Mental Health and Hormones

After Testosterone Replacement Therapy, Adam’s Depressive Thoughts Vanished

Depression might sometimes be treated with unexpected therapies, so being open to seeking help appears essential.

Background to Hormone Replacement Therapy

Hormones play a crucial role in our physical, mental, and overall well-being. Not only do some hormones affect our physical health, such as fat accumulation, muscle building, and bone density, but they also affect our mental health.

For example, even though some hormones are called sex hormones, their function in the body and mind goes beyond sex. They directly or indirectly affect our mental state.

As pointed out in this review paper, “the history of hormone replacement therapy (HRT) started in the 1960s, with very high popularity in the 1990s.” When I checked PubMed, I noticed more than 37,000 published research papers had been indexed.

While the history of hormone replacement therapy has been controversial, over the last few decades, endocrinology, a medical specialty specifically dealing with hormones, made remarkable progress in understanding the roles of hormones and even finding a way to replace them when needed for specific patients.

Thus, a process called hormone replacement therapy entered the mainstream medical practice.

The most interesting hormonal research on depression is related to the physiology of the hypothalamic-pituitary-adrenal (HPA), hypothalamic-pituitary-thyroid (HPT), and hypothalamic-pituitary-gonadal (HPG) axes.

For example, the authors of this paper in the American Journal of Psychiatry reviewed the evidence for selected hormone-based interventions for the treatment of depression to provide an update on the state of this field for clinicians and researchers. The paper is freely available online.

As documented in the paper,

“Major depressive disorder is a common psychiatric disorder associated with marked suffering, morbidity, mortality, and cost. The World Health Organization projects that by 2030, major depression will be the leading cause of disease burden worldwide. While numerous treatments for major depression exist, many patients do not respond adequately to traditional antidepressants.”

Thus, the paper's authors believe that “more effective treatments for major depression are needed, and targeting certain hormonal systems is a conceptually based approach that has shown promise in treating this disorder.”

In this post, I briefly introduce an exciting experience of a male friend over 70 years old who obtained remarkable results from Testosterone Replacement Therapy (TRT), especially in defeating his long-lasting mild depression symptoms.

I also reviewed several case studies documented by clinicians similar to the experience, which I plan to describe in another post to keep this one in a reasonable size.

Adam’s Interesting Experience with TRT

Adam has been suffering from mild depression for several years. His family doctor prescribed him antidepressant medication, but they did not produce the desired results.

Finally, he found a serendipitous and synergetic solution and obtained excellent results. He confirmed that testosterone replacement therapy reduced the symptoms of his depression significantly, even better than the anti-depression medication he had tried before.

His family doctor never paid attention to Adam’s hormonal profile. For several years, she prescribed Adam anti-depression drugs.

His doctor regularly kept changing them, hoping the next one might work for him. However, most of them did not significantly improve his depressive thoughts. After a while, his condition got worse.

Interestingly, a friend of Adam's at similar age solved his depression by improving his gut health which was believed to be the solution to his depression, with the help of a functional medicine doctor.

So, he suggested Adam see his holistic physician. Adam agreed and made the first appointment which caused him under $100.

After reviewing his medical history and blood tests, the functional medicine doctor believed that Adam was experiencing male hypogonadism (deficiency of testosterone).

Thus, he referred him to an endocrinologist to investigate. This specialist’s consultation fee was higher than the holistic doctor’s. However, he was happy with the cost as it was worth the investment in resolving his incapacitating health condition.

During the first consultation, with the medical details provided by the functional medicine doctor, the endocrinologist confirmed the suspected condition, called hypogonadism.

Thus, he put Adam in testosterone replacement therapy. He was lucky as Medicare subsidized the medication, initially injection and later in dermal gel format. Currently, it costs him under $20 monthly.

In his words, Adam felt like a newborn within a year. He shared his thoughts and feelings about this unique therapy. Apart from noticing a few inches of reduction in his waistline, he also noticed an improvement in his mood, reduced stress, and eliminated his depressive thoughts.

He couldn’t believe the improved strength in his muscles, shrinkage in his fat stores, and definition in his abdominal area. It appeared too good to be true, but it was true, as evidenced by his joyful eyes.

I heard these types of inspiring testimonials on TRT from several other friends over 70 years old. For example, I posted an article titled Impact of Testosterone Replacement Therapy on Mature Men. He felt like a teenager.

When I shared my thoughts on Michael’s experience, Adam fully agreed with it. He also did not notice any perceived side effects.

My takeaway from Michael’s and Adam’s stories was openness towards seeking support looks essential since depression may sometimes be treated with unanticipated therapies.

Based on my discussion with Adam and other friends like Michael in Australia, where I live, I provide a quick summary of the testosterone replacement therapy process.

This process might be different in other countries. However, these points might give a helpful perspective on the generic approach.

A Generic Approach to Start the TRT Process

You may try the following approach if you believe you have hypogonadism based on various symptoms.

1 — The first point is to have a conversation with a family physician about the hormonal profile.

2 — The medical doctor, during this appointment, might request specific blood tests for related hormones such as testosterone, estrogen, prolactin, DHEA, growth hormone, etc.

3 — When the blood test result arrives, the medical doctor might refer the patient to an endocrinologist based on the initial indication of the testosterone levels. However, acceptable ranges can be different in various countries.

4 — Based on test results and assessment of the medical history, the endocrinologist might prescribe a testosterone replacement therapy regime. It could be in the form of injection, gels, or patches.

5 — Specialist consultation fees usually are not covered in Australia. A few government-funded hospitals cover it, but the waiting period is believed to be over 12 months.

In some countries, governments might subsidize the consultation and the medication fee. Usually, men over the age of 70 are covered for TRT.

6 — The family doctor and endocrinologist might request follow-up appointments to review the progress of the therapy.

Conclusions and Takeaways

Depression is a very complex mental health issue affecting millions of people. For example, this article mentions that over 264 million people experience depression globally. Even though some theories have been developed, the root causes of depression are still debatable.

Mainly imbalance of neurochemicals is considered one of the causes. Therefore, one of the standard therapies is SSRIs to balance the serotonin levels in the brain. However, imbalances of other neurotransmitters like dopamine might also cause depression.

Based on my reviews, I see depression as a multi-faceted condition. Interestingly, this article by Harvard Medical School informs based on research reviews, “depression doesn’t spring from simply having too much or too little of certain brain chemicals.

Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, and stressful life events. It’s believed that several of these forces interact to bring on depression.”

Furthermore, hormones seem to be related to depression symptoms. In this story, deficiency of testosterone was the cause.

As millions of senior citizens face hormonal decline, considering testosterone therapy for eligible people can be an alternative solution. It is inspiring that the research in the field is active, and some case studies by clinicians shed light on this progress.

For example, this paper indexed in PubMed informs that “TRT has been shown to improve depressive symptoms in most men. This could be because testosterone is a modulator of GABAA receptors and inhibits 5-HT3 receptors centrally.”

Even though hypogonadism is more common among the aging population, young people also face this condition. Therefore, getting our hormones checked and corrected with medical procedures with the support of family doctors and hormone specialists.

Hormone Replacement Therapy for both men and women has become a mainstream medical solution. Even though the private sector focuses more on these solutions, especially within the longevity context, government organizations also support some countries.

Furthermore, natural and behavioral therapies could also contribute to addressing depressive thoughts. For example, the possible use of CBT (Cognitive-Behavioural Therapy) is being investigated for adolescent depression and suicidality. From my experience, we can recognize our troublesome thoughts by using CBT.

Like many others, I also experienced depressive thoughts, even anhedonia, in my younger years. Fortunately, I did not need much medication. As I described in a story before, my solution was to prioritize and schedule fun activities. As we never know where the solution may lie, we need to be open to seeking help for depression with an inquiring mind.

However, it is essential to note that not all mature men might need testosterone replacement therapy. There might be other hormonal factors affecting sex drive and body composition.

For example, after a check-up from his specialist, another friend, Alberto, did not need such treatment. Instead, he balanced his hormones by implementing lifestyle adjustments, as I mentioned in a story titled: How Alberto Melted His Potbelly & Doubled Testosterone in a Year.

Thank you for reading my perspectives. I wish you a healthy and happy life.

Sample Health Improvement Articles for New Readers

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