TB4 Depression?

[Lisa Brent]

I have a client on TB4 subq 15 units 1-2 times daily with BPC for injury. He says that since adding in the TB4 for several days he has experienced crippling anxiety and depression. Is this a potential side effect? He says that he did research and found it can disrupt opioid receptors? He’s concerned about long-term consequences. Any advice would be helpful.

[Miguel Bertonatti]

I definitely would like to know the answer to this as well.

[Rita Ferraro, ND]

Is this patient on any meds particularly psychiatric drugs?

[Lisa Brent]

Not that he has shared with me, nor has he stated any history of mental or physical health issues. His interest in peptides was purely for injury and optimization.

[Lisa Brent]

Oh, he has been using dihexa troche for some time from a previous clinician for mental clarity and memory- it is from a trusted source.

[Lisa Brent]

He is a regular cannabis user. Could that be an issue?

[Kristelle Reyes]

Hello @byurthgmail-com and @cpaigepaigemd-com, would love to have your input here. Thank you! 🙂

[Carl Paige, MD]

Maybe this is what the pt was reviewing:  https://pubmed.ncbi.nlm.nih.gov/30971892/

more history would be useful regarding alcohol, drugs (recreational or prescription).  Also PTSD for whatever trigger including chronic pain.   I would consider LDN for endorphin modulation. If you have access to it then Cerebrolysin, lots of info on it for for depression post stroke/TBI and I have foud it very effective for other forms of depression      .  I have not seen anxiety/depression myself manifest in the 100’s of patients i have used TB4 with but of course that is doesnt mean it couldnt happen.

[Mitchell Fleisher, M.D., D.Ht., D.A.B.F.M.]

Yes, chronic cannabis abuse can potentially cause and/or aggravate underlying anxiety and depression from other etiologies.

Long term use of Dihexa may also cause neurochemical imbalances.  It would be a good idea to discontinue it for now.

Nasal Selank may be helpful.

Also, consider Pure Honokiol or Cortisol Manager in conjunction with 5-HTP 100 mg TID ac.

Best, Mitch

[Elizabeth Yurth]

I honestly cannot think of any association of TB4 and anxiety and depression. Perhaps is somehow influencing CBD receptor activity and making the CBD s have this effect??

Dr Yurth

[Lisa Brent]

Thank you for all the feedback!

[Cynthia Keller]

I just wanted to add here, that if a patient tells me that they got worse on something, I usually have them stop it … even if I didn’t think the treatment could/should/would (or even did) cause the issue.
I would usually explain that this isn’t what I usually see (or have ever seen), however… that I trust their body to tell us what is/isn’t right for it, and that we should listen.
Especially right now, anything that worsens depression (or even seems to worsen depression in the patient’s mind) is likely not the thing to be using.

I think that using the model above of helping empower the patient to help determine what is/isn’t right for them will go a long way to help keep them (and us/our licenses) safe, especially when we are using newer and less widely understood treatment modalities.

-Cynthia

[Rita Ferraro, ND]

I agree with Cynthia. Anything new I wouldn’t recommend. We sometimes have no idea of interactions of what patients are taking. I work with many MCS patients with depression. It’s a hard population to treat. The best thing is listening and empowering. I wouldn’t give Selank or any other peptide. Hope this helps

Rita Ferraro

[Lisa Brent]

Good advice.

Thank you

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