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PostPosted: Sat Apr 01, 2017 8:06 pm 
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It seems I've hit that place again where Suboxone starts to affect endocrine functioning / testosterone levels. This usually happens after I've been on Suboxone a couple of years. Given I've been on Suboxone this time from late 2014. I started needing 8mg to keep my cravings at bay and that dose has slowly increased to 16mg, which no doubt contributes to the issue.

The symptoms of low T are things like no libido, no desire to date the o opposite sex, a general feeling of flatness, feeling meek as a kitten and no desire to compete. I feel rather placid. Those close to me say this might keep me out of trouble. I also notice the symptoms more after I take my daily dose, and in the mornings when the previous dose has worn off a bit my masculinity returns somewhat.

My options at this stage seem thus:

- Go on testosterone supplementation.

- Reduce my Sub back down to a level where symptoms are less (8 mg ideally).

- Go off Suboxone and have another go at a Sub-free existence.

At the moment I'm leaning towards going off Sub. Of course this move is risky, but I can easily go into an interstate rehab facility to help keep me safe from relapse and hook back into 12-step fellowships in a part of my country where there is no heroin (Sunshine coast in QLD Australia - a beautiful part of the world with awesome beaches that is awash with crystal meth but hardly any illicit opioids).

Am considering studying to work in the alcohol & drug field rather than continuing my IT career. Unfortunately with my bipolar disorder, I usually get severely depressed for 1-2 months of the year and a nine-to-five IT career is quite unforgiving of that. There's also some family enmeshment (Google enmeshment it's really interesting) I'd rather distance myself from.

I've done a move like this before. The difference between moving then (in my mid-late 20's) is that I have a level of acceptance about my bipolar condition. I now know there's nothing psychiatry and drugs of any kind (including heroin) can do to relieve my depressive periods, so it comes down to adjusting expectations of what I can achieve in life, and accommodating for these difficult times rather than fighting them.

So what I want from you guys is some input. How have you dealt with endocrine problems from long term opioid therapy (methadone & Suboxone)? Need some insight.


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PostPosted: Sat Apr 01, 2017 10:09 pm 
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I"m pretty sure buprenorphine does not significantly lower testosterone in men. This has come up recently and if memory serves, Dr. J quoted a study he seemed to be satisfied was valid. I could
have this wrong. He might chime in when he sees this thread.

I've actually noticed an increase in libido since getting off DOC and going on subs. I was not expecting
this, so I have to believe it's real.

I have def. heard chronic opiate use can lower testosterone, but perhaps bupe being a partial agonist
affects the body differently in this regard. I do see a comment by docm about this subject in which he mentions patients of his who did have low levels, and who had been treated for it, but he also noted
the low levels predated induction.


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PostPosted: Sat Apr 01, 2017 10:30 pm 
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TeeJay, I feel like I should remind you that you don't have a great track record when it comes to doing well off buprenorphine. It seems that you will taper off and then start having problems again with your addiction. That is just my observation from seeing you post for the last 5 years.

Why not have a go at the testosterone supplementation? See if it works before you take more drastic measures. That is my advice, TJ. Just know that we will always support you in whatever decision you make. We've got your back!

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PostPosted: Sun Apr 02, 2017 12:25 am 
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Yes-- if you seach for the thread you will find it. Use the search at [url]suboxsearch.com[/url] instead of the one built into phpBB at the top of the first page (or use the Google box at the top of each forum section).

Search for testosterone and you'll find the story and see it unfold. Someone came along and said that buprenorphine suppresses testosterone a LOT-- I think he said 'five times more than opioid agonists', or something like that. Initially I wrote that buprenorphine probably reduces testosterone because all drugs that active the mu receptor have that effect... but my understanding was that the effect was less than with buprenorphine.

The guy who started the thread pushed the issue, and cited articles, causing me to do a lit search and read the articles he posted. I found that the studies that have looked at testosterone levels found no significant effect from buprenorphine in addiction patients (i.e. people on the doses used for opioid dependence). The results were the same in a couple studies.

I was surprised at first, but as I thought about it, the effect of buprenorphine is much different than the effects of agonists. Tolerance builds to buprenorphine, and then the effect is minor (if present at all).

I'm not saying that buprenorphine is not having the effect on you. I'm just saying that on average, it doesn't happen. I'll also point out that I have patients on buprenorphine, and I also have patients who do not have histories of addiction, who I see for ADD, anxiety, depression, etc. Many of THOSE patients have 'low T', and I don't see a 'trend' where the bupe patients have more of it than the others. Every man's testosterone levels drop with age, and we all have 'low T' eventually. Realize that your testosterone level may come up off buprenorphine, or it may just keep falling with age.

I should also add-- check the level. You didn't mention a level (unless I missed it), but it is easy to check, and there are other things that impact libido.... so first things first, get the level checked.

Good luck!


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PostPosted: Sun Apr 02, 2017 12:46 am 
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I well remember the OPs 5Xs claim- worth a read...
yes, on low T, but scroll down past what you already know on addiction and bup...
afreshstart = posters name.
Wow we all spent a lot of time on that thread...

Teejay, wish you my best! Peli

I edited this post...sorry I posted too soon...

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PostPosted: Sun Apr 02, 2017 11:44 am 
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Hey Teejay!

I know nothing much about low T so my opinion here may be pointless, but if it were me, I'd treat the low T and stay on buprenorphine. That seems like the best plan to me.

I do agree that ur older and wiser now and wouldn't do things like u did bk then now that u have those past experiences to look bk on. That makes a lot of sense to me also, but I think treating the T and seeing how u feel afterwards is a really smart move on ur part.

Like I said, I have zero experience in that area, but going off buprenorphine would be my last option. Whatever u decide teejay, I wish u tons of luck!

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PostPosted: Sun Apr 02, 2017 11:13 pm 
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Thanks all for your feedback.

Yeah it's a tough call. While I haven't had T levels checked this time around, I had the trio of tests done in the early morning some years ago when I had similar symptoms and while I was in a long term rehab facility that allowed me to stay on Sub for the first 6 months. All three tests were under the threshold for low T, though only marginally. I think back then I was on 16mg as well.

Understand that I'm growing older and this may be contributing. I'm now 33.

I'm also on an SSRI (Vortioxetine) which at higher doses also leads to lower libido etc, which is no doubt contributing.

I also had a relapse into heroin use in February which occurred after I relapsed into severe depression. This has led to me deferring my final year of college / university, and has also made me question the direction I'm taking in life. A lot of my non addict friends work in the IT field and do quite well but I'm unsure how I'll manage a career in that area given I still lapse into severe depression, whether or not I'm using drugs. I've conceded that my depressive bouts cannot be relieved by psychiatry. The only option that hasn't been explored at this stage is ECT and my memory is bad enough as it is! The key to my ongoing recovery will be to learn to manage these depressive bouts without running to heroin. When I get depressed I also get some psychosis which makes functioning through it all the more difficult. Perhaps in future I'll just accept that there may be a month or two occasionally where I hardly get out of bed, and to be OKAY with that and not see myself as a failure for doing so.

If I do opt to get off Suboxone my plan is to spend the next 3 months working to save up some money and pay off some debts, go to a 28 day private detox in my home city to get off Sub, then get on a plane and go to the Sunshine Coast and spend 4-6 months in a place there to keep safe, do another 6 months in supported accom while working and possibly studying.

Or I can stay in my home city, stay on Suboxone and keep doing what I'm doing now, and just try to push through the depressive bouts without using while on Suboxone. It will likely mean staying on a highish dose of Sub (16mg), so dating will be out of the picture for some time.


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PostPosted: Mon Apr 03, 2017 2:51 pm 
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Hi Tee jay,

I feel for you. I too am on an SSRi and that has side effects of low libido which sucks!! Do you think you could taper to a lower dose of subs and just stay at 4mg?? Then do testosterone treatment. Then you could have the best of both. The addiction in check and the testosterone levels back up to normal.

It seems through your writing that you may have already made your mind up to get off subs. I just worry for you that if you deal with another depressive bout, that you will turn to your DOC without the safety net of subs.

Just think about it. Good luck to you TJ


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PostPosted: Thu Apr 06, 2017 3:32 am 
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I've got some advice re my university course and it seems I have longer before some of my old technical college credits expire. So the plan is to stay on Sub until I graduate university halfway through next year. And likely stay on 16mg. This is the dose I require to keep my cravings at bay, especially while on Valproate.

Guess I'll have to put dating on the backburner for a little while!


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PostPosted: Sat Apr 08, 2017 3:20 am 
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I think you're a catch no matter what's going on! ;)

I'm relieved that you will be staying on for now. Thank you for keeping us updated and thank you for dealing with my overbearing opinion. :oops:

Amy

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PostPosted: Sat Apr 08, 2017 5:17 am 
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Teejay
I could see how IT and the drug and alcohol field could work together. IT in the medical field maybe?
I have a co-worker who was hired as a salesperson. He got the job over another candidate because of his IT experience. he's done really well, setting up the new chip reader credit card machines, creating a website customers can shop from online and on mobile, email and web marketing, etc. he does all that yet was really just hired to answer sales calls!

Does anyone have any info on low libido in women on subs or in general!?? HELP!

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PostPosted: Sat Apr 08, 2017 6:04 am 
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Here's an article from Jana Burson about low T on buprenorphine, though primarily aimed at men with a paragraph at the end for women:

https://janaburson.wordpress.com/tag/testosterone-levels-on-buprenorphine/


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PostPosted: Sat Apr 08, 2017 6:12 am 
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I could always get on the steroids and start pumping iron! That'll sort out the issues. Buy now pay later!

Image


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PostPosted: Sun Apr 09, 2017 12:35 am 
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What a great idea! Not! That guy at the end looks like such a freaky version of human!

Amy

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PostPosted: Sun Apr 09, 2017 12:39 am 
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Amy-Work In Progress wrote:
What a great idea! Not! That guy at the end looks like such a freaky version of human!

Amy

OMG his head is SO tiny

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PostPosted: Mon Apr 10, 2017 4:34 am 
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It's gotta be photoshopped.


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PostPosted: Thu Apr 13, 2017 10:44 pm 
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Have dropped from 16mg to 12mg and am feeling a bit more male and human as a result. Still got a way to go, but it's a step in the right direction.

I do genuinely believe that having receptors stimulated by high doses of Sub 24 hours a day doesn't do good things for a guy's libido. There is a sweet spot for me where I get to feel a bit masculine still while still getting decent craving management. It's usually between 8 and 12mg. Still it's a long way from the libido a guy has on zero Sub, where my desire can be so much is verges on an addiction in its own right.


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PostPosted: Sun Apr 23, 2017 8:45 pm 
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Have actually for the first time in my life come to a level of peace and acceptance about having low T for the time being. The idea of being out of the dating game, putting tinder away, and actually working on the issues that make me perpetually needing to have intimacy is a breakthrough. I'm alright with it. For the first time in a LONG time I can have female friends without there being a flirt element. Also my counsellor advised that it might actually work well for me to not be dating while we sort out the issues in my past that cause me to act out with women.

So the plan now is ... stay on a high enough dose of Sub where using is definitely out of the question, which for me is 16mg at the moment (being on Valproate means I need higher doses than usual). Focus on work for the next few months to save up $. Return to uni next semester to complete my final year at uni. Once I graduate, reduce my Sub then go into a 3 month public rehab facility. Come back to my home town and start my career.

There's hope. Sometimes we just gotta use the cards we're dealt and do our best to spin them in our favour.


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PostPosted: Sat May 06, 2017 2:56 am 
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Am back on 16mg because my doctor got annoyed that I took matters into my own hands and reduced my dose by cutting my films without his approval. Fair call. He thinks it's too soon after my relapse for me to be reducing.

That being said, the low libido / low T stuff is starting to get to me. My life has shrunk somewhat. I don't feel "bipolar" depressed per-se. It's not that severe crippling can't get outta bed or leave the flat or function type depression. It's more of a meh, CBF doing anything, life shrinking feeling where I have to force myself to go out and meet my friends. Zero desire to date. All the TV shows with sexy people just don't affect me or draw me in at all.

Whatever. Better than using I suppose. That being said I wouldn't want to be like this forever! Next appointment I'm definitely going to advocate for a dose reduction. 8mg is ideal. That's the "sweet spot" for me, and I hope to stay on that dose until I graduate uni, when the plan will be to taper properly.


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PostPosted: Mon May 08, 2017 3:49 pm 
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we have talked a bit in my thread about it but incase others are reading...

I do have the same problem. I'm on the same dose as you, 16mg. I have tested myself and my levels are very low which leads to me being pretty much asexual. This is not really an option for me being 22 and all.

I know 16mg is above the ceiling level. And in theory the smart thing to do would be to lower the dose to 8mg, and see what happens, and go the medical route which is either an injection or a gel that you put on the the skin (those are the options in sweden)

But i'm so scared to mess with my dose when it's working so good even though i know that in theory i should not notice any difference but positive effects by lowering my dose.

I guess i'll try to just cut my dose in half and see if i get zero withdrawal symptoms since otherwise that would indicate that my ceiling dose is above 8mg sublingually with suboxone.


Anyways i'm happy that you found peace with your lower libido! Whatever works. i'm 100% sure that doses around 4mg would help A LOT with these issues but for me thats not an option right now. I just cannot relapse now it would fuck so much up. Cannot afford to experiment


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