Caffeine Induced Emotion Blunting- Pregnenolone Crash

[electrify]

Hello,

Used to post on PeakT's forum years ago like back in 2015-2017. Since then I have pretty much been well and dialied in on a TRT protocol (I do 0.3 mL 2x a week). I don't take an AI, and things like high E2 or low SHBG (this declined from 25 over the years) have not really affected me. At some point also, low cortisol/pregnenolone on TRT also resolved themselves. I do supplement Preg Cream 15 mg daily. At that time my symptoms were more anxiety and low mood.

Anyways fast forward to this year. Suddenly 1 day completely randomly after drinking caffeine, I felt emotionally numb. I also did not have any anxiety or panic attack. This is *never* a symptom I had in my previous issues with T and the HPA axis back then. It seems to get better at night time, but basically I am not having the emotional response to things that I used to have. This is my only symptom mainly. Things like libido are still OK ish.

As it turned out, my pregnenolone levels took a massive dive out of nowhere. I'm not sure why this crazy reaction happened, its pretty intersting. I wonder if randomly having too high T levels made me super sensitive to caffeine.

My labs 5 months before this when I was normal:

T - 850
E2 - 63
SHBG - 15
Cortisol AM - 15
DHEAS - 550
Pregnenolone - 125

Labs now:

T - 1171
E2 - 54 (No idea why this went down despite T going up, maybe cause ive lost some ab fat)
SHBG - 14
Cortisol - 7.7
DHEA-S - 470
Pregnenolone - 35

How do you raise Preg + Cortisol? This blunting is pretty concerning, it seems like my body had some very weird sensitivity and stress reaction to the caffeine. I do notice a slight effect with the Preg cream, but not enough. It seems like my HPA axis got affected by this strange reaction.

I'm also wondering can symptoms morph over the years? Previously when I had these kind of labs way back, I had low mood+ anxiety. Now this time, my symptom is flat emotions but my mood is not low and I don't feel that anxious (well except over the symptom).

I've also noticed the same dose of T resulting in higher levels this time around. Seems ive gotten more sensitive to everything.

 

[bixt]

It could be the other hormones like Preg / Cortisol had reduced over time, and then the caffeine triggered a crash. Generally caffeine (and other stimulants) "whip" the adrenals to temporarily increase output. (Besides the temp increase in neurotransmitters as well.)

Speculative reason for preg/cortisol reduction...is reduced adrenal function / insufficiency.

To test, take a prednisone (single tablet) in the AM once off, see how you feel that day, and report back. You can get clues like this, for example if you magically feel much better that day. Then you have a confirmed direction in which to investigate further.

Please note I said "once off". Long term prednisone will cause other well known issues, but theres no harm in a once off test.

 

[electrify]

It could be the other hormones like Preg / Cortisol had reduced over time, and then the caffeine triggered a crash. Generally caffeine (and other stimulants) "whip" the adrenals to temporarily increase output. (Besides the temp increase in neurotransmitters as well.)

Speculative reason for preg/cortisol reduction...is reduced adrenal function / insufficiency.

To test, take a prednisone (single tablet) in the AM once off, see how you feel that day, and report back. You can get clues like this, for example if you magically feel much better that day. Then you have a confirmed direction in which to investigate further.

Please note I said "once off". Long term prednisone will cause other well known issues, but theres no harm in a once off test.

It's possible it was lowering before already, but I was feeling fine and it was a pretty profound change after the caffeine reaction. But yea, I think probably Hydrocortisone over Prednisone though, as the latter is very strong.


Years back I have taken HC "as needed" when I had low mood/anxiety symptoms and on some days it would help and I'd basically be cured for the day while on other days it would make it worse, it was very random what would happen. But this time my symptom is very different, somehow my phenotype of HPA dysregulation changed over these years (for the worse imo, I think id rather feel low than emotionally blunted).

Since HPA dysfunction is ultimately a "brain issue" I had tried 1 Ketamine infusion (attempt at a quick fix) a couple weeks ago to try to reset it, but it actually worsened my symptoms for about a week so that option is off the list. Ketamine is for depression, and it wasn't totally clear if it would help this isolated symptom but there are anecdotes of it bringing back emotions but for me it was the opposite.

One issue I have had forever though is low cholesterol. My total cholesterol right now is around 105. I wonder if somehow this is the root for all these issues. I've never figured out why its so low, its partly genetic but even in my family people have levels of like 130, so I might be having malabsorption or something. I think I might need to investigate the gut too.

 

[electrify]

So an update. Turns out I have a very bad case of SIBO (small intestine bacterial overgrowth) with breath test levels of like 130+ in H2, and some slight elevation in methane as well.

Basically the theory is that extreme SIBO can create a stress on the body and then lead to inability to handle stimulants. I recently even tried DLPA (DL phenylalanine) and had crashed bad. I thought it was like L Tyrosine which I can handle but turns out DLPA does a lot more--the L phenylalanine part can convert to PEA which has natural stimulant effects.

Been doing a low FODMAP diet though and it does help my symptoms, indicating there is some connection.

The med Lyrica helps me at a dose of like 200 mg but its temporary. I really need to get rid of the SIBO though, and it might take multiple cycles of antibiotics like Rifaximin.