I feel you buddy, it’s a bit of a shit show up in here. But every once in awhile I come across something good that provides some real value.
I actually gave a pretty lengthy breakdown on Dr. Goldstein in my story post over here: Scott's Story - Age 31, loss of everything
But I can continue some thoughts - Overall, besides being very nice, the man doesn’t really have any insight into how to fix us. He seems to use a ton of conflicting protocols himself - it just depends on what your particular ailment is. My experience with doctors has been largely disappointing, everyone seems to want to attack it as a hormonal imbalance issue; and while there are people out there where hormone supplementation will help, it’s pretty much clear at this point that the root of our issue isn’t a mere hormone or two. Dr. Goldstein showed me a chart of all the enzymes that Finasteride actually affects. It’s much much more than just 5ar reductase conversion of T into DHT, there are plenty of other enzymes that get suppressed/irrevocably damaged which, in turn, creates a whole cascade of downstream effects (including the potential for hormonal imbalance). DHT is responsible for the smooth muscle wall of the penis, and when that gets damaged you lose your penile structure. Your prostate size and strength is affected, as well as it’s ability to produce the hormones needed for libido and sexual appetite. The altered Allo levels cause a bunch of issues with GABA and the ability for the brain to calm and relax itself, as well as having links to dopamine which affect libido, motivation, and pleasure. The downstream effects also affect the gastro-intestinal system, as well as fundamental aspects of the body like forming correct levels of essential/non-essential amino acids. The FDA really screwed the pooch on approving this drug, and the problem is Merck is so unbelievably rich, that they are able to drown out any outcry.
In terms of what to do, I really can’t say. What appears to be close to fact now based on studies (and plenty of discussion on this forum), is that Finasteride use drastically increases the AR receptor expression throughout the body (particularly in the penis), preventing the hormonal pathway from working when DHT levels return to normal after finasteride use. It would seem that if we are able to downward express the AR receptor to the point of where it was before Finasteride use, we might have a fighting chance at getting our receptor/androgen levels back to balance and have them fire like they are supposed to again. But of course, there are plenty of other issues that are probably at play. Goldstein also mentioned the fact that finasteride might have altered the ability for the body to correctly synthesize 5AR reductace enzyme - it can create it, but the use of FIN has altered it’s compound, and now it doesn’t work in the same way it used to. Also, he mentioned that Finasteride turns into Dihydra-finasteride which takes the place of DHT during use, and stays in the body for months after the cessation. The problem here is that blood tests might show certain DHT levels (and even the rare test of 5ar reductase levels) - BUT the test is actually seeing an incorrectly ‘built’ DHT or 5ar enzyme. So it would show levels as being fine, but in fact the test is actually measuring a frankenstein form of what it’s actually trying to test. All of the same can be said for the other enzymes Finasteride affects as well…
The Baylor study should hopefully (praying) shed some true light on this, but when asking Dr. Goldstein, he seemed very reluctant in thinking the study is going to really blow up the thinking on our syndrome, and prove some new insight - particularly to the point that we are able to find a cure. What’s been discovered thus far seems pretty clear and apparent to him, and he is simply able to give us things that will help, but not cure our syndrome.
In order to downward express the receptor, I’ve been told certain things like heavy doses of soy flour may do the trick. There are other ideas as well. But of course, they are all theories. It would just be nice if we had once had a real recovery that was documented and shown the precise science of how it took place. These crackpot recovery posts have created a lot of heart-break around here - I’d be surprised to hear if anyone out there has actually had some serious long-term effects by copying any of them.