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    Suggest treatment for hormonal imbalance while on Etizolam

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Posted on Tue, 26 Jul 2016 in Thyroid Problem and Hormonal Problems
Question: Hi there,

My name is xxxx XXXXXXX and I am a 24 year old male. My question is regarding my endodcrinal system, specifically my hormonal imbalance, and my self assessed low GABA, high cortisol, high dopamine / seratonin levels.

I have a good level of understanding of basic human physiology as my background is the health and fitness field, and I have entry level understanding of endocrinology. Most of my data I will present below is self-observations I have noted over the years in myself, however my guesses as to the causes may not be accurate. I hope I can present you a good picture so you can provide me the expertise on what is wrong.

About me:
24yo male
VERY healthy, I am WELL educated in health, fitness, nutrition, I understand much about nutraceuticals, naturopathy, even eastern medicine such a ayurvedic medicine and some basic knowledge of asian medicine. I have spend 10 years plus enoying a nutrient rich diet, with healthy fats, lots of micronutrients, tons of healthy detoxe's etc. I have worked out 4 - 5x a week religiously for those 10 years.

My key notes of observation:
1. I am a very high performer, and a high achiever, I mention this because i feel it relates to my adrenaline and cortisol function in my body. I can focus for MANY hours at a time, and can run at a high level all day long. If I have a very busy day where i was required to perform much, even with proper nutrition and eating habits, I will end the day feeling very stressed. My body naturally craves alcohol at the end of the day, not because i like it (I don't) but i can tell my body needs it. Also at the end of the day I will have stress on my chest, (not my heart) but almost like my inner diaphragm. (the same feeling when a man feels he has to cry, and can feel the tightness in his chest). This feeling will go away with the aid of a drink, OR some mindless activity such as surfing on my phone or such. My body also tells me that if I was to just cry, it would make the feeling go away (though I am not sad at all) but I can tell that would ease the tension on my chest, and help my body relax. (Does it relate to prolactin ?)
2. Even with proper diet and eating, my body stays very lean naturally, LOW fat, and i have a high burning metabolism under most circumstances.
3. I want to clarify I drink alcohol around 3-4x per week, most times typically wine. I do NOT like being drunk and often will only have around 1-2 drinks, the odd time having 3. I have noticed my tolerance to alcohol is better than most, and it no longer has the calming effect I need. In fact cortisol seems higher once it wears off. I have NOT increased my consumption because of this, as I like more than all else being balanced and healthy.
4. I have noticed my body and brain can perform for many months at a very high level, and even with my strong focus on calming techniques, breathing , meditation or yoga, hot sauna relaxation etc. I will still wear myself down after 3 - 9 months depending. Once I am worn down I am very tired, and must spend days doing nothing. This will even happen during my busy cycle 1 every week or 2 weeks, where I do nothing at all, to help recover my body.
5. I have fatty cysts on my abs. These started when i was 16, and only had 1 or 2, Now i have around 5/6 of them. They are around 1cm each and are hard. This despite my not having fat on myself much. These I think strongly relate to a progesterone/estrogen imbalance in myself. And are part of the picture showing a neuro-transmitter / hormonal imbalance in myself.
5. Coffee: My body CANNOT handle caffeinated coffee. If I even have it 2 per week, I cannot sleep, and my physical reaction to cortisol / adrenaline becomes very increased, causing me to have to take big deep breaths regularly to help calm the tension in my chest. Again this tension feels very rooted in the emotional sector, less physical.
6. Sex: While I have a healthy functioning libido, often times in the presence of physical stress (which is often for me) I can go 3 days without having sex. My erections sometimes are great , other times are around 80%. This i feel is due to cortisol and nor/epinephrine effects. Again, sometimes during stressful / busy days my brain will look to sexual release for a temporary calming effect. I feel this is less mental, and more of a physical means my body wants to use to help curb the cortisol / adrenaline and calm my body down ? Does a certain hormone such as prolactin or oxytocin spike after sex to help calm me ?
7. I have found my body naturally directs me to focus on supplements such as Rhodolia Rhosea, ashwagandha, Lemon Balm, Passion flower, etc. I take the supplements often, and enjoy especially supplements for night time sleeping.
8. Despite having very heigtened energy, I do NOT have anxiety, or a stressful brain. I focus on calm, positive happy thoughts, and possess a great amount of control in calming my body through breath and meditation. This has helped drastically with my sleeping, but yet is not enough for my body.

GABA:
- Recently I have stumbled upon thienodiazepine, It is legal for NON consumption here in canada, and my friend who is like me but worse in terms of high functioning bi-polar, was prescribed benzodiazapine by his doctor. This lead me to experiement with thienodiazepine (Etizolam) in small doses done about 2-3x per week. I choose Etizolam because of it's high affinity for the Gaba receptor, its long half life, and its easy availability for myself. *(I do recognize I have NOT had a doctor prescribe this, and I have been self-medicating. I do plan on reaching out to naturopaths here to further assess my endocrinal balance etc. and offically get on the right substances to help me out. Medical doctors here though aren't much help, as they adopt a VERY clinical approach to medicine, and do not dig deep to find the real underlying causes, or be 100% in their diagnoses. Naturopaths are much more thorough and involved. )

MY observations from Etizolam:
.5mg done 3x per week. Time-off cycling ensured so as to not notice rebound withdrawal symptoms, or dependency symptoms.
1. VERY calming, and helped my body and mind to focus and stay calm throughout the day. I would not feel overwhelmed or overly stressed. That same pressure in my chest would not build.
2. My brain felt nicely balanced, and was able to space out its energy nicely thoughout the day.
3. SEX DRIVE!: A VERY pronounced increase in sex drive, erections are very full, and sex drive sees more than 250% increase. I read that Etizolam can increase prolactin, and I know GABA reduces cortisol / adrenaline in the brain, can this be way ?


My self assessed summary:
Overall I feel I have very strong and pronounced levels of Dopamine / Seratonin in my brain, along with high cortisol / adrenaline hormones. I feel this causes my ability to work for very long, and perform for very high. I feel I may be low in progesterone the modulating hormone for the body, and there is certainly something off with my prolactin. This I feel may cause my small hard fatty cycst on my abs, my emotional stress that builds up from simply having a busy stressful day. (The feeling where chest pressure tells me If I cry it will go away, but I am NOT SAD at all).

I suspect that my bodies healthy craving for balanced alchohol consumption demonstrates a need for GABAminergic based substance. And the VERY positive although short term observations I have seen from Etizolam tell me It has been helping with GABA and prolactin ?

I am writing in to see if you can help to direct me based on your professional expertise.


Thank you very much for your time.
doctor
Answered by Dr. Mirjeta Guni 18 hours later
Brief Answer:
Appreciate your answer.

Detailed Answer:
Hello Mr. xxxxxxx!
I have gone very carefully through your concern and i appreciate your interest in trying to understand how our body functions but i think is a bit exaggerated.
You are too young and at this age try to enjoy life rather than to make diagnosis of your self and even to start treatment.
The symptoms you described above are suggestive of an anxiety disorder and our main interest at this point is not to describe the mechanism of anxiety rather than to treat it. The cause of the anxiety may be probably your exaggerated interest in human physiology.
Regarding to your concern related to endocrinological pathologies ( related to cortisol, prolactin, progresteron ect), i do not see any reason to think abot them in your case.
Anyway if it really concernes you, it is very easy to exclude them. Just do a cortisol, prolactin, progesterone level.
What i would suggest you as an endocrinologist is to stop alcohol consumption and see a psychologist.
You can not take thienodiazepin without the prescription of the doctor and for long-term.
Hope i have been clear znd helpful.

Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Mirjeta Guni 1 hour later
Hi there Dr. Mirjeta

Unfortunately no I didn't get the medical direction I was looking for.

The only reason why you are reading me to have an "exaggerated focus" on myself regarding the endocrinal pathology is simply because there was a need for me to do so in order to provide you with detailed information. You were reading a 4 paragraph explanation of what my problem is. I had to be focussed on what I am saying in order to condense and provide all relevant facts would I not ? It's not like you got to see any other mentality from me in that description in order to read me as balanced.

Non the less, I can assure you I am not overly focused on it, and it certainly doesn't not contribute to my anxiety, nor is it the case. Also you must realize i do NOT have mental anxiety, in fact my mind is very calm, and often helps my body to deal with its physical stress.

Alcohol is not the antagonist in this issue either, and I certainly do not mentally rely upon it. I go many weeks / months without consuming it, and never have more than 3 drinks... However It does seem to help balance a GABA deficiency my body has.

Unfortunately I feel your answer failed to even delve into the points I brought up, and instead glazed over them by determining that I am just to "concerned" about this issue.

This is not the case, there is a real physiological issue here, and I was hoping to reach out to you, an educated professional who could at least give me some more bearing or medical direction relating to the points I brought up.

Hopefully you can elaborate further ?


Thank you.


doctor
Answered by Dr. Mirjeta Guni 3 hours later
Brief Answer:
Hello!

Detailed Answer:
Nice to hear you back xxxxxx!

At your long description you didn't mention any concrete sign or symptom that can suggest an endocrinologist for hormonal disbalance.

If there were a high prolactin ( as you suppose) you should have gynecomastia or galactorrhea or impotence. You didn't mention these kind of symptoms.

If there were a high cortisol, you would have difficulty in loosing weight, high blood pressure, high glucose level etc.

All the symptoms you described are typically suggestive for anxiety. The fact that Benzodiazepine improves them (as you mentioned) is another pro anxiety factor.

I am just giving you suggestions what line to follow. I am NOT making diagnosis.

From what you have mentioned i still recommend you to see a psychologist and to have faith in medical personnel's opinion.

Anyway, if you need concrete answers you may check the hormonal levels and convince yourself that you are ''hormonally'' normal.

-Cortisol level at the 24 hour collected urine.
-Prolactin level at 8 am. after a queit sleep and 1 week without benzodiazepines.
-FSH, LH, Total Testosterone.
-TSH, Ft4 and Ft3.

It will be a pleasure to hear you back after the above results.
Kind regards,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2304 Questions

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