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Extremely Low Free T After 4 Years on Finasteride

Hi everyone! newbie here. Sorry for my English :slight_smile:

Just got my blood work today. After one year feeling horrible and four years on finasteride, I really knew there was something wrong with my hormones. It seems my free t is extremely low and there are a couple of other values out of range. Could be a consequence of Finasteride?

Apart from quitting finasteride (already tapering off), what are the alternatives and the best strategy/treatment to start reverting my situation?

Thanks in advance for your help!

Background:

31yo, 5ft8, 150 pounds, around 18-20% body fat. 1mg everyday Finasteride user for four years. Feeling horrible for the last 12 months. Symptoms: extremely low libido, general loss of interest, frequent mood changes, negative thoughts, feeling always tired and sleepy

Lifestyle / Eating:

Healthy, around my TDEE. Drinking alcohol 6-8 times per month, usually on weekends. No other drugs.

Gym:

Strength training 4-5 times a week. Little to no improvement for the las 12 months.

Glucose 86,0 mg/dL (70,0-105,0)

Creatinine 0,82 mg/dL (0,7-1,2)

Sodium 145,2 mmol/l (135,0-145,0)

Potasium 4,49 mmol/l (3.5-5.1)

GGT 42,0 U/L <60

GOT (AST) 31,0 U/L <41

GPT (ALT) 104,0 U/L <41

Triglycerides 42,9 mg/dL (40-150)

Total Cholesterol 140,0 mg/dL (100-200)

Ferritin 188,2 ng/mL (30-400)

Vit B12 885,0 (191,0-663,0)

Cortisol 16,86 µg/dL (4,82-19,5)

Beta HCG <0,1 mIU /mL (<2,6)

FSH 1,91 mUI/mL (1,5-12,5)

LH 2,44 mUI/mL (1,7-8,6)

Progesterone 0,29 ng/mL <0,149

17-Beta Estradiol 19,72 pg/mL (7,63-42,6)

Prolactine 10,16 ng/mL (4,04-15,2)

TSH 1,8 µUI/mL (0,27-4,2)

Free T4 1,09 ng/dL (0,93-1,7)

Testosterone 4,67 ng/mL (2,49-8,36)

Free Testosterone 7,37 pg/mL (8,9 42,5)

DHEA 26,01 ng/mL (1,11-10,62)

Dihydrotestosterone 0,8 ng/mL (0,25-0,99)

SHBG 41,73 nmol/L (16,0-80,5)

You have low testosterone no doubt. Finasteride is aterrible drug, it block the conversion to DHT which is very important and affects libido, ditch it.
Look up post finasteride syndrome, it is not a recognized medical condition but thousands of people claim to have their lives ruined by the drug.

In regards to what can you do, I would jump on trt, I guess you are from Spain? Have you researched providers in your country?

Thanks or your answer.

Yes, the are a couple of providers here in Spain, but TRT is something pretty new here, so doctors still doesnt have a lot of experience.

Regading my blood work, what could be the reason for my low free T? My total T is in the mid-low range and my SHBG is not that high.

How is DHEA related to my low free T? And progesterone?

Thanks for your help!

Regardless of why… that free T is still pretty low and total wasn’t great either.

I was expecting your SHBG to be higher too. Most of the finasteride guys I’ve talked to have really high SHBG (mine was 150+). Regardless… treatment is pretty much the same. Add T until free T is high enough…

Thanks! Could Clomid or HCG work in this case? Or should I jump straight into TRT

It’s not impossible but I haven’t seen a lot of people with good outcomes. You could to some trials of each if you wanted to see what happens. It’s kind of a trial and error type deal, everyone reacts different to different things. Both will probably improve your numbers on paper. It’s more of a question of whether you’ll actually feel better or not.

Finasteride can cause a loss of androgen action on target tissue, whether that’s the case with you is anyone’s guess as there are no lab testing that can definitively diagnose Post Finasteride Syndrome. The diagnosis is based on symptomatology.

There is no known cure for PFS, recovery is often long and some men have been stricken with symptoms spanning decades with no relief. Some of the worst cases see a doubling or even tripling of natural testosterone levels.

I have heard of a lot of men recover, some fully and some partially.

Liver disease is the most likely reason for high ALT, very high levels can be cause of hepatitis, sometimes due to a viral hepatitis infection.

This could be adrenal cancer and/or tumors on the adrenal gland. TRT may not cure all your problems, clearly you have other stuff going on concurrently.

You really freaked me out with this…

Don’t be freaked out because some random dude on the Internet says you might have cancer or liver disease. There are plenty of potential causes that aren’t worst-case-scenario.

There have been tons of threads with guys talking about addressing their PFS. The elevated ALT could most directly be to alcohol intake. Has your doctor reviewed your labwork and discussed the DHEA?

Based on your weight and bodyfat, there’s a serious nutrition issue. Start another thread with your current plan so we can fix things on that end, because it’ll only help everything else.

1 Like

Hola!
I have your exact same problem and number.
After 4 years on Finasteride my total test dropped from 750 to 490 and my free test from 16 to 9.
I have zero libido and can’t make any progress in the gym.

So what did I do?

I started TRT. After 3 months I am stopping as I am just not dialed in and can’t deal with the anxiety and problems that it brings. My T numbers with 175mg E a were Total T: 1.040, FT: 17.5

I am attempting to re-start my natural production and go on a high fat carnivore diet to increase my test as well as suplement, intermitent fasting and lifting weights.

Before going on TRT I advice you switch to high fat diet (testosterone is made from cholesterol) and take zinc, magnesium. Also, drop the body fat to 10-12%. The less body fat the less estrogen which is what signals the negative feedback loop to produce more testosterone. When your pituitary gland detects less estrogen it will start signaling your testicles to produce more test.

Summary

  1. High fat diet (eggs, bacon, read meat, sausages, pork)
  2. Good sleep and heavy lifting at the gym
  3. Reduce body fat to at least 12%
  4. Intermittent fasting (at least 16 hours daily)
  5. Zinc and Magnesium supplements.

Now since you might be on a restrictive calorie it is best you test your total and free test once you have reached 12% body fat and increase calorie intake as calorie restriction might give you lower numbers.

It’s not easy but it can be done, low test means you have to be very strict to drop any body fat. I have seen guys double their total test. Try some Cardarine cycle 6 weeks (20mg a day) to help with fat loss

1 Like

How exactly did you noticed anxiety? Could it be from to high E levels?
Was it the only reason you quit trt? You never felt better on trt than natural levels?

Thank you all for your messages!

I just visited the doctor today. He said Finasteride has messed up with my hormone system, and doesn´t know if I would be able to recover without help.

He has offered me to start on TRT. He proposed testosterone cypionate, one 350mg injection every three weeks. He mentioned to take also Clomid during the first weeks, but didn´t specify the regime. He said that after a couple of months we should switch to another treatment to preserve my fertility.

The truth is I dont know how to proceed… I have a lot of questions I would like to answer before moving on since I dont want to mess up even more with my hormone system.

  • Does the Doctor know what is he doing?
  • Is there any chance my hormone system get back to normal over time? (without TRT)
  • The proposed TRT regime is reasonable? Should I try to convince him to increase the frequency of injections to avoid testosterone spikes?
  • What is the purpose of combining Clomid with TRT?
  • My concerns are mostly about potential infertility. Could this treatment affect my fertility? (Clomid + TRT). Is it safe for long term use? What should be the long term treatment?

Thank you for your help. I know these might be pretty basic questions for long time lurkers, but I´m quite confused at this moment.

He has no idea what he’s doing. TRT and clomid together isn’t right. Injections every 3 weeks will be miserable. Switching off TRT in a few weeks is moronic.

Once a week is the absolute minimum IMO 2-3x a week is preferred. If he’s letting you inject yourself then you can do whatever you want, just order more syringes.

No.

This is no good and this planned course of action will lead to suffering.

TRT is the end game and long term treatment for low-T, clomid is usually short term do to all the negative side effects. Fertility can be addressed when you are planning for children, stopping TRT and starting a clomid protocol can restore fertility.

HCG can be used in conjunction with TRT to preserve fertility.

For once, we agree.

Hi everyone, quick update after 5 weeks without finasteride. Labs below (BEFORE//AFTER)
Im feeling slightly better but no dramatic changes so far: libido(+30%); Fatigue (-10%); Brain fog (=)

Regardging the blood work, there has been huge changes in my liver enzymes, LH, Free T, DHEA and SHBG. I have some questions:

-LH: it has decreaed a lot. Related to finasteride? Could it be a cause of low libido?

-E2: According to the lab im in the mid range, but I have read in some other places that my value is pretty low. What should be the right value for a non TRT user?

-SHBG has doubled in 5 weeks. Could this be related to quitting Finasteride? Is there any way to lower it down?

-Free T has doubled in 5 weeks without Fin (I think this is very good news!) but Im not feeling much better. What is in your experience an accetable value for someone my age? (30 YO)

But at the end, my main question is, what are the values in my blood work preventing me from feeling better and having more libido and less fatigue?

Many thanks for your help!

BEFORE // AFTER 5 WEEKS WITHOUT FINASTERIDE

Glucose 86,0 // 81,0 mg/dL (70,0-105,0)

Creatinine 0,82 // 0,82 mg/dL (0,7-1,2)

Sodium 145,2 // 141,00 mmol/l (135,0-145,0)

Potasium 4,49 // 4,44 mmol/l (3.5-5.1)

GGT 42,0 // 14,0 U/L <60

GOT (AST) 31,0 // 24,0 U/L <41

GPT (ALT) 104,0 U/L // 24,0 <41

Triglycerides 42,9 // 50,3 mg/dL (40-150)

Total Cholesterol 140,0 // 134,00 mg/dL (100-200)

Ferritin 188,2 ng/mL // NA (30-400)

Vit B12 885,0 // 654 (191,0-663,0)

Cortisol 16,86 // 12,27 µg/dL (4,82-19,5)

Beta HCG <0,1 mIU /mL // NA (<2,6)

FSH 1,91 mUI/mL // 2,31 (1,5-12,5)

LH 2,44 mUI/mL // 1,19 (1,7-8,6)

Progesterone 0,29 ng/mL // NA <0,149

17-Beta Estradiol 19,72 // 18,87 pg/mL (7,63-42,6)

Prolactine 10,16 // 6,13 ng/mL (4,04-15,2)

TSH 1,8 // 0,81 µUI/mL (0,27-4,2)

Free T4 1,09 // 1,28 ng/dL (0,93-1,7)

Testosterone 4,67 // 5,91 ng/mL (2,49-8,36)

Free Testosterone 7,37 // 15,98 pg/mL (8,9 42,5)

DHEA 26,01 // 9,46 ng/mL (1,11-10,62)

Dihydrotestosterone 0,8 ng/mL // NA (0,25-0,99)

SHBG 41,73 // 70,14 nmol/L (16,0-80,5)

25-OH Vit D NA // 40,0 nmol/L (>30)

Did the finasteride keep your hair intact?
Some say it is a feminizing drug, maybe you will be fine in a little while, good luck

Yes, I had good success with Fin, I had a lot of regrowth but side effects are not worth it.

Could you please comment on my LH levels? ( 1,19 mUI/mL) It seems they are out of range. What could be the cause?