This question really baffles me. Why would replacing hormones back to baseline not work for some?
What COULD it be? Receptors? Neurotransmitters? Is somthing happening to the way we metabolise the hormones?
I think this is the key to our problems but WTF is it? I dont understand how if you add TRT, it could still not work.
The endocrine system is far more complex than the blood assays alone would suggest.
Your question;
Why would replacing hormones back to baseline not work for some?
Who says that such people have replaced hormones in such a way as to return to their pre Propecia state?
Who has had their hormones tested prior to Propecia use so that they know what their healthy pre treatment levels are?
I would suggest that virtually no one knows what all their hormone levels were prior to Propecia. I would also say that the delicate homeostasis/balance is just as important as the individual hormone levels themselves.
Your endocrine system is like your own personal chemistry set, its levels, checks and balances are particular to you and so the same is true for me and each and every one of us.
If one hormone is out whether it be SHBG being higher than before, DHT slightly lower, free testosterone a little lower, estradiol slightly higher etc that can have knock on effects and be enough to disturb the hormonal synergy that is required for you to feel well. Remember it only takes one instrument to be out of tune in an orchestra for the collective sound and purpose to break down.
The above mentions just some of the differing hormones and an analogy relating to their inter-dependence; the point to get across is that the relationships are complex.
When you have blood pathology it gives you a set of numbers and supposedly normal reference ranges. One major problem is that the numbers do not analyze themselves and there are many human errors due to ignorance of the issues at hand. There numbers are often not interpreted in relation to one another and they are often overly relied upon to the exclusion of symptoms. Misinterpretation of hormone assays and a general lack of knowledge means that patients are often misled and misdiagnosed and believe that they have a healthy hormonal status when they do not.
At the gp level you may have a one point serum testosterone test, if it is in the normal range you will be told you are ok. But this does not take into account a whole range of other factors that lower the crucial level of free testosterone such as SHBG, estradiol etc.
Such testing as you can see is flawed.
In the UK the Society for Endocrinology has a policy statement that it has released concerning how low testosterone (hypogonadism) should be evaluated.
In the policy statement it says and I quote verbatim from the link below;
In the presence of symptoms of androgen deficiency it is appropriate to measure a 9am testosterone test and if it is around the 10nmol/l mark, endocrine referral is appropriate.
Unquote
endocrinology.org/policy/doc … erone.html
Yet
Many men have testosterone levels above this abstract, nonsensical plucked out of the air theoretical man made boarderline figure and have hypogonadism/low testosterone.
If a man in the UK has a testosterone level of 13nmol/l they will probably not get a further more in-depth analysis of their hormonal status due to the above policy statement despite the fact that a high SHBG level could render a very low crucial free testosterone level (the UK NHS does not measure free testosterone at all).
Many testosterone assays are calibrated in such a way that a level above 10nmol/l would be deemed normal and the individual would not be passed on for endocrine referral yet, you could have Klinefelters or Kallman Syndrome with a level like that.
In the link below you can click on the top right picture. That is the picture of a man who has Kallman Syndrome, he has a serious genetic problem that has resulted in major androgen/estrogen problems- yet his testosterone level is 10.6nmol/l. If you convert this level to the US range it comes out as 306ng/dl. The US has many far more forward thinking doctors, but even so many US doctors and the AACE (American Association of Clinical Endocrinologists) would think this testosterone level would probably be ok.
But this man is far from being ok from an androgen/estrogen standpoint. It is something that highlights the problems inherent in strictly interpreting hormonal assays.
get-back-on-track.com/en/pro … _03_01.php
I am not saying any of us here have genetic problems that affect the amount of androgens and estrogens produced, that we have testicular failure or that we have a problem relating to the sensitivity to androgens……the point above was just another example of the problems with looking strictly at the hormone assays and playing the numbers game.
I would also say that the supposed “normal” reference range is an abstract theoretical normal and that many people within that range do not have normal levels for them. Pathology does not have all the answers and it should only be used as a guide in combination with symptoms- it should never be used as a rule.
I bet few people realize that the reference range for testosterone was created with no differentiation for age. This is another startling reason that highlights the flawed nature of using the reference ranges in a strict manner. There are probably very few areas of medicine where allowances are not made for age. We would not expect a 90 year old man to be the same as an 18 year old man whether we mentioned heart function, blood pressure, mental function, muscular development, etc etc. Yet when we measure testosterone we are putting everyone in the same basket irrespective of age.
The bottom of the male reference range for testosterone is often said to be around 10nmol/l or 288ng/dl, but is this normal for young men?
The fact is most studies and top andrologist agree that this is not normal for young men. In a very large study of over 3000 (Dabbs study) military personnel between the age of 21 and 34 it was found that the average testosterone level for a 32 year old was 31nmol/l (894ng/dl). That was the average serum testosterone level not the highest. Of course that is only one study, but if that was anywhere near approaching correct then it would certainly be fair to say that 10nmol/l (288ng/dl) was anything but normal for most young men.
The pharmaceutical company that makes Androgel/Testogel Schering have their own figures relating to normal levels and it is their opinion that levels of 10nmol/l (288ng/dl) are more typical of men near the end of life as opposed to young men.
Here is the link showing this- please click on the second to last box on the left that shows typical testosterone levels at differing ages.
get-back-on-track.com/en/pro … _01_02.php
So all the above shows problems relating to analysis, but there are more issues;
Does the doctor concerned know how to calculate the testosterone to estrogen ratio?
Do they understand also understand the limitations of the estradiol reference range in men and know that it too is of limited help given that A) laboratory assays of this nature are often calibrated around female reference ranges and that B) again there is no differentiation in age ranges and that the upper third of the reference range is often very unhealthy for men’s androgen status?
Does your doctor understand that SHBG is not just a mediator for testosterone, but also is crucially a mediator for estrogens and that low SHBG can also cause high free estradiol (which is crucial but isn’t measured anywhere).
Many doctors, particularly in the UK look to LH and use that to help diagnose problems. Many think that if testosterone is boarderline low on the male reference range that problems should be diagnosed on the basis of LH. Such thinking is that if LH is high then the body needs more testosterone, but not enough is being made, therefore the problems is one of testicular failure and primary hypogonadism, conversely the thinbking is if LH is low that not enough testosterone is being made and the problem is hypothalamic/pituitary in origin.
Often doctors will think there is no problem if testosterone is borderline low and LH appears normal.
But estradiol has an enormous impact on LH and the HPTA negative feedback system and can often ensure a normal LH level in the setting of low testosterone. Dr Eugene Shippen speaks eloquently of this problem in his book the Testosterone Syndrome. He explains how the body can be tricked into thinking it has sufficient testosterone by having too high a level of estradiol and he describes this as a form of secondary hypogoandism that is caused not by a diseased state but simply too much estradiol; he refers to this as metabolic hypogonadism.
So again the above highlights how expert analysis can be the crucial factor- not simply the blood tests.
Let’s look at another problem that I touched upon, the problem of not knowing your hormone levels prior to propecia use.
I think I’ll quote Dr Eugene Shippen from the Testosterone Syndrome here as you will see the a problem that everyone has;
Quote
To confine ourselves to testosterone for the moment, let me point out what is useless is the standard doctrine that according to which a man’s testosterone levels is within the normal range if it falls somewhere between 300ng/dl and 1000ng/dl.
Such a notion of normality is virtually meaningless, unless all you mean by it is 90 percent of all men do, in fact, have testosterone levels within this range. But a meaningful medical notion of normal surely contains an implicit approval of the level found, a suggestion that when a man’s testosterone is above the lower number and below the higher number, he can rest assured that he is basically on track. In other words, his health, and vigor should be supported rather than adversely affected by his level- he’s “normal”.
If that is what doctors mean when they refer to normal testosterone levels, then they are flat out wrong. Your own personal, “normal” level of testosterone probably is somewhere between 300ng/dl and 1000ng/dl, but no one can say where in the range it lies. You maybe somewhat too low at 600ng/dl, or you maybe adequate at 450ng/dl. By nature, you maybe a high testosterone male, and, without those baseline levels taken in youth, which you certainly don’t have, no one can tell for sure.
(My edit- in the above instance you can take youth to be prior to propecia use).
Back to verbatim quote
Let’s just consider the case of two very different men. One is a high testosterone male who normally averaged between 800ng/dl and 1000ng/dl when he was healthy and young. Now he is fifty, and has suffered a serious hormonal fall. His levels are now between 400ng/dl and 500ng/dl. This is a catastrophe, a 50 percent drop, and he feels every point of it. Now there comes another individual who in the days when he was young and healthy averaged between 400ng/dl and 500ng/dl. He too, has reached his fiftieth year, and his testosterone have also declined. They now average between 300ng/dl and 400ng/dl. The drop is relatively slight, an he notices little change in function. He still feels like a health specimen.
It is relatively easy to make such analysis. Unfortunately, in the real world, the physicians who are treating each of these men, don’t have the earlier numbers, the baseline youthful highs. All the physicians know is that one man has levels between 400ng/dl and 500ng/dl, while the other is between 300ng/dl and 400ng/dl. And surprisingly, the man with the lower level feels much better and reports far fewer symptoms.
Unquote
It is also true in the above that the person with the lower levels would be the one most likely to be diagnosed and treated.
I could go on to cover many, many, many more issues such as lognormal transformations of reference ranges and many other issues but I won’t.
I will move onto the subject of replacement.
When you replace testosterone with TRT, or when you try and get your body to produce more testosterone with HCG or Clomid or GnRH etc, how do you know you are reaching the testosterone level that suits you and supported good health prior to propecia?
How do you know if it is too high or too low?
Either could cause you to not feel well and have the symptoms of post propecia use.
How do you know, even if you do replace your testosterone to the desired level that you do so in such a way that you do not cause a cascade of knock on effects on other hormones that cause you to feel poorer than you did prior to propecia use?
I mean you could quite easily replicate your testosterone level with a bit of luck, but what happens if this in turn results in a high level of estradiol and a consequently low androgen to estrogen ratio or lower level of free testosterone?
What if you replace your medication results in a high levels of SHBG and a consequently lower level of free testosterone?
What if your DHT level is lower than it was prior to propecia use, or what if its ratio to estradiol is poorer and you have resultant symptoms?
Can you see how complex this are of medicine can be?
Sure there will be people who find easy answers for whom all of this is redundant, this can be very simple- but it can as I have hopefully highlighted also be very difficult or complex.
P.S
I apologise for any tyos- but it is a fairly large post.
Actually, quite a few men had pre-Propecia hormone tests. Dr. Crisler told me this personally when I went to see him. He said for a lot of them restoring their hormone levels to pre-Propecia levels did not resolve their issues.
I’m sorry but I do not buy that at all.
Why would many men have hormone pathology pre-Propecia use?
I don’t think that is credible at all and I don’t think you will come up with a credible explanation as to why many men would have done that.
I would say that by far and away almost all men do not have hormone pathology prior to Propecia use- hence part of the problem (not all of it).
Even where men have had pathology prior to Propecia use (very few men) what numbers were the same exactly?
Are you saying that they had complex pathology prior to Propecia use and looked at their free testosterone, free estradiol (can’t even be measured), SHBG, prolactin, LH and FSH and DHT levels as well as having their free androgen to estrogen ratios measured?
All this and with the exact same testing equipment, same reference ranges and same calibrated equipment and at the same time of day….
and having done all this- they managed to replicate all the same numbers?
Poppycock!!!
Show me evidence of even one case!!
I do not believe for one second that men have just happened to have specific complex endocrine pathology that has evaluated all the required baseline levels and managed to reproduce all the prior levels at the same time of day on the same equipement.
Furthermore
If you had thoroughly read what I was saying you would have seen that, even if the above were so (it is not) you would see that even if you had results for all hormones prior to Propecia;
The inherent problems with hormone assays mean that you will not necessarily have the same hormone profile that you had prior to Propecia even if all your numbers appear on the face of it to be the same.
This is not simply a numbers game!!!
To treat it like it is is too fall into the trap that so many poorly educated and ignorant endocrinologists fall into.
There are far too many variables that muddy the waters!!!
Symptoms are the most important factor when looking at hormonal problems; bloods come second and should only be used as a guide not a rule.
The fact is many men post propecia use end up with many symptoms of hypogonadism and propecias principle mechanism of action via finasteride is that of an anti-androgen. The difference is that it seems to affect each individual sex hormones somewhat differently.
The bottom line is one of trying to find individual solutions to each individuals problems. Pathology should be used as a guide (nothing more) as to the nature of problems and the trial and error of differing medications may well be the way forward in finding an answer for each individual.
My point in replying to your post was to illustrate that there is possibly more to our problems than just the hormonal aspect of this; your response to my post now seems to acknowledge this is the case.
I am not trying to argue with you, I am just passing along information I gathered from Dr. Crisler when I went to see him regarding my own condition. From my conversation with Dr. Crisler, of the several dozen patients he had seen with finasteride-related problems, about 10 or so had hormone profiles from before getting on Propecia. Whether or not you believe this is up to you.
No.
I am saying that this is hormonal, but that it is no where near as simple as people seem to believe and not a simple case of supposed normal numbers and supposed normal reference ranges. That is what I am saying.
Fair enough.
Dr Crisler is but one doctor.
He has a good reputation, but he is also a brilliant self publicist.
Dr Crisler is not the be all and end all when it comes to endocrine evaluation and he hasn’t successfully cured anyone of these problems by his own admission if what has been reported by his patients on this site is true. I have helped Dr Shippen to cure at least one patient. Dr Shippen is also a published author and has a worldwide reputation greater than that of Dr Crisler and I have quoted him so that people can see his thoughts on hormone levels- given its relevance in this setting.
With that out of the way I’ll come to another point;
I don’t think you can say that Dr Crisler has undertaken in-depth tailored endocrine pathology that obtains all the baselines we would require in the manner I have stated, because we have no evidence of this. Again even if we did have evidence of this I have already explained that the numbers alone do not tell us everything.
But think about this;
Why would anyone have in-depth endocrine pathology to check out all of their sex hormones if it was prior to propecia use?
Simply put why would anyone be having endocrine pathology of this nature if they were perfectly well?
I just don’t believe that because it just doesn’t make any sense.
The only way anyone would have had this pathology prior to propecia use would be because;
A) They were already taking endocrine altering meds
B) They suspected underlying endocrine disease/ill health prior to propecia use
Either way neither of the above could be considered in the same bracket as people who were well prior to propecia use who did not suspect that they had endocrine disease/ill health or had not taken endocrine altering meds……
If you can explain why on earth anyone who was well and not using endocrine altering meds would be having this endocrine pathology prior to propecia use then I might consider it possible for the odd person to have had some pathology prior- but that is it.
….it just doesn’t add up.
This isn’t your issue- you have been told something and are repeating which is fair enough.
In any respect this is a side issue. The points I make in my original mail remain and are very relevant to the opening post.
I think all josh is trying to illustrate is that besides all the many many complicated intricate, fluctuating checks and balances, complex chemical reactions taking place, and the hormone problems and imbalances probably taking place in many of us, there are also probably some other things happening. Like there may have been some sort of physical damage down there or something, like my balls are numb sometimes. I think it was a powerful medicine that could have done some damge, other than JUST throwing off the hormone balance. I think that sometimes my dick just may need some sort of physical therapy or something.
Btw guys. I’m doing “The Master Cleanse”. Look for my post. Later
Sorry but I feel I have to remind people of what the original question in this thread was,
I feel I have answered that question very well in my original reply with factual reasons as to why that can easily happen. Conversely I also feel that what has been said subsequently as to possible reasons involves conjecture as opposed to the factual answers that I provided.
I could speculate that the reason for post Propecia problems is;
An alteration in the liver’s p450 system, or I could speculate that it is because of an alteration in the function of androgen receptors, or I could speculate that the neurotransmitters are adversely affected. Indeed with just speculation and no hard proven facts, I could say that I suspect that the problem is caused by a giant invisible rabbit called Harvey, or that post Finasteride problems are due to moon tides or avalanches in the alps or interactions with butterflies in the south Atlantic.
Yes it sounds like I am losing it above, I am meant to sound barking mad so I can make a very relevant point and it is this. If you are dealing in speculation instead of proven facts then ALL the examples above are on the same footing because there is no evidence for or against any of them of significant value.
We can all come up with pet theories that are short on facts and high on speculation as to what may occur, but given that none of them can further this cause I see little point in dealing in them. Sticking to the known facts available “at this time” is the only way that you can help provide answers that are likely to be helpful to individuals pursuing a return to good health. No conjecture in the world is going to result in a scientific finding that somehow provides an answer. Sticking to the facts as they are is all that you can do, with the furthering of scientific knowledge being in the hands of others.
P.S
One thing I would say for sure is that I don’t think my original reply has been given either due weight or attention; I think that is because it hasn’t really been read through or understood properly and sometimes I do wonder if there is any point in providing in-depth, detailed factual responses that take up so much time and effort. Particularly given that speculation and conjecture seems to carry equal weight/value as facts do around here anyway……
A P.S to the P.S 
The physical changes that have ben noted in the genitals often ocurr in hypogonadism due to a lack of N.O, and or a lack of androgens and or too high a level or ratio of estrogens. This has long since been known and could easily account for what has been reported here as “damage”.
Why go looking for bogie men when you have a bogie man stood on your door step in the form of the aforementioned condition ???
I think you are wrong. Dont judge only on the replies.
I read and value every post from you, and most of all I dont write your thery off without trying it out. In a few weeks I will try TRT again, and I will share my testresults with you, and give you a chance to help me getting the treatment you feel will work for me, so please stick around a little longer 
JH
Thanks for your very comprehensive reply…wow. I am still trying to digest it all. Please dont be put off by a lack of immediate response, I have just been too busy lately.
I agree with virtually everything you have said. A lot of the stuff about testosterone reference ranges is very true and youve provided some very good information on that.
I agree with Joshcurtz though that if what Dr Crisler told him is true, then to me that really is somthing to worry about because Dr Crisler is in no way an incompetent doctor. Im just being honest here. I mean what could he be possible missing?
I totally agree that being scared of somthing that you dont even know is there yet is putting the cart before the horse.
See the thing with me is that my SHBG is not eleveated, neither is estrgen. I havnt had a total estrogen done but not sure if that matters, ive only had Estrodiol. My free T is low though, so surely I would have to feel better if I can get that up and liike you say, SHBG might rear its ugly head once my T gets up there again.
And I agree too that having your T cut in half definately would make a difference to ones health, how could it not.
I am still digesting your post so their could be more of a response…LOL.
Dont feel like your not appreciated here because you most definately are. You cant help some of the guys being sceptical of just about anything, since they have been trying things for years that have not worked. I think everyone appreciates your input here and I think your right on the money in most of what you say. Thanks a lot for the indepth reply.
Dr John is a moderator on the Anabolic minds forum. Mostly he posts in the Male Anti aging forum. If someone asks him nicely I’m sure he would come over and take a look at the new forum or you guys could ask him questions over there.
He used to post here as I remember him mentioning it on other forums when propecia use came up.
It certainly would be fun to watch his response to Hypo.
Do you use the same name on AnabolicMinds? I asked Dr. Crisler if he knew who you were and he did not recognize your name.
Ok…
If people read all I had to say and think a lot about what I am saying as it is not straightforward; after that agree or disagree or take from it certain understandings etc then that is fine. I certain appreciate the fact that some people have been reading it.
I was just getting a little frustrated, because I put in an awful lot of time and effort to bring that information to the fore and there were many complex points that were made that I felt were at the time were being brushed over completely. As long as people read properly and give such things thought then all is well and good.
It is funny how you disagree with a point raised and by a series of subsequent misinterpretation has escalated matters to the point where you have now somehow supposedly called into question someone’s ability and it becomes a childlike playground you versus them spat…nonsense really (not aimed at J89 or anyone these things just happen on message boards).
To be fair I never suggested anything negative regarding Dr Crislers ability as a doctor.
I said that I disagreed with the nature of what I was being told in second hand information when applied to the specific context that it was being applied to.
The information was second hand and honest enough- I don’t doubt that for a second.
But there were specifics of the context that I was talking about that were relevant and easily missed/passed over. I am not sure Dr Crisler would say the same thing in the context of this conversation.
Yes he said that people had pathology prior to Propecia use. But I doubt that he detailed whether all baseline pathology was specific to Propecia use prior to Propecia use, I doubt all the tests were identical in nature or that Dr Crisler is saying that and I doubt he was referring to it in the context of this post and my prior points that all baseline levels were returned in all such individuals and assays to the exact same pre treatment levels…via TRT or endocrine altering meds
See the point?
It is easy to miss the VERY relevant context and particulars of this situation and posts and think I am saying something very different and indeed that Dr Crisler is saying something very different.
People need to carefully read what is being said and not just give things a quick once over and miss all the subtleties.
I maybe disagreeing with Dr Crisler or I may not be, I have no idea, because what he said was not in this context. So my disagreement is with how his words have been applied. It is hardly fair to Dr Crisler to apply his words to this context and hardly fair on me to say I am calling him into question….talk about mixing apples and oranges.
If I disagree with someone and have a debate or suggest they are wrong etc. I always like to do so courteously by ensuring that they are actually there, involved in the conversation etc, applying their words to me and the given context even LOL…
Now I have had to make one massive detour to explain away what is actually a side issue and not remotely what the focus of my main post was. But I guess that is fair enough as it was a very important point raised nevertheless and one I would gladly further with Dr Crisler at this forum should he wish to detail what he was saying….we may find there is some disagreement, alternatively we may find there is none at all.
Detour aside, please don’t miss the wood for the trees and get hooked on a potential spat that doesn’t even necessarily exist.
Please read my initial post carefully in the context of the opening post in the thread. I have made many complex points that can explain much as to why replacing baseline levels might not necessarily help people……that is the crux of my post- the very point of me posting in the first place.
Joking analogy……have you ever been out with friends made a really serious point and then had one of your friends misinterpret what you are saying and then that becomes the conversation…so that everything you originally said was lost……I hope that hasn’t just happened…. or
Regarding my original post;
What I am saying stands up and I will certainly debate that with anyone who disagrees with it and that includes any andrologist you like. Now I’m ending a post sounding like a child in a playground as well….god help us!
I just read Anabolicminds and the same thing now with Meso. With all the BS going on now how long will it be before th cops knock on your door for talking about steroids. I also will no longer provide any PCT help as I’m sure that is next to come.
Cool, was just curious.
What is going on here?
Can people please stop trying to cause flame wars or whatever.
We are all here looking for answers to our problem, that much is a given.
And we should all be grateful that those with greater knowledge in this area have chosen to share such knowledge with us.
Debating wether that be Dr Crisler, Shippen or otherwise should not be the issue. Healthy debate is encouraged but really, we are here to work together, likely try treatments and hopefully, recover.
Josh, discussing members with other Doctors is probably not the best way to accomplish this. Jim and Hypo, I hope you will change your mind and continue to stick around, regardless of any beefs you may have with one or two members.
Thanks… guys just use some common sense instead of trying to stir up a hornet’s nest.
Hypo, my point is that Dr Crsler is by no means just any old GP or “some” endocrinologist and I only mentioned that to make a point that he is very thorough with his patients and how could he miss somthing, considering he says he has baseline levels? There is probably a good chance he does IMO considering how many patients end up in his care who are screwed from finasteride.
In no way was I saying that you think Dr Crisler is not a competent doctor. In fact Ive heard you say a lot of very GOOD things about him. I know you respect Dr Crisler and his work, there is no issue there.
I completely understand what your saying in your original post. About how refernece ranges for testosterone are not age specific and how all sorts of problems can arise when you add testosterone to a hypogonadal patient such as SHBG can increase, E can increase and if untreated can cause problems.
Some of us here know this stuff already. So does Dr Crisler, Josh has claimed that Dr Crisler has said that even with all of this considered, some do not recover. This is what baffles me.
Your right though, and it could be a far reaching hormonal issue that would be impossible to get accurate before and after tests for. I am not saying your wrong at all. I am just saying that a lot of guys have a lot of what you mentioned covered and are still not cured yet. And if we cant rely on past or present bloods, how do we treat it when that fails?
Hypo, I will say again that your input here is VERY important to me and everyone else here. You have already helped fix up one patient and that is HUGE.
I also dont know why people keep going on about how if Dr Crisler posted here, there would be some kind of showdown between Hypo and him. Where did this come from? IMHO, I think Dr Crisler and Hypo would agree on almost everything.
I don’t have any beefs with anyone and will stick around. How could I have abeef with Hypo when I read the first two sentences of his post and skip the rest. I just not going to post about PCT anymore. I think the message boards (not this one) will be the next thing taken down by the police. Some people post from overseas so you are OK
HIGHLY UNLIKELY !
OK, “almost EVERYTHING” was a little optomistic…lol. But what I am saying is they would agree on how complex mens hormones are and Hypo seems to have a good grasp on that. We know that Dr Crisler thinks that there is more to this than just adding TRT and so does Hypo.
No two people are ever going to whole heartedly agree on ANYTHING especially complex topics such as hormones and especially post finasteride hormones.