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He took accutane has the numb genitals , pfs like symptoms but has normal dht…
I never took fin, accutane , have numb genitals, and have low dht
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They both have an effect on 5-ar.
Boudou P, Soliman H, Chivot M, Villette JM, Vexiau P, Belanger A, Fiet J. Effect of oral isotretinoin treatment on skin androgen receptor levels in male acneic patients. J Clin Endocrinol Metab. Apr 80(4), 1995, pp. 1158-61 (ncbi.nlm.nih.gov/pubmed/7714084 ).
Boudou P, Chivot M, Vexiau P, Soliman H, Villette JM, Julien R, Belanger A, Fiet J. Evidence for decreased androgen 5 alpha-reduction in skin and liver of men with severe acne after 13-cis-retinoic acid treatment. J Clin Endocrinol Metab. May 78(5), 1994, pp. 1064-9 (ncbi.nlm.nih.gov/pubmed/8175961 ).
Lookingbill DP, Demers LM, Tigelaar RE, Shalita AR. Effect of isotretinoin on serum levels of precursor and peripherally derived androgens in patients with acne. Arch Dermatol. Apr 124(4), 1988, pp. 540-3 (ncbi.nlm.nih.gov/pubmed/2965551 ).
Palatsi R, Ruokonen A, Oikarinen A. Isotretinoin, tetracycline and circulating hormones in acne. Acta Derm Venereol. Sep 77(5), 1997, pp. 394-6 (ncbi.nlm.nih.gov/pubmed/9298137 ).
Rademaker M, Wallace M, Cunliffe W, Simpson NB. Isotretinoin treatment alters steroid metabolism in women with acne. Br J Dermatol. Apr 124(4), 1991, pp. 361-4 (ncbi.nlm.nih.gov/pubmed/1827343 ).
Minoxidil also effects 5-ar. I am here because of Minoxidil.
I believe anyone who says that our condition is a chronic infection, or an issue with gut bacteria, or some other shit, is wrong. Whether it has to do with low serum androgens, androgen receptor insensitivity, we don’t know for sure yet. But the evidence points to one thing, it’s an androgen issue.
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Looking at 3 of these studies,
(im guessing your also going to find any abnormal serum levels during treatment returning to normal for the most part, I do know this can be seperate from tissue levels or binding affinity).
“This study confirms that the effects of isotretinoin on the serum hormone levels are small and unlikely to be of relevance for the resolution of acne or the suppression of sebum excretion.”
“It is concluded that 13-cis-RA therapy in men with severe nodulocystic acne did not alter gonadal or adrenal functions”
“Isotretinoin had no meaningful effects on precursor androgens, except for producing an elevation of free T in women. In contrast, isotretinoin produced depressions in the serum levels of DHT and 3 alpha-diol G in women and in 3 alpha-diol G in men. These decreases are believed to be the result, rather than the cause, of a reduction in the size of the sebaceous glands”
I might say the durable long term effects or permanent resolution of acne in over 80% of patients that go on Accutane is not because of long term Androgen deprivation.
Id also say im not dismissing thoughts that this website is based on or whats been studied for years.
Im along for the ride atm.
There is at least one thing that they all have in common, observed at the molecular level and indicating an anti-androgenic effect:
.
@guitarman01, I’m glad you mentioned the local (tissue level) effects. It has been shown that, in at least 1 type of tissue, long-term suppression of local androgen synthesis by Accutane is possible:
.
I’ll just come out and say it: I think the lines of research that claim the anti-androgenic effects of Accutane are not it’s main MOA are flat-out mistaken because they put more weight on serum androgen levels than on localized androgen production and response to androgens.
Androgen-insensitive patients produce very little sebum, while it is much less affected in pseudohermaphrodites with 5-ar Type II deficiency and patients actively inhibiting 5-ar Type II with finasteride:
.
Also taking into consideration the fact that women suffer varying degrees of acne despite low serum androgen levels, and this observation from Boudou:
The most pronounced effect was observed in skin biopsies, which lost 80% of their ability to form 5 alpha-dihydrotestosterone (P < 0.001). It is concluded that 13-cis-RA therapy in men with severe nodulocystic acne did not alter gonadal or adrenal functions, but it did induce 1) a highly significant decrease in 5 alpha-dihydrotestosterone formation by skin biopsies
…shows that serum/circulating levels are practically irrelevant to the production of sebum.
Meanwhile…
Although numerous factors contribute to the development of acne, the requirement for androgens is absolute and is one that allows for effective treatments in women through inhibition of androgen expression. The two prerequisites for androgen expression at the level of the pilosebaceous unit are the presence of androgen in the form of either testosterone or dihydrotestosterone; and functioning androgen receptors. A third component may be the metabolism of androgen precursors to active androgens within pilosebaceous units.
Don’t forget about reduced b12
Let me run down some difference real quick. Some of this might be selective, but its also why this might not be definitive for me. I think stopping at anti-androgens as to what we and these drugs have in common could be a crutch going forward.
Im not saying androgens or it receptors might not be dysregulated, but so could literally hundreds of other genes, at least in the case of Accutane. Based on what I thought was recently said, might apply to Finasteride too.
So any abnormal AR receptor activity could still end up being non-specific. Ive posted before many diseases as common as obesity and the aging process itself can alter ar expression.
I said it when I first came on here, you might be be better to throw out the drugs, see what we have in common and then work backwards from there.
Or maybe the Fin guy pretends he took Accutane, the Accutane guy looks at SSRi’s and the SSRi guys look at both. Idk.
But again stopping at anti-androgens might not be zooming out the lens enough.
I see why its easy to come to this conclusion coming from Fin, considered to be an endocrine disruptor.
The other 2 drugs are alot more complicated and have a lot more research for their multifunctional effects in many directions.
Anyways,
I could maybe use this as a quick example,
Some seem to be greatly afflicted having taken a single dose of Finasteride, effects they endure for at least months. At the same time this singular dosage probably insnt curing anyone’s moderate Acne in a progressive fashion.
Looking at the FDA info it seems dht serum levels are rapidly affected on Fin, also this isnt even targeting the same 5ar enzyme found in the skin.
Idk, im not denying possible anti-androgen effects across the board, but im looking beyond this.
History has not brought these thoughts to resolution of PFS yet.
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