Hang in there man. What caught my attention was your free testosterone is only at 238 and you’re 23? How many times have you gotten this checked? You should be in the 600-700 range for free testosterone at your age. This could be a large part of your symptoms. I would suggest seeing an endocrinologist for a full workup and make sure you take your blood tests in the morning not afternoon. Testosterone declines in the evening for all men. The endocrinologist may be able to help.
Have you tried eating only beef and animal fat like ghee and butter ? I think oysters, Brazil nuts and avocados are fine too, but plants can create inflammation and digestive issues. Eating only meat and animal fat (no plant at all) ended my gastric reflux, stomach ache, stomach not emptying, bloating and chronic headaches. As a bonus, all joints stopped hurting. (those are signs of lower inflammation) My skin really improved too.
I’ve been on a diet like this for more than 15 months, doing weight lifting and fasting 25 hours every fourth day and I’ve had good results. Actually a very similar protocol to what you describe up there, minus the plants and the carbs (I don’t know if you eat carbs), but with the addition of water fasting. I also take more supplements than you although now that I’m better I’ve been cutting almost 50%.
Not eating carbs means being in ketosis, that’s using only fat as energy. Not glucose. It’s not the same as a ketogenic diet which have lots of plants. I was (and still am) in carnivore ketosis. I had my sexual sides getting better after 6 months and it kept getting better from there. The worst neurological sides went away after only a week of not eating carbs. Digestion issues too.
I do eat a little carbs after the fasts as the brain needs 30 gr a day. But I have many zero carbs days, and days with less than 20gr. I get all my energy from animal saturated fat. Altogether, I get less than 5% of my calories from carbs. And fasting every fourth day means more than 7 days of fasting per month.
That’s 3 months of not eating per year ! (but I’m not there yet !)
I’m not saying it will work for you, but I’m saying it works for me.
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Completely forgot I made this post, but I will update in here moving forward.
I have made massive recovery with my androgen levels, bloods below: TT: 32.3 nmol/L (9.5-35.0) SHBG: 46 nmol/L (10-70) FT: 601.2 pmol/L (260-750) LH: 5 FSH: 7 DHT: 2.1 nmol/L (0.4-2.5)
I was hypogonadal for 15 months between Oct 2018 to Jan 2020 with Free Testosterone between 100 and 250pmol/L. It has now been 25 months since my first crash.
How I recovered was by following Health Recovery on YouTube, he gives advice for Adrenal Fatigue, CFS, ME, Lyme, etc… I highly recommend his YouTube channel for PFS sufferers it is working wonders for me. See link below.
Interestingly I have been 100% whole foods plant based vegan for the past 4 months. I see the general consensus on this forum is a more primal / carnivore based diet. I may consider eating animal products again. I personally don’t agree with a low carb diet model, carbohydrates are very Important for testosterone optimisation and keto type diets have been shown to drastically increase SHBG consequently reducing free testosterone - not productive imo. Also our gut microbiome thrives off a diversity of plant based foods and prebiotic fibres found in plants. Finasteride destroyed my gut and I have healed it through prebiotics (plant food) and homemade fermented probiotics.
I have no issues with ED now. Erections are strong and full. Libido is still non existent however. Morning wood is rare. I had a period the other month where I was getting heaps of spontaneous erections and morning wood. I was also able to masterbate twice in one day with no issues. Sensitivity in the penis and erection quality and frequency has improved dramatically over the past few months. So I am seeing progress, but progress is slow.
Still dealing with cognitive issues, brainfog, dissociation, etc… also dealing with sympathetic nervous system dominance + anxiety. I wonder if this is due to allopregnanolone deficiency or C-PTSD + trauma (hyperarousal, hypervigilance,etc). My nervous system is just totally fried, i can’t even talk to someone or look at a computer screen for 10 minutes without triggering an extreme stress sympathetic nervous system response, any kind of stimulation makes my brain feel fried, it’s crazy.
My cortisol is extremely high: Saliva Morning Cortisol 70.30 nmol/L (6.0 - 42.0)
Consequently, as advised by my integrative medicine doctor to reduce cortisol I will be starting supplementation with adaptogens, Phosphatidylserine, Magnesium glycinate, B5 and vitamin C. I also plan to start supplementing with Krill/fish oil and Curcumin to lower inflamation as my CRP was slightly elevated.
I have not been exercising for the past 6 months, how I recovered my androgen levels was purely via rest, relaxation and constant parasympathetic nervous system activation through meditation, yoga, relaxation, etc. I have made massive progress, I feel strong, I am happy and motivated.
I started psychiatric drugs (SNRI + antipsychotic) last week to try reduce anxiety and sympathetic nervous system dominance. However, I will be ceasing these medications this week and taking a natural approach to recovery. I was desperate and looking for a quick fix, however my gut tells me that this is not the right approach.
I suspect my body has gone too far in the direction of sympathetic nervous system and fight or flight, so my baseline of stress and anxiety is now elevated. This is the new default for my body and I must continually override that through calm and relaxation (parasympathetic nervous system).
Moving forward I plan to introduce very gentle, slow, graded exercise in the form of weight lifting to try improve my window of tolerance and resistance to stress.
If anyone has suggestions for supplements to help reduce my sympathetic nervous system dominance, or just general recommendations on my situation it would be highly appreciated. Thanks.
I am positive and optimistic. I am healing, I will recover.
I will also look at doing the survey today. I apologise for not being more active on these forums to help others, unfortunately spending time on the computer makes my symptoms flare up due to my extremely low tolerance to stimulation.
Congrats your new testosterone level is indeed impressive. I wish E2 and DHEA-s tests were included. See E2 is a better mediator for libido and wellbeing than T itself in my personal case. Normally with T level as high as yours, E2 should be in good range yet with a very high cortisol and suspected gut issues, there’s a likelihood that E2 may turn out lowish (i.e. teens pg/ml value).
Whoops, I did test for E2 and DHEA, just forgot to include it:
DHEAS: 12.3 umol/L (4.34-12.2)
E2: 96 pmol/L (<100)
Thoughts on the Estrogen? It’s at the very high end of the range… I personally don’t think the E2 test is that valuable unless it’s the highly sensitive test done by LC/MS method, I’m not sure what lab does it though in Australia. I personally don’t think my issues are hormonal at the moment, it’s likely the PTSD and sympathetic nervous system dominance, but interested to hear your thoughts.
The cortisol test was done on a day after I overstimulated my brain and nervous system. So it’s not representative of a normal day when I’m following my routine, but does give me a clear picture of what’s going wrong when I get stuck in that stressed overstimulated state (“stuck ON” see below)
Initially my gut was so messed up I had to go on a strict elimination diet. I followed the AIP (autoimmune protocol) diet for a couple months and then slowly reintroduced everything back in. The goal here was to remove any food that could possibly trigger a reaction or cause inflammation, to give my gut some time to heal itself. I would not recommend staying on a strict diet like this for very long however as you will kill off many species of bacteria and create food intolerances.
Over the past 6 months or so I have been doing the following:
homemade fermented water kefir (per suggestion by health recovery) I personally drink 500mL a day, which means I’m making a batch once every two days (1L per batch). Stress sterilises our gut microbiome, I think I took 10 years off my life with the amount of stress I went through due to PFS, I highly recommend water kefir to help replenish the gut microbiome!
eliminate all inflammatory foods. No gluten, dairy, refined oils, processed foods, sugar, etc… increase omega 3, decrease omega 6. Health Recovery elaborates on this.
personally I believe a wide variety of plant foods with lots of prebiotic fibre is the best way to build a strong gut microbiome. If you want to go deeper listen to podcasts by Dr Will Bulsiewicz. A healthy gut is so Important for your overall health, it is crucial, and a healthy gut is one with a diverse gut microbiome. Dr Will B goes into great depth on this.
I also believe consuming resistant starch like cold potatoes is great to increase the production of SCFAs and butyrate in the gut,
also you could consider taking anti-inflammatorys like fish oil and curcumin
Lastly reducing all stress is crucial! Stress destroys gut health and steralises the microbiome. You will not be able to heal if you are stuck in wired stressed state.
I believe Health Recovery has also done some videos on gut health also
My regiment moving forward incase it helps anyone.
Goals: Regulate HPA axis, reduce cortisol and sympathetic nervous system dominance. Promote calmness and relaxation, increase parasympathetic nervous system activation. Reduce inflammation in body and brain. Increase tolerance to stress. Maximize bioavailable androgens.
Mindset: I strongly believe my body has the ability to heal itself. The body has evolved over millions of years, surviving generation after generation through the most dire circumstances. The body has such incredible intelligence. It’s working every day to achieve optimum health. There is no doctor that is as intelligent as my body. It’s job is to maintain health. My body is fantastic, it is amazing, I am occupying my body, it wants to heal, it wants to be healthy, and I have to help it.
Sleep: Focus on good high quality sleep every single night without fail. Sleep is the #1 priority in my recovery protocol. The body heals itself when we sleep. Two hours before bed eliminate artificial light and stimualtion from computers, TV, phones, etc… Spend time focusing on meditation and relaxation. Aim to sleep at 9.00-9.30PM - the time you fall asleep is more important than how long you sleep. Listen to Shawn Stevensons podcast with Richroll for more information. Sleep is the MOST important thing for recovery. You could do everything else I’ve listed here, but without good high quality sleep every night, you will not recover. I also have a sunrise mimicking alarm clock and get 15-30minutes of sunlight first thing in the morning to strengthen the circadian rhythm.
Diet: Strictly avoid all inflammatory foods. No gluten, dairy, refined processed foods, take-away, refined oils, vegetable oils, refined sugar, etc. Limit intake of pro-inflammatory omega 6 fatty acids, increase intake of omega 3s. Eat a wide variety of plants and fiber to optimize gut health and build a strong gut microbiome. Lots of whole plant food - fruits, vegetables, potato, beans, whole grains etc. Consume wild caught fish and grass fed beef. Eating at maintenance or in a calorie surplus. No cheat meals.
Stress + Stimulation: Eliminate all stress and focus on staying calm & relaxed. Meditate and practice deep breathing daily. Spend time out in nature. Significantly reduce stimulation in the form of phone, computer & TV. Avoid violent movies & computer games. Focus on being in that calm, relaxed, parasympathetic state as much as possible. This is the state our body heals in. Practice mindfulness. 1 hour per day meditation daily.
Psychology: Positive and optimisic outlook. I believe I will recover. I will recover. I also will be working psychologist (psychotherapy, CBT, etc) who specializes in trauma & PTSD.
Gratefulness & Gratitude: Reminding myself every day what I am grateful for in my life. I truly believe I am lucky even though I have PFS. My life could have been so much worse. I could have been born in Syria and beheaded by ISIS. Or born in Africa and starved to death at 3 years old. Or slaughtered by machine gun fire on the front wave of the D Day landings. I could be paraplegic and be bedridden for the rest of my life. I will always chose to be grateful and positive for everything in my life, it could have been so much worse. I will not compare myself to my friends or other people I see on social media, instead I will be grateful for what I do have. This is an opportunity for transformation, I think of all the positives that will come from my situation, I will be able to appreciate the smaller things in life so much more once recovered, I always chose to be positive with everything in life.
Exercise: I have delt with severe exercise intolerance for the past 2 years. Now that I have recovered my androgen levels I plan to introduce very slow, gentle, graded exercise to help build my bodies tolerance to stress. Ultimately I vision myself weightlifting and sprinting as I believe these forms of exercise will help to stabilise my endocrine system and androgen receptors. I also plan to walk daily and complete walks and hikes in nature. It’s very important in my opinion that you don’t push yourself however. If you feel worse after exercising, don’t fucking do it. Exercise can create a lot of inflammation and stress when your body is in a weak burdened state.
Motivation & Information: I highly recommend the Youtube channel Health Recovery for those going through a similar journey. James who runs the channel, spent I believe 8 years of his life suffering with severe chronic illness and recovered his health naturally through trial and error. How I recovered my androgen levels was purely by following his advice without supplements. I personally have downloaded every single one of his videos (using J Downloader) and listen when I’m bored on my iPod. He gives fantastic information for our situation and is a really great source of motivation.
Supplements: DO NOT LOOK FOR HEALTH IN SUPPLEMENTS. We are desperate, look for quick fixes and want to take a pill to recover. It doesn’t work like that. I believe supplements can aid the process, however, its the fundamental changes to your life and what your lifestyle is like a on a daily basis that is the most important aspect in recovery. Keep it simple, save your money and spend it on good food instead. Don’t go crazy OCD on this trying to find the perfect protocol, keep it simple. I am not recommending anyone to take anything, but I personally will be supplementing with the following:
Vitamin D 5000 IU/d + K2 200mcg/d
Omega 3 DHA+EPA 3000mg/d
Vitamin C 1000mg/d with Bioflavanoids 400mg/d
Ashwagandha Sensoril to lower cortisol and aid sleep
Magnesium Glycinate, 500mg Magnesium
Glycine & Taurine before bed
Sauna 3x per week, help the body detoxify and reduce burden on liver & kidneys,
Time spent outside, in nature, sunshine, walking barefoot on grass,
Laughter every single day. Watch and listen to comedies. Keep a smile as much as you can.
Playing with pets and animals,
Probiotics. I prefer homemade fermented probiotics, I use water Kefir
Affirmations + Mantras,
Deep breathing, Yin Yoga, Relaxation exercises, grounding,
Gratitude + Gratefulness,
Reduce chemical burden. Eliminate Endocrine Disrupting Chemicals. I use only natural toiletry products. Wash all food to remove pesticides.
Remove toxic people, environments and circumstances from life.
Hydrate often. 3-4L per day. Add salt.
Any stimulants, strictly no caffeine,
The wired, stressed, overstimulated state, AT ALL COSTS.
Pushing yourself, doing too much too soon.
Any person or activity that leaves you feeling drained, stressed or exhausted,
News, politics, social media, forums, etc. These are downers in my opinion and not productive to recovery.
Overloading your brain with information and stimulation.
Negative self-talk, rumination, worry. Live in the PRESENT.
Comparing yourself to others.
Strictly no porn, I will only masturbate to my imagination to rewire my brain from years of porn abuse and regulate my dopamine receptors.
I also plan to eat lots of cooked and then cooled potatoes to increase my consumption of resistant starches responsible for the production of the SCFA called Butyrate. Butyrate is a HDAC inhibitor and can be very helpful to reverse any epigenetic damage done by Finasteride. I also plan to complete a microbiome analysis to ensure I have the species of microbes present in my gut responsible for producing Butyrate, and if they’re absent look into a stool transplant. Butyrate also has many, many other benefits, and can help heal a damaged gut and heal the blood brain barrier, both of which can often be causes of brainfog.
I chose to be positive and optimistic. I feel strong, I am happy and motivated. I am healing. I will recover. I will not be active on this forum moving forward, however I will update here when I see progress and when I receive further blood work.
I have also just donated $1000 AUD to the PFS Foundation. If you are reading this and have money to donate, I highly encourage you do also. There are so many people out there suffering and we need as much research completed as possible.
My journey is much more well documented on T Nation, see link below if you are interested. Although I was taking a SARM when I first crashed, I am confident I have PFS for the following reasons:
I crashed, then was hyperandrogenic for around 2 weeks, during these two weeks I felt fucking fantastic, libido was through the roof and I was making PBs in the gym, I also had my testosterone checked during these two weeks and my Free Testosterone was at 82 pmol/L (250-750). No doubt this is due to androgen receptor overexpression due to the presence of extremely low androgens. I then crashed again.
I made a recovery after this second crash and 2 week period and actually felt pretty good for around 3 months. Then I crashed again severely and have not recovered yet. My testicles atrophied severely at this point.
I noticed ZERO improvement on HCG when my free testosterone was at 1000. My testicular atrophy did not reverse at all even on the HCG. My balls are still atrophied to this day.
I still have symptoms of PFS now even though my natural androgen status is fully recovered.
From what I understand, this is typical of Post Finasteride Syndrome.
My blood work to give motivation for others.
And lastly, the most important thing is consistency. Don’t expect to make any progress if you make positive changes and then fall back into old habits a few weeks later. The body loves consistency. Here’s a good video by Health Recovery that elaborates further.
All the best everyone. Stay strong, keep your head up, keep pushing forward, and never fucking give up.
Thanks for this comprehensive and insightful post. It surely is inspiring and touches on many PFS facets and other critical uncharted territories. I see you’ve done your due diligence, kudos to you.
Your E2 and DHEA-s are both in great shape. Mind you, I come from a very low E2 (<60 pmol/L) and DHEA-s (~3ish) background so manipulating these two fellas did a number of things in my case. That being said, I no longer pay much attention to testing hormones and focus most of my attention on optimizing the gut. Believe it or not, it’s the true mediator for countless bodily processes. I couldn’t bypass the correlation between my gut and my mood. The leaky gut syndrome + increased inflammatory response is by far the best working hypothesis during my decade long odyssey to finding a cure. Gut is the factory of pleasure and happiness neurotransmitters (namely dopamine & Serotonin). The 100+ trillion gut dwellers and how they interact with each other and our body changes everything.
I totaly agree supplements can prove helpful in certain instances but they rarely provide a long term solution and in more ways than one can be counterproductive. A picture is worth a thousand words.
Completely agree! Likewise, I am disgusted at the amount of money I have wasted on supplements, tests and doctors appointment. The past 6 months I took the opposite approach and consumed no supplements, however due to chronically elevated cortisol and CRP, some intervention is required and I am not willing to take pharmaceuticals. If the supplements help me stay more relaxed and help to improve my sleep quality, then its worth it imo.
Thanks for sharing your thoughts. Completely agree, gut health is so crucial to our overall health & wellbeing. From my research the #1 predictor of a healthy gut microbiome is the abundance & diversity of plant based foods and plant based fibres in your diet. Hence why I am predominantly vegan based.