T Nation

Advice for PCT? (Post Accutane Syndrome)

Hi Cooper , how are you now? Any betterment after progesterone treatment? Did the results last long after it

Please get a doppler ultrasound scan. I ordered Mifepristone but thinking to fix the gut first.

Update: I think i may found the actual problem and a possible cure.

Makes sense. This guy says that my leaky gut caused Pelvic Floor Dysfunction, which then causes prostate inflammation which can explain all of my sexual problems… Jesus christ.

@lordgains all of this time, worrying about my androgen receptors and gene expression and stuff… Maybe i have none of these…
Thinking back, not losing my libido or crashing immediately like others and getting worse SLOWLY points out that maybe i had a gut related problem after all?

I remember passing gas excessively in the mornings for few weeks after i quit Accutane. This guy says that ‘‘It was the bad bacteria taking over in your intestines, Accutane sure caused that it has nothing to do with receptors and stuff.’’

Isotretinoin and intestinal damage - PubMed

Is this could be true? I am going to do a gut microbiome test now with oral acid test.

When i said that i have improved on Progesterone to this guy, he send me a study: Progesterone decreases gut permeability through upregulating occludin expression in primary human gut tissues and Caco-2 cells | Scientific Reports

He said that this is why i felt better on Keto diet and on Progesterone. Because my gut was started to fix itself? I remind you i don’t have ANY gut related symptoms that you can search on google, maybe some to a slight degree time to time but nothing major.

But guy claims symptoms can be silent and the gut mucosa damage causes a lot of inflammation on the organs etc. I want to also remind that there are at least 10+ people i know who recovered with waterfasts etc. Some temporary but still… Waterfast fixes the gut microbiome!

@lordgains Maybe i am close to finding the cure after all after all this time? What you think, very interesting thread on Reddit.

God damn, maybe everything besides my gut area developed just fine. LOL! What a relief to think about this. Btw, this guy had the EXACT symptoms as i, very very similar sexual symptoms. He said that after Flagyl and probiotics and such, everything reversed back to normal and claims his testicles are even bigger than before after taking L.reuteri probiotics after recovery.

I think im gonna try a 14 day of waterfast. First, let me get the gut microbiome tests, they cost 3K+ 3K of money though, lol whatever.

Another example, see the last sentences.

Research on the gut is in its infancy at this point. The problem with talking about gut dysbiosis is that nobody knows what optimal gut microbiome looks like. The research on this stuff proves to be very difficult. I’m not counting out that it could be your problem. After all, I’ve said repeatedly that it’s odd that your symptoms did not start immediately.

I tell you what I wouldn’t do: spending 6 k on tests that won’t give you what you are looking for.

I wouldn’t even spend 1000 $ on it.

If you think your gut microbiome is not good, just do the treatment, it won’t do any harm usually and if you improve, you’ll see. You don’t need the tests.

If I had some more money (soon!) I’m going to work on my gut microbiome too. I that that the microbiome gets changed every bulk and cut and some adaptations are more healthy.

Be careful with the water fast. You need electrolytes and maybe even some vitamins and minerals. If you induce a bad case of electrolyte deficiency through drinking water that lacks sodium, potassium and others, you could die. You need the right electrolyte providing water for this. Consult a physician (to do a basic mineral reading beforehand maybe).

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Thanks for the concern, yep i will do the research needed before the waterfast of course. Regarding the tests, well, the admin deleted the Reddit post i mentioned but in there, the guy gives great info about why we should do the test because we need to know the exact microbiome in order to pick the right treatment, it is really complex and i want to see the evidence of my disease, i will try to find a cheaper test with insurance in a hospital.

Yeah, well it was much much mild when i first ‘‘crashed,’’ then it progressed badly, slowly but surely.

Closing the past now, still i want to give an one last thought to the hormone\ receptor theory.
Considering my TT and LH was always a bit lower than average?
Is there a chance that Accutane permanently damaged my LH production (HPTA) somehow?

If so, why i didn’t experience any of the classical low T symptoms when i was 16? I really don’t remember anything changing in my life except lowered semen volume. No fatigue or an immediate change of mood. No sleep issues or abrupt changes in my libido. No dry skin etc.

If that was the case i MUST have experienced some of those right? Or that my body was young and developing so that it somehow blocked those side effects but i still had low T ?

Besides that considering i tried Test injections and HCG (fixing my low LH) without any improvements+ i know many SEVERE cases with Total T of 700 or more… Is it fairly OK to assume i have 0 problems on my androgenic endocrine system if HCG, Clomid and Test. trials didn’t even change a damn thing?

Really, it was like taking candy pills and doing some water injections. Except i responded with a deepened voice to Test injections and had more sweat etc. (indicator of my receptors are not ‘‘muted’’ to androgens?)

Maybe, my genetics somehow programmed me for below average TT due to my receptors being sensitive or something? Do you know your own Free T numbers @lordgains? I surfed the whole web and i still can’t find a proper study with mean levels by age considering the Free T. Weird.**
If you know an average Free T chart by age, please let me know.


I could only find this, which is done on Japanese men. I am not sure if it is ok to compare myself with Japanese genes for accuracy. I also found this on another study, LMAO give me a break life: The Japanese men also had higher levels of a testosterone-binding hormone, however, so less of the testosterone was free to act on tissues.

And in this site it gives a chart of 20 ng\dL being the optimal, but when i convert that to pg\mL it shows 200 pgmL as normal?!!? The top range on my paper was 54pg. Im gonna go crazy, how do i convert ngdL to my unit pg\mL? It always gave weird and abnormal numbers.

And if you do a research even the unit is pg\mL, there are multiple different numbers for it, some showing 20’s as the optimal and some showing 200 pg\mL as optimal?!

I had 550 TT when i was 19 with drinking and bad lifestyle, maybe without those i could sit on 700’s? So maybe it was all about my lifestyle and not Accutane?

Btw, should i have a LH number of 7 at least, do every other healthy person at my age have LH of 7? Did i miss my optimal endocrine development? Because i have found this chart:

I really wonder if my hormonal profile, mainly LH and Testosterone is affected any bit due to Accutane? I run these thought experiments so that, hopefully, you can give the best possible answer to this and finally, i want to close this page, forever.

Big thanks.

Found one more:


Should i look at where that black box ends or that thin arrow like line? Isn’t it weird 14.7 aged males had almost 1 levels of LH? There is something wrong here…

Here is the source of this study within that study, it is done on normal children and guys: Assessment of basal and gonadotropin-releasing hormone-stimulated gonadotropins by immunochemiluminometric and immunofluorometric assays in normal children - PubMed

ONE LAST THING: When i search for mean ranges of TT, studies usually show me 600- 700 of total T between 18- 30
But when i look at this study: A Validated Age-Related Normative Model for Male Total Testosterone Shows Increasing Variance but No Decline after Age 40 Years

The chart shows me this:


According to this chart im on the %50- 60 range. Which is pretty ok and on the mid.