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 - PMC

The chart shows me this:


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


Cooper plz check out my thread , I’m recovering from this. I wanted to help you.

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Sorry to be a bummber @Venky7623 but i checked out your thread, you are not going to recover with those ‘‘supplements’’ Yes your orgasms are still numb because something is inflaming your prostate and nerves, probably your gut. You don’t even need to have gut symptoms for this to happen. My recommendation is that try Progesterone injections like i did for a month and see if it helps, if it helps then your issue is also on the gut because:

Progesterone decreases gut permeability through upregulating occludin expression in primary human gut tissues and Caco-2 cells | Scientific Reports.

Go to Reddit and check out the PSSD subreddit, SaffronAide and lastround360. Read the comments and their topics. Get a gut microbiome test.

@lordgains Im going to do a 30 day waterfast, (the thing that i should have done 7 years ago) starting this week, my gut microbiome tests showed up and i have a major lacking on Provetella and Akkermensia bacterias which they are the two major ones that create the gut mucus which acts as a wall for the gut permability.

Theory is that, Accutane instantly changed my gut microbiome somehow (which is pretty possible and expected) and that caused instant pelvic floor issues because they are sitting near each other, which then, years of ejaculation with the f*cked up pelvic floor muscles in turn inflamed the prostate and created edemas (because the semen got stuck inside due to dysfunctional PC muscles, my Dr said this to me.) on top of that years of stress and alcohol, cherry on top. I also have Mifepristone now from the good old China, if waterfast fails.


Hello there, good news is that i started TRT again to fix the ARs after failing with Mifepristone and gut therapies.

After hearing others have recovered with this method, i am currently on this protocol, 3.5 weeks in.

500mg Test E. a week (125 mg eod.)

HCG 300iu every other day.

Do you think that i should also add some Progesterone or the indirect synthesis from HCG would be enough?

And i don’t think i will use an AI, but should i? My E2 conversion seems normal and not high. As for the benefits, it is too early to tell but my semen is getting whiter, and erections are getting stronger slowly!!! Sensitivity is still off though.

Any tips or recommendations? I am using Aburahian Test E Subq. Subq seems more stable and better. No nodules or swellings with that special solvent brand either. Good stuff.

Seems good man and yeah stay away from AI’s if you can.

HCG should help with prehormones although I’m not sure if test suppresses these prehormones. Hope someone else can answer that.

And most benefits from test seem to come after 6-8 weeks imo.

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Has this actually ever been proven? I know it was a theory, but while on TRT I’m not actually seen labs showing HCG will raise prog/DHEA downstream

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I’ve suggested a lighter version of TRT+ months ago, this is cycle territory you’re in. But it would be something I would’ve tried.

I’d do at least six weeks without it and maybe then add it in later. You need to be able to know what worked.

I wouldn’t unless symptoms arise but in your case I would rather then drop the testosterone lower instead of using an AI.

Since HCG facilitates testosterone synthesis, there will be a synthesis of progesterone and other precursors. Apparently they also rise in the blood stream.


Thanks for the feedback guys! @peterson

So here is the thing, for the last 2 weeks or so my improvements has hit a plateau, but this is not a concern for now. People who recovered and my familiar who got recovered with the exact protocol said that the benefits should kick in around 8 weeks in, im at 6.85 weeks in, at the moment.

But i have a concern about injecting the Test E subQ, first off the brand i use is excellent and gets absorbed well because it is so painless, smooth and leaves up zero nodules or swellings. They use a special oil with zero solvents due to religious reasons (Iranian brand.)

But, i didn’t know that i need to change\ rotate the injection site THAT MUCH, on a legit website, they tell that i shouldn’t inject in the same spot again within 4 weeks.

Not on the same spot exactly but i may have broken this rule a little bit, plus, as @lordgains may remember, i was injecting Progesterone for months last winter, and that kinda damaged my belly a lot, i could still feel some damaged tissue 6 months ago, when i massaged my belly, like hardened lumps within…
Anyways, and now, im thinking about how well my Test E. is being absorbed… Another reason for this concern is that:

My voice didn’t get deep as it did before. It is still the same. When i was on Test Cyp 200mg a week and injecting intramuscularly (Also tried to inject SubQ 2- 3 times and realized the lumps ain’t worth it), i remember clearly that my voice was deeper than ever, around just 4 weeks in. And i also remember that i was sweating more, my eyebrows were thicker and i had a stronger body odor.

However, that doesn’t mean that i don’t notice any difference with my current protocol:

  • I’ve been waking up with a strong morning wood, (Although it is gone away a bit for the last weeks.),
  • My semen density is better
  • Libido is better
  • Erections happen faster and stronger.
  • A little bit of the erection size also came back.
  • My body is really changing, i posted my pictures to my GF (Love of my life, so happy we found each other.) and she also said that i loook more masculine. My bodyfat is much lower, without nearly zero exercise i gain muscle!? I can see my ABS when i pose (Never had this.), chest and shoulder muscles look more defined?! And i gained 4 kgs! Appetite def. has increased.

Apart from that my main sensitivity and numb nerve\ prostate issues still continue, although sometimes i experience a bit of return. No thicker eyebrows, voice or sweating changes though.

So, is there any chance that my Test E. isn’t getting absorbed well? Again, im doing 500mg a week this time!
I will have a notebook or something to rotate my injection sites on my belly from now on, better that way.

Anything else youy guys can say? Should i switch to I.M? But i guess that would throw off my E2 and SHBG levels due to absorbtion rate changes.
The guy i talked with used the same belly injections with the same Aburaihan Test E. brand and recovered that way, so…
Maybe this method needs more time to build up in my system and the results will kick in later than Test Cyp?

Any tips and info would be great, thanks! @iron_yuppie

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Your linked site (bd, indeed a reputable source) says this:

Injection sites should be rotated with every injection. Inject at least one finger-width away from your previous injection site and try not to use an injection site more than once every four weeks.

and importantly they are talking about insulin (and antidiabetes) injections which are sub q.

You should inject i.m. in my opinion and yes, don’t inject exactly the same spot twice in a week or a few. Remember that insulin and diabetes meds are injected several times daily.

I would not worry as long as you are not injecting into existing lumps. Again, just go i.m.

Seems you came a long way. When you first posted, you had a basically dead penis. Great for you but I would reconsider all the trying out now.
Maybe go back and try cialis as this should improve erection quality. I know, maybe not what you want to hear, but after this cycle, I would not experiment further and give it time and some cialis. You are after all possibly damaging overall long term health with cycling and try outs of all kinds of drugs.

Glad that you found a girl and it is working out.
You are on a steroid cycle, that is exactly what is supposed to happen. Even with no training at all you should gain more muscle than someone who is exercising; that’s what high dose testosterone does to beginners.

I don’t think so. The muscle gain speaks for itself.

I would and would not worry about SHBG and E2 for now, but that’s entirely your choice.

Since you are 7 weeks in, I’d give it maybe 10 and then PCT.

Watch out for when you stop the testosterone, after all most people feel shitty and some have bad sexual functioning during that time. Don’t worry too much when that starts, time is your friend then. Do you have the PCT ready?


Sorry im on mobile right now, thanks for the feedback.

Is going i.m really better than subQ? What is the pros and cons for real? Someone showed me this video:

Basically, what he recommends is:

  • 0.5 inch needle inserted into the deltoid muscle. Supposedly this should give a superficial intramuscular injection that is painless and efficient.

Should i try this instead of 0.3 inch subQ injections on belly?

Would going I.M cause unbalanced T spikes therefore cause high E2 or work not as good as subQ regarding my spesific androgen receptor syndrome? I heard SubQ is more stable and risk free regarding the spikes.

And well, im not gonna stop at the 10th week, i came this far and i have read that the benefits usually come after 10 weeks in… So. I’ll keep doing this until something happens i guess. Yes my PCT is ready. :slight_smile: Thx

Blood work would tell you

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Btw, i didn’t inject on the same area, never. But i really forget my spots most of the time and maybe i ended up injecting closer to an old spot… Because i also inject HCG on my belly, the spots get reserved quickly… I’ll keep track of it now if im not gonna start shallow I.M.

Today i decided to use a half an inch needle and injected into my vastus lateralis (side, upper/ mid thigh) muscle. I hope it did hit the muscle. I mean it should be.


I have a worrying problem, i will keep this short and clean.

My testicles have actually shrunk! This happened around last week or so i suppose because i didn’t notice it before.

I’ve been using 125mg Test E. and 300iu HCG every other day, together, since 5th of August.

I missed something like 2 to 3 shots of HCG around September but that didn’t cause any problems.

Again, i ran out of HCG last week and missed 2 shots and also injected Test E a bit lower than 125mg.

Now i bought new packages and im all clear but what i have realized especially after shaving the boys today is that my testicles are actually shrunk!

Why did this happen? Was my 500mg a week T shots were too high for 300iu HCG to prevent atrophy?

Will my testicles and scrotum size and function go back to 100% normal after PCT?

I now upped my dose of HCG to 500iu eod intramuscular until i see them getting bigger and i will quit my Test. protocol after this package finishes.

I kept my HCG in fridge, no light damage, last vial was bought around September 15…

I used the same needle that i used to draw Aburaihan Testosterone, while im mixing the HCG maybe that damaged the HCG molecules or what?

Especially my right nut feels like a marble to touch! It was more oval shaped before.

Im kinda freaking out. I hope this is fully reversible, at least i have ultrasound measurements so i can compare after PCT.

I remember @lordgains mentioning his testicles were ABOVE pre- steroid healthy baseline on Clomid before… Temporarily though? So i guess it is possible to fix it fully at least.

Will having grade 2 varicoceles halt or prevent my balls to go back to normal during PCT btw?



@Singhbuilder @zeek1414

What im afraid of the most is, i did solo runs of Tamoxifen, Clomid and HCG on proper doses but they didn’t bring my testicle size back to pre- pas levels or let alone had any affect.

So im afraid this time i might also fail to bring them back to PRE- TRT size and function?

Or is this faulty and negative thinking?

Also, last note, my flaccid penis is also shrinked now. It is really bad to look at. WTF.

I think im gonna stop the TRT and just go on with 500iu HCG and then do a SERM pct.

You indeed have a worrying problem but read differently than you meant it.

You can’t be serious asking these questions AFTER you are on this forum for 2 years and we talked to you about cycling and AAS several times. You are in the Pharma section, people come here with this exact problem every single week.

No. Not possible.

No one can tell you that, that’s a risk steroid users take. Chances are very high that they go back to normal. When taking HCG on cycle chances are nearly 100%.

I don’t know. Why not take a fresh one with no oil on it?

They can lead to lower test and lower sperm count in their own right. I would not bet on them to change your response to PCT.


Thanks @lordgains, im having a hard time lately. That eased my worries.

May i ask what dose should i use it now? And when should i quit HCG and get back to Clomid?

Im taking a fresh new HCG 600iu eod into my delt muscle, shallow i.m. As i said, i stopped the TRT.

Is that ok?

WHEN should i see my testicles getting back to pre- TRT size again by the way? Any ideas about that?

Thanks a lot brother🖐️