Advice for PCT? (Post Accutane Syndrome)

Thanks. So just to make things clear.

On the Melcangi study i shared they say ‘‘Altered methylation pattern’’ (Of 5AR2 gene in CFS.)

On the Baylor study they say ‘‘Gene expression changes’’

Which one is the one we actually experience?

Is it just both together? Can be both? Or that our DNA is healthy but just the expression of the gene and RNA transcription related stuff are altered?

Let’s say i have altered AR gene on my penis. Would that cause lack of development due to lack of protein synthesis? Or the body needs ‘‘enough’’ amount of gene expression and hormones to reach and complete its ideal development state? Would just a slightly altered AR gene cause unhealthy strings of RNA and preventing the needed ideal protein synthesis fully?

Another example is that let’s say my body programmed itself to have 700 of TT so that it could complete the ideal bone growth and development according to my DNA data. Let’s say Accutane permanently altered my TT production via damaging genes on my testicles… Would that ‘‘necessarily’’ cause lack of development on my bones or organs and tissues or the lack of it is still ‘‘enough’’ for my genes to do their job.

Btw, i know a more severe PAS case who recovered after 17 years of suffering… He shared his DEXA scan and his bone mineral content and his total bone mass was pretty healthy, nothing seamed out of range or below. Would that alone may indicate properly working AR gene on bones? Considering even low T can create osteoporosis, our issues are much more severe, so his bones turns out healthy! I will do the test oo.

I know these are hard, theoric questions to answer but i think you may have some general ideas about it.

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Btw, my latest results on TRT. I did this on private lab so my money could cower just 3 hormones. I will add new ones this week.

Free T= 6.53 PgmL
IGF-1 275 (2.2 IU HGH sometimes daily sometimes eod.)
E2= 38.21

My free T is 6!!! It was 20 before when i wasn’t taking anything how is this possible? I am sure my stuff is legit.

Increased SHBG? A guy on our group said TRT can ‘‘expose’’ a bad thyroid and that can cause SHBG issues. He suggest me to check:

TSH, Free T3, SHBG, Free T4

What should i test for? I can hardly cover 3 hormones right now.

Can TRT cause thyroid issues in just like 3 weeks in with it? Why my SHBG skyrockted if it did? Damn. (we will see.)

It works like this:

DNA is rolled up on histones. Inactive. The roll up can be intensified or less intensified by histone modification. Then when DNA should get transcribed into mRNA, it gets rolled off of the histones. Then the DNA itself can be methylated, preventing transcription often. If it is good to go, an enzyme reads the DNA and writes the mRNA, a copy of the DNA strand. Then the mRNA goes through a few modifications or not and then in the cytosol a ribosome comes along and takes the code from the mRNA to translate it into a protein.

Expression = transcription and translation

This includes all modifications that are made on the way! Oftentimes these are to stop or inhibit the full translation, then the process stops. But other times these processes are included to modify the end result, protein.

Very complex, poorly understood in most cases. Fundamental research can’t use the produced findings to achieve therapies yet.

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I understand, thanks for the effort!

Can you please take a look on the other questions on my second comment above? Thanks.

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Yes. That’s one mechanism of down regulation.

Don’t worry about the number. I have probably thousands of genes up and down regulated compared to you regarding a subset of cells at any given time point. The important finding is the significant AR up regulation.

They have thousands more even in the penile tissue. You can only look at so many genes simultaneously in sequencing approaches. I won’t go into detail but the method has a problem of dimensionality which means that you have to reduce the number of genes you look at to a few thousand. Don’t worry about the number. If one pathway is changed usually hundreds of genes are differentially regulated.

No. There are things thrown together here. If the expression changes, there’s less mRNA produced, not broken RNA.

Maybe. It usually does. Environmental changes induce expression changes. Not taking the drug is a change. The body then can revert back but not always.

One can assume that logically and also assume the opposite logically, like me. We don’t know.

You could have, but unlikely. I don’t know how to test that.

Not only our bodies but also our different tissues and cells. That’s why I’m assuming that not all of your body reacted the same to it.

Yes. Everytime there are environmental changes.

More later.

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Thanks for the reply, i have some questions about your answers. But i will save them for later i am kinda busy this week.

But the one thing that i want to ask again is that will decreased amount of X hormone or enzyme or decreased amount of gene expression necessarily create a lack of growth on a tissue, avoiding maximum potential of genetic expression?

People always say do sports when you are young to grow taller etc. Is that really true though? My endo said a height can change due to enviromental factors but how that small spikes of IGF- 1 can really make you taller as a kid doing sports, can change your genetic potential? And i guess height growth requires much much more and can change but not facial bones for example right? So longitudinal growth seems to be affected a lot from environment but not others…

I don’t think one has a bigger cheekbones or jaw just because he did sports and lived healthy? It must be %98 genetics. Only a hardcore genetic disease which causes lack of that given hormone might alter the facial bones in my opinion after much research.

IGF-1 treatment for 4 weeks restored the total height of the proximal growth plate of the tibia. Thus, the double gene disruption LID+ALSKO mouse model demonstrates that a threshold concentration of circulating IGF-1 is necessary for normal bone growth and suggests that IGF-1, IGFBP-3, and ALS play a prominent role in the pathophysiology of osteoporosis.

‘‘However, growth as determined by body weight, body length, and femoral length did not differ from wild-type littermates. Although our model proves that hepatic IGF-I is indeed the major contributor to circulating IGF-I levels in mice it challenges the concept that circulating IGF-I is crucial for normal postnatal growth. Rather, our model provides direct evidence for the importance of the autocrine/paracrine role of IGF-I.’’

For example, take a quick look on these studies. I have read these a long time ago, i don’t know in which one but in of these:

Scientists deleted some IGF-1 gene nearly to full extent on mice and compared the development with controls. There was no difference.

So like let’s say.

Accutane changed expression of my AR genes on my bone, penis and maybe even my IGF-1 receptors etc. (And i guess which is very unlikely given i just took 3 doses and i still have acne and oily skin right?)

Will that necessarily reduce my genetic potential of organ (prostate, penis, muscles) and bone development for example? Or was it still ENOUGH to accomplish my genetic potential.

In that study they talk about a ‘‘Threshold’’ levels of IGF-1 was needed for normal growth.

Threshold levels! That is so damn interesting and good to know.

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So less proteins being produced for that organ to develop etc.?

Really? Do you say this as a steroids user or that even normal people have this?

Btw, im convinced that PAS must be downregulated AR now. My numbness on my genitals has increased. I stopped my TRT and started a PCT with Clomid. (Couldn’t get Enclomiphene)

After that, i will end this nightmare with a proper AR antagonist. I feel close and happy.

Who says this? Lol literally never heard this before

Yes, less protein produced.

As a normal person I’m saying this.

We’ll see how your bicalutamid trial goes but I’m having some issues with your thread now again.

So I sum up (correct me if I’m wrong):

  1. You developed your sexual issues only years after taking the drug

  2. You still have acne and oily skin

  3. You care only about if your bones grew the way they would have “normally”

  4. Your hormones are alright

  5. You don’t care about your several health now

Can you please remind me what problem you want to solve now?

I can go through the studies but it takes a lot of time (as you know) and I won’t do it to no avail.

Do you want to fix your sexual performance issues? I think we can do that. Can you come to terms with your bones? I hope so. Make your peace with that topic.

What mental symptoms are these?

And what about this?

There’s a lot of mental issues that can completely wreck libido and orgasms. I am now thinking again that this might be your problem. If it was, I would completely understand. There would be no shame in it and you could actually do something about that.

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  1. Yes
  2. No, i care about my sexual health of course, developmental concerns are just the cherry on top, you know?
  3. If we can call my bloodtests allright, then i will agree, but surfing through web about the median ranges of IGF-1, LH and Test. by AGE, for example prooves otherwise for me?
  4. I care of course.

No i developed my symptoms at 16, while on the third day of the drug, i experienced a retrogate ejaculation and freaked out, things never been the same way since.
However, i did not ‘‘crash’’ like the classic cases. My symptoms worsened dy bay day, i didn’t even notice that i was losing my penis size until the 3- 4 years in… That shit, happened slowly.
4 years ago when i opened this thread i could feel my orgasms, for example now i don’t. It is all numb down there now.

My hypothesis is that Accutane changed AR expression on my prostate and my poor organ got inflamed and over the years it just got worse and worse because i couldn’t treat it.
My Uro said that once you ejaculate with a damaged prostate, it causes more damage because the muscles which causes ejaculation won’t work properly, so your semen gets inside stuck (my first issue was lowered semen volume.) and this causes more damage and edema on prostate which in turn affects the whole nerve network, therefore muscles and blood vessels and sensations i should experience go offline…

Anxiety, OCD, stress, depression etc.
Now i experience these things much less, i am doing better mentally, i can now fight with it, forget it. But i still have unclosed pages about my concerns and wonders.

Oh no, wish it was true. It is not something like that. The symptoms really feel like that it is not in your head. I wake up morning with a dreamy mind and urinate for example, i feel nothing. I can’t even feel my own urination, it is like %25 of what it was used to be.

Even when i get an erection with a good desire and without performence anxiety, my Pelvic Floor muscles won’t contract and fill with blood at all. They are soft. I can’t feel that rockhard contractions on my perineum muscles, plus it is numb, no sensation. I remember a great sensation there which travelled through my penis that gave me the ‘‘urge’’ to masturbate\ have sex. That sweet warmness and good sensation on muscles and penis itself is gone totally.

Imagine you just entered a very cold sea and your genitals lost all the sensations due to cold, it is something like that, but plus, my prostate is also numb. So you would still feel good to urinate inside the cold sea even though the outer surface was numb! LOL! Or like you could feel the good sensation coming from prostate and travelling inside your penis… And on the perineum muscles…

But i can’t even experience that now due to my prostate issues. That little f*cker seems like the heart of sexuality. I sometimes keep notebooks about the sensations i used to experience before PAS, to not forget. Because if i ever FORGET how good things felt before and how hard i could get, then i am a dead man.

Sorry if i seemed to regress back there, i just sometimes wonder you know… And i would be really glad if you could take a look on those studies, the abstract sums it up well actually, so it is rather quick to read.
I just wonder if there is thing as a ‘‘threshold’’ of gene expression or hormone levels to accomplish genetic potential.

So for example, just because the protein synthesis lessened, would that necessarily mean the affected organs developed less than usual? Penis, prostate etc.
Or let’s say Accutane changed my IGF-1 gene expression or it somehow damaged my liver persistently that my liver couldn’t produce the desired IGF-1, would that cause less height or less bone development on face? Or it was just a ‘‘mild damage’’ and i was still healthy enough to grow fully in every aspect. Hmm…

Just throwing some ideas for future readers too, if you don’t know the answer or can’t speculate more on that, i would understand.

Really, i mean isn’t this a universal known thing? Everyone says that, like eat healthy, do sports to grow taller, to be healthier etc.

Things i experienced on TRT which were positive: More sweat, more sweat around my gluteus muscles and on my groin area which had this weird manly smell that i forgot? (wtf)
Deepened voice. But that’s all and those improvements seems like they disappeared… Did i just sabotaged myself to cut this protocol quick? I did Test for 7 weeks… I mean it should be enough to see a change i would say, and i am scared to go more now. Besides i feel worse than baseline now after quitting.

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Eat healthy, yes. Do sports to get bigger, yes. To get taller though? I didn’t think playing a sport would make you taller. Like basketball isn’t gonna make you grow inches lol

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This sounds very similar to post fin syndrome. Accutane is an anti androgen. It’s possible topically it went systemic, and cause lack of dht at the genital area. This result in collapsed vasculature, effe ting smooth tissue and nerves. Smooth tissue become fibrotic because of hypoxia, which is caused from lack of androgens. If you experience penile shrinking (like myself after topical dutasteride) it’s likely microcascular damage. How to reverse? I don’t know, introduction of androgens should start to help and revascularize the area… But it’s unclear if we can reverse fibrotic formation of tissue in corpus cavernosum back to smooth tissue. There’s more going on than just neurotransmitters too. Many guys in fin syndrome tried dht gel, proviron, trt and still couldn’t improve their penile sensations, and others did have some improvement.

What do you think about this, have you had mri, doppler ultrasound, etc? Hormones are only one part and bodybuilders are always too fast to think it’s all hormone related causing these sides. There are physical tissue changes over time as oxygen is deprived. I’m looking into engorgement therapy with PGE1/2 to potentially regrow some tissue and size… Hcg therapy is helpful for some men with PFS but really everything is experimental crap shoot, and the risks are may worsen your mental side effects.

Ztanzanite with his 6 years Decca dick is also very similar problem here. It seems DHN outcompeted dht at the penile tissue and caused a great physiological change that took him 6+years to get out of. Maybe we have hope to.

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This is interesting man, i will cut this short because i am having a hard time right now due to your message. We have a whatsapp PFS chat and a guy also said he has fibrosis on his corpus, proven by a doppler. Anyways, smart me at that time asked to the recovered cases if they had bends on penis and if they recovered themselves after fixing the root cause/ receptors. @ygb350

I didn’t do a doppler test yet.
Few people said yes, so it might not be actual fibrosis, they said the bend and scar tissue faded away 100%.

I shared my e-mail but admin always deletes it, wish i could contact with you via PM or smth like that anyways. Are you on raypeatforum by any chance? Find me there.

And listen

This is good that you share this info but i think there will be no need for this. Your issues will not resolve if the root cause is left untreated. We need to dive deep in and fix where IT started :slight_smile: (I hope you watched the movie)

I will tell you the cure of PFS, as proven in our group by few guys already.

Sustanon/ Trestolone/ Testosterone+ HCG 250iu 3x a week with Progesterone low dose if you have mental symptoms to keep GABA and Allap. going. Try this man, use an AI if necessary low dose only, Arimidex only. 0.5mg with injections. This may fix you.

Do you have any bloodwork to share? Or any other sperm, prostate, bone, liver, penis tests exams? X- rays? Share everything if you can please. Thanks.

Yep. And I emailed you an explanation why. Ironic, eh? This forum does not have a PM system.

Really? Didn’t see will check.

Hey men, I hope its true what those guys in the group said. I’m honestly a bit scared to try intervention with trest as i never took a 19 nor before and this whole gear thing kind of let me down this path of ED and fin syndrome. I also just finished PCT recently of 6 week. I can try hcg with progesterone and proviron will be ok? I’m worried ment can give the same situation ztanzanite had from 19nor (prolonged ED 6+ years).

I have my story in propeciahelp forum im ygb350 over there as well. I do have some blood work but no scans / mri/ ultrasounds yet. also my blood works are not so comprehensive, lacking DHT analysis or sensitive estradiol (only they give me normal one).
I have referal to andrology unit at hospital near me, and I will try to get MRI/ doppler with inject etc.

My bloods can find here

This set of bloods is when august 25, im still injecting T propionate at this time. I have very bad ED and prostatitis symptoms here even with high free T and shbg and total T, and E2 is 59pg/ml (not so high for my higher total T and free t i believe?)

2nd bloods here

This blood work is from 2 days into PCT, so September 20. My PSA was also below 1ug/L and E2 sensitive was 19pg/ml at this time, but i didnt have it done with the same set of tests.

3rd bloods Here,

This was taken of November 8 or so. I finished PCT already a couple weeks at this point. my fsh and LH seem to be recovering, but i still likely have some nolva in my system, since this takes some months to fully clear. I still have terrible ED at this point, and brain fog etc. classic PFS symptoms. cannot get hard when standing up, no arousal etc…

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Damn! How much Test Cyp you injected? It was 2400 ng.dl

So you took Fin and then tried to fix yourself with Test?

Can you please share your PCT protocol? I am currently on Clomid 25mg every 3 days.

Finished 7 weeks of Test Cyp with no improvements. 150 at first weeks and then 200mg a week.

Maybe i should have tried it few more months? I am not sure, i mean if nothing in 7 weeks, why smth would happen at 12?

I feel bad. May hop back on Progesterone after my PCT. And then try Bicalutamide.

I have a bend like feeling on penis, well it bends to right, it was straight and symmetric like a statue before. Now it seems the right side can’t get blood in it, also the front side facing me, its shape, looks weird man. It’s like the worst nightmare becoming reality. I didn’t even care about my sexuality that much before, i wasn’t even using it that much as my peers did. I was into art and stuff… Now why me? LoL. So i can’t even blame my karma because i did nothing wrong, wasn’t a hedonistic person at all, weird. Anyways.

Well, i will get a doppler for sure, maybe fixing the prostate will fix the issue or maybe i may use some PRP+ Shockwave+ Stem Cell’s in future after i recover.

Ok, so if Test failed to fix you with this skyhigh levels, you need an another steroid i would say. You need to downregulate your AR more strongly. And keep neurosteroids on check with HCG.

And did you use HCG with the Test? Use it with it next time. And stay away from PH, that site is ruled by maniacs and full of depressive lost souls which deny getting help or advice.

Damn! How much Test Cyp you injected? It was 2400 ng.dl

I took test Enanthate first, 200mg/week and then i stopped july 27, and started propionate aug 4… so i think thats why my Total was high and free also, since I had propionate acting and enanthate at same time.

So you took Fin and then tried to fix yourself with Test?

I was on TRT first, then i took topical dutasteride to try stop some balding that i noticed. I also used RU. I thought thesse were safe compound because DERREK mpmd said theyre mostly safe. Also he doesn’t acknowledge real PFS symptom, only mild one. He thinks can be cured with neurosteroids… but this wont repair penis damage… same with leo. I hate these guys for listening to them and pushign dangerous product… and get kickback from affiliate sites. it’s a racket. They prop up a fake / mild version of PFS and portray it as the worst case scenario, leading me to believe its easily solvable if it happened.

Can you please share your PCT protocol? I am currently on Clomid 25mg every 3 days.

because i was 6 month on trt (mid march - early september) I did PCT as suggest by vigoroous steve , 40/40/20/20/10/10 nolva, enclomid i did 25/25/25/25/12.5/12.5
My balls starting to get small again, so i will get new bloods in 1 month and see if i need to HCG + pct again.

Finished 7 weeks of Test Cyp with no improvements. 150 at first weeks and then 200mg a week.

Maybe i should have tried it few more months? I am not sure, i mean if nothing in 7 weeks, why smth would happen at 12?

I don’t know, its possible. Many people told me to do trt 6+ months to have to see a change… but im not sure either, im unsure like you are. I was on TRT already and dut killed my penis. It feels rubbery, like collagen replaced all teh smooth muscle tissue. Its really scary , even on trt this happened it shows how powerulf DHT is. I also was on 200mg primo and taking anavar on some workout days… so thats crazy

I had a very similar type of recovery when i switched to prop from enanthate. I had 4 days in august of very nice boners and then it disappeared… like my body was last call to get hard before forever gone… IDK how it happened or what happened. IT seems in a very short time period of august to september i built full penis of scar tissue? IDK i need test doppler and MRI like yourself, lets share when we get the results

Yea i did run HCG at varyign dosages. sometimes 250iu eod, sometimes 2kiu eod like leo recommended. I used it pretty consistently throughout the 6 months and before PCT.
Do you think we upregulated our AR? there’s one PFS study show the skin of the penis of PFS patients had upregulated AR right? how do we downregulate it, and do you think we can revascularize our penis internally? I think dht maybe can do this, like ANDRACTIM or proviron?

PH i sdepressing yea, but there are a lot of information there. trials people did , some successful some not. This is very new to me to be in this situation, so I am trying to learn as much I can as quickly as possible. There is some useful information there and people talk about studies. Also PFS have many cult leaders, like cdnuts , this protocol may or may not help but he treat it like its the holy bible of recovery. I think the path may be unique for everyone to recover, i’m not sure again though

With androgens.

In theory androgens should have fixed you, strange. I don’t think you have collagen and scar tissue on your penis man, no it is about nerve signals and dilation, don’t scare yourself.

Do you have bends, twists, shape changes on erect penis? If yes, then MAYBE. Otherwise no.

i did see a curve occur recently like 2 months ago… my penis started to curve a bit towards my belly when it never did that. Also i have persistent penile pain, like its not ever stopping. justa dull ache that is felt through the numbness