Will TRT Work for Me?

[Street Spirit]

Hi Dr Nagler,
I would like to begin TRT in the new year and have been in touch with the office of the clinician you recommended. However I suffer from facial nerve pain and TMJD and because of these conditions rely on meds (currently clonazepam) to keep the pain under control.

Outside of clonazepam I would be looking at anticonvulsants, Lyrica, Cymbalta and/or opiates.

Would the taking of any of these types of meds or staying on clonazepam hinder my progress in TRT?

I realize the dependency issue with clonazepam so I am still on the fence whether or not to taper..however, considering I am in alot of pain as I type this I do know that I will have to take something.

Furthermore, does my having these conditions ( TN, TMJD) cause an issue in partaking in TRT? The Neurologist I saw even suggested that I may have post concussion syndrome and atypical chronic migraine causing my pain and sound sensitivity.

I do know one person with PCS undergoing TRT and he has made progress albeit slow.

I feel like my case is complicated because of meds and pain, but I am very interested in the CBT portion of TRT and frankly will try anything now to get better.

So Dr, if you could just give it to me straight. ..would you treat me based on my medical history?

Thanks

 

[Dr. Nagler]

So Dr, if you could just give it to me straight. ..would you treat me based on my medical history?

One of the advantages of TRT is that since it addresses one's reaction to tinnitus rather than tinnitus itself, the cause of the tinnitus is largely irrelevant, as are its psychoacoustical qualities (loudness, pitch, timbre, etc.) and associated conditions (TMJD, etc.)

In terms of medications, in theory the use of benzodiazepines such as clonazepam can delay the habituation process, but it doesn't prevent it. I say "in theory" because the supposed negative effect of benzodiazepines on TRT success rates has never actually been formally studied. I can tell you that I myself have had numerous TRT patients on benzodiazepines, and as best I can recall every one of them has succeeded.

So the short answer to your question is ... Certainly, and I would expect you to do very well with it.

Dr. Stephen Nagler