Males and panic attacks
 

I recently started getting panic attacks again. I posted about my "I've got a blood clot in my leg" a few days ago. Here's some more information about ME and about how some may be able to help themselves when it comes to panic attacks.

I am a powerlifter. I eat plenty, get plenty of rest and I am at the gym 4 days a week training. 3 years ago, I had a blood test that showed I had testosterone deficiency. This deficiency can lead to all sorts of problems. Usually, if someone is deficient in testosterone, they are what is called primary hypogonadal (Which means that something is wrong with the testes and they can't produce enough testosterone on their own) or secondary hypogonadal (Which means that your testes are fine but that something else in your HTP axis is wrong). Your HTP axis is the Hypothalamus-Pituitary-Testes Axis. This regulates your hormones.

To make a long story short, when you are primary you usually need testosterone replacement therapy. This will directly replace your testosterone. This is taken in amounts very very small compared to what bodybuilders would use. When you are secondary, you take tests to see WHY you are secondary (Which can take forever, or you may never know). If the problem with secondary hypogonadism can't be treated by solving the underlying issue, the patient and doctor then decide whether to use testosterone OR another hormone called hCG. hCG will basically stimulate your testes to produce more testosterone instead of directly replacing it like testosterone injections. With hCG, your testes also remain the same size (And somtimes increase) because they are still active in producing their own testosterone. With testosterone injections, your testes no longer need to produce their own testosterone and DO on many occasions shrink. If you are worried about size (Your testes shrinking) you can actually take hCG with your testosterone. I won't get into those specifics unless asked.

Now, with both testosterone and hCG their is potential for a conversion to a hormone that is not good for men in large amounts. This hormone would be the female hormone known as ESTROGEN. Men have it too. When the body has more testosterone than it can handle, it tries to balance itself out and converts testosterone into estrogen. Other factors can also contribute to the converstion of estrogen.

When estrogen is high, it can cause a ton of problems, one of them being anxiety and panic attacks. This is then controlled 2 ways. One, is by using a supplement called DIM (3,3'-Diindolylmethane). If this fails to work, using a drug called Arimidex (Anastrozole). Arimidex will work in reducing estrogen, more importantly estradiol. Reducing it TOO low is not good and can cause erectile dysfunction and other problems. Usually if this happens, one would discontinue use until the problem is gone and then start again.

As for me. I am on hCG and I never considered the estrogen bringing back my panic attacks (Something I thought was a problem solved long ago). However, after thinking about it, and posting on another forum I belong to, I realized that it is LIKELY the cause of my panic attacks coming back. I will go in to get a baseline blood test for estrogen. If it's higher than 20-30, then it's too high and I will start taking DIM. After a month I will get another blood test. If it's still high, I will request to be put on Arimidex.

For others:

If you suffer from panic attacks, there is a possibility that estrogen is playing a role in it. Estrogen can mess you up in high amounts. You don't need to be taking testosterone or other hormones to be getting high estrogen. I would suggest you talk with your doctor about it. If you DO see a doctor, your GP will not know enough (In most cases) about this. I suggest making an appointment with your urologist first, and then an endocrinologist. They will be able to better explain it. Here is a list of what you SHOULD ask to have tested...

• Total Testosterone
• Bioavailable Testosterone (AKA “Free and Loosely Bound”)
• Free Testosterone (if Bioavailable T is unavailable)
• DHT
• Estradiol (specify the Extraction Method, or “sensitive” assay for males)
• LH
• FSH
• Prolactin
• Cortisol
• Thyroid Panel
• CBC
• Comprehensive Metabolic Panel
• Lipid Profile
• PSA (if over 40)

This should then give you some insight into your blood work. If your testosterone is low, or your estrogen is high, then get that fixed. You might find yourself leaving a world of anxiety behind you.

Please understand that I am not a doctor, although I'd like to think I know more about this area than many I've met. Anxiety and panic attacks can be more than just this. I'm only making this post as a way for some who MIGHT have this problem, get the information they need. If this post DOES help anyone, please post back in this thread and let us know.

thanks, doc! that's some excellent information. after a 25+ year battle with agorophobia, i'll be ticked if it was one of the things you mentioned, as i've had many blood panels etc checked over the years, but always through my gp, who is really a nice guy, but maybe not qualified enough in the areas you suggested. thanks for the info---think i'll be calling an endocronologist in the a.m. have a good evening, and thanks for the research!

Your gp likely ordered a CBC. Most of the above is not what doctors would ask to have checked on a normal blood workup. Your doctor MAY even say that the tests aren't necessary. People who suffer from testosterone deficiency usually have to show some severe symptoms before a doctor would recommend seeing a specialist. The specialist would then ask why the GP didn't refer you earlier on. I guess it's just one of those things where if you have little experience with it, you don't look for it.

Talk with your endo about it, see what he/she thinks. Even then, it's hard to find one that is good. Too often doctors go by reference ranges which are meant to be used for the GENERAL public but don't always apply to the INDIVIDUAL patient. I feel good with my testosterone at 600ng/ml. Others will still feel ****** and a good doctor will try to push it up as high as possible without pushing estrogen too high (Because then you suffer). At 600ng/ml I don't suffer the symptoms of low testosterone anymore. Now I just have to see if the estrogen is bringing back my panic attacks.

I should stress that this is for MALES. Females are different. They need their estrogen. I can't go into specifics, but any female looking over this post might think about seeing an endocrinologist just to see if their hormones are in check or not. Adrenal fatigue and thyroid problems are other issues to consider.