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10 Years on Finasteride. 3 Years Later, Shutdown. Advice?


#1

My situation is summed up in the title really. I used finasteride for 10 years and after 3 years of quitting feel completely shut down with the test levels 3 times lower than an average 36 yr old and only half that of an average 80 year old. Major sexual sides, ED loss of libido, long standing minor gyno/puffy nipples and wider health issues I relate to my hormones being shut down. I have used the format of Q and A I found on another forum I hope that’s OK.

Off to see a consultant in a few weeks and looking to research myself so I am as prepared as possible. All and any input/advice on the below greatly appreciated.

  1. What is your current age, height, weight? 36, 6ft2, 13 stone

  2. Do you excercise regularly? If so, what type of excercise? Not anymore formally bodybuilding

  3. What type of diet do you eat (vegetarian, meat eater, raw, fast-food/organic healthy)? Fairly healthy the last month, but a mix of healthy and junk in the past.

  4. Why did you take Finasteride (hair loss, BPH, other)? Hair loss

  5. For how long did you take Finasteride (weeks/months/years)? 10 years exactly

  6. How old were you when you started Finasteride? 23

  7. How old were you when you quit? 33

  8. How did you quit (cold turkey or taper off)? I was already down to consistently taking 0.3m daily and quit cold turkey from there

  9. What type of Finasteride did you use – Propecia, Proscar, Fincar or other generic? Propecia the first couple of years, then I split Proscar into 1/4’s, then generics like finpecia

  10. What dose did you take (eg. 1 mg/day, 1 mg every other day etc.)? 1mg first couple of years, then 1.25mg, then reduced to 1mg and down to 0.3mg

  11. How long into your use of Finasteride did you notice the onset of side effects? 2 years or so I noticed slight gyro/puffy nipples which was diagnosed and has remained the same. Sexual side effects slowly became clearer as the years went by although libido remained ok until I stopped there were ED issues whilst on the drug

  12. What side effects did you experience while on the drug that have yet to resolve since discontinuation? ED, development of breast tissue, decrease in body/beard hair (and no loss of head hair as is supposed to occur when you stop), decreased libido/sex drive, fatigue, joint pain

Put an X beside all that apply:

Sexual
[x ] Loss of Libido / Sex Drive
[x] Erectile Dysfunction
[ ] Complete Impotence
[x ] Loss of Morning Erections
[x ] Loss of Spontaneous Erections
[ ] Loss of Nocturnal Erections
[ ] Watery Ejaculate
[ ] Reduced Ejaculate
[ ] Inability to Ejaculate / Orgasm
[ ] Reduced Sperm Count / Motility

Mental
[ ] Emotional Blunting / Emotionally Flat
[ ] Difficulty Focusing / Concentrating
[ ] Confusion
[ ] Memory Loss / Forgetfullness
[ ] Stumbling over Words / Losing Train of Thought
[ ] Slurring of Speech
[ x] Lack of Motivation / Feeling Passive / Complacency
[ x] Extreme Anxiety / Panic Attacks
[ x] Depression / Melancholy

Physical
[ ] Penile Tissue Changes (narrowing, shrinkage, wrinkled)
[ ] Penis curvature / rotation on axis
[ ] Testicular Pain
[ ] Testicular Shrinkage / Loss of Fullness
[ ] Genital numbness / sensitivity decrease
[ ] Weight Gain
[x ] Gynecomastia (male breasts)
[ ] Muscle Wastage
[ ] Muscle Weakness
[ x] Joint Pain
[ ] Dry / Dark Circles under eyes

Misc
[ ] Prostate pain
[x ] Persistent Fatigue / Exhaustion
[ ] Stomach Pains / Digestion Problems
[ ] Constipation / “Poo Pellets”
[ ] Vision - Acuity Decrease / Blurriness
[ ] Increased hair loss
[ ] Frequent urination
[ ] Lowered body temperature

[x ] Other (please explain)
I developed tennis and golfers elbow/tendonitis at the same time I stopped and this has worsened and not recovered in 3 years despite stopping the gym weight training and resting. A year ago I developed severe Bells Palsy which I think could be related to my system being so shut down and low in testosterone/HPTA activity. My Vitamin D was below normal range in latest bloods even though I’ve supplemented with it since stopping.

  1. What (if any) treatments have you undertaken to recover from your side effects since discontinuation of the drug?

None really, I have not taken any medication to try and restore my levels (latest bloods show I’m below the normal range for free testosterone: 3 times below average for 36 year old and half that of an average 80 year old). I have been prescribed viagra to cope with the ED but doesn’t address the hormonal issue.

  1. If you have pre or post-Finasteride bloodtests, what hormonal changes have you encountered since discontinuing the drug (pls post your test results in the “Blood Tests” section and link to them in your post)? Unfortunately no pre finasteride bloods but I took bloods every few years since starting. My testosterone was consistently below average but within 'normal ranges. It was at the bottom of the normal range in 2011 at 7 years on. At 3 years post finasteride my latest testosterone test is half the already low level it was at 1 year post finasteride. So things have got worse and the body isn’t recovering on it’s own. I will post results and link them here.

  2. Anything not listed in the above questions you’d like to share about your experience with Finasteride? Not really other than it’s the biggest regret of my life that due to bullying and childhood problems I was insecure enough and without anyone around to guide me away from taking such an inappropriate drug for young men at such a young age.

  3. Tell us your story, in your own words, about your Finasteride usage and side effects experienced while on/off the drug.

The above questionnaire does a good job of collating the basic information but I’m sure it’s hard to do anyone’s individual story justice who ends up on this type of forum looking for help and advice. I imagine I am quite an extreme case as I was on the drug for so many years from such a young age. I was completely consistent rarely missing a dose in 10 years as it was so important to me. I travelled to America from the UK for a hair transplant at 25 after 2 years on the drug and became more committed to the hair loss fight. I had follow up transplants in Belgium in 2012 and 2014. This made me feel more trapped as the possibility of stopping finasteride and losing my hair around the transplants scared me. I cared a lot less by the time I came to quit and now wish my hair would thin!

I had anxiety and depression as a young adult pre finasteride which made me vulnerable to the insecurities that drove me to take finasteride. I also experienced some sexual performance anxiety as a young man so it was harder to put this down to finasteride when it continued after taking the drug. I’m sure it contributed a lot to it as I became pretty confident in general it that department. The ED and complete loss of libido/sex drive are what hamper me now in my mid 30’s but I realise the drastically low levels and undiagnosed but fairly obvious hypogonadism have almost certainly contributed to my recent health problems i.e. tendonitis and Bells Palsy.

I trained at a body building gym for years and a pro bodybuilder first pointed out the slight puffy nipples/gyno I developed after 2 years on finasteride. This was diagnosed by doctors but I never had the surgery suggested as it’s quite mild. The sexual sides were always around but admittedly not helped by my anxiety. Now though they are very clearly purely physical rather than any much mental influence.

I’ve realised that as well as the sexual sides and gyro that fatigue, joint pain, immune system low leading to Bells Palsy, not losing any hair 3 years post finasteride are all likely related to and primarily caused by my use of the drug. My current testosterone levels when compared to an average 36 year old are 2.5 to 3 times below what they should be and half that of an average 80 year old. This is quite different to being ‘low normal’ or ‘just below’ the normal range that the doctors use as an excuse to say things are fine.

I think it is quite clear I have hypogonadism and a shut down of my HPTA axis from my blood work. I have a consultant to make a private appointment with via my GP and I hope to gain advice on suggested protocols from posting on here. I believe a drugs protocol to try and ‘re-start’ my endogenous production is preferable first, and then going down the route of TRT as a last resort. This is from initial reading on here and elsewhere. Does this sound correct? I realise restarting things after 10 years on the drug and no improvement after 3 years off it may be difficult or even unlikely. I don’t like the idea of weekly injections/patches for life on TRT but I know this would be preferable to the shut down feeling I currently have and the wider associated health problems.

All views/opinions/advice welcomed. I will post my bloods in the relevant section and link them here but want to copy and paste a summary of the main ones below (apologies for awful formatting but I’m not a tech head):

Finasteride started May 2004 – stopped May 2014 (2014 results 1 month post finasteride)

			06			08		11			14 (1month post)	15 (1yr post fin)	17 (3yrs post fin)

Testosterone 19.9 nmol/L 18.7 nmol/L 8.3 nmol/L 13 nmol/L 15.7 nmol/L 7.5 nmol

DHT 0.140 nmol/L (0.323 – 1.637)

Adiol-G 1600 ng/dL (168 – 3530)

Oestradiol 122 pmol/L 52 pmol/L 96 pmol

LH 3.8 u/L 5.1 u/L 4.8 u/L 4.9 u/L

FSH* 1.8 u/L 2.9 u/L 2.9 u/L 2.6 u/L

SHBG 29 nmol/L

Prolactin 171 mu/L 125 mu/L 242 mu/L 129 mu/L 188muL

TSH 0.56 mu/L 0.56 mu/L 0.76
T4 13.0 pmol/L 13.8 pmol/L 15.7

Vitamin D 72 nmol/L 58nmol


#2

Please repost with lab ranges: -confused
current prolactin
current TT
current LH/FSH
current E2
T4

FT does not seem to be available there. If you test TT and SHBG, calculated FT is available, perhaps bioavailable T as well.

Eval thyroid function via last paragraph in this post.

DHT presumed low now because low FT leads to lower FT–>DHT

The major challenge will be the NHS and the doctors. Can you afford to go private?

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.


#3

Thanks for your reply KSman. My latest 2017 bloods with lab ranges are as follows:

Testosterone 7.5nmol/L (range 8.4 - 28.7)

Estrogen E2 96 pmol/L (range 0.0 - 146)

Prolactin 188 mu/L (range 45 - 375)

LH 4.9 u/L (range 1.5 - 9.3)
FSH 2.6 u/L. (range 1.4 - 18.1)

T4 15.7 pmol/L (range 9 - 22.7)
TSH 0.76 mu/L (range 0.35 - 5.5)

Vitamin D 58 nmol/L (range states minimum 75 nmol/L required for sufficiency)

In 2014 at 1 month post finasteride my Testosterone was 13 nmol/L (8.4 - 28.7) and my SHBG was 29 nmol/L if that helps work out FT/bioavailable. I’ve not had SHBG tested since as it was done privately.

I also paid for my Adiol-G 1 month post finasteride in 2014 and it was 1600 ng/dL (range 168 - 3530)

DHT I paid for back in 2011 whilst still on finasteride and unsurprisingly it was below the normal range. Adiol-G is meant to be even better than DHT so that’s why I paid for that test in 2014 having come off.

I hope that is a bit clearer than the mess of results above. I am going private my GP has given me a consultants name with whom I’m going to make an appointment. He has said he has seen a number of post finasteride issues and may be able to advise on treatment according to symptoms.

I’m hoping to get clued up on some typical medication protocols online before the appointment.


#4

I have not seen finasteride induced secondary hypogonadism reversed. But could some other causes of secondary occur to guys who just happen to have been using finasteride? Prolactin is not a cause. While E2 is quite obviously high relative to T and low FT presumed to create low FT–>E2, E2 in absolute terms is not high enough to be an obvious cause of secondary.

Testes may respond to hCG challenge or hCG therapy. Perhaps a SERM as well.


#5

How are you doing ?


#6

Hi KSman and je2907 - I’ve got my private appointment with the consultant in 2 weeks time. £300 for 20 minutes damn! My symptoms are just the same. I’ve been eating better and took a holiday to Spain so my Vitamin D is hopefully improved given I’ve been taking 3000iu daily for the last month too.

Saw my GP yesterday and he’s given me a follow up blood test to check if vitamin D levels have improved. I told him that my research online led me to believe that if I want the option of having children TRT wasn’t a good option and should be a last resort. He disagreed but didn’t really explain why and said to see what the consultant says.

I must admit it confused me… I know plenty of bodybuilders who have been on long cycles of gear over many years who have fathered children. Surely that is the same as being on doctor prescribed TRT only at presumably much higher doses of the synthetic testosterone? Why would TRT be any different?

I’m just asking the question as I don’t know enough about the whole topic yet and want to have a basic level of understanding at my consultation in a couple of weeks.

On another forum I’ve been told trying to stimulate my own endogenous via hcg and/or TRT won’t be enough and I need to look into neurosteroids, thdoc allopreg etc but initial research on these goes well beyond what I can understand. I’d still welcome opinions on this though.


#7

Hey any updates on this story bro? Im in a similar boat


#8

Hey daniel1286 was due to post an update, sorry to hear you’re in a similar boat. I’d really appreciate @KSman opinion on what to do next following my consultation.

My consultant has asked me to run more bloods which I’m waiting on the results of. Presuming they still show very low testosterone he has at least said we will try either 1) anti-estrogens (I mentioned Tamoxifen and he said no Clomid) or 2) HCG injections or 3) TRT.

Reading the stickies to this forum had got me there myself but at least he had heard of these things and seems happy to prescribe them.

He said my consistently bottom of the normal range FSH and mid range LH bloods showed everything was as it should be/working optimally in that regard. Would experienced poster here agree?

Main questions before proceeding are:

  1. Should I push for Tamoxifen instead of Clomid (after reading KSman’s recovery protocol it seems I should)?

  2. Should I go for HCG first and then Tamoxifen/Clomid or just straight to the SERMs (doctor seemed keener on just going straight to SERM/Clomid but given how KSman said he’d not seen finasteride induced hypogonadism reversed and having just turned 37 I thought the HCG/SERM combo might be a heavier hitter?)

The doctor seemed to be talking either/or rather than as per the recovery protocol on here possibly combining them, so may have to work on him there.

I didn’t get to discuss with him the fact that a year ago I was put on high dose Prednisone for Bells Palsy and whilst I tapered off it, it coincided with my really low testosterone result. I have subsequently read that Prednisone is effectively high doses of synthetic cortisol and is very HPTA suppressant on adrenal cortex affecting DHEA levels and causing Hypercotisolism which can and does cause severe Hypogonadism. Based on this my GP added Cortisol and DHEA to my bloods. I’m wondering if supplementing with DHEA could also help.

Anyway once the bloods are back I will weigh up what I want to do regarding HCG alone, SERM alone (and which out of Clomid & Tamox) or trying to persuade the doctor to combine them as per KSman’s protocol. I’m not sure of the difference between HCG challenge and HCG therapy that you mention above @KSman can you explain for a newbie?

I will update again in due course and hope you guys can help on the questions


#9

I don’t want to speak for him, but I dont think KSMAN means that clomid/Nolvadex (SERMs) won’t help for your situation. I think maybe he means that he hasn’t seen it reversed permanently without the SERM long-term. I started having issues while using finasteride (just got generally lazy, tough to get up in the mornings, and packed on extra weight) and I can tell you that clomid has worked to boost my testosterone (and mood intermittently). I am going to swap to Nolvadex I think on my next visit tomorrow and see if that is a little more tolerable than the clomid though (clomid made me gain about 10-15 lbs in a few weeks and I started getting VERY tired after a few weeks).

If that fails, I’m probably going to go the TRT+HCG+AI route.


#10

i been using this thing for years, now i can understand what was happening to me
after i stopped using it few years back my T went 60 point up (now i would like to think that)

here is a link to my test and some story
https://forums.t-nation.com/t/trt-and-estrogen/233617/15