think a restart with clomid and using just DHT cream would be ideal for the time being until androgen receptors get in place?

My thing against ritanserin and cyproheptadine are the fact that my histamine levels are already low (hypermethylator it appears). Anything else other than an anti-histamine to lower cortisol?

bruschi11 wrote:

Currently, abilify, which made me very restless, is coming out of my system. It has been 5 days since my 5mg dose. Half life is about 75 hours and we are looking at 125 hours now. Cyproheptadine (8hr half life) will be coming out of system for most part by tomorrow morning. I am going to be waking in a pretty bad position.

Abilify is notorious for making people 'restless', the technical term is Akathisia for more severe cases. I would agree with going off of it.
The drug does has some beneficial properties, but the neuro-muscular attributes make it unfeasible.

Adding ''anticholinergics'' to it is simply a poor remedy, then its like saying ''oh, I am getting restless so lets band-aid it and block my memory in the long-run, no big deal''.

Though in severe cases of Akathisia and Dystonia it has to be done.

bruschi11 wrote:
Right now, my plan is starting tieneptine tomorrow standalone as abilify removes itself from the situation. I totally get it, it's probably too weak by itself. But we need to see what it can do by itself. If it can balance serotonin/dopamine and help control HPA axis like cypro/ Ritanserin have to at least a small degree, we may be at the start of something.

I realize if it does not work, tianeptine with Ritanserin or Metergoline will have to be a long term thing. Blocking the serotonin receptors is not something I really want to do as I do not want to cause upregulation, but I realize I cannot be in high stress high cortisol states any longer as we both know that is just going to make things worse as we saw today.

I have a lot ahead of me. Your help is going to be needed I know that and am so appreciative of your work.

I believe Tianeptine might help, but if it doesn't, I would definitely try Agomelatine - at the very least, establish a solid sleep schedule and good sleep quality. You would feel better about yourself and your goals, and in the meantime probably lower Cortisol/ACTH quite a bit from that route alone. Plus it enhances dopamine/noradrenaline in a gentle manner : {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4128060/}.

Metergoline yields strong benefits in the long-run, so it could definitely help.

Maybe onto something here. Had been a week since I had posted and I was really relying on Xanax/Ativan .25mg morning and night to deal with the horrible anxiety. These along with tianeptine and several aminos and vitamins. I knew GABA was all messed up and serotonin as well.

I added Shilajit "purblack" two days ago. Last night I just was extremely tired without any benzo in me and found it strange. Slept "ok" last night for first time without a benzo or cypro/metergoline.

I've been using about 3X the amount recommended of Shilajit, but now 30+ hours without a benzo, I believe it cured that necessity. I believe it's effectively restoring GABA in the brain along with helping that dopamine/ serotonin ratio while lowering cortisol output.

I also applied low dose testosterone cream 25mg (did CYP for a week before this unsuccessfully, less libido) earlier today and have the feeling of T again that I used to get to a solid degree.

Shilajit is definitely getting me excited here. Doctor prescribed me baclofen, but I'm considering not using it and seeing where Shilajit/tianeptine/vitamins/aminos combined with my formerly successful HRT can take me.

That HRT consists of:
100mg Compounded T cream daily
100mg compounded preg cream daily
10mcg t3 daily
100mcg hcg daily (used to do eod, doc wants more now post fin)
Injectable L carnitine 200mg/ml 15ML weekly divided in 3 injections
Very low dose Arimidex.
5a-DHP (since fin use) 5drops daily

I want to say I've learned a lot from your work. The Ray Peat forum as well. I know I'm in a scary, shitty post fin situation but I believe what I've learned may help me get back to normal life sooner than later. Shilajit really may be the key- who knows.

Have yet to get in the gym due to how badly I've felt, but hoping i can change that ASAP.

Would you consider baclofen if I don't see consistent improvement. Or maybe just add agmelotine for sleep?

Will also say combo of tianeptine/ Shilajit is indeed making me feel pretty much zero serotonin in the brain making me feel pretty damn depressed. I know we want to block serotonin, but how much is the question. Cypro/tianeptine was pretty much too much the depression caused by that combo and this resembles that a bit. I'll give it a few days to a week or so to see how it goes.
Maybe getting back in the gym can help this.

Do you think we could take out the tianeptine and try to work with just Shilajit? Maybe Shilajit a couple doses during the day and baclofen for sleep.

Fighting for my life. I'm gonna win it back I know I will. Your help is so much appreciated.

bruschi11 wrote:Will also say combo of tianeptine/ Shilajit is indeed making me feel pretty much zero serotonin in the brain making me feel pretty damn depressed. I know we want to block serotonin, but how much is the question. Cypro/tianeptine was pretty much too much the depression caused by that combo and this resembles that a bit. I'll give it a few days to a week or so to see how it goes.
Maybe getting  back in the gym can help this.

Do you think we could take out the tianeptine and try to work with just Shilajit? Maybe Shilajit a couple doses during the day and baclofen for sleep.

Fighting for my life. I'm gonna win it back I know I will. Your help is so much appreciated.

Try drinking Coffee upon waking, or do 200 mg of Caffeine upon waking, that might help balance you out.

I don't agree with Baclofen, its a GABA-B agonist, it would just decrease your Dopamine levels further. {https://www.ncbi.nlm.nih.gov/pubmed/6818043}

Metergoline wipes cyproheptadine out of the water, its a much better medication and has better anti-serotonin effects without the antihistamine effects of cypro.

Thanks for the quick response. Really means a lot.

Hoping sleep can get tidied up now with shilajit. I really feel something with it that I haven't in a long time. Like its balancing the brain on its own. Tianeptine coming out of system tonight and feeling just the shilajit is really nice. Will probably still combine them for a few more days to see what happens.

I think Metergoline is going to stay out of this- I used it for a few days and liked it but I'm going to stay away from receptors for the time being at least.

Currently plan is shilajit with HRT and possibly tianeptine. I have decent libido while on just small amounts of T cream- so something is working in there. Just wiped out- masturbated twiced today for first time in awhile. The second time really beat me up leaving me in that depression.

Clearly the body is still very weak in a post fin situation. Hoping things get better as I maintain a consistent HRT and shilajit continues to bring its good deeds.

Will be considering a juice feast from the CDSNUTS protocol. While I don't think I'm going to follow everything he did, I think detoxifying the body as much as possible could be great while I get my brain supps figured out completely this week.

bruschi11 wrote:Thanks for the quick response. Really means a lot.

Hoping sleep can get tidied up now with shilajit. I really feel something with it that I haven't in a long time. Like its balancing the brain on its own. Tianeptine coming out of system tonight and feeling just the shilajit is really nice. Will probably still combine them for a few more days to see what happens.

I think Metergoline is going to stay out of this- I used it for a few days and liked it but I'm going to stay away from receptors for the time being at least.  

Currently plan is shilajit with HRT and possibly tianeptine. I have decent libido while on just small amounts of T cream- so something is working in there. Just wiped out- masturbated twiced today for first time in awhile. The second time really beat me up leaving me in that depression.

Clearly the body is still very weak in a post fin situation. Hoping things get better as I maintain a consistent HRT and shilajit continues to bring its good deeds.

Will be considering a juice feast from the CDSNUTS protocol. While I don't think I'm going to follow everything he did, I think detoxifying the body as much as possible could be great while I get my brain supps figured out completely this week.

What's your DHT level at?

Range (25-75)

Mine has come back at around 125-150 with 100mg of T cream (which I am currently on). With 200mg of T cream, it came back around 225. Testosterone has come back in the 6-800 range on 100mg and it came back at 1200 with 200mg.

It's getting more and more obvious I am in a potentially irreversible post finasteride syndrome. The hormones aren't doing much. Sure with higher DHT from T cream I feel more libido, but I am so weak I can't even carry myself to work. I am sick as they get.

I just think maybe getting off everything, detoxing, going through legitimate hell while maybe staying on just tianeptine and shilajit, I could possibly reverse this like the CDNUTS protocol.

Maybe let the dopamine and androgen receptors rest for awhile. They both have been under a lot for quite some time. I don't know man- taking dog for a mile walk yesterday and watching the super bowl last night at friends house left me in the most horrible place last night physically where I was so so sick and exhausted. I didn't sleep as adrenaline was high all night.

This is really what hell feels like. I need to get myself out of it. I have to.

Really depressed post earlier there ^

Starting to see some similarities in stories of a few guys that recovered with tribulus. Believe my biggest issue is androgen receptors in the brain. The more testosterone I give myself, the more dopamine I feel. That said, its not enough- not nearly enough. So its not like my body is insensitive to androgens. The androgen's usage is absolutely abysmal.

I believe its possible I can fix this while on TRT. If not, may go to DAA or triptorelin (one shot). I don't know- I have some hope here. Looking at high dose high quality tribulus to increase androgen receptor activity in the brain. May be all I need for a few months then taper. We will see.

I have been prescribed baclofen. While I know that is not something I want to take several times per day, would you receommend this instead of benzos before sleep? I need to get some sleep badly this week before I try this.

Slept extremely well with 10mg. Will move that to 5mg. Let me know what you think of using this for just sleep, possibly some social purposes too (I'd go 2.5 mg there). Felt amazing on it.

Would you say baclofen would downregulate dopamine receptors? I believe dopamine receptors are something important here, but more so looking to fix the androgen receptor I believe at this point.

I'm considering going baclofen 2.5morning/2.5 afternoon/5mg b4 bed. It just really was great last night. Without TRT- conversion of PREG--> cortisol is just extremely fast. Cannot stop it. I believe baclofen could do this for the time being until I fix the 5ar2/ AR problem with super high dose tribulus and carnitine.

You were spot on... Baclofen leaving zero dopamine in brain. I also stopped TRT with HCG mono simultaneously so could be mix of both, but yea I can't handle any stress at all right now without dopamine.

Stopping baclofen. High dose tribulus will begin this week.