Connective Tissue Disorders/Ehler Danlos, the ECM and Chronic Issues - MCAS, CIRS, POTS, CFS, IBS, Dystonias, Pain, Proprioceptive Disorders, ETC.!

I have been feeling moody like I have pms for weeks, melancholy, annoyed at things my partner does that aren’t even annoying worthy (poor dude) . The only thing that’s changed for me is the introduction of PEA.
So I’m going to stop the PEA which has done nothing notable in the 3 weeks I’ve been trying it- except may be making me a pseudo-premenstrual misery machine the whole time.

I’ll report back in after I actually enter then finish the luteal phase in a few weeks

It has been shown in experiments that high dose of Allopregnanolone can have opposite effects of low dose. Perhaps you have enough of it and you don't need more. Here you can see the graph of Allopregnanolone during the menstrual cycle:


If you cannot tolerate PEA at all perhaps you can try Oleoylethanolamide (OEA) which has many similar effects.
 
Interesting @Persej
I have been feeling moody like I have pms for weeks, melancholy, annoyed at things my partner does that aren’t even annoying worthy (poor dude) . The only thing that’s changed for me is the introduction of PEA.
So I look up Allopregnanolone so see if has any adverse affects associated.

Ai says

Allopregnanolone, a neurosteroid derived from progesterone,
paradoxically induces anxiety, irritability, and negative mood at moderate, physiological levels (e.g., during the luteal phase), despite being a
GABAA
receptor sedative. This biphasic, inverted U-shaped effect is most common in individuals with Premenstrual Dysphoric Disorder (PMDD).

Key Aspects of the Allopregnanolone Paradoxical Effect:
  • Biphasic Action (U-Shaped Curve): While high concentrations (as in late pregnancy or high-dose therapy) and low concentrations produce calming, anxiolytic, or neutral effects, moderate levels (1.5–2 nmol/L) cause adverse emotional symptoms.
  • Mechanism of Action: Allopregnanolone acts as a positive modulator of the
    GABAA
    receptor. In specific individuals, it may act on different receptor subunits

    rather than calming, lead to paradoxical effects. It is thought to increase amygdala activity (associated with anxiety) at moderate levels, rather than decreasing it.
  • Role in PMDD/PMS: The rise of allopregnanolone during the luteal phase (premenstrual) triggers these paradoxical symptoms, with symptoms, mood, and irritability, declining when allopregnanolone levels fall.
  • Treatment Approach: Research suggests that using a
    GABAA
    modulating steroid antagonist, such as isoallopregnanolone (Sepranolone/UC1010), can counteract these effects and reduce negative mood in PMDD.
    ScienceDirect.com +4
Contextual Factors:
  • Sensitivity Differences: Only 3–8% of the population experiences severe, and up to 25% experience moderate, negative mood changes, similar to the prevalence of PMDD.
  • Neurodivergence: Individuals with ADHD, autism, or a history of mood disorders may be more susceptible to this effect.
  • Contextual Stress: Chronic stress may play a role in increasing sensitivity to these paradoxical effects.

It’s me again. So I’m going to stop the PEA which has done nothing notable in the 3 weeks I’ve been trying it- except may be making me a pseudo-premenstrual misery machine the whole time.

I’ll report back in after I actually enter then finish the luteal phase in a few weeks

Another way of looking at it is that PEA is changing your physiology, and providing you with an opportunity to do the emotional work. If PEA is clarifying your system, which it probably is, it would also be improving your neuroception. So it may be that what you're now noticing was already there, just another layer of the onion. Generally this is how healing or deprogramming happens, OSIT - not by 'feeling better', but by increasing self-awareness, noticing our BS more, accepting it, and the lessons involved, and struggling with oneself to make the necessary emotional or mental changes. My two cents.
 
Such regenerative effect of Allo is dose-dependent and exhibits a classic U-shaped dose-response curve indicating that more is not better. Based on that principle high doses of Allo, that induce a sedative response, do not promote neurogenesis. The inverted-U shaped dose response profile of Allo is particularly important from a safety perspective. Greater than normal concentrations of Allo or continuous unrelenting exposure to Allo inhibit neurogenesis thereby protecting against uncontrolled cell proliferation.

Outcomes demonstrated that Allo was safe and well-tolerated after a single IV infusion and after weekly IV infusions for 12 weeks (G. D. Hernandez et al., 2020). A maximally tolerated dose of 6 mg was established using sedation as a threshold which interestingly demonstrated a sex difference in sedation tolerance. Women exhibited signs of sedation at doses ≥10 mg whereas men did at doses ≥ 6 mg. Therefore, to optimally target neurogenesis, the sub-sedative dose of 4 mg was chosen for the treatment regimen.


Critical to success was a dosing and treatment regimen that was consistent with the temporal requirements of systems biology of regeneration in brain. A treatment regimen that adhered to regenerative requirements of brain was also efficacious in reducing Alzheimer's pathology. With an optimized dosing and treatment regimen, chronic allopregnanolone administration promoted neurogenesis, oligodendrogenesis, reduced neuroinflammation and beta-amyloid burden while increasing markers of white matter generation and cholesterol homeostasis.

(...)

However, the continuous release treatment paradigm was much different pharmacokinetically and pharmacodynamically than the “treat and excrete” approach wherein the neurobiological system is stimulated and then allowed to return to baseline over the period of 1 week or longer duration. (...)

Although the levels of Allo were higher in the single pulse dose experiments, the neurobiological system was able to respond in a proactive manner to induce neurogenesis and learning and memory improvements and return to homeostasis. Comparison of intermittent bolus dosing and continuous release treatment regimens further demonstrate the importance of precise neurosteroid treatment paradigms. (...)

In a series of studies, continuous subcutaneous osmotic pump infusion of Allo proved to be detrimental and decreased learning and memory performance while simultaneously exacerbating AD pathology markers (Bengtsson et al., 2012, 2013). Although not measured, neurogenesis possibly was inhibited in the continuous Allo exposure studies. From these tabulated studies we hypothesized that the dose and frequency of Allo are critical components of efficacy at neurogenic and pathological endpoints.


Remarkably, intermittent allopregnanolone treatment regimens have shown benefit in multiple preclinical neurodegenerative disease models including Niemann-Pick type C, traumatic brain injury, diabetic neuropathy, peripheral nerve crush injury, multiple sclerosis and Parkinson disease. By contrast, continuous infusion of allopregnanolone for several months is not efficacious and can worsen pathology in a preclinical model of Alzheimer disease (Figure 4). The benefit of intermittent treatment regimens might apply to other regenerative factors where constant infusion for extended duration has met with adverse outcomes.


The long-lasting antidepressant effect observed in clinical trials, which outlasts the pharmacokinetics of the drug exposure, is not easily explained by the known mechanism of action of these compounds. One could envision that allopregnanolone acts on δ subunit-containing GABAARs to shift the network to a healthy network state that is more stable and can persist in the absence of the compound.


Something to take into consideration.
 
I was reading this study where they gave people Pregnenolone because you cannot buy Allopregnanolone, and Pregnenolone converts into Allopregnanolone. I checked and you can buy Pregnenolone online.

Allopregnanolone Elevations Following Pregnenolone Administration Are Associated with Enhanced Activation of Emotion Regulation Neurocircuits

These results demonstrate that in response to emotional stimuli, allopregnanolone reduces activity in regions associated with generation of negative emotion. Furthermore, allopregnanolone may enhance activity in regions linked to regulatory processes. Aberrant activity in these regions has been linked to anxiety psychopathology. These results thus provide initial neuroimaging evidence that allopregnanolone may be a target for pharmacologic intervention in the treatment of anxiety disorders and suggest potential future directions for research into neurosteroid effects on emotion regulation neurocircuitry.

 
Another way of looking at it is that PEA is changing your physiology, and providing you with an opportunity to do the emotional work. If PEA is clarifying your system, which it probably is, it would also be improving your neuroception. So it may be that what you're now noticing was already there, just another layer of the onion. Generally this is how healing or deprogramming happens, OSIT - not by 'feeling better', but by increasing self-awareness, noticing our BS more, accepting it, and the lessons involved, and struggling with oneself to make the necessary emotional or mental changes. My two cents.
Could be true, could also be that it’s throwing me further out of balance. I didn’t react well to using progesterone cream either. I have a blood test on day 21 of my cycle to check my hormones in a few days. If I have low estrogen then adding more progesterone isn’t ideal at all.

I understand the working on the self element is an important part of what happens when I feel like crap, which for years has been for about 3 weeks a month, and this is catalyst for growth, that that one week break where I feel okayish is enough to restore my morale so l could keep up the battle. I really want that one week. I don’t think that’s being too unreasonable, is it? It’s not like I ever feel good. I’ve got no idea what feeling good feels like.
 
I understand the working on the self element is an important part of what happens when I feel like crap, which for years has been for about 3 weeks a month, and this is catalyst for growth, that that one week break where I feel okayish is enough to restore my morale so l could keep up the battle. I really want that one week. I don’t think that’s being too unreasonable, is it? It’s not like I ever feel good. I’ve got no idea what feeling good feels like.
Fluffy, I understand you perfectly because the exact same thing is happening to me. It's like I have permanent PMS. There's only one week a month when I'm calm, joyful, balanced, and can feel good, sometimes even happy. The rest of the days of my cycle, I'm irritable, anxious, tearful, etc. Constant emotional rollercoaster. It's very hard for me and for those around me. I'm trying to figure it out, but so far not very successfully. I had my hormone levels tested on day 3 (no clear signs of perimenopause) and I'll soon test them again to check my hormone levels during the second half of my cycle. In my case, everything is exacerbated by nervous system exhaustion after chronic stress, approaching perimenopause, and hormonal fluctuations.

From what I've read, it seems I might also have Premenstrual Dysphoric Disorder (PMDD). I call it PMS before PMS. Probably right after ovulation, not only estrogen but also serotonin drops sharply – hence the outbursts of anger and tears. Articles say it's treated with SSRIs (for a few days around ovulation) and combined oral contraceptives. I don't want to take either. For now, I've decided to take L-tryptophan or 5-HTP to boost serotonin, and other supplements. They also mention Vitex agnus-castus (Chasteberry), diindolylmethane (DIM), and black cohosh extract. But I'm not very confident they'll help

I've also noticed a paradoxical reaction to GABA; it makes me anxious. Progesterone cream had no effect on me, and taking Wild Yam seemed to make me even more irritable and angry. I'm perplexed.

I remembered that 5-6 years ago, I had something similar and COCs helped me a lot. They were prescribed by my gynecologist because of severe endometriosis and resulting anemia. On one hand, I don't want to go back to hormones, as I'm still dealing with a complication from them – melasma on my face. But I'd rather be calm and spotty than feel like I'm going crazy and be afraid of myself.
So it may be that what you're now noticing was already there, just another layer of the onion. Generally this is how healing or deprogramming happens, OSIT - not by 'feeling better', but by increasing self-awareness, noticing our BS more, accepting it, and the lessons involved, and struggling with oneself to make the necessary emotional or mental changes. My two cents.
I partly agree with iamthatis's thoughts as well. That's exactly how I thought, and I worked on myself for almost a year, only to fall into even greater despair and self-flagellation, because no matter how hard I tried, I only felt worse, my condition defies conscious control and regulation through various psychological, somatic, and other methods. It doesn't mean I want to hide from my life lessons. I just want to fix what's broken and restore at least a minimal balance so I can move forward, instead of being destroyed by my own hormonal storm.:cry:
 
Fluffy, I understand you perfectly because the exact same thing is happening to me. It's like I have permanent PMS. There's only one week a month when I'm calm, joyful, balanced, and can feel good, sometimes even happy. The rest of the days of my cycle, I'm irritable, anxious, tearful, etc. Constant emotional rollercoaster. It's very hard for me and for those around me. I'm trying to figure it out, but so far not very successfully. I had my hormone levels tested on day 3 (no clear signs of perimenopause) and I'll soon test them again to check my hormone levels during the second half of my cycle. In my case, everything is exacerbated by nervous system exhaustion after chronic stress, approaching perimenopause, and hormonal fluctuations.

From what I've read, it seems I might also have Premenstrual Dysphoric Disorder (PMDD). I call it PMS before PMS. Probably right after ovulation, not only estrogen but also serotonin drops sharply – hence the outbursts of anger and tears. Articles say it's treated with SSRIs (for a few days around ovulation) and combined oral contraceptives. I don't want to take either. For now, I've decided to take L-tryptophan or 5-HTP to boost serotonin, and other supplements. They also mention Vitex agnus-castus (Chasteberry), diindolylmethane (DIM), and black cohosh extract. But I'm not very confident they'll help

I've also noticed a paradoxical reaction to GABA; it makes me anxious. Progesterone cream had no effect on me, and taking Wild Yam seemed to make me even more irritable and angry. I'm perplexed.

I remembered that 5-6 years ago, I had something similar and COCs helped me a lot. They were prescribed by my gynecologist because of severe endometriosis and resulting anemia. On one hand, I don't want to go back to hormones, as I'm still dealing with a complication from them – melasma on my face. But I'd rather be calm and spotty than feel like I'm going crazy and be afraid of myself.

I partly agree with iamthatis's thoughts as well. That's exactly how I thought, and I worked on myself for almost a year, only to fall into even greater despair and self-flagellation, because no matter how hard I tried, I only felt worse, my condition defies conscious control and regulation through various psychological, somatic, and other methods. It doesn't mean I want to hide from my life lessons. I just want to fix what's broken and restore at least a minimal balance so I can move forward, instead of being destroyed by my own hormonal storm.:cry:
It would be worth getting the hormones checked for sure and the thyroid. There's a company called DUTCH test which is very comprehensive. The test is taken on day 14 if I remember correctly.

You may want to check out myoinositol for Pmdd, see here: Myo-inositol in the treatment of premenstrual dysphoric disorder - PubMed for the two months that I took it consistently at a high dose, I noticed it helped the physical symptoms but I was also much calmer.

Personally, I had much better results with this type of progesterone- ProgestE Progesterone by Raymond Peat, PhD

And then work on gut and liver health too. For me, I have slow phase II detox of the liver, and irregular digestive issues, so my body seems to reabsorb hormones creating an excess. It's something I'm still learning how to manage, but I can say for sure that when my digestion and hormones are off, the mental suffers, and things that would normally be manageable become difficult to deal with.

Sweating and exercise/movement may also help, and lithium can be useful for the difficult days. Sorry for going slightly off topic here!

Hang in there Korzik:hug2:

Added: if as the C's said there are as many conditions as there are people (paraphrasing), it would make sense that there is no one size fits all. That's what makes it SO challenging, there's no magic pill! That said, it keeps us on our toes, researching, sharing, growing.
 
I can also recommend Progest-E, it's helped me a lot with mood and energy. One thing I would like to mention is that I've had to slow it down to only taking it day 14-21 (around) instead of day 14-28 because I got pretty bad constipation and other issues like acne right before my period, after having taken Progest-E for about 5 cycles. I think that this might be related to connective tissue problems. Progesterone naturally peaks at day 21 and then recedes so it is more like following a natural cycle anyway. Progest-E is considered a very potent and bioavailable progesterone compared to other brands so it is good to be a bit careful with dosing, from my experience.

Since one month I am taking Objective Nutrients Thiamine Protocol to help with mood and energy problems from hormonal imbalances and so far (after 1 month), I feel like it really helps. These are just my experimentations and observations. Will try myoinositol next, thanks for the tip @Jenn!
 
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