A week or so ago I asked a question about this in the Medications forum - no response. (That's ok. I checked all of NT's archives and there is very little other than bare mention of this topic.) I spent a month or 3 prior to that looking into it after reading several of Forest Tennant's (and others) articles about Hormone Therapy with regard to Chronic Pain.

http://www.practicalpainmanagement.c...tractable-pain

http://www.practicalpainmanagement.c...in-update-2010

http://www.prescription2000.com/Inte...ranscript.html

I Had my adrenal hormones tested per the recommendations in the articles, and I'm below the minimum indices on several of them, which according to Dr. Tennant could possibly indicate adrenal fatigue/exhaustion.

Problem is, that term/condition/syndrome/whatever - "adrenal fatigue" is not recognized, and dismissed by the medical powers that be. (Well, they don't recognize R-Lipoic & ALC for PN either, so....)
http://en.wikipedia.org/wiki/Adrenal_fatigue
(N.B. Addison's disease & Cushing's syndrome have been ruled out)

I asked around, and I got that look they give you - like there's a tree growing out of your head. What the doctors cannot dismiss is that my tested levels of these hormones are quite low, and in a couple of cases, have been for some time.

Anyway, since these adrenal hormones, which can be suppressed by chronic pain, are all derived from a "master/mother" hormone called pregnenolone, and pregnenolone is one of those that I'm low in, it made sense to me to begin there. I also read that the process of converting pregnenolone into these other hormones is fueled by pantothenic acid (vitamin B-5). Most people have enough B-5 from foods and multi-vitamins, but like B-12, it's a water soluble vitamin with no upper limit, and some work is being done with megadosing with encouraging results.

My (and I think Dr. Tennant's) theory is that if I supply my body with the raw materials it needs to mfr. these deficient but essential hormones, it may work out on its own (my ACTH is fine for those who are wondering). So earlier this week I began a conservative regimen of taking 10 mg pregnenolone (sublingual) with 500 mg pantothenic acid (timed release) twice a day.

After just 5 days, I think I'm sensing a change, however I remain conservatively cautious, if optimistic, and I'll be getting retested in a couple of months. If this doesn't work, I still have the option of directly replacing each of the deficient hormones individually, however that entails some risks - moreso than my current experiment.

Stay tuned.

Doc

It's been 3 weeks since I started taking the pregnenolone as described above. The first week, I titrated up to get closer to the 50mg./day recommended by Dr. Tennant, but had to cut back to the original 20 mg./day. Within two days I started breaking out with acne, which indicated it was too much. When I cut back again, the acne disappeared as fast as it appeared. No other side effects except some slight stimulation (like a little too much coffee). To comply with the "intermittant" dosage, I skip weekends, taking it only on weekdays.

I am now confident in saying there has been a worthwhile improvement. My pain levels have decreased noticeably, cognitive functions have improved measurably, energy levels increased, and overall just feeling better (than before taking it), and have started losing weight again (just a couple pounds so far). Family & friends who were unaware of this experiment have noted a positive change. This stuff is by no means any kind of miracle, but keeping in mind I'm low in several of these adrenal hormones, it seems to be doing what it's supposed to do. I'll take what I can get!

Doc

It's been about one month. The first bottle of pregnenolone is gone (coincidentally, it was a one-month supply at the dosage I am taking). The label on the bottle says:
so I'm taking some time off until I touch base with my doctor (and more arrives in the mail).

In just a few days, I have noticed my pain levels are rising again - no other effects so far. I am surmising that this is because my levels of the various deficient hormones are slowly dropping again. The plan, as discussed with my doctor, is to repeat the regimen for 3 months and then get re-tested and take it from there.

Doc

It's now two months into the pregnenolone + pantothenic acid (B-5) regimen. As I've been taking weekends off, I have about a week's worth of pregnenolone left in the second bottle, but in accordance with the label, I'm taking a few extra days off.

As I surmised in the previous update, when I restarted the regimen after the last break, my pain levels again dropped, energy level and overall mood increased. Cognitive function has further improved incrementally.

It's still early with another month to go before re-testing, and I am curious where my levels of the deficient/suppressed hormones are, but I'm very optimistic. Depending on the results, I'll discuss with my doctor either continuing the current regimen or decreasing the pregnenolone to a lower "maintenance" dose.

Doc

It's been about 4-1/2 months now. My first restesting got pushed back due to an unexpected change in insurance - had to pay entirely out-of-pocket. Got the results back today, and they were mixed:

Two of my adrenal hormone levels are now up within normal levels, which I am pleased with. The other took another dive - almost half of what it was the last time (which was well below the minimum reference range to begin with). This has me somewhat devastated, and at a loss for the negative change.

My doctor said he was more concerned with how I feel rather than what the actual/particular number was, but I can't help but think that these numbers, and the prospect of feeling better by getting them back into normal ranges, were the reason I embarked upon this quest, and that if I feel somewhat better now, how much better still might I feel by raising this other crucial level?

I can think of a couple of possibilities for the nosedive. One is that I discontinued the pregnenolone for 3 days prior to the test. I wasn't able to get an answer from anyone on whether I should or not, but it seemed like it might throw the test off by taking supplemental hormones just before the testing, so I timed it to coincide with the end of the weekly break.

I asked about increasing my current dosage, or supplementing it with another further along the adrenal chain. He said to continue with what I'm doing and get retested again in another 6 months. Adding the other supplement is up to me. I've decided to research it further (more homework) and decide then.

How I'm feeling is still better than before I began all this, but it feels like some of the improvement may have tapered off - not as vibrant as it was at first. I just don't know...

Doc

Sorry to hear that. If you are feeling better overall it’s still a good thing.

I cannot string together more than 2 days of feeling decent, so whatever I am doing is not working. I have become to learn pain is a pain. It's hard to find a pattern and its just so darn complex. I hope you can solve this puzzle.

My testosterone is low so I will be trying that soon. I hope it helps with my pain. As soon as I go on androgel I will let you know my progress.

I am dealing with a irritation/pimples from a rash in the areas where eI have the pain due to a cream I was trying rx from pain doctor. DMSO ingredient must have caused irritation so it’s making my pain worse. I also know testosterone can cause acne which I can’t afford if it happens on my back but I will have to wait for this to clear up before I start the androgel.

After reviewing Dr. Tennant's articles again, doing more homework online, and discussions with family & other patients, I've decided to add DHEA to my regimen. I began today. Again, I'm taking it slowly, titrating to find a good level, and will be taking regular breaks every week.

I've been off the pantothenic acid (B5) for a few weeks due to a foul-up in re-ordering. I've noticed a slight difference in how I feel in general (not as good as I did) and perhaps more significant, I've had a flare of cystic acne, which hasn't happened since I began the B5. If for nothing else, it's worth taking just for that.

Got all my fingers & toes crossed - I'm due for retesting in July.

Doc

I read all the articles you posted on the pain forum. thank you for providing that. I do all the correct things mentioned for my pain control, and I am overly candid with my pain doctor. Completely honest, and fear of the pain can make you do that for sure. Maybe that is why he is not overly concerned about me. I just read so much that is scarry about this drug, and I do not want to up and up the dose and have some mental problem with it. I want to go down, so that there will be help if I should need it in the future. He knows this. Treating this pain has been the most difficult part of my cervical problems, and that includes surgery. Keep posting about pain, I need all the articles you send to us. I will read all of them. ginnie

I can tell that you do. Discussion forums are an imperfect means of communication, prone to miscommunication of every sort, but the best we have despite their foibles. When I post something to a public forum, I'm assuming everyone can read it (because they can ), so I try to do it in a general informative way (even when I fail miserably, and I do). I don't ever mean to talk down, or be condescending, to anyone, and if I've ever appeared to do that, I am truly sorry.

If/when I have something to say to just one poster, I do it via PM.

Doc

You do great Dr. Smith. You do the research and present it to us. Couldn't ask for more. I appreciate your responces to the forum alot. When you deal with pain, one can never be too carefull with the medications. I have a healthy respect for the med. I am on and have no wish to upset the apple cart. I also insist on good communication with my pain specialist. I don't think it could be done any other way. Ginnie