Since the dozen or so doctors I’ve seen haven’t had much experience (or any) with finasteride and PFS I had a conversation with ChatGPT about my symptoms. For those interested here it is below. It seems pretty insightful and maybe helpful. I gave it my list of symptoms and asked how Finasteride could be involved:
Symptoms and test results: memory and cognition impairment, swollen/sore neck above and beside Adam’s apple, frequent bowel movements, frequent urination, dehydration, low blood pressure during sleep, anxiety, irritability, numb hands/arms during sleep, dizziness/lightheadedness during sleep, sleep disturbances, high reverse T3, high glucose levels (after fasting), high cortisol levels at bedtime, high GABA levels, high Epinephrine, high Dopamine, low DHEA, high SHBG, heart palpitations, hair thinning, blurred vision, tinnitus and hearing loss.
ChatGPT wrote:
With your symptoms and test results Finasteride’s potential effects are likely multifaceted, involving hormonal, metabolic, neurological, and autonomic pathways. Here’s a comprehensive overview of how Finasteride might have triggered or contributed to these symptoms and why lifestyle changes, such as diet and exercise, may be helping mitigate them.
Comprehensive Overview of Finasteride’s Potential Effects on Symptoms
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Hormonal Dysregulation
• Finasteride reduces DHT production, leading to changes in sex hormone balance:
◦ Low DHEA and high SHBG indicate disrupted androgen regulation. DHEA is a precursor to sex hormones, and lower levels could lead to reduced testosterone and overall hormonal imbalance.
◦ The reduction in DHT may have affected the thyroid, leading to symptoms such as swollen/sore neck, high reverse T3, frequent bowel movements, and hair thinning. This suggests possible thyroiditis or a related thyroid condition.
◦ Hormonal imbalance can also lead to high cortisol at bedtime, causing anxiety, irritability, sleep disturbances, and cognitive impairment. -
Adrenal and Autonomic Dysfunction
• The hypothalamic-pituitary-adrenal (HPA) axis) could be disrupted by altered sex hormones:
◦ High cortisol at bedtime indicates dysregulation of the HPA axis, contributing to sleep disturbances and anxiety. It can also lead to high glucose levels, which indicates possible insulin resistance.
◦ Low blood pressure during sleep and dizziness/lightheadedness might be related to adrenal insufficiencyor an imbalance in aldosterone, affecting blood pressure and fluid regulation.
◦ Frequent urination, dehydration, and heart palpitations can all be linked to impaired aldosteroneregulation, affecting fluid balance and electrolyte stability. -
Autonomic Nervous System Dysfunction (Dysautonomia)
• Dysautonomia is suggested by symptoms such as low blood pressure, dizziness/lightheadedness, and numb hands/arms during sleep. Hormonal disruptions from Finasteride could impair the autonomic nervous system (ANS), leading to poor regulation of blood pressure and circulation.
• High epinephrine and high dopamine indicate a heightened sympathetic nervous system response, which may be exacerbating anxiety, irritability, and heart palpitations. This sympathetic overdrive might also explain tinnitus and hearing loss, as excessive stress hormones can affect the delicate structures of the inner ear. -
Metabolic and Neurological Effects
• High glucose levels (after fasting) point toward insulin resistance, possibly influenced by high cortisol and disrupted sex hormones. This can contribute to blurred vision, frequent urination, and dehydration.
• Memory and cognition impairment, high GABA levels, and high dopamine suggest neurochemical imbalances. Finasteride affects neurosteroid production, such as allopregnanolone, which modulates GABA receptors. Elevated GABA might indicate a compensatory response to a reduction in neurosteroids, leading to disruptions in mood regulation and cognitive function. -
Immune and Inflammatory Response
• The swollen/sore neck above and beside the Adam’s apple may indicate thyroiditis, possibly triggered by an immune or inflammatory response to Finasteride. The inflammatory process may also be contributing to systemic symptoms like numbness and tinnitus.
Possible Conditions Resembling Your Symptoms
The collection of your symptoms resembles conditions such as:
• Thyroiditis or Hyperthyroidism: Indicated by swollen thyroid, high reverse T3, hair thinning, and anxiety.
• Adrenal Dysfunction (e.g., Adrenal Insufficiency or HPA Axis Dysregulation): Suggested by high cortisol at bedtime, low blood pressure, dizziness, and frequent urination.
• Dysautonomia: Symptoms like numb hands/arms during sleep, dizziness, low blood pressure, and palpitationssuggest autonomic nervous system issues.
• Insulin Resistance/Diabetes: High glucose levels, frequent urination, dehydration, and blurred vision suggest a metabolic component, potentially influenced by cortisol dysregulation.
• Neurological Dysfunction: Symptoms like memory impairment, high GABA levels, high dopamine, tinnitus, and hearing loss indicate disruptions in the nervous system and neurochemical balance.
Summary:
Your symptoms—including thyroid swelling, adrenal dysfunction, autonomic dysregulation, insulin resistance, neurological effects, and hearing issues—are likely linked to the effects of Finasteride on multiple body systems, particularly through hormonal, neurochemical, and autonomic pathways. Finasteride’s impact on DHT, the HPA axis, neurosteroids, and overall hormonal balance has likely led to disruptions in these systems, resulting in the wide range of symptoms you’ve experienced.
Regular exercise and a clean diet can help mitigate many of these symptoms by:
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Balancing Hormone Levels:
◦ Exercise helps reduce SHBG, boost DHEA, and improve testosterone production, which supports thyroidand adrenal function.
◦ The intake of micronutrients (such as selenium, zinc, and iodine) through a diet rich in fruits and vegetables supports thyroid health, helps lower reverse T3, and reduces inflammation of the thyroid gland. -
Reducing Inflammation:
◦ Avoiding ultra-processed foods and added sugars reduces systemic inflammation, helping to alleviate thyroid swelling, joint pain, and other inflammation-related symptoms.
◦ A diet rich in anti-inflammatory foods (such as fruits, vegetables, and omega-3s) also combats inflammation, supporting immune system health, and helping mitigate irritability and symptoms like tinnitus and hearing loss. -
Supporting Adrenal and HPA Axis Health:
◦ Exercise regulates the HPA axis, helping reduce excessive cortisol and balance epinephrine and dopaminelevels, mitigating anxiety, irritability, sleep disturbances, and heart palpitations.
◦ Nutrient-rich foods, particularly those high in vitamin C, B vitamins, and magnesium, support adrenal function and improve blood pressure regulation, reducing dizziness. -
Improving Autonomic Nervous System Regulation:
◦ Regular aerobic exercise enhances autonomic stability, which helps normalize blood pressure, reduce heart palpitations, and improve circulation to reduce symptoms like numb hands/arms during sleep.
◦ A balanced diet that avoids added sugars helps regulate blood sugar levels, reducing strain on the autonomic nervous system and minimizing symptoms like frequent urination and lightheadedness. -
Metabolic and Cognitive Health:
◦ Exercise significantly enhances insulin sensitivity and helps regulate blood glucose levels, reducing symptoms such as blurred vision, frequent urination, and dehydration.
◦ Exercise also promotes neurosteroid production (such as allopregnanolone), which helps modulate GABA receptors, improving cognitive function, mood stability, and reducing sleep disturbances and memory impairment.
◦ Omega-3 fatty acids, antioxidants, and vitamins from a healthy diet support brain health, helping alleviate memory and cognition impairment, tinnitus, and hearing loss.
In summary, by targeting multiple underlying disruptions caused by Finasteride—including hormonal, autonomic, and inflammatory pathways—regular exercise and a clean, nutrient-rich diet can help restore balance and significantly reduce the severity of your symptoms, contributing to improved overall health.