I noticed during the time I was on fin I was drinking a crap load of coffee. Literally had a 24 oz in my hand most of the day just to have the energy to function,get through my day etc. Now that I’m off the drug I have a constant restlessness/nervous energy feeling to the point that my body doesn’t tolerate/require caffeine like it used to. Now when I drink a cup of coffee I feel more like a nervous wreck then ever. Makes me think that during the time I was on propecia my cortisol levels were severely depleted and now that I’m off the drug they went through the roof. Can anyone comment on this or maybe guess to what could be happening>? Plan on seeing an endo to have my cortisol levels checked sometime soon.
Finasteride depletes DHT and Allopreg. DHT is super important for immune system, recovery, and abating inflammation. Allopreg. is super important for being able to handle stress and being able to recover among many other things. Allopreg is actually depleted WAY more than DHT is (and DHT is depleted a lot).
With these 2 depleted, as you can imagine is wrecks our CNS and homeostasis. One of the ways our body tries to combat this is to increase cortisol. Some people might be able to handle the increased cortisol for a few years or a few months, some only for a few days. Cortisol will eventually crash, and now you have very low cortisol. Most people with PFS are stuck in this low cortisol mode. With low cortisol, your body is dominated by adrenaline. This is when you get the tired/wired feeling, where you are sleepy/groggy all day but unable to ever fall asleep or get recovery sleep.
One of the reasons GHB works so well on PFSers is because it activates GABA-a receptors (same receptors that Allopreg. activate). I have offset the wired/tired for the most part with cortef, but this is just a patch. I need to keep my cortisol and cortisone levels in the upper 3rd of the range. My androgen receptors are still not expressing gene products (presumably) and I would not be surprised if there are still issues with Allopreg. Idk the path to true recovery, but hopefully these studies that are being published soon will shed light on it.
Btw, I am not saying that “adrenal insufficiency” is the cause of PFS. It is definitely a symptom of PFS, but nonetheless focusing on adrenals will bring great benefits. You will not recover from PFS by this alone though.
Below is a chart showing the progression I explained. We are/were on course C.
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Interesting so my wired/restlessness is probably more of an issue of heightened adrenaline as opposed to high cortisol then? I guess that would sort of explain my sudden intolerance to caffeine. Should I look into something like cortef or have an endo test my cortisol levels throughout the day first to indeed make sure there low all day? Wouldn’t regular intense exercise make my adrenaline issue worse?
You want to measure your cortisol levels at 4 times of the day, 8am, noon, 4pm and 10pm. Check your heart rate at these times and take your temperature on 3 different days
hormone.org/hormones-and-hea … al-fatigue
Low cortisol is lovely. You wake up feeling unfreshed, then feel sleepy until noon, from noon to 4pm you feel better, then feel sleepy again between 4-6pm and then after 6pm you’re wide awake and ready to take on the world, come 10pm you’re struggling to sleep and maybe your heart rate is elevated and then the cycle continues next day. So a body low in cortisol struggles to cope with stress then we get anxiety and our guts get messed up just when we need our immune systems working the best.
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I prefer 24 hour urinary cortisol test. You probably want to be in the upper 1/3 of the range for cortisol and cortisone. Rhein Labs does a good test. After that is worked out you can focus on thyroids if needed.
Yes, exercise will further deplete your cortisol/adrenaline ratio. I play basketball, surf, and soccer weekly. But I have to take an extra 10mg right before and sometimes an extra 5mg right after or else I am super wired/tired and can’t fall asleep.
So in your opinion would you say that the lack of allopregnalone would be the main culprit behind the messed cortisol/adrenaline levels? Did you notice the wired/tired while on propecia or not until you crashed? Cause I was definitely only tired for a long time when taking the drug. Thanks for the lab recommendation btw. I wasn’t sure what avenue to take there. Were you also hypothyroid? I had my levels checked a year after my symptoms started and they were all within the normal range.
Is Cortef mainly used with raising cortisol levels or regulating them? Any side effects?
24 hour saliva cortisol test is the best to do. You’ll test cortisol 7 times during the day. urinary and blood test are unreliable and will only tell you that everything is oké.
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Hi Moonman, was just wondering how long you’ve taken Cortef for/how much you take/ and which issues it’s helped with? I’ve just started trialling it again to help reduce inflammation in my body.
On and off for 6 or 7 years. Mostly on the past year and a half.
I currently take 30mg a day. On days that I play basketball, surf, or hike I might take 35-45mg, depending on what I feel like I need.
It has improved the following…
-Sleep (falling asleep and feeling refreshed when waking)
-Wired/tired feeling
-More energy
-More social
-Less irritable
-Able to handle stress better
-Ability to exercise and recover from exercise
-Brain fog
-Memory
-Ability to handle thyroid meds
Among other things. It has not helped sexually. I am still dead in that department, although I did just impregnate my fiance a few months ago.
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Congratulations 
How weak were your adrenal glands when you decided to take it in the first place?