Neuroendocrinologist confirms persistent Finasteride side effects & Post-Finasteride Syndrome

Any updates PPS?

Hi All,

It’s been a while since I posted, but I have some stuff to report that should definitely be of interest:

I got my Adiol G level tested on 05/26 and it was 212 (260-1500 scale), at that same time my DHT was 61 (25-75 scale)

Dr. Jacobs was shocked by this and that is what led him to write those posts.

I then took Andractim alone for 12 days because I was encouraged by JN’s posts. I did not take TRT at the time. My DHT level went to 512 (25-75 scale)!! My Adiol G went to 632 (260-1500 scale). It took almost ten times the normal amount of DHT to get my Adiol G level to go to the low end of the normal range. Something is not right there. Unfortunately at that time my T (348 on scale of 250-1100) and Bio available T (93.8 on a scale of 110-575) went way down. I noticed maybe some small, small effect on libido, but hard to say if it really happened and given the fact that my T level went down, it would not be suprising if I didn’t have a libido anyway.

I didn’t have any of these labs back yet, but Dr. Jacobs felt the best treatment plan was to put me on TRT and keep estrogen low with arimidex, and keep upping the dose every week until I felt something. At this point I had stopped taking the Andractim. I took the first dose (1ml test cyp injection) and my T went to 1475 and my estrogen stayed low. I didn’t notice a thing. The next week I doubled the dose (2ml test cyp injection) and my T level went to 4000!!! I emailed Dr. Jacobs and he said that was a record, which I was really not happy about. Anyway, get this, I didn’t notice a damn thing. No change in libido at all. I stopped upping the dose, and stopped TRT all together after that because I don’t want to hurt myself.

Two weeks ago I got my CAG repeats tested because of Dr. Jacobs’ post. My result came back as 18 on a scale of 10-25 (i think). Nothing unusual there.

So guys, what does all this mean. My DHT/Adiol G is screwed, which might suggest partial androgen insensitivity, but I just took more Testosterone than most people on the planet and it didn’t do a thing. I didn’t even get irritable or angry or anything.

One thing that is good to know is that Andractim increases Adiol G, but you definitely need to be on TRT.

Maybe that is a last option…taking TRT and DHT at the same time and Arimidex…jesus.

What else could this screwed up Adiol G thing mean apart from androgen insensitivity?

Man this is obvious something is seriously wrong. At least if someone takes TRT and Andractim maybe he can get better libidowise.

PPS,

Please get a full thyroid panel done. Where trying to narrow things down here…We can’t rule hypothyroidism. Your body may not be metabolising efficiently. You may have low T3 and High Reverse T3(inactive). You need to get these tested first and them proceed.

This is a struggle man…I know and beeing dealing with it 8 years…

Lord will he have compassion on us and give us a lift…

PPS’s example, along with others on this site had me thinking last year that one of the only regimen-oriented solutions for our problems would be to moderately lower testosterone production and/or DHT in an effort to perhaps make the tissues/receptors more sensitive at the lower levels of available androgens—perhaps concurrently running an estrogen blocker. My basic idea was that this would be the opposite kind of treatment to the Finasteride. Maybe I’m looking at it completely wrong though.

I don’t know how such a thing would be accomplished through diet or supplementation. I suppose cortisol levels should be a concern too during such a hypothetical regimen.

PPS, do you think you will actually experiment with such combinations in the future?

From what you’ve posted here, it seems like an inexplicable problem resulting from neurochemical/hormone imbalance in the CNS–or, that’s one theory. You’re saying that you still felt anhedonia or lack of “good” feelings along with a lack of libido?

Hey pps, welcome to the club. I have been on the same regiment like you (200% TRT and 200% DHT with Andractim) with the same results. Having been on TRT before taking fin, I know what even small doses of TRT normally feels like: Good. Now, no matter what I take, I feel nothing positive - actually high doses of androgens make my symptoms WORSE. I’ve also messed with reducing estrogens via Arimidex and even Aromasin. Nada.

For those that have been there, the conclusion is clear: Androgen insensitivity is the only answer. There is no way on this frickin planet that any hormonal “excuses” can even come close to explaining this. If you think about it, what has happened becomes very clear:

  1. 5AR inhibitor massively reduces cellular and circulating DHT levels
  2. AR becomes hypersensitive (google terms androgen receptor hypersensitivity) due to low androgens. This is why we get hypogonadal LH/T values.
  3. Side effects start
  4. We quit 5AR inhibitor
  5. DHT returns full force and hits upon hypersensitive AR (do the math 100% > 30% is a 70% reduction. 30% to 100% is a 333% increase. Combine this with a hypersensitive AR and you get a train crash. This is why the symptoms really go south about 1-2 weeks after quitting.
  6. AR negative autoregulation kicks in an probably methylates some AR regulatory element, effectively silencing the AR signlal

The approach we have to take to this is to understand what changed and try to undo it. Overloading the system with further hormones will not work in many cases. Some guys do indeed seem to be lucky enough to have enough remaining sensitivity to get some benefit from hormones. Most of us, however will not - or even get worse by using them.

Btw, common misconception on this board: Adiol-G is about 75% a marker of AR gene expression and NOT of 5AR activity. 3a-HSD is mainly induced by AR gene expression. The remaining 25% come from direct induction by androgens (likely) or some other hormone (maybe). That is why you can have perfectly good serum DHT values and still have fucked up Adiol-G, because low Adiol-G is mostly telling us something about Androgen sensitivity.

PS: I am referring to 5ARI’s in general and not only finasteride. As you probably know from this board SP, dutasteride and isotretinoin lead to the same problems.

Hang in there, we’ll get there.

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Another very informative post awor but it doesn’t explain some things. For example many men with this syndrome/disease don’t crash, they get very bad symptoms on the drug which don’t improve when they come off. I think JN and cdnuts are among these but there must be many more, probably the majority, who lose libido/get ed that doesn’t clear up when they stop but don’t suffer that cruel, massive deterioration in symptoms AFTER they quit the poison.

Hormones definitely don’t explain much of this mess. Mine are similar to ‘troubledfinuser’ (low T, cortisol) yet he just has low libido and energy while I tick virtually all the boxes. Also some of my total testo readings were close to mid-range while my muscle was melting off. I have had just about every symptom of androgen deprivation. This makes sense if T levels are only supposed to fall by 2% a year and mine collapsed off a cliff at once, anyone should feel as fucked up as I did and do, yet loads of guys only have libido issues with sub-range T levels. Why do some of us barely seem to respond to androgens compared to others? High dose TRT seems the only feasible option but going by your experience and similar side effects will likely not work.

I was reading this thread about a bodybuilder who didn’t do a PCT after a cycle and had to go on TRT, for months his T level was only 1 (!) on a scale of 10-30 yet the only sides he seemed to get were no ejaculate and less bulk at the gym!
uk-muscle.co.uk/steroid-test … cover.html

It could all be because of the rate in which the body responds to the androgen relapse, and to what degree hypermethylization occurs.

However, with statements such as “Adiol-G is about 75% a marker of AR gene expression and NOT of 5AR activity” - it would be great to see a source so we can all be better informed of what is going on.

If you could assess the function of hypothalamus-hypophysis, gonads and hippocampus as a whole unit you could find a solution, but the whole system seems twisted to me. GNrH is definately downregulated but i doubt it is only below that, hippocampus is damaged as well, otherwise it would recover promptly after fin use

you’ve confirmed this via testing? have a source? not trying to be a dick here, but don’t love hearing statements like “you’ve got brain damage” if your just saying it out of the blue without backing it up.

I dont think hippocampus is damaged. I have days when i fell very close to normal (rare), days when i feel very very bad (rare also) and most days i feel somewhere in between. Many symptoms appear depending on what food i eat or stress related. I feel like something has been turned off, and can be turned on again if some kind of enzime is restored in my system.If hipocampus was damaged, i would never have good days and bad days would be the norm.

Well then, you’re likely an exception… who knows, perhaps your issues were not as severe as others, or as Awor points out, that each individual’s body and genetic makeup is different, this drug affects each individual to different degrees, and correspondingly any “sensitivity” to androgens will be variable.

In my case, things like penile shrinkage, loss of libido, gynecomastia, decreased ejaculate volume, no morning/nocturnal/spontaneous erections are not influenced by “diet” or “stress” one bit. These appeared on the drug, got worse off the drug and have continued for 5 years irregardless of diet, excercise, supplements, waiting on time and any other natural treatments tried thus far.

Something in my (our) bodies has been fundamentally altered and is no longer working correctly since quitting, when DHT returned and the Testosterone crash occurred. If it is androgen resistance, that would explain a lot regarding lack of symptomatic improvement, as some have noted despite even being put on TRT.

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I crashed on the day i quit. How can this be explained…not being sarcastic

I m sorry to hear that Mew.
But i need to rephrase one sentence: Many symptoms WORSEN depending on what food i eat or stress related. Sorry, english is not my first language.
In the first two years i had penile shrinkage on most days. Now, on most days it looks normal. Loss of libido is still a major problem for me. Even on the days i am feeling better, i have maybe 15% of the sex drive i used to have. On these days penis seem a little more sensitive. But it also fluctuates, there are days i have zero libido and i cant feel my penis. Morning erections also vary a lot for me. Some days a half erection, some none, and some a normal one. Spontaneous erections are still absent. But i am able to get an normal size erection by manual stimulation on most days.
I just had a couple of bad days this week. I was having to take Omeprazole daily for Acid reflux and when i stopped it my metabolism took a couple of days to return to where i was prior to Omeprazole. I couldnt sleep well, erection was bad, depression, anxiety, skin rash. After three days i am better. So my point is when my body goes under a stronger stress, my symptoms worsen. I need two or three days to improve. This has happened many many times in five years. So maybe my body is still capable of producing some of the stuff i need but not enough to make me feel normal. The production of this stuff (which we dont know what is… DHT? Adiol G? An enzime that makes body sensitive to DHT?) gets affected when my body is stressed. Then after the stress is gone, i feel like it slowly builds up and i improve. Thats how i feel, sorry i really dont know another way to describe it. This fluctuation gives me hope it is reversible. For all of us.

How many guys has Dr Jacobs seen for this? Others outwith this forum?

Has anyone got ultrasounds done to check out our livers for “liver Cirrohsis”.

I’m at complete awe right now…My hormone profile and thyroid profile is normal and I’m still sick. I’m going to start a liver cleansing regmine and see where to go…

The liver is a very forgiving organ and although damaged by fin I doubt this would still be a factor a long time off unless yuo are a serious alcoholic. I probably damaged mine more a bit drinking a lot between quit and crash but it’s not any kind of answer now.

Basically those of us with low t levels and accompanying symptoms that last for ages have to accept we have acquired some sort of resistance to androgens and move forward from there, however difficult and scary it is to accept as there seems nothing can be done.

Has anyone tested for copper, im going to this week.

letsconvenience did - and came back positive.

jeez, if copper toxicity were an answer for some us, that would truly amazing. chelation therapy anyone? It’s more effective and faster than any oral liver/system cleanser regimen. I’m speaking from experience.

please keep us updated if you’ve identified copper toxicity and plan to begin treatment/regimen.