Crohns and Depression / Hormone production

[lukefarrell7]

Hello All,

I previously had an account on the forum with ‘my storey’ etc but I managed to lock myself out and thus have started a new account. I have crohns disease and a brief history is as follows:

I am 28 yo, dx when I was 12, in approximately 1999. I had 3 years of flaring badly on and off after being diagnosed with crohns in my ileum. I was treated with long and large doses of Prednisone and I would feel better, taper and flare again.

Aged 15, in 2002, I ruptured my ileum following a bad flare and had emergency surgery to repair the damaged. I also had a chunk of my ileum removed during the surgery and had a colostomy bag for 1 year. This was successfully reversed a year after the surgery. I started taking Azathioprene in 2002/2003.

I had minor flares and was generally in good health until the age of about 23/24 ( circa 2011) when I started to have strange symptoms of extreme waves of abdominal pain and constipation/diarrhea and occasional vomiting, but they were not typically the same pain and style of a crohns flare and would last 1 - 4 weeks at a time before disappearing. My inflammation levels were low and MRI scans and colonoscopies were inconclusive. eventually I was diagnosed with a stricture in my ileum and the pain had been a result of food ‘plugging’ my intestinal pathway from time to time and then somehow releasing itself an the pain would disappear. I had open surgery in September 2012 - a strictureplasty - to repair the stricture and got bad wound infection and the recover was quite long.

In February 2013 I had a bad flare and was diagnosed for the first time in my life, with crohns in my colon (large bowel) as well as my ileum. I started Humira in May 2013 and have been taking it since (40mg every second week), except from a 4 month break from January - April 2015, where I started to flare again and treatment was re-started. I have been pretty well since.

Anyway to get to the point, I was diagnosed with depression in Jan/Feb 2013 and was given prozac. I tried this and took it for about 4 months at that time, but I didn't feel I was definitely depressed and tried to make positive changes to my life in order to feel happier - a CBT approach.

Despite doing this, I still get days and week where no matter what I do, nothing can make me feel happy. e.g. someone could hand me a cheque for £1,000,000 and I still wouldn't feel happy deep down. I have been reading about serotonin production and see that a lot of it is produced in the small intestine (although I’m no expert) and therefore I feel it could be possible my body just does not produce normal levels of the hormone due to the effects of crowns over the years.

In addition, I have recently had my testosterone levels checked and they are also extremely low for a 28 yo male.

has anyone else had a similar experience and if so - how were they treated? was it effective? Any help / info would be much appreciated. ps I am based in the UK.

Thanks
Luke

 

[lukefarrell7]

To summarise my previous post -

1. Do we, as crohns suffers, have more difficulty than other producing normal levels of serotonin?

2. As a general crohns sufferer and someone who is using Humira, would I struggle to produce normal levels of Testosterone?

Thanks

 

[DJW]

Hi,

There are many studies that show Crohn's sufferers are at a higher risk for depression than the general population. Whether it's linked in anyway to inflammation, it could be.
I have no idea if it inhibits serotonin product; know way to know for sure. I don't know of anyway to measure serotonin.

The testosterone question...don't know.
It's not something I've come across in any literatur on biological treatments.

 

[Worrywart]

Hi Luke,
I too am from UK. I can't answer your questions but can relate to the depression. I too feel like you and feel a sadness deep inside. I am on Prozac also which helps a little but at the moment seems to be doing very little. I had ilesotomy 30 years ago and in January had another op and my bowel perforated which has left me with many problems.
Hopefully someone more knowledgeable will be along soon to answer your questions.
Keep fighting,
Best wishes

 

[Cat-a-Tonic]

Depression is very common with IBD and I do believe that there's a brain-gut connection there. When I flare, my emotions go completely haywire - I cry at anything and everything. I have cried at TV commercials ("There's a puppy on TV!" *cries uncontrollably for no reason*) and I once cried at the thought of calling my mother. I didn't even call her, I literally just thought about calling her and burst into tears. I also experience days where there is a dark cloud above me and nothing anyone does or says can do anything to help, similar to what you described. For me there's usually a correlation between the dark days and my symptoms, so it seems pretty clear that for me there is a strong connection between my disease activity and my depression. Not scientific, I know, but it sure makes sense to me based on what I've observed.

A lot of us on here take anti-depressants, and there's no shame in doing so and those medications can be very beneficial. There are other things that can ease depression as well - certain vitamin deficiencies (such as low vitamin D) can sometimes contribute to depression, and us IBD'ers tend to commonly be deficient in vit D, so you may want to get your vitamin levels checked and consider supplementing if you don't already - getting out in the sunshine is another good way to get vitamin d. Getting physical exercise can also help alleviate depression - for me, this has been the best antidepressant. As long as I'm in the gym regularly, that dark cloud and the crying fits tend to stay away for the most part and I feel far happier and more content and less stressed out after a good workout. If you're well enough and able to, definitely give exercise a try. You don't have to go crazy with it, it can be something as simple as taking a walk outside on a nice day.

 

[mackraslo]

I take Testosterone Replacement therapy because my levels are very low. Here is some interesting information on crohns and testosterone:

https://www.ncbi.nlm.nih.gov/pubmed/26020563/