My blood test results (suffering from sexual side effects of Accutane/isotretinoin)

In my case I spent months treating the acne I had in the back, using Accutane/isotretinoin, this was 2011. For at least 2-3 years I was feeling depressed, then over time this symptom vanished. But the sexual side effects such as low libido still persist to this day. Low testosterone, high prolactin, etc.

What I am going to post next are my recent blood results. Perhaps they will be useful for others suffering from the same issue.

I haven’t received the CORTISOL results that measured my saliva at 8 am, 4 pm and 8 pm, they will be delivered in the next days. My issue is described in this video:

Last results:

Previous results, from total/free testosterone, and prolactin, only:

The total testosterone change from 240.5 to 380 ng/DL (+ 58%) is not surprising at all. Free T also increased from 5.28 to 8.76 ng/DL. Prolactin remained the same, from 19.3 to 26.3.

And why is that? Because when I did the first test a few weeks or a week before I was indulging in other foods outside my current diet prescribed by a nutritionist (pizza among them) that we all know to be detrimental to testosterone. And I was also not getting enough sleep. Bad diet and bad sleep are two things that can have a huge impact in these results.

Still, 380 is very low and prolactin has always measured in the 20’s. I think I measured prolactin 5 times by now in the last 2 years, and it has never, NEVER MEASURED BELOW 20s. For a man ideal levels are half that number, or perhaps less.

The max total testosterone I measured was 409 I think (1-2 years ago), and only after supplementing with vitamin D-3 (2000 UI a day) for 3 months. This increased T by 35%. And vitamin D for 40’s.

These two blood tests were done after more than a year without any vitamin D-3 being taken as supplement, and without proper exposure to the Sun (since I only go out there covering my body). The 380 ng/DL and 8.76 for free T are not impressive because when I did my first blood test in 2017 the results were:

3.09 for total T and 6.15 for free T. 26 for vitamin D;
Link for the 1st blood test:

If we add 240 to 380 and divide by 2 then the end result is 310. That means I am back to square one.

Vitamin D measured 31 now. It’s close to the first measure of 26.

So what is interesting and revealing about these blood results? Besides all that?

Zinc: like the first time I measured, it is normal. Many say zinc is responsible for increasing T. Lab range is 60 to 120 for adults and I measured 114.3.

Magnesium: lab range is 1.60 to 2.50 mg/DL and I measured 2.4. Also normal.

Vitamin B-12: lab range is 210 to 980 pg/ML and my result was 599 pg/ML

SHBG: lab range for men is 10-57 nmol/L. My result: 26.1. If this is low or simply normal I can’t tell.

Luteinizing hormone (LH): lab range for normal men is 0.57 to 12.07 and my blood test showed 1.88 mIU/mL;

Follicle-stimulating hormone (FSH): lab range for men is 0.95 to 11.95 and I got 5.09 mIU/mL

LH: this is the first sign (I believe) of something abnormal.

It’s odd, because I measured LUTENIZING HORMONE before and the result was 4.61 and the lab range was 1.24 to 8.62, but this was January 15, 2018. However this was already under the effect of months of vitamin D-3 supplement, and vit-D in this day measured in the 40’s.

Searching the internet I found comments such as these:

“In men, high levels of LH in the blood are a sign of a problem with the testicles. Low levels of LH mean the issue is with the pituitary gland or hypothalmus. Your LH level, by itself, isn’t enough to make a diagnosis. So you may get other tests, too.”

“If you’re a man, abnormally high LH levels along with low levels of testosterone may mean that your testicles aren’t responding to LH’s signal to make more testosterone. Low levels of LH may mean that your pituitary gland isn’t making enough LH. That can lead to too little testosterone production. The normal ranges for men is 1.24 to 7.8 IU/L”

Then there’s estradiol (E2). The lab range for men is 11 - 144 pg/mL and I got 9,00 pg/mL.

At first I thought it was a good thing because I expected this to be high.

Then I found this:

Quick explanation to what low estradiol means for men:

Testosterone deficiency in men accounts for decreases in lean mass, muscle size, and strength, whereas estrogen deficiency primarily accounts for increases in body fat, according to a new study. Deficiency of both hormones contributes to a decrease in sexual function.

“Our findings support changes in the approach to evaluation and management of hypogonadism in men,” investigators concluded in the New England Journal of Medicine (2013;369:1011-1022).

Low E Not Low T May Be the Problem

Some symptoms traditionally attributed to low testosterone may actually be due to estrogen deficiency, researchers found.

In a small study of men whose hormone levels were altered to mimic low testosterone – and in some cases, to completely inhibit estrogen production – it appeared that androgen deficiency accounted for decreases in lean mass, muscle size, and strength, while a lack of estrogen was responsible for increases in body fat, according to Joel Finkelstein, MD, of Massachusetts General Hospital, and colleagues.


Among men who were blocked from producing estrogen, the researchers saw increases in body fat at all levels of testosterone supplementation – but there was no effect on lean muscle mass, muscle size, or leg strength, the researchers reported.

They also noted that the adverse effects on sexual function became more obvious when estrogen was suppressed.

Finkelstein and colleagues concluded that the results imply testosterone levels regulate lean body mass, muscle size and strength, while estrogen levels regulate fat accumulation – and that sexual function appears to be regulated by both hormones .


Men Low Sex Drive: Low Estrogen May Be The Cause, Study Says

Well, well, well! Very interesting.

Does that explain the abdominal fat I have for years and that has never vanished?

Who would have thought? So this is also another confirmation, besides high prolactin, that I have low libido?


Dihydrotestosterone (DHT) - lab range between 135 and 1365 pg/mL \r for men, and old ranges were between 250 to 1600 pg/mL. My result? 183 pg/mL

Low DHT? Is this another side effect of… Accutane?


Isotretinoin, used to treat severe acne, has been shown to induce hormonal changes, especially to reduce 5 alpha-reductase in the production of the tissue-derived dihydrotestosterone (DHT) metabolite 3 alpha-Adiol G.

However, the effects of isotretinoin on other pituitary, adrenal or gonadal hormones have not been thoroughly elucidated. In the present study, isotretinoin administered at a dose of 0.5 mg/kg/day for 4 weeks caused no marked changes in the serum levels of pituitary, adrenal or gonadal hormones or 3 alpha-Adiol G in patients with severe papulopustulotic acne (n = 19).

After 12 weeks of therapy, there was a decrease in the levels of the precursor androgens androstenedione, testosterone and 3 alpha-Adiol G in 6/9 patients. Acne improved after 4.5 months in all but 2 male patients, who had very low serum hormone binding globulins (SHBG) and a high free androgen index (FAI). Isotretinoin did not affect the elevated LH/FSH ratio in a patient with the polycystic ovarian syndrome (PCOS); nor did it change the high FAI or low SHBG in the male patients.

For comparison, tetracycline had no effects on the serum hormonal levels of patients with mild acne (n = 19) after 7 days of treatment. This study confirms that the effects of isotretinoin on the serum hormone levels are small and unlikely to be of relevance for the resolution of acne or the suppression of sebum excretion .

5α-Reductase inhibitors (5-ARIs), also known as dihydrotestosterone (DHT) blockers, are a class of medications with antiandrogenic effects which are used primarily in the treatment of enlarged prostate and scalp hair loss. They are also sometimes used to treat excess hair growth in women and as a component of hormone therapy for transgender women.

These agents inhibit the enzyme 5α-reductase, which is involved in the metabolic transformations of a variety of endogenous steroids. 5-ARIs are most known for preventing conversion of testosterone, the major androgen sex hormone, to the more potent androgen dihydrotestosterone (DHT), in certain androgen-associated disorders.

5-ARIs are generally well-tolerated in both men and women and produce few side effects. However, they have been found to have some risks in studies with men, including slightly increased risks of decreased libido, erectile dysfunction, ejaculatory dysfunction, infertility, breast tenderness, gynecomastia, depression, anxiety, self-harm, and dementia.

In addition, while 5-ARIs decrease the overall risk of developing prostate cancer, they have been found to increase the risk of developing certain rare but high-grade forms of prostate cancer. As a result, the FDA has notified healthcare professionals that the Warnings and Precautions section of the labels for the 5-ARI class of drugs has been revised to include new safety information about the increased risk of being diagnosed with these rare but more serious forms of prostate cancer. Finasteride has also been associated with intraoperative floppy iris syndrome and cataract formation. Depressive symptoms and suicidality has been reported .

Sexual dysfunction

Sexual dysfunction, including erectile dysfunction, loss of libido, and reduced ejaculate, may occur in 3.4 to 15.8% of men treated with finasteride or dutasteride. This is linked to lower quality of life and can cause stress in relationships. There is also an association with lowered sexual desire. It has been reported that in a subset of men, these adverse sexual side effects may persist even after discontinuation of finasteride or dutasteride.

Mine is clearly low, otherwise it would be at least in the middle of that lab range.

Homocysteine was also measured. Lab ranges between 5.46 to 16.20 umol/L for men, and mine was 7.3.

Insulin blood test lab ranges: 1,90 to 23,00 MICRO UI/mL, mine: 5.19.

TGO, TGP, TSH and T4 and others = all within the lab ranges

To increase DHT all the recomendations I am already following, which is modify the diet and a new workout routine instead of the not demanding one I always had:

What I am interested to know is if my results are somehow helpful in discovering what Accutane did in the first place.

P.S. What I am currently trying is this, besides a new diet/workout routine:

  1. Vitamin B-6 (P5P), 25 mg a day in 1 pill at breakfast.

  2. Ashwagandha KSM-66, Vitacost, in 1 pill at breakfast.

  3. Vitamin D-3 (2000 UI) + E (200 UI), 1 pill at lunch

  4. Omega 3 fish oil, 1000 mg - 180/120, 3 pills at the same time, at dinner

  5. ZMA (I know, many say it’s not needed, but I bought anyway), 2 pills at the same time, 30-60 minutes after last meal and 30-60 before going to sleep. Mine has 256 mg of magnesium, 7 mg of zinc and 1.3 of vitamin B-6 in this ammount.

After months I’ll do a new blood test to measure everything again.


When my doc sees low LH the first thing he checks is prolactin.
In my case prolactin is in range.
Your case might be a solvable one.

Do you have testicular shrinkage with low LH?

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No problem with the testicles… you got that part wrong. It’s the exact opposite of what you say:

The article reads:

In selected patients, FSH, LH, and prolactin can be measured. If the FSH and LH levels are raised, this suggests a primary testicular cause, and if levels are low or normal, a hypothalamic or pituitary cause should be considered. A raised prolactin level suggests that further investigation of the pituitary gland should be undertaken

My LH is now in the lower range of that scale. Years ago I also did an MRI pituitary scan, which showed nothing wrong. Also a sperm test was revealed to be normal.

This is what happened to me after my Accutane treatment:

What I can’t say right now is if everything is reversible with the proposed changes in diet/workout routine and supplements. About TRT:

It looks like a scam to me. It’s expensive, they say you need to do it for the rest of your life, because if you stop then the supposed benefits will not last… and just like Accutane you are relying on a drug that might help with your side effects, but don’t attack what really caused the problem in the first place.

Ubiquitous symptoms like fatigue or erectile dysfunction don’t justify in ALL cases TRT, if at all. Blood tests are not the only way to tell if we need to do this treatment.

You need to do others, too.

Then there are some nasty side effects for TRT. I know even vitamins can have them, yet there’s always a chance TRT is not done properly or any of these effects happening anyway.

One of them is that your brain stops telling your body to produce testosterone when it senses there’s enough. Over time, that can lead to testicular cell damage, cell death and even visible testicle shrinkage, which inhibits sperm production.

No one will warn you that you will become infertile after doing TRT. But that can happen. There is also increased risk for cardiovascular conditions including blood clots, heart attacks and strokes, negative effect on the prostate in men who already have some conditions, including prostate cancer and benign prostatic hypertrophy, or an enlarged prostate, which causes the need for frequent urination, mood issues if T gets too high…

When I started with the Accutane treatment I wasn’t suffering from severe acne. My acne was mostly in the back. Did I start a new lifestyle, a new diet, going to a gym (I never did this in the previous years), exposing my skin to receive vitamin D/to the Sun? No. I spend most time indoors. I was eating junk food. Among many things that I am sure exacerbated my acne.

Perhaps if I did what I am doing TODAY then in a few years or by now the acne would have vanished.

What was the quickest and easiest solution? To try a drug that many years later I am sure it’s still affecting me, considering all the damage it can cause.

That’s why I am reluctant to rely on ANY MED. I am not adopting an idiotic stance to reject this as a possibility to help me. There’s nothing more antinatural than medicine, otherwise we would embrace cancer and other health issues, and never treat them.

I am merely saying we need to investigate EVERYTHING in our environment, in our food, our air, our water… that might be detrimental to our health. Nothing can be ruled out. Even EMF radiation, that no one mentions, can be a good explanation and may severely impact us. Ask the late John McCain about that…

And since vitamins are cheaper and safer, I think they deserve to be tried first. Not at the very high and not recommended dosages everyone is saying they work, for B-6, for example, I am using 25 mg which is the max daily dosage.

This link explains the max dose for vitamin D:

About the reference ranges, they vary widely (for testosterone) in laboratories, and only an imbecile (and most doctors are really, really stupid) would rely on a number to tell if a pacient needs TRT or if it’s sick or not.

First of all, who determines the range I mentioned before, from 241 to 800s? My result was 240 and then 380. If I measured 241 in a single test then does that mean I am not sick anymore?

Worse: if I don’t have any symptom that indicates a disease then that doesn’t mean a psychiatrist is the only one I should visit, and it’s all in my head and antidepressants are what I need.

Regardless of your age you should look for the best health you can have, and that means higher testosterone. Not extremely high, yet higher. If the patient has all the signs that indicate low T such as low libido, mental decline, fatigue, not being able to achieve good results at the gym, then a lof ot things need to be carefully analysed.

It could be a vitamin deficiency. It could be so many things that decrease testosterone that to list all of them here would be… impossible.

Instead of tackling with all the things that can be impairing our health, what do we do?

We rely on a drug/on meds, of course!

That’s the last thing we should think! Before taking any med investigate other things first.

For example, I also suffer from nonallergic rhinitis. Recently I was prescribed a nasal spray, to be used for at least 3 months, since my tests couldn’t detect a specific allergy.

You know what I did at the same time? Changed everything in my bedroom/environment that could be making the allergy worse. From ditching the mattress (every 5 years at least) and it’s foundation (if it’s still there it will lead to rapid recontamination of the new mattress) and pillows to buying anti dust mite covers, to use a new vacuum cleaner with an HEPA filter instead of a broom, perhaps use a mask during certain tasks, etc. I could list 50 changes to improve things besides just using the nasal spray.

The end result is that my allergy improved dramatically.

Would just using the nasal spray deliver me any result after these months if were not for the other things I did? Absolutely NOT! I would have wasted my time and money like I did before with a different med.

The thing is, no one wants to do what it takes, everyone thinks a drug will cure them and that’s it.

Now, back to lab ranges: of course if most people ARE SICK and suffer from low T/high prolactin (the latter even due to stress), the ranges will be lower.

A good example is a LEAD BLOOD TEST.

In adults, lead blood levels up to 10 mcg/dL are considered normal. So let’s say the range is between 2 and 8. Some people can get sick with 1. Others with 5. Then with 7.

However a good doctor would tell you that ALL OF THEM are sick, because the ideal should be having NO LEAD AT ALL in your result! The same thing I said about my testosterone.

Perhaps my T 10 years ago when I hadn’t started with Accutane was 500. It could have been improved with all these changes to 700 nowadays. I don’t know how high it was since my first measure was 2 years ago.

Now it’s down to 240. And maybe, just maybe, most modern men are in the 300s or 400s. Over time with more toxins, more drugs and poisons in our food, air, personal hygiene products, plastics (BPA) these will only decrease.

So don’t ever trust these results as an indication that you are healthy. You are being a fool that only reads a number and don’t think about what it entails.

One last thing: don’t do the same mistake I did, to trust 1 or 2 doctors. Don’t even trust doctors from where you live. Always ask for as much different opinions as you can.

Perhaps it would be wiser to approach (if possible, of course) the doctors who studied all the Accutane side effects, including low libido. Why waste any time with charlatans?

It’s tough to do a lot of tests and try different approaches for all these issues, yet it’s the only way and at the same time you might uncover what Accutane actually did to you.

No one wants to discover anything these days, everyone just want quick answers and solutions.

We are the exception in these forums.

Perhaps with all my changes I might double my testosterone and solve once and for all this problem. Who knows?

The internet is filled with gurus that promise quick solutions for low T and other health issues, and many tips are wrong, such as using high doses for vitamins without any fear this can impact us. And we should never embark on anything without medical advice first. That includes a new diet or workout routine. But I must say I am appalled at how conceited and dumb most doctors and “professionals” are. 99.999999… % don’t believe a drug can cause serious side effects even years or decades after you stop using.

If this is all new information (in fact it’s the opposite, since there are reports of sexual dysfunction from decades ago, and of course Roche ignored all of them, while at the same time argued it doesn’t know exactly the ways Accutane act in our bodies), and they are not informed, they opt to ignore the information anyway, even if you present all the evidence.

Next time all of you visit a doctor and the guy doesn’t even try to imagine how this could be Accutane’s fault, leave the room immediately.

Because that person is only there to make money as much (and quickly) as possible and doesn’t care in any way about your outcome.

And even if he/she does, that doesn’t mean he/she are qualified to help you.

Recently I spoke with someone involved with clinical nutrition and asked about how to increase my testosterone, mentioned I was looking for a specific diet for a new workout routine, and that I am trying vitamins. The first thing the guy says is… YOU NEED TRT. Not a single word about trying to increase these levels the ways I said before. At least to see in a couple of months if the experiment would fail.

So yeah, most people are sadly eager to find an easy solution for their problems, we are the exception because we know more than others they are not going away after we snap our fingers. This isn’t a movie, it’s real life. And it’s not just Accutane, Finasteride is another drug that is reported to cause Permanent Sexual Dysfunction.

That’s why I am always suggesting to check with multiple doctors and do as much tests as possible, as much changes to rule out toxins as you can, and try supplements and things that are not detrimental, before trusting Big Pharma again, which caused all our problems in the first place. If I had the chance I would only visit doctors that actually published reports about Accutane’s side effects. Unfortunately even these reports do not tell the whole story from all affected, so there’s not much information at this point to study this side effect.

I was not suggesting low T points to a testicular issue.

When I first experienced sexual sides from accutane I had low T, low LH but good sperm and testicular function.

After 5 years spermiogram showed azospermi with low sperm motility. This didn’t improve. I was told my only chance was IVF with this sort of sperm function.

Today after 8-9 years I think I am having test shrinkage. Hence I was asking if with long-term low LH you observed the same.

Sexual sides are one thing. Observing size/volune changes is a different beast which is freaking me out.

Amen to that!

What fills me with hope is that I was wise enough to measure all these things during the Vitamin D-3 treatment (2000 UI each a day) and now, in 2019, more than a year after stopping with it.

Because I wanted to find out if taking for a few months was enough. These results answer this question: once you stop with the supplement and don’t expose (properly, of course) yourself to the Sun, you’ll reduce your D-3 levels and also others at the same time.

There were no drastic changes in my lifestyle and diet/routine between 2017 and 2019.

If the old results were not promising, they were at least better than now.

So now that I am back with this and more I hope things will improve even further.

Look at these results:

BEFORE taking D-3:

August 28, 2017 (first blood test ever)

Total testosterone: 3,09 ng/mL
Free T: 6,15
Vitamin D-3: 26
Prolactin: 25

Already taking D-3 (2000 UI a day) for 3 months:

November 27 and 30, 2017

Total testosterone: 4,19 ng/mL (35% increase)
Free T: 6,91
Vitamin D-3: 40
Prolactin: 25 (again)

Reduced Vitamin D-3 to 1000 UI a day:

January 15, 2018

Total testosterone: 357 ng/dL (small decrease, but still higher than what I had in August 2017)
Free T: 7.21 (even higher)
Vitamin D-3: 42 (still high)
Prolactin: 28

LH: 4,61 mUI/mL (lab range: 1,24 to 8,62 MUI/ML) - better than today
FSH: 6,54 mUI/mL (lab range: 1,27 to 19,26 MUI/ML)

SHBG: 32,6 nmol/L (lab range 13,2 to 89,5 nmol/L)

January 31, 2018

Prolactin: 20 (lower?)
ESTRADIOL (E2) - 18,00 pg/mL (lab range 11 - 144 pg/mL) - twice what I have today
Vitamin D: 44 (70% more than what I had in August 2017)

February 2, 2018

Dihydrotestosterone (DHT): Result: 360 pg/mL
Lab range from men between 31-40 years old: 17,7 to 775,0 pg/mL


September 2, 2019

Total testosterone: 240 ng/dL
Free T: 5,28 ng/dL
Prolactin: 19

NEW RESULT UNDER BETTER CONDITIONS (better sleep and resuming current diet):

September 23, 2019

Total testosterone: 380 ng/dL
Free T: 8,76 ng/dL
Prolactin: 26
Vitamin D: 31 (30% decrease from last result)
SHBG: 26,1 nmol/L (lab range 10 to 57 nmol/L)

LH: 1,88 mIU/mL (normal men lab range: 0,57 to 12,07)

FSH: 5,09 mIU/mL (lab range 0,95 to 11,95)
ESTRADIOL (E2) - 9,00 pg/mL (lab range 11 - 144 pg/mL) - half what I had when vit-D-3 was being taken

Dihydrotestosterone (DHT): Result: 183 pg/mL (lab range 135 to 1365 pg/mL, old range was 250 to 1600 pg/mL)

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About vitamin D:

It’s widely known that a vitamin D deficiency means lower testosterone and my blood tests also proved that. Yet there was no sensible change in the prolactin levels all this time, and a 35% increase is not enough for someone that needs at least 100-150%.

The optimal testosterone level for my age (35 years) is way above 300s or 400s. From 0 to 400 ng/dL I think you can consider yourself as having low T. Most men that have symptoms fall into this range. There are even few that have had symptoms close to 500 ng/DL.

500-700 ng/dL is the range of normal testosterone. It’s where there’s normally no symptoms or signs of anything wrong.

By modern standards 700-1000 ng/DL is high. Our ancestors probably had this amount of 2-3 times more. Building muscle is easier, for example, for these men.

I am sure my diet played a huge role in these low levels, too, not just my workout routine and not using certain supplements. I’ve been adopting a diet that lacks FAT, and good fats, eating avocados, drinking coconut oil, etc. is a recent change for me. I have opted for skimmed milk and other foods that never help with higher T. Even BACON, despite all the controversies surrounding, helps with this goal.

I am following what this article says:

To see if things will improve I’ll not restrict myself to simply changing a few things here and there, I’ll do radical changes to my lifestyle, and record them for at least a 2-4 month experience. Because I want to make sure with tons of changes this side effect from Accutane will be greatly impacted, perhaps things will never return to what they were before my 2011 treatment, but they will change a lot, that’s for sure.

And if these doses for vitamin B-6, Ashwagandha and vitamins D-3/E don’t work, then I’ll see if they can be increased as well. For example: I was told to use Ashwagandha twice a day, still I only opted for taking 1 pill at breakfast. I don’t want to overdose on anything, especially on vitamin B-6 to lower prolactin, because higher doses pose a risk and there are some bad side effects from them, too.

You should even take them at a proper time of the day, some of these are stimulants.

Ashwagandha may have a minor impact on testosterone levels, however it is known to decrease cortisol. I don’t think my cortisol test will reveal anything wrong, though.

What is missing from all sexual dysfunction reports are detailed analysis of what was tried to change this condition. Without this I can only assume it’s not just Accutane’s fault, these people have other deficiencies they have not tried to fix. Once I try all of this and make sure it’s not achieving the expected results then I’ll know another approach will need to be considered.

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Back in 2011 when I realised I was hit by accutane, I was doing extensive search to find recovery stories to have some hope on a potential recovery (I couldn’t find any at the time). During that time one point I caught was common between sufferers was that most were taking alcohol while on accutane. I made the same mistake too…

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An update: I just received my salivary cortisol results, they were done September 30, before I started with all these changes mentioned in my previous posts, to overcome my sexual dysfunction, low testosterone, high prolactin…

The results are:

For the morning (collected at 8 am): 0.319 MCG/DL
For the afternoon (collected at 4 pm): 0.068 MCG/DL
For the morning (collected at 8 pm): 0.054 MCG/DL

Lab ranges for the morning are between 6.7 and 22.6 mcg/dL, and the paper says that after morning the levels are usually lower than 10 mcg/dL.

This test is different from all others since it demands a little more effort in terms of properly collecting and storing the samples. So I don’t trust a first result as a definitive one to evaluate my health. But let’s assume this is accurate. What do these mean?

And for my new diet plan I am also adding MACA POWDER, which is said to improve libido, every morning. Also, once I replace my stock of ZMA a few months from now I’ll buy from a new brand with a different formula, this time not with 7 mg of zinc, instead 29.59, and 350 instead of 256 mg of magnesium. It also has vitamin B-6 so I don’t need to take the latter as P5P (25 mg) in the morning. The pill has 40 mg of B-6 as pyridoxine hydrochloride.

About prolactin, one thing I didn’t know is that we need to abstain from sex/fapping prior (preferably a couple of days) to doing this test, otherwise the results will be of course higher.

Edit: I looked the YouTube video (from the beginning of my post) a little bit and it appears that my low cortisol levels are explained by of course this side effect and my lifestyle. That’s what I thought, I don’t think I have some unknown disease and this obviously will need to be retested after months of improvement. Even vitamin deficiencies were mentioned as a reason for low cortisol. So that’s it, after my changes being in place for a while I’ll check these levels again.

I was also. The thing is, for an adult, it would not be out of the ordinary to drink at some point over a 6 month course. There also doesn’t appear to be any warning to avoid alcohol while taking Accutane.

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About dry lips, I suggest you all take a good look if you have any vitamin deficiency, since vitamin B also contributes to healthy skin, a deficiency can cause a variety of skin problems such as acne, split lips, dryness, and rashes. Low levels of zinc and iron can also lead to split lips, especially at the corners of the mouth.

My advice is to take a complex B like this one, in this case at least 1 pill everyday, I am thinking 2 it’s too much:

As for zinc and magnesium, a few warnings about how much should be taken:

I am taking ZMA for a month by now (it helps with muscle recovery, giving me a restful sleep, since a workout routine is what I need for increasing my testosterone), it should be taken 30-60 minutes before you hit the bed and 30-60 minutes after last meal. It should be taken with an empty stomach and never with calcium, as calcium blocks the absorption of zinc. Then there are some forms of zinc and magnesium that are poorly absorbed:

Aspartate seems to be the best, oxide the worst.

This ZMA from O.N. is what I have in mind once my current stock ends (note: it also has vitamin B-6, 10 mg), and I stop taking 25 mg of P-5-P vitamin B-6, the latter was included to lower my prolactin (that is in the 20’s). However taking vitamin B-6 for a long time and in a high dose can cause some health issues: and (watch after 2 minutes and after 3:53, when the guy mentions taking as little as 24 mg a day is bad)

Both overdose and deficiency may cause peripheral neuropathy. It’s possible a lower dose of 25 mg is not enough to lower prolactin (many have reported benefits at much higher doses) or it’s high enough for me to experience the side effects of toxicity after a while. These will resolve weeks after discontinuing taking. I realize by now it was a mistake to include this for my sexual dysfunction. My prolactin is not high enough to require this or meds like Cabergoline.

What I am doing now is a workout routine to increase my testosterone, just like it was suggested in these links: and

With the help of a personal trainer/coach qualified for strenght training. This + diet + good sleep quality (kill electronic devices 2 hours before going to sleep and your bedroom should be in total darkness).

Peruvian MACA powder (or in caps): definitely helps with low libido.

After seeing this video:

I bought a blender and am currently adding in my breakfast, pre-workout: 1) 5 g of maca powder, 2) whey protein, 3) creatine, 4) oat fine flakes or chia seeds or quinoa flakes (1 tblspoon), and 5) 200 ml of almond or cashew or coconut milk (cow’s milk and cheese I am not including anymore).

Ashwagandha: this one is only worth taking if it’s KSM-66 and preferably organic. However I consider expensive and once my current stock ends I will not buy again, too. It’s more useful if someone experiences some stress on a daily basis, and it’s definitely the most useful supplement if that’s the case. Not for me since I have low cortisol and rarely something annoys me.:

And below I am listing interesting books that I discovered, and would like to recommend:

Vitamin K-2 (MK-7, 100 mcg) should be taken together with D-3, and this one I’ll add once my D-3 (2000 UI) + E (200 UI) pills are over. Not going to buy vitamin E again, since a proper diet is not deficient on it. Another reason is that Omega 3 fish oil (also taking) may have vitamin E in the list of ingredients.

Once things are evolving I’ll do a new blood test to see how my levels have improved.

Here’s a warning for those with sexual dysfunction, low libido and lower testosterone, caused by Accutane:

Taking Vitamin B-6 to lower prolactin and raise libido was a bad idea.

(This first link summarizes what I am going to say next).

And trusting these gurus from the internet that want us to buy their books and supplements (and subscribe to their Youtube channels), and treat vitamins as if they were candy was even worse. Christopher Walker is one of them, he mentions some studies that of course don’t take into account all possible health issues from even lower doses over prolonged time.

Not everyone can take a supplement and feel the same, this is as stupid as proposing the same diet, only a qualified person can prescribe, each case is unique.

Some people have vitamin deficiencies that can account for their diseases, but we should always strive to correct these not with a pill or another med (again Big Pharma and the idea that all our problems will be solved with no effort at all).

I was always against this idea of taking vitamins or doing something out of the ordinary to fix us. Or at least the idea of doing that forever.

Now, back to vitamin B-6:

I started taking P-5-P (the active form of vitamin B-6) at 25 mg / a day a month ago.

Also a ZMA that has 1.3 mg of vitamin B-6 as pyridoxine, before going to sleep. This ZMA I’ll continue to take for the zinc and magnesium, which are at lower doses, 7 and 256 mg.

Then recently I noticed my left index finger had (I think this is the right term, despite no signs of anything in my skin, both my hands appear to be 100% normal) an “inflammation”, as if it was more tired than usual, from something I did at the gym that caused that and would take a little while to recover. I am not feeling anything except when I have to put some strenght into this finger. It’s odd that my finger suddenly tired this way, and so far has not recovered, I don’t remember hurting it or putting under any stress that could have caused this.

Then I started researching a little more about… vitamin B-6 TOXICITY. And side effects of overdosing.

The EFSA recommended a max safe dose of 25 mg a day. And some sources say that 50 mg is harmful.

First of all, a normal adult will require 1–2 mg of pyridoxine per day. This is adequately supplied by a normal diet.

What happens when there’s too much B-6?

“Burning, shooting pains in your limbs, hands and feet can be caused by nerve damage from B6 deficiency or overdose.”

  • A lack of muscle control or coordination of voluntary movements (ataxia)
  • Painful, disfiguring skin lesions
  • Gastrointestinal symptoms, such as heartburn and nausea
  • Sensitivity to sunlight (photosensitivity)
  • Numbness
  • Reduced ability to sense pain or extreme temperatures

It’s also said that the side effects will go away once we stop taking, but this will always take weeks (perhaps a few months).

Now, what about which dose would cause any of it?

This link:

Seems to suggest it’s possible to experience problems if the daily dose is under 50 mg.

And this one:

Says the following:

Notably, pyridoxine itself has been documented to cause sensory neuropathy in humans with prolonged use, even at doses as low as 24 mg daily (14,15).

  1. Katan MB. How much vitamin B 6 is toxic? [Dutch]. Ned Tijdschr Geneeskd 2005; 149:2545–6.
  2. Silva CD, D’Cruz DP. Pyridoxine toxicity courtesy of your local health food store. ann Rheum Dis 2006; 65:1666–7.

That’s not all:

This link and the 8 minute video I mentioned before:

Seem to suggest the same thing. In the video the guy clearly says “as little as 24 mg, especially if you don’t need it”.

My prolactin is high, but not high enough for me to take Cabergoline. In fact I have never been diagnosed with any tumor or specific disease. And there’s no solid evidence that vitamin B-6 can help people like me, at least not in lower doses.

The problem is that we are replacing one issue with another, when we take vitamins at any dose and as if they couldn’t harm us.

About increasing libido: you’ll see there’s no evidence of that here:

Even if there is, I believe that only higher doses can benefit the men taking and that would be useful if their prolactin was really high.

Not my case, that is in the 20’s. The ideal levels are a litle less than 10.

On the other hand there are safer ways to increase libido:

One I already mentioned: taking peruvian MACA powder (or in caps).

This link mentions the things we should look for to increase testosterone: vitamin D (and now I am taking with K-2 MK-7), zinc and magnesium.

That’s it, and if the supplement has vitamin B-6 then search for magnesium and zinc without it.

Testosterone boosters are a sham. Supplements are harmful if we exceed the max daily doses and for prolonged time.

Q: How can you increase testosterone naturally?

A: When it comes to increasing your testosterone, quality sleep, physical activity, and weight management come first. A few supplements can help sustain healthy testosterone levels, but most supplements marketed as testosterone boosters don’t work, though some can make you believe they do by boosting your libido.

Peruvian Maca is listed at with a “Very High” in terms of consistency of research results, for increasing libido.

For the libido column this is what the site says:

I also read some users reporting a substantial increase after taking for a while.

The only other mention in terms of increasing libido is for Fenugreek:

Increases in libido have been noted before, which is notable due to the lack of significant influence on testosterone and possible suppression of DHT (theoretically should reduce libido, yet a large increase is seen with fenugreek)

However I would avoid it since decreasing DHT levels is detrimental.

Mucuna pruriens also appear to be a good idea, not only to decrease prolactin, also for testosterone:

Still, this fits into my warning about taking these things over prolonged time, since we are messing with dopamine.

What is more concerning is that all over the internet we will find guys recommending all of this and only warning about the problems in the footnotes.

We also need to evaluate if stop taking for a while (cycling) and then restarting could be a good idea:

I have decided to do the following:

  • Stop taking vitamin B-6 (even before my current stock ends)
  • Stop taking Ashwagandha once my 120 pills are over - for someone that is a little uneasy and stressed on a daily basis it’s the best adaptogen - remember that high anxiety and cortisol means lower testosterone);
  • Stop taking ZMA after my 8 month stock ends. I’ll search for another one, without B-6 in the list of ingredients.

@Perene, could you please complete the post-drug patient survey?

We are badly in need of more data on PAS patients.