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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by AndrewB on June 21, 2000, at 18:54:59
I anyone using TRH nasal spray as an antidepressant?
Posted by Seamus2 on June 22, 2000, at 0:09:41
In reply to TRH nasal spray, posted by AndrewB on June 21, 2000, at 18:54:59
> I anyone using TRH nasal spray as an antidepressant?
Thyroid Releasing Hormone?
I thought that was a purely diagnostic drug, and had no idea it could be delivered intranasally.Where do you find this stuff?
Seamus
Posted by noa on June 22, 2000, at 5:44:44
In reply to Re: TRH nasal spray, posted by Seamus2 on June 22, 2000, at 0:09:41
I never heard of it either. Isn't TRH the chemical that sends a signal from the hypothalamus to the pituitary to signal it to release TSH? If so, I guess TRH would be useful for people who have a thyroid problem based in the hypothalamus, no?
Posted by AndrewB on June 23, 2000, at 7:46:44
In reply to Re: TRH nasal spray, posted by Seamus2 on June 22, 2000, at 0:09:41
Yes, TRH is useed primarily a diagnostic tool and in that application effects the thyroid. When used intranasally though, it stimulates the trigeminal nerve. This results in a variety of effects. One previous poster said he was being prescribed it as an AD. A doctor uses it on those with chemical sensitivities. Dr. Brain Goldberg uses it for CFIDS patients and has noted the AD effect. The following is the first part of an article from Dr. Goldberg's site (http://www.drjgoldstein.com/frames/05artbook.html).
Thyroid Function in Neurosomatic Disorders:
Stimulation of Trigeminal Nerve Activity with Thyrotropin Releasing Hormone
Published in The National Forum - Spring 1999
by Jay A. Goldstein, M.D.I use thyrotropin releasing hormone (TRH) nasal spray to treat people with what I term neurosomatic
disorders. These illnesses include fibromyalgia syndrome, chronic fatigue syndrome, irritable bowel
syndrome, premenstrual syndrome, and a host of other disorders that are not handled properly by
the brain and, as a result, the way the brain regulates the body is inappropriate. TRH has a number
of properties that would make it difficult to treat disorders such as fibromyalgia syndrome. I have
been using it for several years intravenously, injecting 500 units with moderate success. At this
dose, it primarily affects mood disorders and alertness but can affect all symptoms. There are
usually some transient signs of arousal of the autonomic nervous system as manifested by nausea,
change in blood pressure, and an urge to urinate. The effects of intravenous TRH usually last a
week or two when the medication is effective.TRH enhances norepinephrine, dopamine, and serotonin secretion. Norepinephrine is a major brain
neurotransmitter that increases signal-to-noise ratio, i.e., the ability to filter out relevant from
irrelevant stimuli. Many patients with neurosomatic disorders are highly distractible and function
poorly in environments of stimulus overload such as malls. Their performance also deteriorates in
neuropsychological testing situations when the amount of information presented is increased even
if the information is in the form of helpful cues. Dopamine also increases signal-to-noise ratio, but
even more than norepinephrine, it is implicated in reward. Dopamine, acting at the level of the
nucleus accumbens, a structure in the basal ganglia of the brain, makes people feel considerably
better in general and increases their activity and sensations of pleasure and motivation. The
interaction of dopamine with other neurotransmitters in nucleus accumbens is too complex to
discuss here. Serotonin, which stabilizes information flow in neural networks in the brain, thus
constraining behavioral, affective, and cognitive output, has been found to be decreased in
fibromyalgia syndrome in cerebrospinal fluid, as have norepinephrine and dopamine metabolites.
TRH has nerve endings on structures in the brain stem called the dorsal raphe nuclei which secrete
serotonin. TRH is a string of three amino acids. When amino acids are strung together they are
called peptides. When peptides act in the nervous system, they are called neuropeptides. TRH is a
neuropeptide in addition to its role in stimulating the release of thyroid-stimulating hormone, which I
shall discuss shortly.A physician can buy TRH in 500 unit ampules of I mi. Five hundred units is the usual amount that is
administered during a TRH stimulation test, which is performed to measure the amount of TSH the
pituitary gland will secrete in response to TRH. The neurons that secrete TRH are in the
hypothalamus, right above the pituitary gland in the paraventricular nucleus, which also contains
other regulatory peptides such as corticotropin-releasing hormone and gonadetropin releasing
hormone.We make a dilution of 500 units or I ml of TRH in 9 ml of normal saline and put it in a nasal spray
bottle. Each spray delivers approximately 3 units of TRH, an amount that one would not think would
have a physiologic effect if injected intravenously. However. there must be receptors for TRH
somewhere in the nasopharynx or in adjacent ganglia such as the spenopalatine ganglion because
patients who respond to one spray of TRH solution in each nostril report that they feel much more
alert and much more energized in less than one minute. Gordon Baker, M.D., in Seattle, uses TRH
nasal spray to treat multiple chemical sensitivity ("Does it help anything else?" he asked).I have written extensively about stimulating two of the three branches of the trigeminal nerve, which
conveys sensory input from the face, with pharmacologic agents. This mode of administration has
an effect on brain function because the tract of the trigeminal nerve in the brain stem is an important
integrator of sensory information. The solitary tract of the vagus nerve performs a similar function,
but is much more difficult to access for external modulation. (Clark KB, Naritoku DK, Smith DC,
Browning RA, Jensen RA, 1999) It can only be stimulated electrically with various wave forms
intensities and rates. The trigeminal nerve synapses with almost all of the relevant nuclei that would
be involved in having a desirable physiologic response in fibromyalgia syndrome. These include the
locus ceruleus, the periaqueductal gray, the parabrachial nucleus, the dorsal raphe nucleus, and
the ventral tegmental area, which secretes dopamine to the nucleus accumbens. Other important
modulatory structures are involved, but I do not want to make this discussion too technical. Since
trigeminal nerve function can be altered pharmacologically, electrically, and mechanically, this route
allows the use of a wide range of modalities to tune brain function.
Posted by noa on June 23, 2000, at 8:50:54
In reply to Re: TRH nasal spray, posted by AndrewB on June 23, 2000, at 7:46:44
Thanks for the info. Sounds fascinating. Are there studies going on?
Posted by AndrewB on June 24, 2000, at 10:04:00
In reply to Re: TRH nasal spray, posted by noa on June 23, 2000, at 8:50:54
> Thanks for the info. Sounds fascinating. Are there studies going on?
Noa,
Elderly depressed patients are being studied to see if a relationship exists between TRH’s mood and cognitive effects and its endocrine responses by a Dr. Gabriel Tsuboyama. Effects on neurotransmission (serotonergic, norandrenergic, cholinergic) could underlie the alleged mood-elevating effects and the cognition-improving effects observed after the administration of TRH.
AndrewB
Posted by Abby on June 29, 2000, at 11:46:53
In reply to Re: TRH nasal spray, posted by AndrewB on June 24, 2000, at 10:04:00
Andrew-- I haven't used it, but I think that some other chronic fatigue doctors mention the same use. Dr. Lowe, I believe, is one. His site is mentioned by Mary Shomon http://www.thyroid-info.com
There wasn't any mention of its use as an AD, and I was wondering why no one had tried it. Thanks for letting us know about the research.
Abby
This is the end of the thread.
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