Hi Oliver,
Thanks for posting your story. I think you’re on the right track. I am about to try TRT myself. May i ask you why he prescribed you methylprednisolone and fludrocortisone? I am not familiar with cortisone replacement, so i am wondering when it is indicated and what you re supposed to improve.
Thanks
Hi Scared!
I had a bit oilier skin on the forehead in the first days on the full dose of 200mg T but that faded away. My body hair may have become a little thicker on the breast and arms, and of course my pattern hair gets thinner. Besides that I had some signs of overdosing such as acne and aggressiveness in the first days but that faded away, too. But we have to consider that I also take a catabolic hormone, cortisole (in form of methylprednisolone).
Even on propecia, I slowly became more weak, tired and exhausted every year. After quitting fin my phyical condition immediately crushed, I had no recovery period. Today I think that my T (which fin held high) decreased while my DHT didn’t increase. I was so weak that I couldn’t walk or even stand anymore. I was concerned to have a neurological disease such as MS, ALS or Parkinsons. I was very tired, exhausted, anxious and with poor concentration. Then I was diagnosed with Hashimoto’s in September 2007 and spent the last two years with raising thyroid hormones which indeed helped me significantly but wasn’t a breakthrough.
Since I’m on T my phyical energy again improved significantly, in numbers I would say from 60 to 75 % so far but it’s still quite a way to go. But ok, I was 10 years on this awful drug so I can’t expect to recover in six weeks. My concentration and memory is much better now. I can focus on my work and think more complex. I would say it is 85% of normal.
BTW: Could you describe or give me a link to your story? Did you have such severe physical side effects, too?
Best,
Oliver
Hi Correiovip,
he prescribed me these hormones because he diagnosed me with andrenal weakness. I think my adrenals had to work very hard in the last 10 years because of the physical stress resulting from the lack of male and thyroid hormones. As you can see, my aldosterone in blood was very low and - as I interpret it - 2 or 3 cortisol metabolites in 24h urine were low, too. Furthermore, two saliva cortisol tests I had done before Hertoghe were low in normal range.
Fludro is a prestage (<- wrong word in English?) of aldosterone and methylprednisolone (MP) is a derivative of hydrocortisone which is normally given to treat adrenal fatique. It is a bit difficult for me to classify the improvements of all these hormones but the MP seemed to give me a bit more energy and made me more stress-resistent. But I seem to be on a relative low dose of MP.
Best,
Oliver
Hi Oliver
Thanks for answering all my questions.
I’ve never written a comprehensive account of my story on the site. But, in short: I took Propecia between 2002 and 2008. In 2008 I suddenly crashed into a state of ED, low libido, fatigue, etc, and stopped taking Propecia immediately. My symptoms sound pretty similar to yours. My muscles are weaker, but not so weak that I have trouble walking or anything like that.
Blood tests revealed a v low T level: about 12nmol range 10 to 30. In about March of this year I took a course of Tamoxifen, and this boosted T to about 28nmol. But - in common with many post-finasteride cases - despite the increase in T I felt no symptomatic improvement. Stories such as these have led us to talk about the idea that the post-finasteride condition is not about straightforward androgen deficiency, but rather about some kind of dysfunction in the response to androgens. In short, it seems we our bodies don’t use T and DHT properly anymore.
I’m now evaluating my next move. Most likely I’ll try TRT with hCG, which is why I’m very interested in your reports. As you’ve probably picked up, some post-fin cases try TRT and feel no better. Others report mixed results.
Just before you came to this board, Dr Crisler mentioned on another forum that he often finds it takes supraphysiological levels of T to get post-finasteride cases feeling better. Obviously your reports would appear to corroborate that, which is very interesting. It perhaps make sense that you may be able to partially oversome a poor response to androgens by providing the body with very high levels of those androgens.
On the whole, this post-finasteride syndrome is still a mystery. I’m not even sure that the reason you are feeling positive effects from TRT is in any straightforward way because your T has gone up. After all, your T wasn’t that bad before. It may be that supraphysiological amounts of T
is now allowing an at least acceptable amount of T to DHT conversion and use in target tissue, but God knows how that really works, and that is just speculation.
In a way, though, the only important thing is that you are feeling better. There are those on the site who understandably are extremely keen to discover the true nature of the finasteride condition, and those who are more interested in simply finding symptomatic improvement, and I suppose ultimately I fall into the latter camp. I don’t want to spend the rest of my life thinking about finasteride. I want to feel better, and move on.
Thanks again for all your reports, and keep us posted on your progress.
Jo aus germany.
3 years on 6 years off. Same probs. Less mucles, mucles weakness, no energy, brain fog ,always tired ec… I will not start a new medication because i have a liver hepatopathie after using finasterid. I`m very interested in your done blood tests and your further experiences with side effects.
Please E-Mail me at: jooo27@yahoo.de (sehr gerne auch in Deutsch)
Gruß Jo 
postfinsufferer
Had a similar reaction when I found this site back in December - finally all my symptoms added up. HCG as a restart protocol is somewhat debatable in that the majority feel it is suppressive to HPTA.
You should take a look at the thread in Recoveries entitled “My Recovery Via Clomid” I post some info in the later pages. Importantly, you should print out AT Guay’s papers on the use of clomiphene citrate and take them to your doctor. Clomiphene is much more thoroughly researched by the scientific community than tamoxifen, and the former is a little easier on your liver. The folks playing with tamoxifen tend to be body builders coming off a steroid cycle - when they try clomiphene, they invariably try far too much.
Clomiphene was able to reverse a wicked case of secondary hypogonadism that I got from fin use. I am currently on a 3 week holiday from the drug in part to see if I have “restarted” HPTA (I did about 6 months of low dosages three days per week - see the thread). I do not have a lot of hope of a restart as I am in my mid 40’s. You have a better chance if you’re in your mid 30’s.
I also have cortisol control issues similar to yours but without any muscle wastage (just catabolic attack of testosterone IMHO). I tried low dose topical hydrocortisol under the care of a doctor specializing in adrenal issues with mixed results. The thing I am researching right now is phosphatidylserine, although the pure stuff gets rather expensive at theraputic dosage levels. There is some research that suggests it can resensitize receptors to cortisol levels and correct either overactive cortisol production, or too low cortisol production.
Basically, fin has rapidly aged our neuroendocrine systems by downregulating various hypothalmic receptors. Restoring testosterone helps many, but not all. If the doctors will not treat you there are a couple of herbals worth trying.
Good luck - kazman
Thanks for your posting, Kazman. I agree with you that part of our problem might be a receptor insensitivity to hormones and neurohormones. Could you tell me which herbals you are thinking of?
Best,
Oliver
Hey Oliver are you still feeling improvements?
Hi Scared,
yes my improvements haven’t faded so far but increased a little bit further. Especially my leg muscles became a bit stronger. Maybe my receptors are getting more sensitive or - as you speculated - it is just the overdosing of T which gives me back at least some of the necessary DHT resp. 3diol G. But as you know I had severe physical side effects that most fin sufferers never faced in that intensity.
I’m curious about my next bloodwork and consultation end of September.
Best,
Oliver
Oliver,
Glad topical T is helping you it helped me some back when I was on it. Be forwarned that topical T is suppressing your HPTA, and atophying your Ledyig cells - after 3 or 4 years of endogenous T use many secondary hypogonadism types lose Ledyig cells and can not try other therapies (and there are some new ones in the works that you will need your Ledyig cells for). Watch for testicular shrinkage once I got to that stage I woke up to the issue and started researching other approaches.
The two herbals worth looking at are tribulus terristis and tangkat ali. You can NOT mix these with your current therapies. Especially Tonkat Ali you have to be careful about the source. Many body builder places sell stuff with tribulus or Tonkat in it but in very small amounts that will not do anything.
That is a lot of cortisol stuff they have you on - were you given an ACTH challenge test first to see if your H-P-Adrenal axis is functioning at all? Mine works it just gets out of control half the time.
Hi Kazman,
I’m aware of the possible long-term side effects of TRT. Do you think that testicle shrinkage or lose of Leydig cells may be stopped by regular low doses of HCG?
If our theory of receptor insensitivity or durably damaged 5AR-II is right, supraphysiological T may currently be the only effective treatment attempt we are left. Do you think the herbals or something else already is a really promising alternative? Look at my situation, my last years were totally ruined by muscle weakness, so I’m relieved to have found at least one treatment attempt that seems to help me noticable.
I didn’t do a ACTH challenge test so far but my ACTH was measured once and there ist was above normal range. So my pituitary may not be too weak to stimulate adrenals. I think my adrenals themselves have become weak because they had to compensate a lack of male and thyroid hormones for a long time.
Best,
Oliver
hello postfinsufferer … my main question is why we have hair falling out if 3-andiol-g is low …hair shoould not fall out and if it is,than the 5ALPHA REDUCTASY2 is working…maybe not enought for sexual abilities but enought for hair falling out???
thanks
Italy,
i think 5R activity might be damaged more in areas related to sexual activity, such as the prostate and the pituitary. In my case, i am not losing my hair as fast as i used to.
Hello Italy,
similar to correiovip’s case, my hair loss remained somewhat slow after quitting fin. Now, on supraphysiological T and Arimidex I notice more hair loss again. But I also think that the 5AR-II acitivity may not be damaged equally in all tissue.
Best,
Oliver
Hi everybody,
just want to give you a little update after my second appointment with Dr. Hertoghe. Here are my new blood tests:
img185.imageshack.us/img185/999/ … 040909.jpg
Present treatment (daily dosage):
- 2g Testogel 10% (200 mg T)
- 1/4 Arimidex 5 times a week
- 3mg methylprednisolone
- 100µG fludrocortisone
- 210µG Thyroxine (T4)
- 22,5mg Armour
- plus several minerals and vitamins
Surprisingly, although I seem to take a huge dosage T, my free T almost didn’t increase and my total T even decreased a bit. Only my A-diol gluc. increased from 5.5 to 10.7 which is still in the lower middle of range. Therefore Hertoghe supposed me to go up to 2,5-3 g Testogel a day. Since my estradiol declined very much I’m ordered to reduce Arimidex to 1/4 for 3 times a week. Because of high blood pressure I should quit fludrocortisone. But I should raise methylprednisolone to 3,5-4 mg and take DHEA (30mg per day) because I have a new deficiency there. The dosage of thyroid hormones can be varied by feeling.
Optionally he prescribed me growth hormones (Omnitrope, 0.15mg per day) because although my IGF1 was above normal range he said that my binding protein IGF-BP3 was a bit too high which impedes GH. He thinks that this will help to improve my main complaints (muscle power, energy, libido) further.
Well, I’ll go on step by step now. Since HGH is very expensive (500 euros for 5 months) I will first raise T and implement the other changes and check what happens. My personal target is a high-normal A-diol gluc. Hertoghe thinks that the body needs plenty of months to adapt to a better hormone supply again.
Best,
Oliver
Thanks for the update.
One question though:
Considering you’re on all of this, how can you be sure it is the TRT responsible for your improvements in libido etc?
Hi Mew,
I’m quite sure that my sexual improvements result largely from T and Arimidex. I took thyroid hormones for more than two years and they didn’t have a big impact on libido etc.
When I started the Hertoghe regimen, I began step by step. At first I took T and Arimidex and felt (coming from a very low level) significant improvements. Some weeks later I started with the adrenal hormones methylprednisolone and fludrocortisone, and I can’t say that they had any positive effect on sexual functions. It was quite the opposite, I felt that these hormones had a damping effect - which seems to be logical since they are antagonists of androgens.
Oliver: I am on 2,5gr of testogel a day, and have recently increased the dose to 3gr. I am also having 90mg of Armour thyroid, plus 30g. of hydrocortisone, 25 mgs of DHEA and several vitamins and minerals daily.
I have been on all that for almost two months and have not noticed any improvements. I am happy to hear that you are making improvements; maybe arimidex has a big role in it.
I have some on my hopes placed on HGH. Hope it works well for you when you start with it. Please keep us posted.
Hi Jairus
Is there anything else that you can tell us about your experience with Androgel?
You’re on a high dose, are you experiencing any symptoms of high estrogen: chest pain or enlargement? Testicle pain? Hot flashes? Bloated feeling?
Did you feel any improvements in the first few days of Androgel, that have now disappeared?
Or have you simply felt absolutely nothing all the way through?
Thanks.
That may be true, Jairus. I’m not happy to take another enzyme inhibitor after one ruined my health. But Arimidex blocks the “wrong” pathway of T into E2 so it forces the 5AR-II to work and produce DHT. As we can see from my A-diol this seems to work at least a little bit.