Dear Dr. Richards,

I just wanted to thank you for putting up this website. This site is a remarkable resource.
I’m 36 years old and I’ve had chronic fatigue most of my life. I’ve been to over a dozen doctors and the most recent diagnosis is adrenal fatigue. I’ve taken numerous supplements of which none have worked that well. My testosterone (free and total) and growth hormones have been normal in the past and I believe in the present. I have no problem getting an erection unless I wear a condom. From various tests, consistently my serotonin, cortisol, gaba and dopamine levels are low. The tests were done by a company called Sanesco.

My symptoms are:

• Severe fatigue
• Need at least 9.5 to 10 hours of sleep and don’t feel refreshed when I wake up.
• Feel unmotivated unless I take caffeine or Guarana and then I’m super motivated and feel normal.
I have an uncle who is an acupuncturist and has told me for years that there is a correlation between my ejaculation and fatigue. On average I was ejaculating 15 to 20 times per week. Many western medical doctors online and ones that I have met have stated that there is not a correlation. Dr. Richards, you are the first western doctor to explain the connection in medical terms (neurotransmitters, hormones) between ejaculation and fatigue.

4 weeks ago I started a program that the Taoist call “self cultivation” which simply means masturbation or sex without ejaculation. I wanted to get your opinion on this topic. Is it true that my body will recover as long as I do not ejaculated? Is ok to masturbate without ejaculation? Cutting out sex and masturbation for 1 to 3 months is a daunting task which I’m sure many who comment on this website would agree. I wanted to see what your take is on the subject of Taoism and self cultivation with respect to fatigue and ejaculation.

During the beginning of this program of not ejaculating, my energy was sky high but after 2 or 2 ½ weeks it began to fade and I’m not sure why. I wanted to ask you if this is normal. I might have ejaculated after 2 or 3 weeks, I’m just not sure. Also, I could be having retrograde ejaculation and/or too much pre cum when I masturbate without ejaculation. Do either one of these issues (pre cum or retrograde ejaculation) affect neurotransmitter function? In other words, would pre cum deplete my system? I don’t think it is retrograde ejaculation because my urine is not cloudy but I’m not 100% sure.
Just from observation, it seems that the best results that I’ve had so far have between associated with acupuncture coupled with not ejaculating plus taking some of the supplements you recommended.

Right now I’ve been taking fish oil, amino complex, 5htp (100mg), ginger, saw palmetto, acupuncture supplements, Tyrosine, codycep, dhea, panax ginseng, Siberian ginseng, lysine, arginine, b-complex, zma, carnitine, vitamin D3.
Is there anything that I should or shouldn’t be taking?

Thank you so much in advance,

The over-production of epinephrine, norepinephrine, cortisol, and other stimulatory hormones can actually exhaust thyroid and adrenal functioning. So one will suffer adrenal fatigue.

Edging is not a great idea. I can’t even state that it is better than normal masturbation. One will avoid the huge prolactin surge after, so will be able to keep somewhat normal dopamine levels (if not overdone). However, it is still harmful since it will promote the standard inflammatory response for excessive prostaglandin E2, histamine, glutamate, epinephrine, norepinephrine, cortisol, and burn androgen hormones and neurotransmitters. The chinese observed the positive effect of avoiding the prolactin surge and low dopamine levels immediately after ejaculation, so they decided that this will preserve one’s energy. Edging will actually confuse your organism’s protective mechanism that prevents you from making sex to death. It will (quicker than normal masturbation) lead to excessive sympathetic firing for anxiety and even panic attacks. Excessive precum production will be observed through excessive epinephrine, prostaglandin E2, and oxitocin, especially if there is lack of serotonin-GABA nervous modulation on the sympathetic nervous function for a flooding of precum if sexually aroused. Also, a weak serotonin-GABA nervous function will result in excessive oxytocin release for oxytocinergic nervous function that will over-excite the bulbourethral glands for excessive prostaglandin E2 production, testosterone – DHT conversion, and precum release. There are positive and negative sides, but it is still an abuse and is as harmful.

It’s quite a set of supplements you’re taking. DHEA dosages should be lowered and eventually discontinued. There is no need for so many separate supplements to address the issue adequately. Also should be well balanced to avoid reactions through negative feedback mechanisms.

Hi Dr. Richards,
Thank you so much for your reply.

Assuming a person is healthy, do you see the benefits of using Taoism and “the big draw”. I think I remember reading a comment that you expanded upon the “yellow stream”. I believe this occurs when a person is in a heightened state and draws up energy from their prostate to their brain and does what’s called the micro-cosmic orbit. Can you comment on this process? Do you believe like the Chinese that this is beneficial to a person’s wellness and energy? I understand that if a person is sexually exhausted you would not recommend the “big draw”. But if a person is healthy do you see it benefiting a person with respect to neurotransmitters and hormones? What I’ve considered doing is postponing this practice for 3 months or so until I’m healthy.

Is it important to take Lysine together with Arginine? Can you expand on “balanced to avoid reactions through negative feedback mechanisms”? In other words, why would this occur…? Also, are there any that I shouldn’t be taking? I’m taking quite a few herbs: Licorice, ginseng, cordeycps, etc.

Also, what’s your opinion on meditation and recovery and acupuncture and recovery? Any comments…
Thanks for the DHEA recommendation. I’ve been taking 50mg for years…

Again, I just wanted to say thank you. It’s amazing how many doctors that I’ve been to and none have ever come up with sexual exhaustion. I’ve even been to 4 alternative medical doctors. Masturbation and sex is just not one of their inquiries. What you’re doing is truly a philanthropic endeavor. I read 30 different stories on this site and I’m so amazed at how common this is.

also, do you think testicle massage increases testosterone?

No need to perform the big draw. Actually such practices will absolutely confuse one’s organism and will lead to superficially beneficial results. The slow breathing and the squeezing of the anus, if not accompanied with PC muscle squeeze, will actually activate the parasympathetic nervous system for a calm feeling, while at the same time the energy gathered with the sympathetic activation earlier will not be suppressed by the neurochemicals released after ejaculation – so one will experience an overflowing energy from the inside, which is true, but nevertheless is extremely selfish and a complete misuse of substance. The neurochemicals burned through the process of sexual excitation will be the same, the overflowing energy is actually indicative how much energy is burned in reality through sexual activities.

L-Arginine and L-Lysine is a very beneficial combination. However, they should also be combined with other amino acids for optimal results.

A negative feedback mechanisms will occur if one is overdosing or supplying a substance of which certain neurohormones are produced, while neglecting others. The resulting imbalance will result in overburdened liver and endocrine functions (striving to keep the homeostasis). There are many such mechanisms and are different through individual internal imbalance.

One will strongly benefit from meditation and acupuncture. However, they are to be performed properly. No meditation with the scope of achieving “over-worldly” experiences or other mispractices. Just concentrate on the proper organism functioning and energy flow.

The testicular massage will better the local blood flow and better testicular functioning if the problem is in the local artery constriction and insufficient blood flow.
Thank you for the kind words!

Thank you for your reply.
I have a few more questions…

I’m also low in dopamine and cortisol according to my test. I noticed that the supplements you recommend particularly target gaba and serotonin. What would you recommend to increase cortisol and dopamine levels? Currently I’m taking a formula which has tyrosine, phenalyline, and other supplements which is called Procite D. Does stable gaba and serotonin levels support energy with respect to dompamine? In other words, do you need to stabilize serotonin and gaba first and then follows increased dopamine levels? Right now I’m looking for ways to increase my energy and stamina.

I’m currently taking:
1. 300mg of 5htp
2. Amino blend
3. Gaba formula
4. Procite d- which focuses on dopamine
5. Fish Oil

Also, I noticed that I have tightness in my sternum which seems to be associated with my severe fatigue and general muscle weakness. I would like to hear your thoughts on this. Any comments or suggestions? It’s strange some days I go to the gym and I’m strong while other days I feel like I can only lift 50% of the weight I would normally be able to lift.

I just wanted to share a recent experience. Recently I cut back on my supplements. In addition to the supplements above, I was taking 100mg of L-theanine, 2 gaba formula caps instead of 1 cap, 1000mg of tyrosine, and a few other supplements. One night I felt like I was on drugs such as ecstasy. I haven’t done MDMA in over 10 years, but the symptoms were similar. I felt uncomfortable, dry mouth, hard to talk and think, confusion, felt hot, little dizzy, and had a hard time falling asleep. I’m not sure what caused these symptoms except for the supplements. What would your take be on this outcome or experience? I just felt overloaded…

Also, would you recommend my to take bc-liver? I have a healthy diet and I’m not on prescription drugs. Although in 2002 I did take some anti-depressants which were suppose to help me with my fatigue and mood. the only one that worked temporarily was wellbutrin which lasted for about 3 weeks and then stopped.

Also, what is your opinion on taking supplements to increase acetylcholine? Are there any that you recommend? or is the amino formula and a good diet sufficient?

Also, do you have any recommendations with sleep. Ever since I stopped all sexual activity I’m having a real hard time falling asleep. I’m already taking 5htp and the gaba formula…

Thank you in advance…

Yes, the adrenal fatigue will lead to low cortisol levels, while high prolactin will keep the dopamine levels low and the other way around.

The cortisol levels should be increased by a proper hypothalamic-pituitary-adrenal axis functioning restoration, which is a gradual process. The dopamine levels must be stabilized through a proper modulation on inflammatory response and proper neurotransmitter levels, which are interrelated. Yes, you will need to stabilize proper neurotransmitter levels to achieve stable dopamine levels or will suffer great fluctuations.

About the sternum, you are most probably experiencing inflammation of the cartilage and soft tissue nearby, it is not uncommon.

Yes, Zeolite-DA will prove to be beneficial. It will detoxify and restore proper liver functions, frequently overburdened, especially in chronic cases of altered homeostasis.

Supplements are a viable way of stabilizing Acetylcholine levels.

You should lower the 5-HTP dosage if you are experiencing problems with the sleep.