Advice for PCT? (Post Accutane Syndrome)

Pharma / TRT
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Well, because i think that’s why it’s not working well on many people. An another PFS guy for example, felt recovered fully with Clomid for a week but then crashed. Maybe due to Estrogen increase and effects of Zuclomiphene? Im not sure of course.

Yeah, i have been researching a lot and there is very little info on Enclomiphene. I found this chart and im kinda scared of Tamoxifen’s affects on bone. Wikipedia info states horrible stuff on Tamox and how it damages bone growth etc.!
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That’s too difficult to pinpoint. But I will state that in my opinion it is far more likely the side effects came from the clomiphene than from a rise in E2.

Cancer patients take Tamox for A MINIMUM of 5 years while you are going to take it for a few weeks. I don’t think you should worry about your bones.

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I think im going to use Tamoxifen because my impatience grows. Who knows will i ever receive my Enclomiphene.

I tried to find some sources about the tissue spesific Estrogen agonistic effects of Enclomiphene and Tamoxifen. There is very little information about Enclomiphene. Im assuming Enclomiphene’s effects on bone and other tissues are similar to Tamoxifen? So maybe there is no need for me to wait for Enclomiphene? If there isn’t any chemical differences?

I also thought about trying HCG after researching a bit. It increases bone density and heals prostate in addition to T increase at low doses. Supressed LH, well maybe it will recover naturally. My mind is a mixed bag.

PS: Just visited hospital and my Prolactin is 32.35 ! Holy shit. What’s going on? (4.60- 21.40) I did some research and it is clear that MK-677 i use increases Prolactin but it should not to this degree…

My total T rised up to 490 though. Which is nice.

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I would have preferred if you tried. Here’s a link for you:

In the pharmacology section there is a table. I tried to prove this table with studies but the studies are contradicting. That’s why I said it’s difficult to verify and find good sources.

They are very different.

I don’t think there is a need.

There are chemical as well as pharmacological and metabolic and other differences. But I don’t think they really matter in your case. Start with Tamoxifene.

You could take it for 3 weeks before starting tamoxifene. 2 injections a week.

What did the docs say about that?

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Currently my doc didn’t comment on my Prolactin but i don’t really care, it’s probably due to mk-677.

I did. I checked out many studies and also i saw that chart too. However there isn’t much data on Enclomiphene. What makes me hold at this moment is this:

However, one in vitro study in 2007 and later an in vivo study in 2008 have shown that tamoxifen induces apoptosis in growth plate chondrocytes, reduces serum insulin-like growth factor 1 (IGF-1) levels and causes persistent retardation of longitudinal and cortical radial bone growth in young male rats, leading the researchers to express concern giving tamoxifen to growing individuals.[107][108]

But same page also states this:
When tamoxifen was launched as a drug, it was thought that tamoxifen would act as an ER antagonist in all tissue, including bone, and therefore it was feared that it would contribute to osteoporosis. It was therefore very surprising that the opposite effect was observed clinically.

Another source from another site: Studies in vitro and in animals have shown that the effects of tamoxifen on bone resemble those of estrogen. It reduces bone resorption and turnover, stimulates bone formation, and prevents bone loss after oophorectomy.8 9 10 11 12 13 14 15 Its effects in humans are less clear; data from longitudinal and cross-sectional studies of small groups of both premenopausal and postmenopausal women have shown no evidence of accelerated bone loss and some evidence of preservation of or increases in bone density.16 17 18 19 20 21 We report the results of a prospective trial specifically designed to address these uncertainties.

NEJM Journal Watch: Summaries of and commentary on original medical and scientific articles from key medical journals Also this study again says: However, the tamoxifen group had a significantly lower median serum alkaline phosphatase level (suggesting decreased bone turnover or bone remodeling) and a significantly lower rate of new bone formation. (What the hell?)

I want new bone formation, that’s why im trying to recover, i want to grow prominent brow ridge, cheekbones and jawline if possible. My brow ridge is very flat. Im not sure if these thing related to those terms about bone health.

I mean, what the hell? This is very contradictory. It is proven Tamoxifen doesn’t affect bone density or bone mineral content, it even increases it in some. But other horrible things i shared about bones are still there.

Considering my biggest concerns, im afraid about this ‘‘persistent bone growth retardation’’ Also i don’t really know stimulating bone formation or reducing bone turnover and resorption is good or bad for me.

PS:
Bone turnover replaces old bone with fresh new bone. When in balance and not excessive, bone turnover is a beneficial feature of skeletal homestasis. However, in the adult, bone turnover is usually not balanced, with bone resorption exceeding bone formation, and sometimos excessive. In these settings, bone turnover can be deleterious for bone (130).

Things are getting just more complex when i dive in. Lastly, are these effects temporary or permanent changes on bones? No one talks about this, im ok if they are all temporary.

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47

Im waiting for your last opinons, i added some sentences and changed my last post a bit. Added things. I think im going to really lose my mind if i don’t start a protocol as soon as possible. Almost took the Tamox pill but holded myself. Thanks.

Some notes:

  • Osteoblasts, osteocytes and osteoclasts are the three cell types involved in the development, growth and remodeling of bones. Osteoblasts are bone-forming cells, osteocytes are mature bone cells and osteoclasts break down and reabsorb bone.

  • We also found that urinary NTX, a marker of bone resorption, increases after withdrawal of tamoxifen, a finding that supports our hypothesis that the decline in BMD seen after withdrawal of tamoxifen is similar in character to that associated with withdrawal of estrogen. (So i guess these effects on bone are temporary? Yay : ) )

  • Remodeling or bone turnover is the process of resorption followed by the replacement of bone with limited change in shape; this process occurs throughout a person’s life. … Bone remodeling : Bone tissue is removed by osteoclasts, and then new bone tissue is formed by osteoblasts.

  • These results suggest that tamoxifen increases BMD of the lumbar supine by reducing the bone turnover in postmenopausal breast cancer patients, and this bone restoring effect of tamoxifen is more marked in ER-β 21 CA repeats allele carriers than non-carriers.

  • Bone turnover replaces old bone with fresh new bone. When in balance and not excessive, bone turnover is a beneficial feature of skeletal homestasis. However, in the adult, bone turnover is usually not balanced, with bone resorption exceeding bone formation, and sometimos excessive. In these settings, bone turnover can be deleterious for bone (130).

  • Markers of bone formation declined 17-36%, with a variable return toward baseline. short term effects of tamoxifen on bone turnover in older women | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic

From what i understand: Reduce in Bone Resorption via Tamoxifen= Osteoclast reduction. I think that’s a benefit for me rather than negative. But, im not sure the role of Osteoclasts on growing new bones and remodeling them. I have read that it levels needs to be ‘‘Balanced’’ in body.
This changes seems temporary so im happy, only thing boggles my mind is this:

Without this, it seems all is well.

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Hey Coopper, I got a lot to do at the moment but it seems I can dive into your questions tomorrow. I’ll try to cover the AR theory you mentioned and your questions of today.

PS: Watch out for these cycles.

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You are right here.

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You seem to be over complicating this.
Why did you decide against clomid?
You had received good advice, yet decided on tamoxifen because you read some side effects of clomid?

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Thanks a lot! Jeez. These must be the darkest days of my life, i hope i can get through this.

Only thing that needs an urgent answer is this issue about persistent retardation of longitudinal and cortical radial bone growth in young male rats

This is on wiki about Tamoxifen.
I learned you are a pharmacist btw, that’s cool, now it makes sense.

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First tamoxifen. Tamoxifen acts as an ER agonist in bone so it promotes bone thickness. It’s used in pre menopausal women with breast cancer and it prevents osteoporosis depending on the amount of estrogen present before treatment.

Tamoxifen also closed up the growth plates (again estrogen like action). It’s speculation from the authors of the study you cited if Tamoxifen stops growth in man. In women it’s even more unlikely.

Look here:

We conclude that when pubertal bone development is concerned, tamoxifen is safe for the treatment of pubertal gynecomastia as neither bone mineralization nor growth potential was affected.

Wiki is a sometimes nice source but not the best.

Man, you got a lot of advice for tamoxifene now. I understand your concerns, it’s intelligent to do research before. But if you want to start something, Tamoxifene is relatively safe and you can do it now. Just see if you feel better on it.

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Yes, I’m starting in neuroscience in December. That will be the road I’m going down for the coming years.

I started answering your other questions but I’m pressed for time now, I’m gonna finish it at the latest on sunday.

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I will read the studies and re-read my own findings tomorrow. Thanks again! I feel good about my future.

My only concern is Tamoxifen’s effect on facial bones etc.
I want to lengthen my shoulder bones, lengthen my mandibular bone (lower jaw), brow ridge, jawline prominence if possible. I hope Tamox won’t damage that, unlikely it seems so far?

My long bone growth plates already closed at this age anyways.

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I took my first dose just now, at 11 p.m. My 10mg pill didn’t cut in half perfectly. I guess i need to buy a pill cutter. It was slightly less than a half.

Anyways, i just took 5mg of Tamoxifene Citrate. I wonder, should i do this every other day or every day. I want to increase my dose to 10mg eod after a week.

Someone said: Tamoxifen’s half life is long so i should take it every 3-5 days to keep a consistent serum concentration (?)

‘‘The decline in plasma concentrations of tamoxifen is biphasic with a terminal elimination half-life of about 5 to 7 days’’

Finally, im here. At this moment. I pray to god, if there is any, to recover. Thank you to all.

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The half life is way too long to worry about 1 mg more or less. If you took 4 today, you take 6 tomorrow. Don’t worry.

No. I’d take it every day or every other day, that’s stable and since it’s a pill, it isn’t much hassle to pop one.

Good luck!

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57

Don’t ask yourself these kind of questions. That’s not something you can change acutely maybe never. You don’t know if there is even a problem. Focus on the things you can control and see where it leads you.

There is the possibility that the retinoid damaged some cell types more than others yes. The epigenetic make-up of a cell differs from tissue to tissue which means that different regions of the genome are active ergo there’s is a difference in distribution of RXRs and RARs which are the elements that respond to retinoids. These receptors are so complex that not even today there’s a real understanding of all their implications. They form heterodimers with various other receptors (for example the androgen receptor at the ARE) and therefore influence a wide variety of pathways. Then it gets even more difficult because they not only form active heterodimers but they also form inactive ones (this is called corepression). So yes, retinoids can in fact change the expression in some tissues more than others.

Since you send the PDF, I guess you also saw the website where it stems from. The authors are just speculating in my opinion. There’s some passages that I don’t think are quite logical. But all that would need further research. But if you didn’t already, you can read the articles they post for yourself.

https://www.propeciahelp.com/post-finasteride-syndrome/

You can see that with a blood panel and you posted one, so yes your LH is lowish but not extremely low. I also don’t know WHY you got low LH and T levels, is it genetic, is it stress, is it accutane? That’s difficult to answer since your T is not extremely low.

See here. Your T levels are good for your LH so your LH receptors definitely respond and your balls work.

FSH is responsible for sperm production, so if you get that up with Tamoxifen you should have more sperm. Let’s see how that goes.

I would have to know what you look like. Do you have a beard? Do you have any signs that you are not fully developed? Or is it just the semen and sexual issues?
I’m skeptical of the idea that you can unlock 1000% masculinity, the changes would be subtle except for if you have really serious signs of underdevelopment but that would have a been a thing a doctor catches. So I tend in the “no0 direction.

Here’s a few tips I insist you follow:

I’ll add:

Don’t avoid every stress, you need to do something that you find worthwhile. Eustress is good for you in a moderate amount.

Also no fap. See if your semen is thicker if you don’t jerk off often.

No porn or video game excesses. You gotta become sensitized to dopamine. Also I’d add no scrolling (Instagram, TikTok and the like). It fucks with your brain, emotions and sexual well being.

No excessive researching until late in the night. Do it during the day and set time limits.

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Thank you for everything. Im on mobile now so it can be a little messy.

Just these, i have beard under my chin, my face did change since 16 too. And people say i did grow 1-3 cm’s. My father always measured himself with me, standing next.

Im a good looking guy too but you know this is a very traumatic obsession, after all what happened and what i heard about this drug… Even a slightest possibility that it damaged me makes me so sad. Maybe even halted my penile development… Many people, including today in gym told me that i don’t look like 22. More like 18. Still have the god damn acne.

For example, 5 of my close friends posted pictures for me from side profile and they all have more prominent brow ridges than me, my brow ridge is very slight. And my lower jaw is a little behind, as if i have very slight receeding chin. Check this study out: Effect of low-dose testosterone treatment on craniofacial growth in boys with delayed puberty | European Journal of Orthodontics | Oxford Academic

So i think whether these small issues due to lack of GH and T. I took an endocrine distruptor before even my T levels peaked, at young age. So i think what if my hormones never peaked as they should and i missed my true potential and looks? I had a very high and good libido before PAS.

Can body reach to it’s genetical potential even with reference range T values? Or we need what we should have in order to maximize our genetical development?

Do you have any idea that can Accutane or PAS damage my GH or T levels persistently? Nobody i talked can say a thing about this.
Body is also very smart, a Professor Endo said to me that every cell and receptor regenerates and clears the damage… He said it is unlikely that 3 doses can cause such thing, (but yeah here i am)
So i keep holding on these thoughts and clear stress.

I think there is no more need for me to make research, thanks for that detailed info about cells. But i think best thing is to quit and forget this disease altogether because now im on a protocol and need to stay away from all of this to recover. Im an artist so i should focus my art a bit more. Those were my last questions.

:+1:t2:

Lastly, eod is a good idea then rather than every 3-5 days? Allright. I had dizziness-vertigo today due to Tamox. I hope that goes away.

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After reading this my brain braced for the impact of six Dickpics

People with acne always look younger. The acne is going to get better with age, trust me.

Difficult question. I don’t know of there’s guys on here who got a bigger chin during cycles or during GH usage. I didn’t hear from anybody who reported that. It would be risky to try if you don’t want to cycle anyways.

Because there is nearly no research on this.
As I said, your T levels didn’t look bad in the first labs you posted. Just normally in the lower half but not low.

I think he’s wrong here. Epigenetic changes have been proven to be able to persist for a lifetime. Doesn’t mean that that happened to you. The changes I’m talking about stemmed from a way longer impact of environment. I’m just saying that I think he’s wrong.

I think that is the case for now. Let’s see how your next weeks go.

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Should i jump to 10mg eod now or continue with 5mg eod? I think Tamoxifen is slowly working, i am feeling good. No sides and my libido and erections seems better. Early to tell but im happy at the moment.

I found this regarding dosage: Effect of lower versus higher doses of tamoxifen on pituitary-gonadal function and sperm indices in oligozoospermic men - PubMed In conclusion higher doses of tamoxifen in this study prove not to be superior to lower doses in improving mean sperm density and total sperm output.

However, i don’t care about my sperm. I don’t know if increasing to 10mg eod would do a better job for my symptoms.

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Give it a week more. You can always increase the dose but if the low dose protocol starts working then don’t change it for now because this is a protocol that can work long term. Higher doses usually don’t work as well long term (cost, taking it every day, increased chance of side effects,…).

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