Sexual dysfunction under Panax Ginseng and Zinc - Alpha Reductase Inhibition?

Member Stories
#1

Where are you from (country)?

Belgium

How did you find this forum (Google search – if so, what search terms? Via link from a forum or website – if so, what page? Other?)

PSSD Forum

What is your current age, height, weight?

31 years old, 66 kg, 1m80.

What specific drug did you use (finasteride, dutasteride, saw palmetto, isotretinoin/Accutane, fluoxetine, sertraline, citalopram, leuprorelin, etc…)?

Accutane for 6 months when I was 13. Then escitalopram (SSRI antidepressant) for 2 weeks in April 2021. Then ofloxacin (fluoroquinolone antibiotic) for 7 days from 9 June 2021.

I have also been taking a supplement stack on and off since the beginning of 2021 comprising the following: calcium (210 mg), Panax Ginseng C.A. Meyer (20mg ginsenosides) EPA (37mg), DHA (50g), Vitamine A (218 ug), magnesium (400 mg), Vitamine D3 (10 ug), vitamine B6 (3.4 mg), vitamine B3 (16mg), zinc (10 mg,), vitamine B5 (6mg), vitamine B2 (1mg) vitamine B1 (1mg), vitamine B9 (200 ug) vitamine B8 (50 ug), selenium (50 ug), vitamine D3 (5 ug), vitamine B12 (2.5ug), Iode (150 ug).

What dose did you take (eg. 1 mg/day, 1 mg every other day etc.)?

Escitalopram 5mg 13 + 10mg1 (14 pills).

Oflxacin 200mg twice daily.

Then a vitamin supplement stack comprising the following: calcium (210 mg), Panax Ginseng C.A. meyer (20mg ginsenosides) EPA (37mg), DHA (50g), Vitamine A (218 ug), magnesium (400 mg), Vitamine D3 (10 ug), vitamine B6 (3.4 mg), vitamine B3 (16mg), zinc (10 mg,), vitamine B5 (6mg), vitamine B2 (1mg) vitamine B1 (1mg), vitamine B9 (200 ug) vitamine B8 (50 ug), selenium (50 ug), vitamine D3 (5 ug), vitamine B12 (2.5ug), Iode (150 ug).

I cut the dose of the above supplement stack in half from 16 August.

What condition was being treated with the drug?

For Ofloxacin an epydymitis which, it turned out, did not exist.

Burnout for escitalopram.

For how long did you take the drug (weeks/months/years)?

Escitalopram 5mg 13 + 10mg1 (14 pills) in April 2021.

Oflxacin 200mg twice daily from 9 June to 16 June 2021.

Above vitamine supplement stack (including zinc, Ginseng and B6) on and off from the beginning of 2021 to the beginning of April, then daily from the beginning of April to 2 July, with a break from 12 July to 22 July.

Then I resumed the stack from 23 July. However I halved the supplement stack dose from 16 August until today.

How old were you, and WHEN (date) did you start the drug?

Accutane 13 years old, other drugs 31 years old.

How old were you when you quit, and WHEN (date) did you quit?

I quit escitalopram on 14 April 2021 (31 years old).

How did you quit (cold turkey or taper off)?

Cold turkey

How long into your usage did you notice the onset of side effects?

Few days under escitalopram, the symptoms disappeared after discontinuation. Then severe sexual dysfunction upon starting Ofloxacin. Symptoms seemed to improve a bit until 2 weeks after halving my supplement stack (the one that includes Ginseng and zinc), where my sexuality worsened day by day (i.e. since late August).

What side effects did you experience that have yet to resolve since discontinuation?

Sexual dysfunction, low libido.

Check the boxes that apply. You can save your post first, then interactively check/uncheck the boxes by clicking on them. If your symptoms change, please update your list.

Sexual
[ ✓] Loss of Libido / Sex Drive
[ ✓] Erectile Dysfunction
[ ] Complete Impotence
[ ✓] Loss of Morning Erections
[ ✓] Loss of Spontaneous Erections
[✓] Loss of Nocturnal Erections
[ ] Watery Ejaculate
✓] Reduced Ejaculate
[ ✓] Inability or Difficulty to Ejaculate / Orgasm
[ ✓] Reduced Sperm Count / Motility

Mental
[ ] Emotional Blunting / Emotionally Flat
[ ] Difficulty Focusing / Concentrating
[ ] Confusion
[ ] Memory Loss / Forgetfulness
[ ] Stumbling over Words / Losing Train of Thought
[ ] Slurring of Speech
[ ] Lack of Motivation / Feeling Passive / Complacency
[ ] Extreme Anxiety / Panic Attacks
[ ] Severe Depression / Melancholy
[ ] Suicidal Thoughts

Physical
[ ] Penile Tissue Changes (narrowing, shrinkage, wrinkled)
[ ] Penis curvature / rotation on axis
[ ] Testicular Pain
[ ] Testicular Shrinkage / Loss of Fullness
[ ] Genital numbness / sensitivity decrease
[ ] Weight Gain
[ ] Gynecomastia (male breasts)
[ ] Muscle Wastage
[ ] Muscle Weakness
[ ] Joint Pain
[ ] Dry / Dark Circles under eyes

Misc
[ ] Prostate pain
[ ] Persistent Fatigue / Exhaustion
[ ] Stomach Pains / Digestion Problems
[ ] Constipation / “Poo Pellets”
[ ] Vision - Acuity Decrease / Blurriness
[ ] Tinnitus (ringing or high pitched sound in ears)
[ ] Hearing loss
[ ] Increased hair loss
[ ✓] Frequent urination
[ ] Lowered body temperature

[ ] Other (please explain)

What (if any) treatments have you undertaken to recover from your side effects since discontinuation of the drug?

None

If you have pre or post-drug blood tests, what hormonal changes have you encountered since discontinuing the drug (please post your test results in the “Blood Tests” section and link to them in your post)?

Anything not listed in the above questions you’d like to share about your experience?

Tell us your story, in your own words, about your usage and side effects experienced while on/off the drug.

Hello,

In April 2021, I made a 2-week round of escitalopram (5mg x13 and 10mg *1). I quit cold turkey. I experienced sexual dysfunction and usual withdrawal symptoms upon quitting.

I managed to gradually recover 90% of my sexual functions within a few weeks.

The real problem started on 9 June, when I took a 1-week round of Ofloxacin (a fluoroquinolone antibiotic) to treat an infection which, it later turned out, did not exist.

Ofloxacin caused a strong rebound in sexual dysfunction: I went from 90% to 30% in a few days as I took the drug. The crash did not resolve upon stopping Ofloxacin.

I have been taking 200 mg of Panax Ginseng C.A. Meyer (i.e. 20 mg of ginsenosides) daily since mid-April (save for break over 10-22 July), along with vitamine B6 and zinc (10 mg) daily as part of a larger vitamine supplement stack. I had also been taking the stack on and off in the beginning of 2021, without experiencing sexual dysfunction.

There may have been a sorry drugs interaction as fluoroquinolones can pose a risk of serotonin syndrome when taken in combination with antidepressants, and Ginseng is often said to act as a mild SNRI.

I made some progress from my Ofloxacin crash until around late August.

However, I have been experiencing severe sexual symptoms since late August, around two weeks after cutting the dose of my supplement stack (so Ginseng, zinc and the rest) in half. Again, I felt I started to make slight progress on the sexual front since my June Ofloxacin incident. That progress has been erased and I now feel close to being asexual.

To sum up: I did incremental improvements from my Ofloxaxin crash on 200mg Panax Ginseng and 10 mg zinc (mid-July-mid-August), managed to keep on improving for one week after lowering to 100mg and 5mg (19 August-24 August), and then started to experience a worsening of my sexual condition since late August. I have been on 100 mg Ginseng and 5mg zinc since late August but cannot seem to return to my early August status quo, the sexual symptoms seem to get worse and worse by the day.

Should I stick to the 100 mg Ginseng and 5 mg zinc dose for a while before engaging in a proper taper, or lower the dose back to 50 or 75 mg now, for example? Should I “reinstate” 200 mg, in spite of all the risks involved?

The thing is that the brand of Panax Ginseng I have been using (Panax Ginseng C.A. Meyer) as part of my vitamine stack seems to have alpha-reductase inhibition properties.

https://www.sciencedirect.com/science/a … 0110600210
https://pubmed.ncbi.nlm.nih.gov/21538628/

Taken together with zinc and vitamin B6 (which itself seems to be catalyst of alpha-reductase inhibition when taken with zinc, see link bellow), I may have developed finasteride-like symptoms, especially since I had mostly recovered from the sexual symptoms induced by the escitalopram I took for 2 weeks in April 2021.

I am getting worse by the day for a few weeks. I halved my dose of Ginseng and zinc in mid-August. For the first week, everything seemed fine but now my sexual dysfunction is worsening.

Again, am I developing PFS-like symptoms? Should I cut it, go back to my initial dose or taper off gradually?

https://onlinelibrary.wiley.com/doi/10. … .tb03474.x

Thank you in advance.

#2

Yes. Panax ginseng is 5ar inhibitor, it’s proved in many studies.

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#3

Hello @Elias

Welcome to the forum. So to understand correctly, you’ve been dealing with PSSD and you started using panax ginseng to help with your symptoms?

If that’s the case, it’s entirely likely the improvements you’ve experienced are as a result of interference with the same pathway, as panax ginseng does appear to be anti-androgenic and a 5ARI. I’d drop it completely immediately and give it a few weeks to see if you improve.

Please note as PSSD and PFS share remarkably similar symptom profiles and are induced in a very similar way, they should both be treated the same way. That means steering clear of anything anti-androgenic that could trigger the same mechanism which led to developing the condition, which may cause further, sometimes permanent, worsening. For example, there are cases on this forum of Post-Accutane and PSSD patients who took finasteride, felt better, then permanently worsened. There are also cases of PFS patients going back on the drug, feeling better, then permanently worsening.

Hopefully that’s not the case here but please be careful.

Take care,
Mitch

1 Like
#4

Hello and thank you very much for your answer.

I have been using Ginseng on and off since the beginning of 2021 (i.e. before PSSD) as part of a vitamines and supplements stack that I took on my mother’s advice.

I have been using Ginseng more systematically since the onset of my (mild) PSSD, in April 2021, save for a two-week break in July, when I ran out.

My PSSD was mild, and fully remitted itself by the beginning of June.

Again, my current condition was caused by a 7-days round of Ofloxacin (antibiotic) from 9 to 16 June.

My morning woods disappeared within 2 to 3 days of starting the antibiotic, and my semen volume dropped by 80-90%. Extremely weird. It is possible that Ofloxacin had caused a modification to my exposure to Ginseng, as those types of antibiotics can inhibit the metabolism of some drugs.

Again, I stopped Panax Ginseng for two weeks mid-July (I ran out). I resumed Ginseng towards the end of July and experienced improvements in my conditions until late August, when I started to deteriorate further. I had also cut the dose by half (i.e. 20mg to 10mg ginsenosides) mid-August. Everything was fine till end August where I started to deteriorate day by day.

Thanks for the advice, I will drop it. Don’t know if I taper off what’s left of it (I have a precision scale) or quit overnight, though.

#5

As you used Ofloxacin and worsened just a few days after using it I would be more inclined to think that it is the culprit rather than the ginseng.

It’s a Quinolone antibiotic, and they’re known for being potentially toxic.

Take a sneak peak under adverse effects on Wikipedia.

“In 2016, the FDA found that systemic use (by mouth or injection) of fluoroquinolones was associated with “disabling and potentially permanent serious side effects” involving the tendons, muscles, joints, nerves, and central nervous system.”

#6

Thank you again for your answers and for providing a platform to express myself.

My condition was indeed triggered by Ofloxacin.

Although fluoroquinolones come with a creepy number of side effects, which I experienced until a few days after stopping (insomnia, leg pain, burning sensations in my heels…), sexual dysfunction should not be one of them. I could not find evidence on the internet.

Hence the possibility of a bad “combination effect” between Ofloxacin, zinc and Ginseng, which I kept using during my 7-day antibiotic round. Or a rebound effect of my early mild PSSD under escitalopram.

My sexual condition is now even worse than when quitting Ofloxacin, I am nearly asexual. I did not experience any modifications of my symptoms when stopping Ginseng for two weeks mid-July. Back then, my libido was low, but I could function.

They even improved a bit until a tipping point late-August (I halved my Ginseng dose mid-August). Since then, my sexual function is worsening day by day.

My symptoms are purely sexual. No cognitive decline, no emotional blunting. I feel a bit tired but it may be because I am worried about my condition.

I therefore don’t think the issue is caused by a rebound of my mild escitalopram PSSD. My post-escitalopram sexual dysfunction was very mild and resolved itself fully after a few weeks.

I am seeing an andrologist next week.

#7

While there is indeed not much information about Quinoloes and sexual dysfunction, there is plenty of information that it will interact with the GABA-A system.

And it’s well known that gaba is pro-sexual. Many have theorized that one of the main mechanism behind sexual dysfunction in PFS is due to fins negative effect on the gaba system, though it’s inhibitory effect on allopregnanolone.

I found this blog talking about Quinoloes and sexual dysfunction. It’s a blog, so take it for what’s it’s worth. But I wouldn’t rule it out of the equation.

After all, just a few years ago Quinoloes and Finasteride was perfectly “safe” and it’s not until recently it’s been show to maybe not be that “safe”.

But there’s also a possibility that the zinc and ginseng was part of the issue. Although it would be impossible to prove, sadly.

I truly wish your visit to the andrologist will yield you some answers. While there is a lot of theories and questions about these kind of diseases, the answers are scarce.

And being without answers are almost as bad as the disease itself in my opinion.

#8

Hello!
I had the same thing. Crashed from vitamins contain panax. How are u now? I lost all slightly improvements after escitalopram xtreme pssd

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