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Men with ADD/ADHD This forum is for men to discuss issues related to being a man with AD/HD.

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  #1  
Old 03-16-18, 05:02 PM
ChRoTa3 ChRoTa3 is offline
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ADD or Low T

Background and Facts

Average testosterone levels have been decreasing since the 80s. This is also about the same time that ADD/ADHD meds took off.

Amphetamines, what the majority of ADD/ADHD meds contain, have been shown to decrease testosterone in animal studies. Admittedly, the literature on this is somewhat mixed. I've also seen some studies suggesting that there is no effect in short term trials.

Testosterone treatment in animal studies has been demonstrated to have an effect on dopamine, and testosterone levels correlate with norepinephrine levels. These are the same chemicals ADD/ADHD medications act on. I've also seen a couple of studies showing a relationship between serotonin (the primary neurotransmitter involved in depression) and testosterone regulation.

Males are three times as likely to be diagnosed with ADD/ADHD than females.

My Interest in All This

I'm wondering if the decrease in average testosterone levels is causally related to the spike in ADD/ADHD treatment. I'm inclined to say no. There's certainly a correlation, but it seems more likely to me that some other environmental factor is causing the average decrease in testosterone and ADD/ADHD treatment is compounding the problem.

I am also wondering how many ADD/ADHD diagnoses in men between 18 and 30 are actually misdiagnoses. Testosterone levels in men start a slow decline in their mid-to-late 20s. So if someone is exhibiting ADD/ADHD-like symptoms for the first time in this age range, it seems reasonable to test their testosterone levels prior to providing a diagnosis. Comorbid conditions like anxiety and depression could also be attributed to hormonal changes and would, at least in my mind, strengthen an argument for exploring hormone therapy where psychotropic medications would usually be prescribed.

What do you guys think?
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Old 03-17-18, 02:53 AM
CharlesH CharlesH is offline
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Re: ADD or Low T

Interesting idea, but I'm skeptical. How would T issues account for the rise of ADHD diagnosis in children and adult women?

Also, ADHD is by DSM definition a neurodevelopmental disorder. To qualify for diagnosis, symptoms must be traced to childhood onset (even if the patient is no longer a child). If a man only starts having symptoms of inattention once he is an adult, then it's not ADHD that's causing it, and it would be inappropriate for a clinician to diagnose the patient as ADHD.
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  #3  
Old 03-17-18, 04:21 PM
ChRoTa3 ChRoTa3 is offline
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Re: ADD or Low T

None of this was meant to apply to women or children hence my post's location. Men still represent about 3/4 of all diagnoses.

If ADD/ADHD is neurodevelopmental and every case is diagnosed correctly, then the ratio between men and women should be closer to 1:1. It's not; the ratio is about 3:1. So let's accept that ADD/ADHD is neurodevelopmental. We still have a huge disparity, so there has to be some difference between men and women in relation to ADD/ADHD diagnoses that accounts for it.

Low T is one possibility as I outlined with the original post. This would explain rates among men older than 20.

What could explain the gender disparity in children?

I don't know. I wasn't trying to answer that question. I've heard some good arguments from academics about the education system and its inability to handle young males appropriately. The inability creates a problem. The problem is conflated with ADD/ADHD. Now that the problem has a medical diagnosis, doctors treat it as such.

Nothing in this thread is meant to suggest that someone should stop taking their meds. or that they're misdiagnosed. I'm just wanting to explore the idea and was hoping that some men on here have had their T measured.
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Old 03-17-18, 05:14 PM
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Re: ADD or Low T

This could (maybe) explain a minority of cases, just as thyroid imbalance can
explain a minority of cases, just as allergies can explain a minority. Interesting.

As far as the number of girls and women diagnosed with ADHD, that is rapidly
gaining and I think it won't be too much longer before it is just as often dx in
girls and women as in hyperactive boys, now that doctors realize that it's not
a behavorial disorder but it's a neurobiological disorder that can have many
symptoms beyond hyperactivity in both genders.
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Old 03-18-18, 07:56 PM
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Re: ADD or Low T

Quote:
Originally Posted by ChRoTa3 View Post
Nothing in this thread is meant to suggest that someone should stop taking their meds. or that they're misdiagnosed. I'm just wanting to explore the idea and was hoping that some men on here have had their T measured.
To be clear, I wasn't intending to suggest that anyone should stop taking their meds. I'm just saying that if a man's issues with attention only started after childhood, then he does not qualify for a diagnosis of ADHD. If a man's issues with attention go back to childhood, then those attention issues are not caused by T issues, since young boys don't have problems with T.

So I just don't see how a T test would be helpful for the general population of men with attention issues. Certainly, if a man presents with both symptoms of ADHD and low T, then it would be helpful to do a T test.
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Old 05-20-18, 12:06 PM
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Re: ADD or Low T

Nope. Not related at all. Just one thing, guys with add(like me) had been handed down a couple of PTSDs,depression, anxiety,ocd and what not. So, my testosterone levels will be low which can further exacerbate depression and anxiety. But, saying that low T might be the cause,not ADD, is like saying the moon is the Jupiter
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Old 05-20-18, 01:25 PM
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Re: ADD or Low T

My T levels more than doubled after beginning Adderall. I went from borderline low before Adderall to well into the normal range after 6 mos.
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Old 05-20-18, 07:24 PM
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Re: ADD or Low T

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Originally Posted by Greyhound1 View Post
My T levels more than doubled after beginning Adderall. I went from borderline low before Adderall to well into the normal range after 6 mos.
I think Adderall helping me to cope much better with my co-existing conditions like anxiety, ruminating, OCD and fatigue is probably why it helped my T-levels is my guess.

My Dr. had no idea why just glad it did.
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Old 05-20-18, 10:41 PM
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Re: ADD or Low T

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Originally Posted by Greyhound1 View Post
My T levels more than doubled after beginning Adderall. I went from borderline low before Adderall to well into the normal range after 6 mos.

Actually that doesn't surprise me at all.


One of the features of ADHD is an overactivated stress system (Sympathetic nervous system along with hypothalamic- pituitary adrenal axis)


The neurological issues in ADHD inherently destabilise the autonomic nervous system, creating a stress state, and then the psychosocial issues caused by the ADHD are doubly stressful.


One model of what happens is this: a relative diversion of the steroid hormone precursor pregnenalone to the manufacture of cortisol, and away from sex hormones. A cortisol deficiency will kill you, but you wont die form a low testosterone-- except maybe of boredom.


However there are weaknesses with that model, and it may just be simpler to say that high stress diverts energy away from reproduction- itsless ofa priority than being safe.



Successful treatment of ADHD reduces that stress reaction (I have had many occasions where amphetamine drops my pulse within 20 minutes of a 15mg dose of dex)- and it would be reasonable to expect that that would make T levels likely to increase.
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Old 05-20-18, 11:48 PM
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Re: ADD or Low T

Quote:
Originally Posted by ChRoTa3 View Post
Background and Facts

Average testosterone levels have been decreasing since the 80s. This is also about the same time that ADD/ADHD meds took off.

Amphetamines, what the majority of ADD/ADHD meds contain, have been shown to decrease testosterone in animal studies. Admittedly, the literature on this is somewhat mixed. I've also seen some studies suggesting that there is no effect in short term trials.

Testosterone treatment in animal studies has been demonstrated to have an effect on dopamine, and testosterone levels correlate with norepinephrine levels. These are the same chemicals ADD/ADHD medications act on. I've also seen a couple of studies showing a relationship between serotonin (the primary neurotransmitter involved in depression) and testosterone regulation.

Males are three times as likely to be diagnosed with ADD/ADHD than females.

My Interest in All This

I'm wondering if the decrease in average testosterone levels is causally related to the spike in ADD/ADHD treatment. I'm inclined to say no. There's certainly a correlation, but it seems more likely to me that some other environmental factor is causing the average decrease in testosterone and ADD/ADHD treatment is compounding the problem.

I am also wondering how many ADD/ADHD diagnoses in men between 18 and 30 are actually misdiagnoses. Testosterone levels in men start a slow decline in their mid-to-late 20s. So if someone is exhibiting ADD/ADHD-like symptoms for the first time in this age range, it seems reasonable to test their testosterone levels prior to providing a diagnosis. Comorbid conditions like anxiety and depression could also be attributed to hormonal changes and would, at least in my mind, strengthen an argument for exploring hormone therapy where psychotropic medications would usually be prescribed.

What do you guys think?

I don't think there is a relationship here. Low testosterone does not present with ADHD symptoms--- think of your average healthy grandfather. T levels often very low but still usually fit and mentally sharp.

There is good evidence to point the finger at endocrine disrupters in the food and water supply. These are a major problem.

I also doubt that there is any evidence that there is a significant issue with over diagnosis of the ADHD syndrome.
ADHD is actually very clinically distinct- to the point that Im finding that my first impressions simply on sighting an ADHD individual correlate extremely well with the history backed by extensive questionnaires.
Now that the syndrome has entered the mental consciousness of doctors - we have excellent symptom scoring and assessment tools to back up our judgement.

I was not diagnosed till 46, and there has been a huge problem with missed diagnoses. Virtually all of us had clear cut childhood symptoms.
There is some discussion about true adult onset of ADHD (usually following TBI) but there is no agreement on that yet, and those cases are not classified as ADHD.

The myth of overdiagnosis has been driven by groups with set agendas. Many claims are made of incorrect diagnosis- but no cases are ever submitted for proper scrutiny.

Hormonal therapy will not work for ADHD, it doesn't touch any of the critical networks. It might soothe some of the secondary anxiety and depression.


The reasons for the different diagnosis rates between male and female are probably bases on neuroanatomy and neurophysiology.
The average differences seen between brain scans of ADHD and non ADHD individuals are less than the average differences between males and females.


Female brains have greater integration between separate networks- and especially between the left and the right hemispheres.


It is suggested that the female brain is better at global attention of the kind needed to keep toddlers safe while doing other useful work, whereas the compartmentalisation of the male brain favours complex problem solving while hunting, at the expense of some of the obvious psychosocial advantages females have.


However, one useful model of ADHD (and dyslexia, autism etc) that is growing in acceptance is the idea of a functional disconnection syndrome in which the normal balanced and interdependent function of both hemispheres becomes unbalanced as a result of function, not as a result of an area of tissue injury. These imbalances can be seen on neuroimaging- I had a very big imbalance. Equally they are a predictable outcome of normal brain function pushed too far- because many brain areas work in concert with other specific areas and normally mutually inhibit- and balance each other.
However sometimes one area that gets too overactive can oversupppress its opposite number and the system can get "locked in" to a stable but dysfunctional pattern.


The male brain with its greater separation into functional areas and its lesser - L connectivity is logically likely to be at particular risk.


Now as for whether to screen and treat in all cases- it depends on how far you want to go. It is not a standard concern in ADHD patients and testosterone levels are more of a side issue.

If you want really thorough treatment f the problem then the way to go is to a see a functional medicine practitioner. They will look at the whole lot form a neurohormonal aspect, from an energy supply and toxicology level and from a gut level.


But it will cost a fortune.


Personally, if I were to add in another modality- thorough assessment of gut bugs would be the top of my list.
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I regard consciousness as fundamental. I regard matter as derivative from consciousness. We cannot get behind consciousness. Everything that we talk about, everything that we regard as existing, postulates consciousness.

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