Topical ketoconazole saw palmetto shampoo PFS symptoms

Welcome to our community. Please fill in the following template as a way of introducing yourself, and helping others to understand your background and situation.

Where are you from (country)?
United States portland Oregon
How did you find this forum (Google search)

What is your current age, height, weight?
Weight 160 height 5 7” age 23
What specific drug did you use Regenepure DR shampoo contains ketoconazole and saw palmetto

What dose did you take
Small dab around the size of a quarter/nickel give or take as it is shampoo so hard to measure it.

What condition was being treated with the drug? Hair loss

For how long did you take the drug (weeks/months/years)? 3 years

How old were you, and WHEN (date) did you start the drug? 20yrs old beginning of 2015 around January/February

How old were you when you quit, and WHEN (date) did you quit? 23 stopped at the end of May/early June 2018

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

How long into your usage did you notice the onset of side effects? 2 years

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

ED loss of libido testicular atrophy insomnia severe anxiety depression suicidal ideation chronic fatigue joint pain rapid heart rate brain fog loss of appetite and taste

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.

[/] 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

[ ] 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

[/] 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

[ ] 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)
Rapid heart rate and high blood pressure
Heart rate is 85-100 bpm but goes even higher blood pressure is high and fluctuates to normal at times

What (if any) treatments have you undertaken to recover from your side effects since discontinuation of the drug?
TRT and hcg along with Anastrozole
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.

So here’s my story with how I got PFS please hear me out because I’m one of very few people that have had this problem with a topical alpha 5 reductase inhibitor.
It all started the beginning of 2015 around February I started to use regenepure DR shampoo which has ketokonzale and saw palmetto as the two dht inhibiting ingredients. I used it as stated on the bottle 3 times a week letting it soak in my scalp for 3 minutes then rinsing thoroughly.

By the second year using I began to feel weak fatigue and brain fog but didn’t know what was causing this because I didn’t think a shampoo could do such a thing. After the 3rd year I realized what was going on after I read the side effects of keto and saw palmetto oral I was horrified my symptoms were the same as the oral forms and I got it from a shampoo. I’m now dealing with horrible joint pain, severe anxiety suicidal ideation, loss of appetite, depression , permanent erectile dysfunction, testicular atrophy/damage I can’t tell but they are shrunk down to nothing, penis shrinkage it’s like the skin became very soft and numb forgot to add that in my last post insomnia rapid heart that will not slow down and no libido even lost my sense of smell its no where near what it used to be and even my taste also dealing with chronic fatigue

I’m now 23 years old started at 20. Been off the shampoo for 4 months I only got worse after stopping. I’m currently on TRT with very little improvement none with erection quality only brain fog went away joints feel slightly better but not significantly. Hope someone out there sees this and doesn’t use anything topical this is very dangerous stuff I even complained to the FDA but I doubt they will do anything. All this just to keep some hair on my head not worth it at all. I’m going through mental break downs every single day and have to stay with my parents. Feeling lost and hopeless. I had to go to a men’s clinic to get TRT because my doctor at kaiser did not believe me, he even said it’s not possible and told me to see a physiatrist. Not looking for sympathy but I’m just shocked how this even happened. I hope admins on the site will believe this as I know it seems hard to believe due to the fact it’s a topical.

Might copy and paste my story to other forums to see if anyone else has had this experience
To any one who reads this thanks, Aaron


Hi Aaron, You’re not the first person to come here with problems after using a topical treatment. Sorry to hear you’re dealing with this. Could you fill out a member story, please? Go to New post, then select “member stories” and the template will appear.



Thanks just did. Hopefully it looks okay Brain fog is bad at the moment hard to keep typing. I appreciate it.

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Hi @AaronF,

I’m sorry to hear what you’re going through. I am personally familiar with how astounding it can be to experience these changes after use from an exposure that seems so mild, and of course the ignorance of the medical profession regarding these (at this point) very recognisable clinical presentations. Many members do stabilise or improve over time so don’t give up hope.

Don’t worry about not being believed - I and the other admin/moderators are well aware of this being attributable to any inhibition of the 5alpha reductase enzyme, inhibition of the androgen receptor or sharp depletion of available ligand. Although it’s rarer, PFS is rare to begin with and you’re not the first case here from topical use. You are very welcome here and there’s many supportive members I hope will bring you some comfort you’re not alone with it. Thank you for sharing your story and I hope you will take the survey offered to members (mentioned in part 2 of this post) when it is ready in a few weeks.


Ketoconazole inhibits the convertion from cholesterol to testosterone and saw palmetto inhibits 5ar.

-Rapid heart rate and high blood pressure

Im on trt and interesting enough, I have noticed that my heart beat is slower and more calm than before but I dont know the cience behind

So as of the last 3 months I’ve gotten significantly worse out of nowhere.
I’m not sure what happened for a while I was stable with my baseline, obviously far from my normal self but for some reason my heart issues have gotten much worse, constant rapid heart beat and high blood pressure and when I try to fall asleep it starts to slow down and I lose my breath and feels like I’m suffocating. I’ve completely lost my ability to sleep and I’ve developed these strange seizure like episodes where my head rocks back and forth. I have severe twitching now all over my body that is constant and does not stop throughout the day. I have had excruciating headaches to top it all, I’m getting a CT scan tomorrow of my brain, I doubt anything will come up of this but I’ll update this post if they find anything.
I don’t know what the hell has happened but my memory is completely shot now I wake up each day forgetting what I did the day before, I feel like I’m suffering from some sort of nerve damage my hands and feet are numb. I’m still working doing my online business but now even shipping orders out has become difficult for me but I’m still trying to get by everyday pushing through. Just thought I’d post an update.
I hope everyone else is managing with their situation,


waiting and fighting.young man.

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@AaronF sorry to read this I found potassium rich foods were making these symptoms worse in me

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I have my fingers crossed for you, Aaron. I hope this is a blip and that you’ll be back to some kind of normal soon.

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I seem to get bad inflammation in general now with anything I eat it’s terrible.

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Thank you :pray:

Yes mate the same here I do 1 day fasting 1nce per week to give my body a rest. Unsure if it helps but it certainly doesn’t hurt. I’ve also started carnivore this week. Multiple food sensitivities are a major issue.

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Fasting has also helped my brain fog a lot. 36 hours water fast every 2-3 weeks.

For inflammation / food sensitivity, I had some success with reducing polyunsaturated fat (PUFA) from my diet, and replacing it by saturated fat. I now avoid most cooking oils and most nuts except hazelnut.

Shampoo molecules are very big to cross the scalp. This problem was cause by Saw palmetto.

I don’t think it’s true in case of ketoconazole, this thing has disabled me in the past when i used to apply it, ketoconazole also seems to have very adverse effects on liver, i used to get severe pain in my liver after my showers with keto.


How are things @AaronF?

Is very strange, some units must be defective. A shampoo cannot have the possibility of systemic absorption

Hi Aaron. Did your memory improve? I also have/had (It improved slightly) that low pressure when sleeping that makes me suffocate. And now i have bad memory. Maybe we had lack of oxygen.

Sry for disturbing and thanks!

No improvements for me unfortunately. My condition seems to be progressive


Im sry to heart that. Thanks for your response. I rly appreciate It