A lot of discussion has been had regarding the role of dopamine in the side effects we have been facing. Numerous people have claimed to have some, albeit, short-lived, results with anti-depressants and l-tyrosine. However, I theorize that a lack of dopamine may not be the cause of our issues, but rather a lack of dopamine receptors.
Consider the occasions where a PFS sufferer has taken l-tyrosine (a dopamine precursor) or Wellbutrin (a dopamine reuptake inhibitor) only to find temporary relief, and sometimes, even find themselves feeling worse than they did prior to their supplementation. I find it possible that the reason the positive effects are transient is because by increasing dopamine, PFS sufferers actually begin to further decrease their levels of dopamine receptors. An influx of dopamine, such as is seen in cocaine users, actually causes the body to respond by decreasing the number of dopamine receptors (thus creating a tolerance). In order to feel the same, one needs to increase the source of dopamine, causing more losses to the number of dopamine receptors. Similar effects have been found in obese people, where obese persons, possibly due consistently rewarding oneself with food, have less dopamine receptors than their thinner counterparts (bnl.gov/bnlweb/pubaf/pr/2001/bnlpr020101.htm).
I find further support for the dopamine receptor theory in the results seen by those who have seen improvements via exercise and/or fasting. Exercise is generally known to increase dopamine production, and consistent exercise increases the level of dopamine receptors. While people such as japanther have claimed success via fasting because fasting has “detoxification” properties, I believe that fasting may contribute to PFS healing via dopamine receptor increases. Fasting has been scientifically proven to increase the count of dopamine receptors one has (sciencedaily.com/releases/2007/10/071025091036.htm). Even marijuana (which I believe MartinM or someone from a post involving MartinM) has helped some regain libido, if only temporarily. Surprise! THC, the active ingredient in that sticky-icky some PFS sufferers have been smoking causes a release of dopamine!
Unfortunately, the most reputable list of symptoms for dopamine deficiency that I could find quickly has “The Edge Effect” as a source. Nonetheless, the symptoms of dopamine deficiency include:
Reduced ability to feel pleasure
Flat, bored, apathetic and low enthusiasm
Low drive and motivation
Difficulty getting through a task even when interesting
Difficulty paying attention and concentrating
Slowed thinking and/or slow to learn new ideas
Crave uppers (e.g. caffeine/nicotine/diet soft drinks)
Use these to improve energy/motivation/mood
Prone to addictions (e.g. alcohol)/addictive personality
Low libido or impotence
Mentally fatigued easily and physically fatigued easily
Sleep too much and trouble getting out of bed
Put on weight easily
Family history of alcoholism/ADD/ADHD
By increasing dopamine, yes, PFS sufferers may receive some temporary resolution of symptoms. But, if PFS sufferers can increase their dopamine receptor levels, is not prolonged relief possible? Could this explain why time has been the only consistent factor with recovery? Our bodies begin to increase our dopamine receptor levels, so that more dopamine can used?
Let’s take a mathematical look at this theory…
If on a day to day basis, a PFS sufferer has 10 available dopamine receptors and 5 units of dopamine floating around, then he is at 50% utilization. However, if he takes some l-tyrosine or some Wellbutrin, he may achieve 100% efficiency by making 5 more dopamine units available. But, if the Wellbutrin/tyrosine causes dopamine levels to go past 10, then the body begins to drop dopamine receptor levels to 9, leaving the PFS sufferer with a less high level of optimal dopamine experience.
However, if a PFS sufferer increases his dopamine receptor levels via fasting or exercise from 10 to 11, then his total possible dopamine experience increases. Maybe there are some minimum thresholds (each person’s would likely be different); if a PFS sufferer reaches 13 dopamine receptors filled with dopamine, brain fog begins to subside. At 15 receptors filled, brain fog disappears. At 18 receptors filled, emotions increase. At 20 receptors, emotions restored. At 22 receptors filled, libido increases, and at 24 receptors filled, libido is restored. With this theory, a lack of dopamine receptors would mean some people can never reach 100%, even if they are filled to the brim with dopamine, because they do not have enough receptors to make use of all the available dopamine. If you have 30 units of dopamine, and only 15 receptors, well, you’re libido won’t be helped at all because you need to be filling a minimum of 22 receptors.
So - is it possible to increase the number of dopamine receptors? Yes, via exercise and fasting. Is increasing the number of dopamine receptors further/more quickly possible? Yes - through antipsychotic medications which are dopamine receptor antagonists.
Do I advocate going to your neurologist/psychiatrist and seeking out meds that will increase your dopamine receptor levels? No, because I’m not a doctor, nor a healthcare professional of any sort. Do I think this may have some promise? Yes - and it can’t have any less promise than the other methods that have been attempted.