I told my trt provider that I’ve taken Straterra in the past for concentration as it relates to ADD. She immediately told me to dump the idea and that ADD meds do not mix well with testosterone. Is this true?
I was diagnosed with ADHD when I was younger and was on various meds to treat it, however on TRT I don’t need them.
Testosterone increases the release of dopamine, the hormone in short supply for those with ADD/ADHD.
I’m not sure what “mix well” means. While testosterone does help with ADD in some, it does not with everyone. If you find it works for you, great. If not, medication is an option. You might check into DHEA before adding an ADD medication.
I have started taking DHEA, as lab test showed it was low. I’ve been taking 10mg per day, as 15mg or 20mg has had me feeling aggressive. More specifically, she told me that the side effects of most ADD meds can counter the effects of testosterone replacement. And she told me to just forget about taking ADD meds while on TRT. I did tell her that there’s been mild improvement in my concentration but not to the extent I had while taking an ADD med.
Basically, it sounds like there’s no serious interactions….but maybe the dose can potentially offset some of the gains I’ve had from testosterone?
What does she mean? TRT could lead to more neurotransmitter activity, partially helping ADHD, but probably not to the level actual ADD meds can. At best I’d say you can begin to adjust your dose, but there’s nothing that would stop you from taking both together
Cant speak as to TRT+ADHD meds, but being on Adderall XR 40mg/day i can pretty confidently say that the the two are intended for different purposes entirely.
If you go to an endo saying “i have a hard time focussing” do they say TRT?
Or if you go to a psychiatrist saying “i have low libido” do they say ADHD meds?
IDK what your endo was saying, but the two are entirely different and shouldn’t interact.
Moreover:
Your endo needs to read up on endo stuff
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Yeah, I had a feeling her comments were odd. Thanks. Going to start low dose straterra today and find where it works for me.
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There can’t be any interaction, testosterone whether exogenous or
endogenous is still just testosterone. It’s not some foreign substance, it’s testosterone.
If you havent used ADHD/ADD meds before, dont be afraid to experiment with some different ones. I had to try 3-4 different meds before i found what worked for me… some of those were outright disastrous and others were okay, then my current protocol fixed 95% of the problems i was having.
Ok, just my two cents but Strattera is not a good med. It made it to market on the premise that it wasn’t a stimulant and whether it is or not depends on who you ask. It wasn’t supposed to increase heart rate or BP but, as soon as the patent expired, papers started coming out saying BP increases did occur. Over the years, to learn about strattera beyond my own experience, I’ve asked others and it does not seem to be as helpful as Ritalin and it is not in the same league as Adderall. The only concern is that the level of prolactin, something that most people seek to reduce, will be lowered beyond what is healthy (immune system performance, plaque formation in penile arteries, isn’t that enough? LOL!) by the stimulant medications. It is great to go to the gym and lift and be healthy, ADHD can be managed but it can also wreck your life. Treating the ADHD, IMHO, has to take priority and I hope you will be able to obtain some better treatment than strattera. (AFAIK), strattera has not been found to be addictive and that might be important for some people. However, in a sense, all of us that have had our ADHD treated successfully, are, a kind of “addicted”. Certainly, I do not want to live with the inability to focus on what I am doing or paying attention to a loved one or finishing anything I start. Inattention can interfere with lifting success very easily, as much as I dislike having to worry about time at the gym (it is a kind of freedom, even a luxury, to not have to worry about how much time you spend at the gym) a periodized program demands that one pay attention to things like the time between sets, even the cadence of the reps so that an ineffective ADHD treatment can, not only wreck something that helps the ADHD in the first place, it can prevent one from using the most efficient program one is able to find or use. Having said all that, the replacement of testosterone has been very helpful to me when combined with the adderall. I have not found it to be a hinderance and my caloric intake did not need to increase much (probably a couple of hundred kcals) and even when it did, it was more a matter of the shake not really filling me up, I felt I was growing well enough. There is more to this though, GROWING UP with untreated ADHD is not benign in any way. The problem is finding the specific problems that one actually experiences and the right treatment for them. Anxiety, for instance, is not a product of the ADHD itself but rather, of growing up with the untreated ADHD and the people who express their poorly considered opinions concerning the child that will grow into the adult. Personally, I suspect that your provider is imagining (or has had the experience) of someone whose (other issues such as anxiety, psychological trauma, even to the point of PTSD, fears, etc…) went untreated and was on both, testosterone and some particular ADHD medication and reacted violently to some particular situation; the myth of the ‘roid rage dies hard, why isn’t alcohol —think western with bar fight— something that she says doesn’t mix with ADHD meds? Having said all that, I have no experience at levels beyond the therapeutic so that a level of 1500 ng/dl found five days after injection may or may not be a completely different experience. After decades of treatment for both, I am yet to feel an impulse to violence of any sort and I probably am too serious for the flakiness that stubbornly remains even after effective treatment of my ADHD; however, my experience has been very positive. If, hitherto, you have not experienced any ED with the strattera, congratulations, you’ve survived the experience, change to adderall as soon as you can and start your HRT. Myself, I will always be grateful to the providers that saw through all the dogma and mythology, took a chance, and treated me successfully and my life has been all the better for it. TrtNow, I hope you find my words helpful and I wish that this problem will be resolved soon and successfully for you.
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I appreciate the level of detail in your post, but I do not agree with this statement. If Strattera doesn’t work, then seeking a change is typically recommended - but what works great for YOU may not work great for OP and vice-versa.
I do recommend trying a few different medications to see if one suits you better than another though.
Andrewgen, you are absolutely correct, the benefits that any given medication, given a particular condition, that is to say, your statement is correct beyond the scope of the treatment of ADHD, vary wildly. The variation can be such that (as an example) a person can take a particular angiotensin receptor blocker and experience zero effect, then, use another ARB and end up with orthostatic hypotension. That being said, when it comes to ADHD medications, it is generally been accepted (a turn of phrase that is difficult to justify even when true) that Adderall is better than Dextroamphetamine Sulfate which is better than Ritalin; the long acting medications exhibit similar, oftentimes, better, effect than their short acting counterparts. Strattera may not even be as good as modafinil, a medication that has never been approved for ADHD and was prescribed off-label because it is not a classic stimulant (it makes you awake but not by giving you a jolt, ironically, the therapeutic effect might be most similar to caffeine) that has low abuse potential while also being (the pharmacology is still very much a mystery, I’m surprised it is still available) -among other things- a dopamine reuptake inhibitor.
I would expect that most physicians would be far more likely to prescribe Wellbutrin than Strattera because the biggest therapeutic “draw” of Strattera was what it wasn’t. Cost wise, Strattera lost its patent protection relatively recently whereas meds such as adderall have been available as generics for so long that… the original patent (as a weight loss medication [sic]) dates back to 1973! I was surprised by that, I thought it was in the 80’s! Given that racemic mixtures of either dextro or levo amphetamine exhibit a demonstrably different pharmacology, one could also argue that there is more to adderrall than the mere mixing of optical isomers.
While none of this addresses your objection directly, I am hoping that it does illustrate that while I do not disagree with you (hopefully, the Strattera people won’t sue me “wink”), when it comes to ADHD, there is a rational hierarchy of therapeutic effect that is probably related to the fundamental molecular basis of the condition. I presented my own personal experience because the question was a kind of “there, but for the grace of God, go I” experience. I left only things that could be personally identifying or privacy, such as it is, negating information because, I believe, that, for me, what made the difference is that my life crossed paths with someone with decidedly superior knowledge and a willingness to take a risk based on his evaluation of me and my condition.
TrtNow finds himself in the unenviable position of attempting to convince a provider that what they believe may not be entirely correct and to the detriment of their patient’s health; I hope that I provided, at least, enough of a case-study to persuade his provider to reconsider his or her beliefs. To that end, the experience is something of a shibboleth; one which I hope TrtNow will be able to use to demonstrate that my case wasn’t a matter of someone stroking their own ego by providing medical advice without a license, that it was a real experience. In particular, I wanted to address the specific point of strattera because the provider lumped EVERY ADHD med together when she suggested that a medication that was important for what it wasn’t rather than its therapeutic effect would somehow cause a problem with his hormone replacement, all the more so because testosterone increases dopamine production and secretion, as systemlord correctly stated. That there is a lot more to the condition is without doubt, it just seems like a particularly uninformed provider crossed paths with TrtNow.
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Well, she started me on Strattera and surprisingly the insurance is covering 100%. Tbh the only real benefit I’m feeling is that I feel more wide awake. It’s isn’t increasing my focus as methylphenidate or adderall have done in the past.
When I took Ritalin (methylphenidate) several yrs ago, I started at 10mg but that increased my anxiety. As the dr increased the dosage, my brain started to quiet down and I felt more mentally focused and had a nice sense of “quiet” in my mind. That was at around 40mg and 60mg. Adderall was much similar. But I’m having a problem finding a Dr who will readily assign me methylphenidate or adderall again . They act as if they’re forbidden…. I’ve offered to show my history of having to take either med in the past for help with my focus as it relates to school or work. I’ve even offered to sign a release of a past psychiatrist who treated me with one or the other.
So now I’m searching for a new psychiatrist who may be open to helping me with adderall. Frustrating. I can pay attention and have less to zero breaks of concentration when taking adderall or Ritalin at particular doses. Yet either seem so hard to get.
Yes, trt has helped my concentration and emotions to some degree. I just need some more help on the concentration. Shouldn’t have to be a fight!!!
You should speak to your doc about changing medications. Speaking only in the capacity of ADD/ADHD symptom relief