[deleted]
This post on finasteride and dry eyes might be of interest:
I am now around 10 weeks since stopping finasteride and for the last 10 days I have been back to baseline and consider myself free of finasteride effects bar the changes in penile morphology but my feeling is this will correct with time.
I have kept a log of my thoughts since stopping finasteride that I will post in its crude entirety below as well as blood tests over the period. In it you have access to the day to day changes in thinking to what I thought was causing my issues and the interventions I trialled and the progression of symptomology over the period and that is how it should be taken, my thoughts contributed and coalesced to form the viewpoint I have now.
My view now is that my symptoms were caused by HPTA axis dysfunction following abrupt cessation of finasteride, this led to a hypogonadal state and my recovery was the consequence of a natural readjustment (TIME) that was not influenced by external factors. This was supported with overall beneficial interventions such as intermittent fasting, Vit D supplementation, calcium supplementation, magnesium supplementation, circadian regulation (trying to get my body into a routine- take supplements at the same time, eat at the same time, sleep at the same time). Circadian regulation is the primary way in which to maintain a stable hormonal profile.
Over the period I had symptoms of hypothyroidism, hypoestrogenism, histamine intolerance, allergies, anaemia, muscle wasting, everything the forums on this sight are choc full of. There are two very important points that everyone should keep at the forefront of their thinking:
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Hormonal stability is more important than any particular profile.
By this I mean that constantly changing protocols is a recipe for no progress whatsoever. If there is an issue ( a deficiency/ up regulation/ down regulation) that is stable over time the body will adjust and compensate however if there is constant fluctuation there is no possibility of this as the body is not given long enough to solve the problem. This leads onto my second point. -
The timeframe over which symptoms settle is much longer than current thinking understands it to be: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474193/
This is a very important article. After castration and loss of sexual behaviour, testosterone was administered and sexual behaviour returned in mice after 9 days despite serum testosterone reaching peak levels a few hours after administration. 9 days for mice is 1 human year for an adult male. The implication here that you can find the solution today and correct your hormonal profile but the outcomes and behaviours of the change won’t be apparent for a good while. You need to stick to a hormonal protocol for up to a year before you will see its benefits
On my current protocol I feel very good and better than I ever remember feeling. I intermittent fast (eat only between midday and 6pm, but eat whatever I want), Vit D (6000 IUs a day), Magnesium (800mg of elemental magnesium a day), Calcium (1g a day).
I seriously recommend everyone begin Vitamin D supplementation, PFS or not. Vit D is a bit of a misnomer it is a hormone on par with the others (test, estrogen, DHT), almost all cells have Vit D receptors and it is responsible for the regulation of 100s of genes. Studies have shown that large proportions of the populace are deficient/insufficient, I am not saying it will cure your PFS but it will improve your situation and symptomology. I take 6000 IU a day. The following is a casual discussion between Joe Rogan and a researcher on the benefits of Vit D, it is worth a watch and does a better job of hammering the point home than I can do.
11 Mar - 24 Mar 2020
Stopped finasteride on the 11th, simultaneous with nofap.
I think nofap is important as orgasm usually causes anxiety, weak voice, perceived increase in hair loss, general weakness and generally just does not seem to go well with my current hormonal state.
I have felt good with a complete easing of anxiety and an increase in libido and sexual fantasy. Women seem more attractive. My voice is stronger and more powerful.
I am making progress with press ups that is positively surprising. I feel more powerful and composed. There is no pressure in my head.
It is the corona pandemic and so I am at home most of the day and I have noticed an occasional fatigue since stopping that is unusual.
26-27 Mar
The extreme libido has abated and has been somewhat flat the last few days.
Anxiety is non existent however there seems to be a sense of fatigue at times.
I have cold extremities
29 Mar
I woke up this morning with an ache in my neck and having had poor sleep. I look really pale with extremely dry lips and have no appetite. I have little energy for exercise. I have had some sexual thoughts and a couple of mild spontaneous erections. This is all suggestive of low oestrogen.
My beard feels thicker and fuller and I noticed an increased body odour yesterday, early signs that DHT is increasing. My mood is also surprisingly good, even though I have low oestrogen symptomology I prefer this state to the finasteride state, however I feel my social functionality (appearance, mannerisms) are worse. People have pointed out that I don’t look well and there is a tendency to avoid me.
I spent the entire day lying on the sofa working, I did a good amount of work and in this regard I am doing better than on finasteride but there was a real downturn in spontaneous physical activity, which is a sign of low estrogen.
Plan:
- Make a symptom questionnaire that is easy to fill in everyday and allows for easy tracking.
- Figure out the finasteride elimination so that you can try to figure out what the optimal levels of DHT and oestrogen are for you.
- Book GP appointment, this is something you should consult your doctor about, remember to show emotion.
- Make a mind map for all the drugs and behaviours (no fap, season, diet, stress) that affect your hormonal profile.
- Take a blood test in this post finasteride low estrogen state.
- Read up on the conversation of testosterone to DHT, oestrogen and any other pathways: ratios, time
- Read up on oestrogen metabolism and ways of regulating the hormone with behaviour and substances.
My current theory on your situation is: on finasteride there is reduced DHT and increased oestrogen:
- Reduced DHT responsible for cognition issues, poor memory, pressure in head, loss of ability to visualise concepts, poor performance in the gym, changes in penile morphology, poor response to alcohol.
- Increased oestrogen responsible for mood swings, anxiety, high body fat, no libido.
When you come off finasteride there is a period of optimal function: high libido, good performance in the gym, energy for days, good cognitive performance, humour, spontaneous erections, increased emotions, people want to be around me, girls preen themselves for me, strong posture, feeling of power etc. etc. Essentially exactly where you want to be in all regards. At this point oestrogen, test and DHT are optimised. The first step is to figure out what the hormonal profile looks like at this optimal stage and the second step is to figure out how to maintain this state consistently.
As time progresses of finasteride you begin to develop symptoms of low oestrogen: cold extremities, joint pain, fatigue, pale dry skin, inconsistent libido, low appetite, neck pain, disinterest in sugar, pins and needles.
Though penile morphology, memory, concentration, anxiety, social interaction, response to alcohol, feeling like my penis belongs to me, are all better than your state on finasteride, which suggests that DHT has a minimum threshold below which you suffer negative symptoms but that above this you are okay.
I have a very strong pounding heart even at rest almost always.
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I am interested by the period last summer where I was full of energy and women flocked to me. If I remember correctly I had a turbulent mood/ road rage (smashed the house up and fought with mum) and anxiety (swallowing tick and reluctance to speak) through the period. I was super blunt and would occasionally snap at people, I could feel testosterone and rage rising up in me and could muster it on demand if I liked. I would often see fear on people’s faces when they interacted with me. I was very careful with my words and became quite selfish and indifferent to others. I listened to Skepta’s new album on repeat. Progress in the gym was not great but cardiovascular performance was great. I ate a normal diet but supplemented with high dose vitamin D and high dose magnesium daily. My libido was low to non existent , On rare occasions I would wake up with morning erections but it was inconsistent. I had no genuine After exercise my penis would shrivel up. My skin was clear and my hair was the best it has been in years . I was very flat emotionally during this period. My energy levels were perfect I would exercise 14 times a week and so estrogen was likely between optimal and too high. Despite the attention from women I didn’t pursue any girls and so the attention is not important and for that reason this is not a hormonal profile we should aim to replicate, instead we should aim to improve on it, in particular mitigating the anxiety and lack of libido. Your v oice was also non-existent during this period, weak and raspy to the point that your were afraid to speak.
The protocol at the time was:
Finasteride 1.25mg daily - lowers DHT, increasses oestrogen
Nofap - no hormonal shifts, stability in hormonal profile
Gym every other day - increases test, increases oestrogen, increases DHT
High intensity exercise everyday (boxing, running, squash) - increases test,
Summer
No work pressure
Vitamin D - high dose
Magnesium - high dose
My feeling from the period is that nofap caused a shift in my hormonal profile, the exercise increased the amount of testosterone, and the vitamin D and magnesium lowered my SHBG which increased the amount of and responsive to both testosterone and oestrogen. Most of all I feel good in summers, I always do, blue skies and the sun have an amazing effect on me.
It is important to differentiate strength training and cardiovascular training as your body and hormones react differently to both.
Hormonal shifts and changes in hormonal profile are causes of a change in symptoms as much as any specific profile is.
30 Mar
Today is the first day post finasteride that I would not feel comfortable turning up to work as a medical student (Finasteride stop + 20 days).
I have been extremely forgetful and have had poor spatial awareness- constantly bumping into things and misplacing things. Despite this I have no anxiety and my internal landscape is peaceful. This is a worry as I it has the effect of masking my poor functional state.
I have felt relatively anti social compared to the last few weeks, I was reluctant to talk to my mum on the phone. A few days ago I enjoyed an hour long conversation with her.
Today social interaction has been very strange, a strange sort of underlying anxiety that makes you unable to hold eye contact and lose the ability to convey the right emotion- conversations suddenly become emotional when you don’t want them to.
My libido and penile morphology on waking are good, I had a couple of spontaneous erections.
While reading this morning I found that high levels of estrogen with women correlated with an increased ability to identify fear in the faces of others, this correlation did not exist for positive emotions. This may in part explain why you began to notice fear in men and women last summer and had the general sense that people where scared of you.
All of your states need to be tested in the real world, socially and functionally. Your sense of well being is not a good indicator of how you’re going to perform at work or with friends. The way that other people react to you is an objective indicator .
As time progresses I feel my memory and cognition deteriorating, I have memory and mind blanks, I woke up today and could not remember what month it was.
Plan:
- Try to improve symptoms with oestrogen inducing foods and behaviours
- Take blood test when it arrives
- Take blood test when symptoms resolve in initial finasteride period
Estrogen
- Estrogen is important in the transport of glucose into skeletal muscle cells and a reduction in estrogen leads to a reduction of glycogen stores in cells
- Estrogen is an important vasodilator and cardioprotective, low levels are associated with cardiac dysfunction.
- Estrogen the most important regulator of spontaneous physical activity.
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1 Apr
I am increasing my intake of soya as it is a phytoestrogen , today:
- I am struggling to concentrate
- My skin is still dry, thin and lifeless.
- I still feel a tiredness between my eyes though this is not brain fog or head pressure, much tamer.
- I snapped at someone and was aggressive
- I have had reduced libido compared to the last few days. 2/10.
- I have 5/10 spontaneous physical activity
- I am still suffering the symptoms of low estrogen
- I also feel functionally worse, my ability to form arguments and communicate is at a low.
- I ignored a call from my borther today, this is not a viable state.
- My thumb has started to twitch uncontrollably, it micro twitches when I am using the phone.
- The previous few nights I have had broken sleep, last night it was not broken.
I think this may be a consequence of a sudden hormonal shift.
Moves between hormonal profiles cause a scrambling of symptoms as your body adjusts, I think this may be transient, stick with a protocol for a short period of time to get past this. Stability of hormonal profile is key ! Be consistent with any protocol and give it time.
Libido is the true indicator of your functional state. If you wake up in the morning with good libido and erectile function you are in a good state. Libido is what you are aiming for.
Having done some reading my cold intolerance is severe and I think there may be an interaction between my sex hormones and thyroid hormones . There is also a lot of overlap between the symptoms of hypothyroidism and what you are experiencing.
The ear pain you experience is very specific for a thyroid issue.
There is some evidence that low estrogen states predispose to hypothyroidism.
After eating soy I feel extremely lethargic and my vision has become blurry. I have also become much less social with my housemates.
I am worrying about this in too much detail, get your bloods done and stay on this protocol until mid April, go to your GP if things don’t improve.
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2 Apr
I masturbated today after a 23 day nofap streak. There was a good amount of thick white semen both times I masturbated. A few hours later my cognition and mood and sociability were at optimal levels, no sign of libido however.
What effect did the soy have on your sleep? My Garmin is telling me that I had 45 mins of deep sleep which is much more than usual, though I doubt its accuracy.
I took the blood sample this morning, I had nocturnal erections that woke me but I felt very impotent in the morning. I have lost that feeling of composure that followed the few weeks after finasteride and there is an undercurrent of uneasiness, though it is minimal (1/10), it is more that I don’t feel super relaxed and peaceful internally as I did then.
My skin is papery and feels lifeless. I masturbated earlier and this change in texture extends to my penis which feels very weird when erect. I am pleased this change is affecting all my skin and not just my penis. My hands are the most affected, the skin feels very thin and papery.
I feel asocial and have no real desire to interact.
I feel a pressure behind my eyes that I feel prevents me from having soft eyes and makes me want to avoid eye contact.
My erect penis was at 70%, narrower than normal, orgasm intensity was reduced maybe at 60%, though this is difficult to assess. It did not have that fully engorged feel or appearance.
A couple hours after masturbation I feel good, I have a pressure behind my eyes but other than that I feel energised. The papery texture of my hands has improved slightly but nowhere near normal.
As the day has progressed I have felt better and better, the masturbation had a positive impact .
Blood test- It would be great if it came back saying you had low testosterone and the solution simplified to TRT. Look at the SHBG, yours seems to show wide fluctuation, high levels when you feel worse and low levels when you feel better.
Up until now I had thought that coming of finasteride was causing a progressive increase in DHT as time progressed and that this caused the sense of calm that I felt and that the shift to a PFS state was caused by a decrease in estrogen as more testosterone was converted into DHT and less into estrogen. This was based on my being able to maintain a serene internal landscape while other symptoms began to arise (white papery skin, aching joints), to me suggesting that DHT was still high but that estrogen was decreasing.
However the serene internal landscape has dissipated and I am in a very low level anxiety state.
This has made me think that perhaps after coming of finasteride there was a surge in DHT, during which time neuroprotective steroids where created and stored, that this increase in DHT was met with AR down regulation leading a return to a low effective DHT state once the stored neurosteroids have been depleted.
I need to keep an eye on hairloss, it is a good indicator of DHT levels, do not shave your head, I have the feeling that my hair is not falling out anymore and has stabilised despite me being off finasteride. I have not had any acne breakouts which I would expect with such a surge in DHT.
It is important to get a true sense of the effect of DHT, estrogen and test on your body.
I think a lot of my symptoms arise from having become super estrogen sensitive and small fluctuations causing issues, my body needs consistency of hormonal profile before it allows your libido to return.
Interventions that improve symptoms
Soy makes your emotions come out - suggesting low estrogen
Nofap helps make your voice stronger and deeper - suggesting low androgens
HIIT - makes you feel better and increases libido suggesting low androgens
Based on how I see things now I think TRT would help improve your symptoms, I hope that the bloodworm supports this.
If my assessment is correct I am currently low test, low estrogen, high SHBG
Conjecture
You have symptoms of low thyroid hormones and low testosterone. Maybe there is an antibody attacking the identical alpha subunits of TSH and LH?
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3 Apr
I masturbated to pornography today and was overcome by overwhelming fatigue and slept till 6pm.
There is a sexual reserve that you have and its ability to refill has been damaged by finsteride, it takes a period of nofap before you are able to produce arousal and sperm for a fulfilling ejaculation.
For a healthy individual this refilling is a seamless process and does not take very long. This is because their hormones are working effectively and are at the right concentrations and ratios.
Early ejaculation, before sexual reserve is at an adequate level, is prevented by low libido, however with pornography you can bypass this and force your self into an ejaculatory state before your body is ready, this is catastrophic for your body and something you have abused since you were introduced to pornography.
Axiom: Only ejaculate when the arousal and erection are spontaneous.
Otherwise I have felt good today, I set a personal best on press ups. My internal state of mind is good, however my sociability is less than I’d like it to be. Masturbating when not aroused has definitely thrown my voice off, it is less confident and less deep.
My ability to Sweat is significantly reduced, I no longer need to wear deodorant and even exercise does not cause me to sweat, and this suggests that I have adjusted to a low DHT state.
Axiom: Daily strenuous exercise is a constant, it needs to be imbedded into the deepest layers of your psyche and behaviour.
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5 Apr
I have woken up the last few days with weak morning erections and my penis is now returned to pre finasteride fullness in its flaccid state (perhaps with a hint of narrowing/ loss of girth).
Again I am being told that I look tired and I feel tired also, I can see dark rings under my eyes, I also have reduced spontaneous physical activity and a fatigue.
My sociability is very poor, I do not feel anxious but humour is non existent . I have a flat affect and am not seeing the colour in the world. My current understanding is that this is caused by low effective estrogen . My skin is very dry and I can feel that my eyes are tired as soon as I wake up and this persists throughout the day.
I am still unable to sweat, even during workouts. This suggests that I have low effective DHT however. I masturbated twice yesterday and both times the semen was thick, white, creamy suggesting a high sperm concentration however there was very small amounts in total, supporting a low DHT state as the prostate is responsible for seminal fluid.
Strawberries make me feel good.
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6 Apr
I need to give this no finasteride no intervention (baseline) state some time to stabilise, I am definitely suffering from hypogonadism at the moment but perhaps it is just adjustment while my body sorts itself out post finasteride. I will give it 8 weeks from cessation of the drug. May 10.
In this period work on raising testosterone levels naturally.
If the following measures do not normalise then I will intervene, I would like to see 6’s and 7’s:
- Libido - 1/10
- Erectile function - 3/10
- Sociability - 2/10
- Motivation for activity/ exercise - 2/10
- Appearance - 2/10
- Access to emotions - 2/10
Take bloods on May 10.
Your cold intolerance has disappeared and so thyroid hormone activity has normalised over the last week or so, there is hope that sex hormones normalise also.
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8 Apr
The blood test results arrived today, I have low estrogen as expected however my testosterone is normal. The surprise is that my prolactin is elevated. This is something that I need to think about and really factor. It would be absurd to start TRT or any other protocol if hyperprolactinaemia is the cause of my symptoms. TRT will likely be ineffective if hyperprolactinaemia is the cause of your symptoms.
I have noticed that I become very sexual while exercising and my sleep is awful and I have insomnia.
I recently had an intense sexual solo experience on cannabis and I am now thinking that the increase in dopamine as a result of cannabis led to an inhibition of prolactin that facilitated the entire experience. Though it is unlikely that cannabis would be able to act so rapidly to reduce prolactin.
My skin and hair are extremely dry and lifeless.
I will now try supplements to lower my prolactin until May 10. I am looking into Vitamin B6 and dopamine precursors.
Your baseline prolactin levels are higher than levels men experience following sex and are sufficient to sustain their refractory period.
An importnat question, why did your libido increase in a linear fashion once you came off finasteride and reach normal levels before tapering off again. How does this tie in with high prolactin levels?
Cabergoline increases serum DHT 3-fold and also increases testosterone production.
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9 Apr
There is a difference in penile morphology between the distal and proximal half of my penis. I have the feeling this is caused by the low estrogen state induced by finasteride cessation. The difference begins at the level of the kink (Peyronie’s) and the skin is thinner and darker and seemingly less vascularised on the distal half. The distal half is also narrower and is more sensitive in a negative way, during masturbation there is a hint of pain when stroking the region.
My penis is now hanging fuller in its flaccid state and when you are beginning to get aroused it takes that engorged flaccid state that you were used to when you where younger and is a point that you are comfortable exposing your penis at.
I have completely lost that at ease feeling associated with DHT and I am back to an uneasiness in my head and low level constant anxiety.
Based on my reading I do not think the prolactin levels are a cause for concern, there is thought which suggests your elevated levels could be down to the stress of venipuncture alone.
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10 Apr
Prolactin inhibits 5AR and estrogen.
Today something very interesting happened. A dose of Macuna pruriens improved my mood and cognition symptoms, not to optimal levels but there is certainly a positive improvement. This suggests that I dopamine has potential to improve my symptoms.
All of my bloodworms has shown elevated levels of prolactin, the levels though elevated are not consistent with pituitary pathology or any well understood prolactin pathology. Perhaps I have reduced activity in the dopamine pathway? A reduction of dopamine synthesis or issues with D2 receptors?
This would explain the positive response to Macuna pruriens and the elevated levels of prolactin. I have a history of drug abuse and pornography addiction that could underlie the issues with dopamine.
I believe this issue is separate to post finasteride issues. It is exacerbated by the post finasteride state.
Alternatively, your dopamine system is stable and Macuna acting like a recreational drug. Careful not to develop a dependence.
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12 Apr
Today I feel more energetic and social than usual, tho still not at an acceptable level. This maybe a natural progression or a consequence of the Macuna pruriens that I took yesterday.
I have noticed that I have brittle nails, again a symptom of hypothyroidism or reduced circulation to the peripheries due to low estrogen.
Symptoms arise as the day progresses, the mornings are okay.
Tinnitus can be caused by low estrogen . More evidence that you are hypoestrogenic. Tinnitus and ear pain has been ever present since you stopped finasteride.
I think you have to accept that your body has set no libido at its set point, focus on the other aspects of your life. Maybe you will come to accept this as different solutions fail. The cognitive stuff is a must, medicine and social are more important than sex.
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12 Apr
My refractory period has decreased considerably, where previously an orgasm would knock me out I can now continue with my day which suggests my body is adjusting to the new state.
I have spent the morning googling images of PAWGS I think there may be an underlying improvement of libido that your porn use is masking.
Today I felt much better, almost as if things are improving, I spoke to my mum and dad effortlessly, though perhaps a little stern and not enough humour. I have not been applying any interventions, no nofap etc.
Perhaps my hormones are normalising and adjusting. I have not had a clean break from finasteride since I started, a break that was not confounded by depression, stress, drug abuse. Let’s see how this plays out.
I still have slight symptoms of low estrogen, tinnitus, dry skin. But the head pressure and anxiety where minimal today.
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13 Apr
Today I felt completely normal, I walked tall and had good energy. My appetite for carbohydrates has been voracious! I feel my estrogen has risen for some reason. There are some possible causes:
- natural progression of pituitary adjustment after stopping finasteride
- B6 you had a few days ago
- Macuna pruriens you had a few days ago
- A yet to be defined cyclical hormonal fluctuation that you go through without realising.
- No stress
- Something in mum’s food. Spice?
Skin and dry eyes have improved, still not normal however.
More spontaneous physical activity, more social
However, strength has halved, only 10 press up sets, after 19 the other day.
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14 Apr
Today was good, similar to yesterday.
However at night after eating Krave I started to experience itching all over, what I had always previously associated with DHT. I now think it is a histamine intolerance caused by your estrogen dysfunction. I am feeling this now and I have suddenly become very anxious and short of breath which is completely out of sync with how I have been feeling the last few days. This is certainly a strong allergic reaction.
Avoid crap food! Cut out the rubbish and stick to healthy foods and this problem can be managed…
I have eaten krave before and not had this which is a little odd.
Estrogen is known to cause an increase in histamine, the normalisation of your estrogen levels could be causing a spike in histamine production. This response may normalise with time as your body adjusts to the higher estrogen levels.
Apparently B6 promotes the degradation of histamine but is also a cofactor in its synthesis and promotes histidine to histamine.
My sleep cycle drastically shifted last night without any intention or effort on my part. (from sleep at 6am wake at 3, to wake at 8am sleep at 12am). Histamine has a strong role as modulator of sleep cycles in the CNS.
I have ordered some anti-histamines to see how they make me feel. Again this could be a high or low histamine issue, if I feel worse on the anti histamines then I will try histidine. Hopefully I wake up tomorrow and I have forgotten all about this and never feel this itching again.
I have taken 300mg of B6.
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15 Apr
I had a 12 hour sleep but on waking I am spritely and spontaneous. I think histamine is very important .
It has the largest role in sleep and wakefulness. That jump out of bed in the morning feeling is histamine related as is sleep cycle orientation.
I have a feeling you are moving from a low histamine to a normal histamine state, that parallels your shift from a low estrogen state to a normal estrogen state (as the two are associated). For this reason you are experiencing symptoms of histamine intolerance and seeing changes In your sleep-wake functioning.
Antihistamines increase NREM sleep (deep sleep).
Histamine promotes wakefulness and disrupts deep sleep.
All periods of good well being (keto, summer where you were working out and getting crazy female attention) ended with lump in the throat reflux and crazy disruption to sleep wake cycle and sleep architecture.
Histamine is associated with gastric secretions and this points to histamine disruptions playing a part in those declines.
H2 (but not H1) receptors have been identified in the erection response and have been shown as a potentially useful treatment for psychogenic erectile dysfunction.
Theory
You always have good periods at home during summer as you spend your time in the living room with the door to the garden open, this leads to environmental exposures that promote histamine release in your body. The elevated histamine causes an alertness and spontaneity that promotes a sense of well being and there is deep and timely sleep during these periods, you experience a period of wellbeing until the levels of histamine increase to the point where you experience acid reflux and fragmentation of sleep.
However the deterioration always seems to coincide with leaving home and there should be a corresponding decrease in histamine release. You also experience itching episodes associated with histamine when you are not at home.
The key finding is that histamine plays a very important and crucial role in your well being, perhaps more so than other hormones. Estrogen and histamine are the two crucial ones.
Estrogen inhibits DAO (Diamine oxidase which breaks down histamine). Over the last few weeks as your estrogen has fluctuated there has been a knock on effect on histamine.
Today has been a really good day in terms of cognition. Perhaps this is the B6 taking effect or an increase in Estrogen or histamine intolerance?
Reading more there may be an effect of diminishing histidine: As your body creates more histamine it uses up histamine and after the upsurge caused by the elevated levels of histamine there is a deterioration when histadine stores run dry and synthesis of histamine is reduced. Thus supplementing histidine with B6 (a cofactor in the conversion) may be important to maintaining the high levels of histidine that make you feel good.
This changed at night, I was unable to fall asleep and masturbated 6 times and felt a change in my state on the horizon .
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16 Apr
Very low estrogen state again, flat affect, no libido, penile shrinkage. There seems to be a random fluctuation of your hormones. Perhaps sleep is the culprit? Your sleep cycle is all over the place and the disruption to your circadian rhythm is throwing all of your hormones out of whack.
Very thin lips, easy bruising.
This hormonal fluctuation is possibly due to SHBG. Try raising your SHBG levels naturally to discern an effect.
Constant headache has returned.
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17 Apr
Again I felt off and not right.
Theory:
Stopping finasteride abruptly caused disruption to the HPGA. The sudden three-fold increase in DHT caused down regulation of AR receptors and suppression of estrogen. Leading to low DHT (no hair loss, no sweating) and low oestrogen symptoms (well documented above).
This would result in normal levels of DHT and test but symptoms of low test/DHT due to down-regulation of AR receptors and also low serum estrogen as DHT antagonises estrogen. I think there is hope that your receptors adjust and compensate to the surge and new levels of DHT over time without intervention , changing symptomology would be an indicator of this. Increase in sweating and increase in hair loss are good indicators DHT processing by AR is increasing.
Since stopping finasteride your strength has improved, you are able to do several sets of 15 push ups regularly, sometimes more. This is a sign that testosterone is still working on the AR receptor. Your penis is fuller and more responsive than on finasteride, again suggesting that AR activity has seen some benefit from stopping finasteride.
There are some options moving forward:
Let your system play out, hormonal changes take time to settle and cement, monitor your symptology and aim for stability as your body adapts.
TRT - If AR is down regulated this will only improve symptoms of low estrogen. This would be an improvement on the current situation.
Starting on finasteride and then tapering off to allow your HPGA to gradually adjust to the post finasteride state and hopefully prevent mass down regulation of the AR
Finasteride + TRT?
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18 Apr
Really cold extremities and loss of fluency when talking.
I don’t have any anxiety however, this may be because I am at home and there are no external pressures.
My voice has remained constant recently, about average depth but with no hesitation or anxiety, despite excessive masturbation. A sign that androgen activity is good?
My speech is stilted however and lacks fluency and rhythm. Almost autistic. The fluency will return when your emotions do.
Stability of hormonal profile is the most important variable in all of this.
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20 Apr
This is a very important article. After castration and loss of sexual behaviour, testosterone was administered and sexual behaviour returned in mice after 9 days despite serum testosterone reaching peak levels a few hours after administration. 9 days for mice is 1 human year for an adult male.You need to stick to a protocol for up to a year before you will see its benefits .
Additionally, sexual behaviour and sexual motivation seemed to be controlled separately, hormonal fluctuations have a greater impact on behaviour and not so much of an impact on motivation. The desire is there but no impetus to act. This is similar to your desire for porongraphy but complete lack of impetus to chase girls.
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21 Apr
Pretty bad day again today, really frustrated internally, snapping at things, not willing to talk, avoiding social contact, irritable and unsettled.
My left shoulder feels off( stiff and sore) and I am now more and more convinced it is a hormonal issue. Frozen shoulder is a condition that middle aged folk experience in response to hormonal changes.
Sent off a blood sample, which was taken at 8pm.
23 Apr
I would like to give Keto and intermittent fasting a chance again before I think about TRT.
Keto increases SHBG and test and previously I felt like god on it.
Intermittent fasting regulates circadian rhythym and this is important for hormonal stability.
TRT is a big commitment and a lifelong commitment, something that you can come back to but not something you will be able to undo easily. It is certainly something you will do in your life, the question is timing. Is now the right time? Before you have had children etc.
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24 Apr
4.5/10
It feels like things are going in the right direction. Still a long way from libido but the physical symptoms seem to be improving.
I took magnesium last night and I had morning wood, my beard feels thicker and I have a little spontaneous sweating today.
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25 Apr
Physically I feel normal, cognitively not so. Magnesium and natural resolution are the causes I feel.
Sweating is beginning to normalise, I had the best erection to date last night though still not normal. After ingestion of magnesium my skin feels less dry and more life like.
I still have muscle twitches, lets see how these progress with time. I may still have underlying low estrogen that is being masked by magnesium.
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26 Apr
Good day felt normal
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27 Apr
Back to crap, woke up spontaneously at 3am and couldn’t get back to sleep. Hypothyroidism is a potential concern, the peeling lips, easy cutting, really messed up sleep are very specific for hypothyroidism.
I want no interventions till june, let your pituitary normalise, give it time. Then have a look if things haven’t changed.
Symptoms today:]
Poor memory
Dry skin
Hair brittle
Bags under my eyes
Slow thinking
Pressure behind eyes
Peeling lips
Easily cut
Bloating
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29 Apr
VITAMIN D AND MAGNESIUM ARE A COMBO, TAKE TOGETHER FOR EFFECT.
Vitamin D seems to be the answer, return of full erections and good sperm, skin on penis returning to normal texture, good mood throughout day though perhaps a little faitgued.
A 10 week course of 4000IU a day is needed to return levels to baseline.
————
30 Apr
Headache and general malaise since waking. Ate junk yesterday, perhaps we are into the territory of general day to day acute fluctuations not linked to some underlying pathology/deficiency?
Bad day.
Very slow cognition, no depression however, but just very slow and disinterested, general feeling that something is off, extremely thin and papery skin, several cuts on hands following innocuous activities like opening a parcel as your skin is so weak.
Took thyroid blood test at 8.30pm to catch the nadir of thyroid activity, hopefully it comes back actionable, if it is normal that makes this more difficult to solve.
Hashimoto’s is possible, the test includes autoimmune antibodies.
Estrogen stimulates the thyroid and so low estrogen could be causing hypothyroidism.
That weird head pressure behind the eyes is back.
On a more positive note, my humour is back, my muscles feel hard, I am having 80% erections (best I’ve had since last summer) and my voice is always strong. It seems DHT is back and exerting its androgenic effects.
There has certainly been a grdual improvement of overall symptoms since stopping finasteride to now. I hope the thyroid corrects itself with time.
——————
2 May
Body temp 36.7C
Symptoms:
Pressure in head
Twitches in legs
Flat mood
Dry unruly hair/ body hair
No libido
Dark circles around eyes
Dry skin
Fatigue
The uneasiness in the head is constant and unbearable
My plan is to Keto diet again. That period was the best of my life.
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4 May
Erections 90% when lying flat watching porn daily, so likely very good when standing up and after some abstience.
Really poor concentration today, however hands seem to be returning to normal texture, improved blood flow to them
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5 May
Vitamin D level came back low, this is the first port of call. Correct this and then assess symptomology.
Aim is to double the current level. Summers have always been good to me as have Vit D supplements. This is a fundamental we need to correct before trying anything else. Get level to 90nmol/l before trying anything else.
My current daily protocol is: Intermittent fasting + 6000IU Vit D + 440mg elemental magnesium citrate
I will continue this until my vit D is optimal and then reassess
————————
6 May
Yesterday was good, 9/10 erection for the first time in years
All of today was good until 6pm when I had a tingling epidote and allergic reaction type response which has completely thrown my mood and sense of well being off, made me flat, fatigued and anxious for the last 6 hours.
I feel fatigued after concentration and exercise, I need to correct that before term starts.
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7 May
Concentration is extremely poor and fatigue is deceptive, you wake up feeling like you have energy but as soon as you sit down to work the fatigue, inattention and poor concentration kick in.
Your memory is still not there.
Symptoms:
Severe bloating, this has been constant for the last two weeks
Muscle twitches, these seem to be getting worse
Weight gain, getting fat now
Dry skin
Bags under eyes
Poor memory
Awful concentration - lost the ability to read and digest, cannot work for more than 20 mins
Fatigue
Pressure behind eyes
Blurry vision when you are in sunlight
PLAN:
CORRECT VITAMIN D LEVELS + CALCIUM
ASSESS FOR IMPROVEMENTS - JUN 30
- IF YOU CAN WORK FOR 6 HOURS A DAY THEN CONTINUE WITH PROTOCOL
IF NO IMPROVEMENT: KETO
ASSESS FOR IMPROVEMENTS: AUG 30
IF NO IMPROVEMENT: BACOPA PROTOCOL ON PROPECIAHELP
IF NO IMPROVEMENT: TRT
Today is the first day where I have noticed a very obvious lack of interest in conversation, but not due to fatigue, energy levels have been good, worked out etc, but you just don’t respond to conversational cues from others.
———————
8 May
Everything seems to be improving apart from, libido, memory, cognition and the pressure in the head.
Erections are 9/10
Physical energy is good
Skin seems to be improving but not normal
Head and shoulders conditioner is helping with hair dryness.
Magnesium and vitamin D are insanely beneficial to you, I think you may have been harbouring a life long vitamin d deficiency.
Muslce twitches are still present, maybe getting worse.
12 May
Things seem to have reached a plateau in terms of improvement and I have not yet reached a level that I am happy operating at:
Current symptoms:
Head pressure
Fatigue
Poor concentration
Poor memory
Lack of emotions
Disinterst in conversation
Lack of humour
Poor balance
Muscle twitches
Dry skin
Awful unruly dry hair
Bags under eyes
No libido
Slow beard growth
Minimal sweating
Slow pubic hair growth
Vitamin D deficiency aspect of symptoms will improve as I continue to raise levels, I have ordered calcium and will add that to see if there is additional improvement.
June 1st start Keto if not at 100%.
———————
17 May:
Hair is starting to thin and skin is more oily, sweat is returning, head pressure has been absent the last three days as well as a better mood. Things are looking up. There is a little anxiety about the return of hair loss but you will look extremely handsome with a shaved head if it comes to that so nothing to worry about.
21 May
I feel like I’m back, my emotions are back so is my charm and vocabulary and ease with conversation, this is just at home and I haven’t tested it in the real world but things have definitely improved.
I think the vit D played a huge part, my symptoms improved for the best after starting calcium so this may be having a synergistic role with vit D. Intermittent fasting has helped also.
Current protocol: vit d 6000iu, 1g calcium, 800mg magnesium, intermittent fasting between midday and 6.
Hormonal profile mid May (+ 9 week finasteride stop)
Estrogen has almost doubled from the period after stopping finasteride (where symptoms were at their worst)
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Sorry my posts are so crude with no formatting and analysis but there is too much raw thinking and data for me to process, I hope it will be useful to someone. If you have any questions feel free to ask though I do not imagine myself frequenting the forum to often in the future.
Hi SS1, when do you take vit D and magnesium?
Hi telpek, I take the supplements in the 6 hour eating window (midday to 6pm).
6000IU vitamin D + 440mg magnesium + 500mg calcium at around midday with a meal with some fat in it to help absorption.
440mg magnesium + 500mg calcium with my meal at 6pm
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i loved reading it brother. good thing to log, however you can see the symptoms are all over the place from day to day, week to week.
Some questions though:
How long has passed since you stopped?
Do you have jointpains?
Do you still have earpain or tinnitus?
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Hey man,
Your right, it’s all over the place, my body went through a big change and it threw everything out of sync and I got all sorts of symptoms. The fluctuations in my estrogen levels over the period are pretty absurd, my body basically went through the menopause and back, sex hormones like estrogen are so fundamental to our function it is no surprise that the effects are so diverse.
I had really bad joint and bone pain, if I sat on the floor with my legs crossed I would struggle to get up and when I did I would have to hobble and the pain would persist for a while. I don’t have this anymore and I feel strong, flexible and stable. If I do a full body workout (press ups, leg raises, squats, lunges etc.) I feel good and there is no resistance from my joints.
My ear pain and tinnitus has also resolved, I remember it being very bad during the first couple of months off finasteride.
Hope this information helps. I read your story and think there is a very strong chance your body will normalise in the next few months or so. All the best.
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Hey man , It’s been interesting to read your story it really has . I am struggling at the moment as I have had a little dip over the last month after previously doing a lot better . Anyhow you have got me thinking about something …Estrogen . I used the drug finasteride for 4.5 years and most of my symptoms started while I was still taking the drug ( ED , yo-yo libido, Anhedonia and gynocomastia) once I stopped finasteride in September 2019 all these symptoms continued and I got severe insomnia , Anxiety and Tinnitus added to the mix post discontinuation. Out of everything here I rank the Insomnia the worst thing for me to go through and I have it as my number one priority to eliminate- it seems to make every other symptom worse and adds all the drama and frustration associated with sleep deprivation . I have researched the topic of insomnia through medication/ hormonal interference and there’s not a lot of info out there and doctors I have seen just seem to pass you off to the psychiatry wing and say the insomnia is in your head , blah blah blah. The thing that helped the most has been Zopiclone , but that is no long term fix and will eventually come with its own problems if continued (right now I use it twice a week) . This type of insomnia - that I may add even my psychiatrist labeled as “severe” - I have noticed seems to be common in a certain Sex and age group - middle aged women . Several times in sleep forums I have come across insomniacs who describe exactly what I have (0 - 3 hours broken sleep ) and they are all post menopausal women . For a while I thought it was odd but just put it down to them having hormones messed up from their menopause- like my hormones where messed up from medication . However , when you stop and think about it - they are getting MORE DHT and Testosterone produces by their ovaries and LESS Estrogen ( some women start developing facial hair , femal pattern baldness after the menopause for eg) so the Insomnia they are getting must be from something to do with their Estrogen levels plummeting .
Tinnnitus is possibly my least concerning symptom in terms of quality of life , however I associate it with PFS and the ongoing syndrome . When I’m having a rough time the ringing seems to be louder and when I’m doing better the noise seems to be less. I have often thought to myself once that tinnitus goes that’s a clear sign I will be free of this syndrome .
I then read your post on Estrogen and tinnitus and I looked again and sure enough - tinnitus is also common amongst menopausal women from the estrogen disruption . As you have said so much focus here is on androgens and I have come to associate Estrogen as a problem (especially after the gyno) but with regards to these 2 symptoms at least there could be correlation with Estrogen and improvement?
Hey Forwardsnotbackwards,
Thanks for sharing your story to the thread. I completely agree that insomnia is one of the more awful and debilitating parts of the whole PFS picture, it really sucks the colour out of life. I am intrigued by your experience since stopping, how have your symptoms progressed since you stopped taking the drug?
Similar to you I noticed the overlap between the side effects caused by finasteride use/discontinuation and the symptoms of menopause, I am a medical student and through various women’s healths blocks I have had the chance to interact with patients who are going through the menopause and after a while you develop a sense for the kind of role Estrogen plays in the body and how the body reacts when Estrogen levels are low. When I read the stories of people suffering on this site there is a great deal of similarity as there was in my case also.
I am by no means saying that all of the symptoms are caused by disruption to estrogen action but I do believe it to be the largest piece of the puzzle.
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Yes it would be interesting to investigate that - especially when some of the Aromatose inhibitors seem to have caused insomnia in some people too.
Well… it was an odd one . Started in April 2015 And didn’t really have any side effects . It got to around dec 2017 when I first noticed something odd - soft erection. At the time I just blamed it on a drunken encounter , that comes with the territory sometimes lol but I realized in the coming months afterwards I was getting the same issue whilst at home- soft , especially when lying down . Standing up they were ok . I didn’t think it was the finasteride at first as I had got to nearly 3 years on it and I thought side effects would appear only within the first 3-6 months . So I carried on taking it . A few more sexual fails - including one where I actually quite liked the girl and the dating had been going really well …until one night she stayed over and it was kind of awkward . I think she probably felt that I didn’t find her attractive or something - but the reality was I was suffering with ED by then . Around 2019 I started getting gynocomastia on one side only (left) and I knew then this stuff had to go . As I had taken it for 4 years I decided to taper down - it was during the taper that some savage insomnia kicked in. It was the nights of ‘zero sleep’ kind . Horrific. Got prescribed Trazodone and it seemed to help at the time . I then took the final pill of finasteride - on September 11th 2019 . All the symptoms I had during the last year remained (ED, gyno , libido loss and also Anhedonia within the last couple of years ) however the insomnia got a little better .
I even thought at this stage I was in the clear and was just worrying I might get some rebound hair shedding in the coming weeks of October when boom ! The insomnia returned full blown . It was more nights of complete zero , the occasional falling asleep at 5am for a couple of hours …all whilst working a 55hour a week job. Tinnitus also developed at this stage - 1 month after discontinuation. Trazodone was doing nothing by now for sleep. My doctor wasn’t the most helpful - just kept prescribing higher and higher doses of sleep meds . He even gave me some Belsomra - which didn’t do anything at all. I was getting real desperate wondering if I should go to ER when the doctor switched up my Eszopiclone to 3mg and I tried it and got a night of 6 hours . Then the same the next night. It made me feel so much better .
I tried going without the Eszopiclone but I would always have a zero sleep night if I did so in the end I just went with - I’d rather be addicted to Eszopiclone and at least get some sleep than try and live a life in this sleep deprived state . So I did . I took it every single night without fail. I’d say I averaged about 4-5 hours per night on it which wasn’t bad but wasn’t great. I always had anxiety but around this time I also developed real bad Generalized anxiety , compulsive checking and reassurance too. It was clearly from the PFS.
I quit my job in LA (I had been unhappy for a while there anyhow ) and moved back to UK after Christmas 2019 to live with family and try and recharge .
From January to April I did really well. Of course I didn’t have hardly any stress now and was in a place where I could recharge and focus on recovering . Sleep improved and i was able to taper down the Eszopiclone and eventually was off it completely by March. The previous Gynocomastia got really punished by me bench pressing it and doing dips in my garage gym lol it really took a beating and it stopped hurting and seemed to decrease in size. I have developed some muscle mass. Anxiety has slowly decreased - it’s not gone totally but it’s improved .
I was doing really well and then around the end of April I had an insomnia relapse . It got as bad as it was when I first quit finasteride , which was odd as I had been doing so much better and I had been sleeping for 7 weeks just using the occasional melatonin or valerian and getting about 6 hours sometimes 7 a night. Anyhow the last 4 weeks have been bad again…I used zopiclone a couple of times but don’t wanna get into a relationship with it again. I use it twice a week at the moment where if I really need some sleep after a bad night . I started using this sleep aid I got in California before I left - it’s a melatonin ,5htp and Rhodiola supplement by Irwin naturals. It has magnesium in it too , plus L theanine , ashwagandha , lemon balm, Passion flower vitamin D , chamomile - pretty much all the herbal GABA babies in it . It has taken a while to kick in but is actually improving my mood and wellbeing in general. I got about 6 hours broken sleep last night on it . I do hope something has shifted - inside I feel it has . I feel great support from people on here , I appreciate everyone that has got in touch with me lately with encouragement and also tips on what to do with some of these symptoms .
If I can diminish the insomnia and Gyno fully first of all (priority symptoms) then I’ll work on the Anhedonia, tinnitus and I imagine I’ll be stuck with ED the longest as it was the first symptom to appear . Things have already got better on that front though so I’m hopeful. That’s my story post discontinuation anyhow sorry if it’s a bit of a ramble!
Hey, not ramble at all, I think I’m starting to get the picture. I have some questions if that’s ok.
How was your sleep before finasteride? What is the insomnia process like for you? Are you lying in bed the entire night unable to get to sleep? What sorts of thoughts will you have while you can’t get to sleep?
You haven’t spoken too much about cognitive symptoms and for me that was my main concern, do you get a pressure/ache type sensation in your head? How is your focus, memory etc. ?
Also, have you had any blood tests done?
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Hey SS1, i have read all of your comments and my side effects and experiences are %90 same of yours. What have you been doing? Did you manage to cure yourself?
So restarting fin made you feel better,? Do you think that would be a good recovery option for others,?