Thecause and the potential answers for Finasteride problems

General Discussion
#1

As I am sure many of you here are aware the cause of Propecia based problems is finasteride.

Finasteride is an anti androgen and lowers dihydrotestosterone (DHT).

DHT is an androgen like testosterone.

The definition of hypogonadism is a lack of testosterone and/or its metabolites.

One of those metabolites is DHT.

The problem when many men go and see their doctor or endocrinologist to have a hormonal evaluation is that DHT is often not tested, yet this is the specific hormon directly affected by Finasteride.

Many men who have hypogonadism are told that they are eugonadal because they have low normal testosterone, but that it is not overtly low, but this is to misdiagnose the condition givent he definition of hypogonadism. It is to miss exactly what it is that Finasterid targets.

DHT is responsible for positively affecting the male endocrine balance in favor of androgens and preventing and estrogen to androgen bias ratio that allows for the development of gynecomastia. It is responsible for the achievement and maintenance of erectile function and it is required for libido.

A loss of DHT is obviously problematic.

But sometimes even where DHT is tested post Finasteride use it turns out to be normal. In such cases where symptomatic problems remain I have found a second mechanism of action that has occureed in the pathology of many men who have used Propecia and other Finasteride based products.

I have found that often, although serum/total testosterone is not reduced below the normal range, often Sex Hormone Binding Globulin (SHBG) is often elevated into the upper normal range, something usually only seen in elderly men.

Such elevations of SHBG tend to significantly and adversely reduce the crucial level of free testosterone.

It is often then the case that although such men do not appear to be hypogonadal via a serum/total testosterone testm, they often do in fact have and appear to be hypogonadal or boarderline hypogonadal when the crucial free testosterone test is undertaken.

There are two treatment that have the potential to rectify these problems that can be prescribed by forward thinking endocrinologists/andrologists, the first is Andractim DHT gel, the second is Danazol which reduces SHBG.

In the hands of highly qualified aforementioed doctors, Finasteride problems can be overcome.

#2

Greetings Hypo, welcome to the forum.

I see you have some experience in dealing with Finasteride.

Could you please provide us some background on yourself? Are you a medical professional, if so where from, what is your specialty? It sounds like you have experience treating patients that have experienced HTPA disruption due to Finasteride.

Or… did you take finasteride yourself? Did you have side effects, end up quitting and experiencing secondary hypogonadism? If so, did you try the aforementioned tests and treatments you laid out in your post and have since overcome your situation?

What about low LH/FSH and elevated Estrogens? How would supplementing Andractim or Danazol correct the T/E ratio and low LH/FSH, and low Total T levels even?

Finally… how did you find this forum?

Thanks for any and all input in advance!

Mew.

#3

Hypo is here,

Thank you for your excellent post!

Would TRT be required in conjunction with using Andractim DHT Gel from your experience?

Do you or your patients (if you’re a doctor) have any experience with other forms of DHT such as the oral DHT Proviron?

Thanks!
R.

#4

I am someone who has hypogonadotropic hypogonadism as a result of chemotherapy. I have never taken Propecia or any finasteride product.

What I have done is studied andrology in terms of looking at literally hundrends of male endocrine pathology results and also the pathology of dozens and dozens of Finasteride/Propecia users.

I have read the works of Dr Eugene Shippen (The Testosterone Syndrome) and that of Dr Malcolm Carruthers (The Testosterone Revolution and more specifically Androgen Deficiency In The Adult Male). I have read the work of John Crisler, the American Association of Clinical Endocrinologists (AACE), The Endocrine/hormone society, the Pituitary.org both in the UK and US.

I have also read almost all the endocrine white papers relating to hypogonadism, gynecomastia and Finasteride over the past twenty years, including that published by John D Braunstein, Carlson and that by Ismail and Barth.

I have helped many men who have suffered from the effects of propecia and Finasteride. What I mean by that is;

I have contacted endocrinologists on behalf of patients who have been misdiagnosed and have detailed the problems that exist post Finasteride use. Where I have been unable to gain accordance and appropriate treatment from such doctors/where endocrinologist have disagreed or not understood the nature of such problems, I have on certain occasion obtained second opinions, correct diagnosis and effective treatment.

Just in the last few months;

I have spoken to an endocrinologist in Canada on a patient’s behalf that completely misunderstood the situation and incorrectly pegged his patient diagnosis. I helped him and he is now being correctly treated by a world leading andrologist and his health has greatly improved. I told this individual what was the likely cause of his problems and what was the likely best treatment many months before the world leading andrologist set in motion the exact treatment I had mention all those months before. He is now a new man almost.

During the same time-frame I helped another guy who saw a professor of endocrinology at a top university. I pointed out what seemed to be required and pointed him in the direction of another world renowned andrologist. This doctor independently agreed with my thoughts and the medicine that should be prescribed and the professor now agrees too. Hopefully he will be correctly treated; he just has to overcome the intransigence of his ignorant gp.

He is on another treatment, again the one I mentioned prior and feeling much better.

Each endocrine situation is somewhat different and the diagnosis and treatment is dependent upon such.

For this reason there is no standard treatment.

I hope that clarifies some of what I have said at least, more questions are expected and welcome.

#5

Thanks for your response Hypo is here,

Can you tell me which doctors you’ve contacted in Canada. The reason I’m asking is because I’ve seen many different doctors here in British Columbia and non of them have been able to help me.

Do you which Province the Doctor you contacted was in?

Thanks!
R

#6

The person I was helping in Canada has traveled to the US on my recommendation to see a world leading andrologist. He only did this upon once I had viewed his pathology and ascertained the likely cause of his problems.

You could do one of two things;

You could get an endcrine referal in Canada from a regular endocrinologist and then request your pathology results and reference ranges and post them here. If something appears to be amiss, I could give you my laymans opinion and see what other fellow hypogonadal men experienced with such issues think and you could then look to get an appointment with the same andrologist in the US- Dr Eugene Shippen.

Or;

You could make an appointment directly with Dr Shippen in the US. Though in the latter case that would be expensive if there is nothing apparent in hormonal assays.

Let me know if you want to do either of the two above and we can discuss further.

#7

Hi Hypo,

Thanks for all the info… though off-topic, I’m still curious to know how you found this forum? :slight_smile: It’s only been online for a few months at the current URL, before that it was on Yahoo groups.

Back to the point at hand, you’re welcome to review my hormone charts in the Personal Profiles section and make a comment there if you like… I’m still having erectile dysfunction issues, low semen volume, penile/testicular shrinkage, no sex/ambition drive, and lack of emotions/difficulty remembering things. My last test in May showed borderline LH/FSH, high Estradiol, and mid-level T (519, up from 388 in January)… I’m sure my T should be up around 700-800 were it not for having takin fin for 11 months.

As well, I’m quite certain I have a mild case of Peyronie’s Disease at this stage (14 months off the drug), as my penis is twisted on its axis 45 degree to the left, is now curving to the left by about 20 degrees, and has 2 seperate “nodule” rings at the base and near the top of the shaft. All of this was NEVER present prior to taking finasteride.

Like RR3, I am also in British Columbia, Canada… still having difficulties finding doctors that are willing to work with us on this, or prescribe the proper tests. DHT is not even tested in Canada, it needs to be done in the US… SHBG is also not a “standard” test that’s easily accesible here.

Anyways thanks again for helping and sharing your knowledge with us, we are very grateful and hope you will continue to offer your insights… the unlisted effects of this drug have been a complete nightmare for all of us, as they never resolved upon discontinuation.

#8

Hi Mew,

I have been aware of an anti Propecia site for a couple of years now that was linked to the yahoo group and now updated to this location. It’s author was a man who developed hypogonadism.

I have hypogonadism (the connection) as a result of chemotherapy and I know how significant an impact it can have. I myself have osteoporosis as a result and have also had gynecomastia (removed).

Anyway I have seen a steady/constant stream of Finasteride users turn up on a gynecomastia support group over the past two years, many of them experiencing the same sad symptoms that many have experienced here. It was remiss of me not to have posted a long time ago, given the strong associations and issues involved.

Anyway I have been very much aware of Finasteride problems and have been actively warning people against its use and pushing for awareness on the issue, informing people of the yahoo group as part of that etc. So although I have not been here before, I have pushed many guys on the verge of Propecia here and have done the same with those guys using the drug and experiencing problems- getting them aware that they are not coincidental but part and parcel of Finasteride use.

In studying my own condition for nothing other than my own benefit (see first post) I have over time become proficient in interpreting/understanding sex hormone pathology having seen my own and that of hundreds of men via hypogonadism and gynecomastia websites. I thought it was a bit wasteful to not help other men with hormonal issues where I could. I have come across a great deal of pathology of guys who have used Finasteride and I thought it worth posting my observations and offering help (albeit only experienced layman’s help).

I guess that is very long winded, anyway that is where I am coming from.

I would be happy to take a look at your pathology, but I cannot see your name in that particular forum, if you point me to your results I’ll give you my layman’s take on them.

Not forgetting that pathology is only a snapshot of how you were at a given point and might not reflect how you are at present. If your pathology is old you might wish to consider obtaining a new evaluation, particularly given the fact that you are still experiencing many post Finasteride problems.

On which note don’t forget that;

Reference ranges are required for all tests. This is because actual test results differ from lab to lab based upon the calibration of equipment

And

All sex hormone MUST be tested for between 9am and 11am as this is the time frame around which the reference ranges are calibrated and hormonal status alters throughout the day in line with the body’s normal circadian hormonal rhythm.

Sorry for waffling :slight_smile:

I wonder if this will end up as a double post after editing…odd?

#9

Hi Hypo,

Thanks for the clarification, glad you are here to help. In regards to my hormones, they are in the “Hormones and Blood Tests” section: propeciahelp.com/forum/viewtopic.php?t=12

I need to update my story in the Personal Profiles section since the last time I did was in the summer… anyways if you’d care to glance over my last tests and let me know your thoughts, please post under that post.

Still trying to find some doctors in BC, Canada that will even consider Finasteride causes problems… most of them say everything’s in our heads…

#10

Dear hypo…

you are a great samaritan indeed!

I too developed thyroid problems. I thought i was going crazy until my eyeballs started to feel they were going to pop out of my socket.

I’ve finally started to heal slowly.

Have you had any prostate problems? seems like propecia did something to my prostate as well…

#11

Hypo,

Good to have you here mate. I have just posted all my latest blood test results on the blood tests section and I wonder if you could have a squizz and tell me what you think my issue might be?

I value your input here a lot and appreciate you taking the time to help us all out.

Thanks…J89.

#12

I apologise for not responding sooner to those who have posted here and in pms. Moreso for the fact that given the time of year, I will not be able to respond in an adequate manner until early in the New Year.

I will post to each person that has either sent me a pm or posted here and look at each situation with care and attention with the view of helping anyone I can in any way I can.

I have suffered much due to ill health and hormonal problems and I know how urgent and desperate it can feel to have to deal with these types of issues day in day out. Waiting for some guy to try and help on the internet is far from ideal…but I will be back and I will help where I can.

Until then have the best Christmas and New Year that you can possibly have all things considered…speak soon.

#13

you mentioned Andractim DHT gel and Danazol as a potential cure. for how long do these have to be taken to see results and do you have to stay on them for life? or is it simply a treatment for a short white that gets your body back to normal?

what about the testicular/groin pain that most of us have? whats you opinion on its cause and cure?

thank you for your input. id just like to mention to everyone that this man is NOT a doctor. so take all this advice with an open mind and figure out whats best for you on your own. but at least someone here as finally posted a solid theory as to what happened to us.

#14

Can anyone who has questions about there own situation that has come about via my posts here pm me and detail anything that is relevant.

I apologise for the amount of time getting back to these posts (Christmas/the New year and commitments have caused problems).

I understand that some people have already posted me private messages and detailed responses. I apologise for anything missed and also for requesting that such details and posts be made again. I know it is not fun and games to have to do this again. However it has been some time and I have also been helping out on many other patient forums and to do justice to what anyone has said requires detailed attention/to look at things afresh (no one here needs half assed help).

Thanks

#15

I think I have been in touch with all that have contacted me from before New Year.

If you contacted me but I have somehow not got back to you, or you just wish to contact me having read my posts- drop me a line via pm or post a thread with my name in the title.

#16

Hypo, rather than have people start threads with your name and clutter up the topics, it would be preferable if people post their pathology in the BLOOD TESTS & HORMONES section, which you could then comment on there directly.

Speaking of which, if you wouldn’t mind reviewing my charts, you can find them there. No need to PM, please post openly as I’m sure all of us would benefit from your insights.

Thanks.

#17

I stand corrected; people should not post in the manner I previously mentioned as it could indeed clutter up the main board.

I will comment on results I see in the sub-section mentioned and perhaps a little more from time to time, but by and large ongoing issue are something I prefer to deal with via pms for the sake of continuity- it allows me to keep focused on what is going on (poor help is sometimes worse than no help at all.

If people wish to share anything I say by posting it on the board that is fine, it becomes their information as far as I am concerned.

Of note, I do not necessarily share the view that shared information on individual pathology is helpful, because I think it can equally leads to assumptions and misinterpretations- but that is not my call if people want to share what I pm them.

I’ll take a look at your pathology…. If you can point me to it, I do not see it in the section you have mentioned.