The gut microbiome: implications for neurogenesis and neurological diseases

I’ll say this right now, mental health is probably the biggest debilitator for those with PFS. It puts the life on pause or worse.
I’ll jump right to Finasteride.

The gut microbiome: implications for neurogenesis and neurological diseases
Year : 2022
https://www.nrronline.org/article.asp?issn=1673-5374;year=2022;volume=17;issue=1;spage=53;epage=58;aulast=Liu

Finasteride, an inhibitor of the enzyme 5alpha-reductase, can induce depression. Diviccaro et al. (2019) found that administration of finasteride induced a short-term enhancement of neurogenesis, as demonstrated by increased proliferation in the dentate gyrus, and a long-term inhibitory effect on neurogenesis one month after finasteride treatment. Importantly, the reduction in hippocampal neurogenesis was accompanied by depressive-like behaviors, neuroinflammation and gut microbial composition alterations [Figure 1].

^To me thats a possible pretty simple cut and dry. Cause and effect.
Its also why its not showing up in your genes.
I have shown the same possibilities with Accutane and SSRIs.
Instead I have heard, eh I dont think so, it doesnt have our support.
Ok why?

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Really interesting read. is there any evidence that 5ARIs cause these alterations in gut microbial composition?

Pulling a line from that study,
I think there can be a difference between beneficial inflammation that supports tissue repair and defense vs ongoing chronic inflammation that is more of a irritant. Allergies could be one example of this as well as some autoimmune diseases.

Neuroinflammation

A well-organized inflammatory response is critical for supporting the ability of the CNS to defend against damage and maintain a normal reparative function.