Disclaimer: I don’t want to suggest treatment option for anyone. This is an entry before I myself take treatment options and I want to update you with the treatment option I take. I also would want to hear what other people tried to cure themselves or what people think about the option I take.
We need to keep the discussion rolling what could be a possible cure for PAS.
Isotretinoin changes the gene expression of the gene of the 5 alpha reductase. It does not mean it changes the gene, just the expression of it. As a result of the changed expression there is less 5 alpha reductase available. This definitely happens while taking isotretinoin. It would be speculation to say that the changes in gene expression persist, what I don’t wanna do. I want to follow a protocol which is aimed at the 5 alpha reductase activity and keep you updated, but first I want to further eloborate the function of 5 alpha reductase. 5 alpha recutase is responsible for the conversion of testosterone to dihydrotestosterone. So if there is less 5 alpha reductase available during treatment less testosterone is transferred into dehydrotestosterone. This is affirmed by a study which also shows that there is less dehydrotestoerone available and that isotretinoin also effects androgen receptors negatively. https://pubmed.ncbi.nlm.nih.gov/7714084/
I thought if we can downregulate the expression of the gene, how can we upregulate it? I found that Vitamin D upregulates the expression of the gene SRD 5A1 which is the gene for the 5 alpha reductase. https://academic.oup.com/jcem/article/99/10/3766/2836468
I don’t know how much Vitamin D though, but will look further into it. This is only one approach for me, I could take.
A different approach for me would be to increase the 5 alpha reductase naturally which could be done by adding a glycin and Niacin amid supplement and by eating sorghum. I don’t know how effective this is yet.
Another function of 5 alpha reductase is to convert progesterone into 5 dihydroxy progesterone. This is then further converted into alloprgenanolone which calms anxiety.
5 di hydroxy progesterone is not available, and allopregnanolone cannot be taken orally. So the only possibility to get an effect after my opinion is to take progesterone. That would mean more progesterone being available, so that more 5 dihydroxyprogesterone can be built and so on.
The protocol I will be following will be this: I will take 10 mg of progesterone creme for 2 weeks on 4 days off for a period of 5-6 months. I will also take tongkat ali. This is the protocol suggested by light_at_the_end for people with Post Finasteride Syndrome. I already ordered both substrates and will start taking it as soon as I have it.
I also had some bloodwork done and will share my results, especially my progesterone and allopregnanolone levels.
I will keep you updated.