Time to update the FAQs

The FAQs of this website are meant to guide new and scared post-fin sufferers through the battle of their life (http://www.propeciahelp.com/forum/viewtopic.php?f=13&t=7). They should reflect what we know about this terrible condition, so that new members can have a quick grasp on the situation. While I agree with most things written on that page 4 years ago, I have to say that it is time to update a few points, according to the knowledge and experience gathered in the past 4 years. Let me re-write the last points of the FAQs. My comments are within the text.

  1. It’s been months, I have yet to recover and have obtained the above recommended blood tests. Now what?

The objective from this point forward would be to find doctors, endocrinologists and urologists knowledgeable enough to recognize Finasteride’s dangerous effects on the endocrine system, having them believe your case and then be willing to work with you to identify possible hormonal/other issues and treatment options if you have yet to recover on your own.

Not necessarily. Many people who recovered have done so by NOT messing with their hormones.

At this stage, be prepared to face much adversity from the very medical community which prescribed you the drug in the first place. Most likely you will be told that all symptoms are “in your head” and that Finasteride could never cause such problems. They will likely quote that Merck’s medical literature states that all side effects resolve after discontinuation of the drug. They may also prescribe other drugs such as Viagra or Cialis to help with erectile dysfunction – while potentially helpful in the short-term, be aware that these are simply bandaid solutions and do not address the root causes of our Post-Finasteride syndrome.

Thus, before undertaking such appointments it is advisable that you read and educate yourself via the Studies section of this website. Consider printing out and highlighting the relevant materials, and consider bringing them with you to your appointments to discuss. Hopefully the medical professional will take an interest in the material and rethink your case; if not, you’ll need to move on again until you find one who does.

Ultimately, besides the side effects themselves, this is possibly the most frustrating and tiring process of dealing with the post-Finasteride syndrome – the ignorance of the (majority) of the medical community in recognizing the possibility that such persistent side effects exist, and dealing with medical professionals that claim nothing can be done to treat them (false).

Oh good. So, what can be done to treat them effectively? We should rephrase this by saying that people have tried all sort of supplements and drugs. But very few cases achieve a sustained success

  1. Does anyone recover from Finasteride side effects?

For the majority of men, they recover without issue; unfortunately for a small percentage (members of this forum and others out there), these side effects persist… and unfortunately the medical community does not have definite answers as to why (yet). Thus, while most Finasteride users generally recover from side effects in a short time frame (often in weeks/months), for some it may take much longer, sometimes years… or in some cases, they only recover up to a certain point. As each person’s endocrine system and situation is different, there are no guarantees.

For those with more “permanent” problems, natural supplements, excercise and consistent weight training can help somewhat. However, for those that have ended up with near hypogondal levels of Testosterone/elevated Estrogens as a result of the drug, some have required the assistance of additional drug treatments to try and stimulate their Hypothalamic Pituitary-Testicular-Axis (HPTA) to produce more endogenous Testosterone/DHT, and/or reduce elevated Estrogen levels (for starters).

Common endogeneous Testosterone-boosting drug treatments include:

  • Clomid (Clomiphene Citrate)
  • hCG (human Chorionic Gonadotropin)
  • Nolvadex (Tamoxifen)

Common estrogen reducing drug treatments include:

  • Arimidex
  • Nolvadex (Tamoxifen)

Still others have been able to recover by going on Hormone Replacement Therapy – mainly Testosterone Replacement Therapy (TRT), which involves injecting or applying a patch containing extraneous Testosterone to boost one’s levels accordingly.

Unfortunately, TRT is often a lifelong commitment with its own set of issues, as the body senses the extraneous Testosterone and thus shuts down it’s own endogeneous production… the result of which can lead to testicular atrophy and sterility (unless hCG is used in conjunction with TRT to maintain fertility). Nonetheless, TRT is probably the “ultimate” attempt to correct Post-Finasteride induced low Testosterone – but should only be undertaken as a last resort, as even then there are no guarantees it will correct Finasteride-related issues 100%.

Be aware that there may also be many other hormone imbalances which can be commonly overlooked as a result of Finasteride use (ie, some men present with elevated Prolactin, elevated Sex Hormone Binding Globulin – aka SHBG, etc.). Thus, it is imperative to obtain a full hormone profile to assess your situation, and work with a knowledgeable medical professional who will help select the proper drug treatment course, depending on your bloodwork results.

It also goes without saying that each of the above treatments should be evaluated in terms of their own associated risks and/or side effects. As such, the decision to pursue any further medical treatment should not be taken lightly, and only under the care of a competent medical professional (if you can find one willing to take your case).

Finally, be aware that while some have completely recovered via medical intervention, there have been others who have tried all of the above and have yet to recover 100% to their pre-Finasteride self (but may nonetheless approach it). Again, as each person’s situation and endocrine system is different, your personal recovery capability and response to any potential treatments will vary.

mmm… it sounds like many near-hypogonadal people recover using clomid or TRT. If not, these therapies will help them a 100% recovery. Unfortunately, not only is this false, but actually some people get WORSE with high level of T (with of course E2 and everything else being fine). In other words, the risks of TRT and clomid include, as correctly stated in the FAQ, the side effects of these therapies, and ALSO the further worsening of hypogonadal symptoms. These experiences must be written somewhere

Some recovery stories can be seen here: viewforum.php?f=22

  1. I had my hormones checked and was told all my results are in range.

This is a common misconception you will likely come across in dealing with unknowledgeable medical professionals. Hormone levels operate on different levels for each individual, and its hard to know what levels you operated on prior to using Finasteride, unless you took a baseline hormone profile before commencing use of the drug.

As a general rule a young person should have Testosterone, Free Testosterone, and DHT in the upper third of the reference ranges, with Estradiol and Estrogen in the mid ranges for optimal performance. Deciding if a person is OK or not based on a large range is an outdated protocol which the medical field has yet to address. Such ranges are taken as an average from people aged between 18 - 80 years old.

Unfortunately most doctors do not think of, or entertain the need to require blood tests prior to starting Finasteride. Having a pre-Finasteride baseline hormone profile would be your evidence that Finasteride disrupted your hormone balance post-use. Unfortunately, very few men obtain such pre-drug baselines, and are thus at a disadvantage because they have nothing to compare their post-Finasteride bloodtests against.

An example of optimal ranges can be found here: lef.org/protocols/appendix/b … ing_01.htm

Misconception? Sorry, but #9 should be completely changed. It is NOT true that to feel well you must have sky-high T. Why don’t you take a look at my pre-finasteride T level? It was in the LOWER THIRD. And yet, I had raging libido and incredibly good functionality, and I was craving sex like a healthy male.

  1. Do you have any recommended doctors that have experience dealing with Finasteride-induced side effects?

Dr. John Crisler – allthingsmale.com
Dr. Eugene Shippen – Author of The Testosterone Syndrome
Dr. Irwin Goldstein – irwingoldsteinmd.com

These are a few of the top doctors who recognize finasteride is a problem and have treated many patients suffering from its side effects.

Maybe we should add more doctors. In any case, I would write clear and with a big font that, among their patients who are on this board, NOBODY recovered. Obviously, this may mean one of the two: 1) none of their patients who recovered are on this board or 2) their “recovery success rate” (claimed by Shippen and Crisler) is false. I’m not saying by any means that they are bad doctors, but I feel that new members should know that, according to our experience, your recovery chance does not increase if you become their patient. The current FAQ, on the other hand, are encouraging people to become their patients

TRT is going to help some more than others depending on the degree to which you have become androgen insensitive.

Should consider adding Dr. Mariano to the list of Doctors.

From THIS BOARD we cannot find any total successes. That is true. And, at this point I think I’d rather be like this then go on TRT for the rest of my life (if that would even help). But, we should encourage everyone to go to a PFS doctor. This can only help raise awareness and add to the case studies. Maybe wont help us, but might lead to something further down the road. I think its a mistake to be dismissive of the PFS doctors.

Also, I believe Dr. Jacobs and Dr. Mariano are “fairly” new to the issue. I’ve met with Jacobs and even though he may not have the answers right now we are all very lucky to have him on our side. In the condition we are in being under the care of a doctor who recognizes what Fin can and has done is something we all need.