T Nation

Finesteride Messed Endroctrine System


#1

hi guys

so i used finesteride for 3 years,the first two years everything was fine,i actually gained muscle mass and felt the best in all my entire life until one day i couldnt acheave an erection
so i stopped everything cold turkey and everything returned just fine
but my hair was falling like creasy so i decided to go back on a lower dose eod
i was let say 70% of what i would normaly be and was fine with that but i then decided to go back on a daily dosage again,and i crashed in just a week(bloating,gyno symptoms,difficlt erection,fat on stomach) so i took my finesteride tablets and throw it in the toilet

now 1.5 year later and i'am worst from when i crashed,i got worst mounth by mounth

my symptoms now are:
-pseudogyno(no real gyno comfirmed by doc),still there is some puffiness in the nipples
-extremly oily face and scalp,i mean EXTREMLy
-body hair incraised draticly but i was heary even prefin (high dht?)
-fat on stomach,buttock and chest
-bloating that accur mostly at night(belly get bigger than ever)
-disturbed sleep
-rare and weak morning woods
-erection difficult to get and maintain,
-sometime very weak and other acceptable erection quality
-reduced penile sensivity to pleasure
-reduced libido (i still want to masturbate but no urge like before)
-penis look/feel smaller in erect and flaccid state
-feeling hotter/warmer than enyone else
-anxity and mood changes (flucturate) but i think it's related to the fact that i always obsessed with my condition

now the side effect that i like:
-a better muscle mass than pre finesteride use

what i have tested

just took cabergoline for one week after the final crash and stopped,i guess this was a stupid idea.

now for the bloodworks

1er bloodwork (feeling very bad)
testosterone 2.4 [3-12]
fsh 1.2 [1.3-11.8]
l.h 2.7 [2-7]
oestradiaol 55 [<55]

2end bloodwork (feeling better)

testosterone 6 [3-12]
fsh 1 [1.3-11.8]
l.h 3 [2-7]
oestradiaol 45 [<55]

3ed bloodwork (feeling worst)

testosterone 5.4 [3-12]
oestradiaol 80 [<55] very high
prlactin 16 [<15] high
tsh 3.1 [1-5] normal?
t4 was fine
alt,ast: fine but alt is in the upper limit

testicule scan:everything fine

like you can say my hormone is flucturating like creazy and my doc doesn't understand why

but in the last bloodwork it seems like the problem is the high e2 and prolactin(stimulated by the high e2 i guess?)

my t level seems fine dispite the high e2 and prolactin,this is a good sign

my liver enzime are fine,a little high maybe but in range (i dont drink alcohool or coffe but i dont drink alot of water and a heavy smoker)

my symptoms also correlate with high e2 but i dont feel emotional and dont have night sweat

now my doc may prescribe an AI to correct the problem but honestly i dont feel very optimist

i hope some experimented member could help me in any way or another,this condition have literally changed my life :confused:


#2

tsh 3.1 [1-5] normal?
t4 was fine

TSH should be nearer to 1.0
T3, T4, fT3, fT4 should be mid-range or a bit higher.
The lab ranges are useless.
Please post actual T4

Please check oral body temperatures to eval overall thyroid function.

  • when you first wake up, should be 97.7-97.8F, higher is usually OK, 97.3 is a problem
  • also check for 98.6F/37C mid-afternoon

Have you been getting iodine from iodized [salt | bread | dairy]
Is your thyroid enlarged, lumpy, sore or asymmetrical?

Prolactin is from a pituitary adinoma and a MRI is used to evaluate size.
Dostinex/cabergoline 0.5mg/week typically manages this well.
Not connected to E2 levels
Can contribute to gyno, low-T, depression

I think that you do have a problem with E2 clearance by the liver.

Please read these stickies:

  • advice for new guys
  • things that damage your hormones

Focus on:
thyroid and body temperatures
liver
E2
pituitary, MRI, cabergoline

You have more than one problem.


#3

[quote]KSman wrote:
tsh 3.1 [1-5] normal?
t4 was fine

TSH should be nearer to 1.0
T3, T4, fT3, fT4 should be mid-range or a bit higher.
The lab ranges are useless.
Please post actual T4

Please check oral body temperatures to eval overall thyroid function.

  • when you first wake up, should be 97.7-97.8F, higher is usually OK, 97.3 is a problem
  • also check for 98.6F/37C mid-afternoon

Have you been getting iodine from iodized [salt | bread | dairy]
Is your thyroid enlarged, lumpy, sore or asymmetrical?

Prolactin is from a pituitary adinoma and a MRI is used to evaluate size.
Dostinex/cabergoline 0.5mg/week typically manages this well.
Not connected to E2 levels
Can contribute to gyno, low-T, depression

I think that you do have a problem with E2 clearance by the liver.

Please read these stickies:

  • advice for new guys
  • things that damage your hormones

Focus on:
thyroid and body temperatures
liver
E2
pituitary, MRI, cabergoline

You have more than one problem.[/quote]

thank you for your feedback kSman

t4:1.43 ng/dL (0.8- 1.8)

the fact is that i dont have any hypothyroid symptom,i dont feel fatigeted,feel warm all the time (including hands and feet),my skin is not dry and i dont have puffy face…but i will try to get more labs from my doctor including antibodies and t3/rt3
i have also read some doctors saing that high estradiol can create a state of functional hypothiroidism that resolve once the level corrected,dont know if this is true

-i dont feel anything abnormal on my thyroid,it’s not enlarged or lumpy
-i eat alot of seafood so i think i’am getting the iodine

for the prolactin my doctor said that the high level of estradiol can stimulate the release of prolactin and that on this level an mri is uselss because if i had prolactima my level would be 10 time the upper range or more…veru confusing

for the liver my levels are considered normal by my doctor,do i request a liver scan?

also how can you explain the flucturation in my e2 level? it have almost doubled without doing anything


#4

Do the body temperatures, that is the bottom line for thyroid function. Feeling hot does not always mean that body temps are excessive.
Consider labs when we have temperatures posted here.

You are repeating things that your doc stated that I addressed earlier.

Yes a well developed prolactinoma can produce very high prolactin levels. But your doc’s attitude prevents detection while small. Larger adinomas can press on the optic nerves and the diagnostic opportunity is to prevent things like that.

Have you also been getting iodine from iodized [salt | bread | dairy] ?

Your higher AST/ALT does seem to fix reduced E2 clearance.

"bloating that accur mostly at night(belly get bigger than ever) "
You can try to find a high quality probiotic and take that for a month to see if you can shift your gut bacteria population. Some get a population that converts estrogen metabolites in the liver bile back to estrogens that are the reabsorbed. If hematocrit is low, a GI bleed is suspected and an occult blood [stool] test can rule that in or out. There are a lot of rather useless probiotics.

Try to find something that you can take some action on instead of grasping for reasons to do nothing.


#5

[quote]KSman wrote:
Do the body temperatures, that is the bottom line for thyroid function. Feeling hot does not always mean that body temps are excessive.
Consider labs when we have temperatures posted here.

You are repeating things that your doc stated that I addressed earlier.

Yes a well developed prolactinoma can produce very high prolactin levels. But your doc’s attitude prevents detection while small. Larger adinomas can press on the optic nerves and the diagnostic opportunity is to prevent things like that.

Have you also been getting iodine from iodized [salt | bread | dairy] ?

Your higher AST/ALT does seem to fix reduced E2 clearance.

"bloating that accur mostly at night(belly get bigger than ever) "
You can try to find a high quality probiotic and take that for a month to see if you can shift your gut bacteria population. Some get a population that converts estrogen metabolites in the liver bile back to estrogens that are the reabsorbed. If hematocrit is low, a GI bleed is suspected and an occult blood [stool] test can rule that in or out. There are a lot of rather useless probiotics.

Try to find something that you can take some action on instead of grasping for reasons to do nothing.

[/quote]

you’re right kSman

so now i will do:

-take my temperatures upon waking up and in the morning,and make a full thyroid panel

-do an MRI to rule out prolactima or other issues

-try to take more iodine EDIT:actually i’am alredy consuming alot of iodine rich food

-do a liver ultrasound scan and try to detoxy it

-do saliva cortisol 4x/day and dhea to rule out adrenal fatigue

-take probioitics and follow a strict diet to shift my gut bacteria population
(do you have some good probiotics to recommand?)

please tell me if i have forgot something

also i want to know why this flucturation in my hormones especialy estradiol level,it doubled withoid changin anything,does this sound normal?

i want to add that my condition is a rollercoster,sometime i feel 50% better and by the next day i can feel like shit,this is such a disturbing condition…


#6

"(do you have some good probiotics to recommand?) "

  • in what country. In USA suggest Ultimate Flora, may be in Canada too.

#7

update

still feeling like shit and nothing seems to imrpove

here is my new bloodwork

bloodwork

total t: 3.74 [2.5-10]
free t: 6.8 [8.9-42]
bioavalible t:0.84 [1.3-7]
dht:0.42 [0.33-1.2]
shbg:31 [18-54]
androsterodione:3 [0.6-3]
dheas:5865 [1600-4500]
estradiol: 43,78 [8-42]
estone:75 [15-90]
17 ah prog:1.1 [0.6-2.2]
prolactin 13,58 [1.5-19]
fsh 0.79 [1.7-12]
lh 4.31 [1.1-7]
progesterone:1.19 [0.2-1.4]
tsh:2.54 [0.25-5]
ft4:20,44 [12-22]
ft3:7.31 [3-8.3]
thyroid andtibody :clean
acth:59 [10-50]
aldosterone:114 [13-145]

oh vit3/d2:19,25 [>30]
cooper:1118 [794-2000]

AST - 48 (reference <38)
ALT - 55 (reference <40)
GGT 35 (reference 10-48)
phosphorates alcaline 379 (reference 90-320)
Bilrubins:
total: 5 (<13)
direct 3 (<3)
free: 2 (<11)
hepatit b,c:clean

my bio t ,free t and fsh are extremly low…adrenal hormones are high

what i dont get is why my t level is so low when my lh is normal/high

what do you think guys?


#8

Are you taking anything? Or just waiting to recover?


#9

i wasted 2 years of my life waiting for recovery…now it’s time for action

i dont know if clomid is a good option here because my lh is high

maybe i will go TRT directly


#10

I wouldn’t call that LH “high”. Maybe midrange. FSH is really low.

I’d say clomid / nolva is worth a shot, and if you don’t see some recovery, go straight to TRT.


#11

LH is released in pulses and you can catch a peak or a trough. FSH is a more accurate predictor of pituitary functioning as it has a longer half life. You are definitely secondary, Finastride doesn’t affect testicular function directly. An HPTA restart could work.

Having said that, choice of treatment is dependent on you. HPTA restarts don’t seem to work particularly well with Propecia/Finastride victims but that’s not to say it’s not worth a shot. If restart does not work, TRT is better than staying on Clomid long term.


#12

24h urinary cortisol
55 nmol/24h (range 55-138)

is this normal?