T Nation

Post Finasteride Syndrome is Killing Me

Pharma
#1

Hi,

so a little about myself first: i am 34 years old and have used Finasteride multiple times for short periods in the last 1.5 year. The only other medication i take and have taken for quite some time is low dose tramadol for a bad back which works great and really offers me a benefit in terms of quality of life, i am also a smoker.

I always came off Finasteride because of the horrilbe feeling and side effects, especially mentally, this medication gave me. The first two times i recovered within 1 or 2 weeks. Well, the third time after i actually took it for 3 months in combination with anastrazole (to minimize the freaking feminine fat gains) was a charm i guess, i had the so-called crash Christmas 2020 and while some things have improved, other stuff gets worse day by day.

The severe depression with daily suicidal ideation got a lot better, my sleep that used to be absolutely dreadful and resistant to any sort of pill including strong benzos or behaviour (at some point i used to wake up after 2 hours of sleep and coulndā€™t for the life of me return to sleep while having having anxiety) got a lot better, i still wake up in the middle of the night but manage to get back to sleep, averaging 6-7 hours of unrestful sleep. I also was experiencing nightsweats which i sometimes still do. I was also constantly feeling cold no matter how warm it was, that also got better.

When i was feeling like this in the past months i didnā€™t really care about my dick or my body/looks. My dick still worked when it had to with so-so erections but certainly enough to have sex, still had morning and sporadic spontaneous erections, also still had some urge/libido.

Well, that changed in the last 2 months, my dick is like dead, no erections what-so-ever, while flaccid itā€™s cold and rubbery. I can get just like 25% hard only with manual stimulation and climax in no time, orgasms also feel like nothing, Viagra/Cialis help only a little. I donā€™t really have any libido, i just check once per week how the little man is doing. I kind of feel that my balls also shrunk but iā€™m not sure, but my loads are tiny, even after abstaining for a week or more.

My hands are also severely dry that they get bloody and my palms shed every week or so, my hair is also like straw.

Before doing Fin i used to be 75Kg at 1.83m, BF 12%, lifting 3xweek, could eat whatever the fuck i wanted and also drink moderate amounts of alcohol every night and still mantain a tight, hard midsection and sixpack, hard muscles, not overly pumped up, from only doing low volume high intensity workouts and a veiny dry look even without working out for months after injuries/surgeries. Now i am at 70Kg but my body composition changed profoundly, midsection sucks and i think i have a mini-dad-bod.

I have actually got a basic hormone panel befor starting fin the first time, also at the end of may this year when i was feeling the worst i have ever felt in my life and got a really detailed one last week. Will write down the values below:

01/2020:
Total test: 7.57ng/dl (2.59-8.16)
Free test: 28.29 pg/ml (1.0-28.20) slightly raised
Estradiol: 37.01pg/ml (<34.0) slightly raised probably because of daily beer/wine
DHT: 614pg/dl (112-955)
Progesterone: 1.02ng/ml (1.98-6.97)
SHGB: 66nmol/dl (10-57) slightlĆ½ raised, prob the boozeā€¦

03/2021:
Total test: 6.19ng/dl (2.59-8.16)
Free test: 17.74 pg/ml (1.0-28.20) reduction of whooping 40%, could also be the lack of sleep
Estradiol: 29.33pg/ml (<34.0)
DHT: 588pg/dl (112-955)
Progesterone: 0.89ng/ml (1.98-6.97)
SHGB: 47.2nmol/dl (10-57)
DHEAS: 431Āµg/dL (80-560)
LH: 6.15mUI/ml (1.24-8.62)
FSH: 14.75mUI/ml (1.60-12.9) sky high
Prolactin: 13.52ng/ml (2.64-13.13) slightly high

05/2021: (different lab than the first two)
Total test: 6.34ng/dl (2.30-8.50)
Free test: 18.2 pg/ml (7.00-22.7)
Estradiol: 54.9pg/ml (<39.8) !!!wtf!!!
DHT: 589pg/dl (300-850)
Progesterone: 0.68ng/ml (0.28-1.22)
SHGB: 61.2nmol/dl (14.5-94.6)
DHEAS: 4.07mg/L (0.35-5.69)
LH: unfortunately missing
FSH: 12.5mUI/ml (1.50-12.4) still high
Prolactin: 5.05ng/ml (2.10-17.17)

Also, after reading some stuff about androgen markers, there is this recomandation i saw that stated that instead of measuring Serum DHT, a better marker for intracelular Androgen metabolism would be 3Alpha-Androstandiol-Glucuronide, meaning how much test and DHT is actually used by the cells of the body, metabolizing into this end-produc of the pathway.

Well, my value is 23.9ng/dl (168-3530) which is clearly fucked up, so despite having enough androgens it seems like my body has forgotten how to use them.

So, i donā€™t know if replacement therapy test or DHT derivatives, even with supraphysiological levels which i could easily get will do anything in case.

I donā€™t want to go to Propeciahelp page, that place is depressingā€¦everybody just say do nothing, take nothing and after that they whine arround after 5 years of PFS.

Like i said before, the suicide thoughts have actually passed, but from a rational viewpoint now, i donā€™ want to live like a asexual zombie.

Has someone with PFS recovered in the past with normal androgens on labs with HRT in supraphysiological levels? Or other means? I would love to hear your experiences/adviceā€¦

#2

Maybe this is ng/mL? Looks low off by a factor of 100.

Anyway, nothing else on there is jumping out. E2 of 54pg isnā€™t alarming since your SHBG is on the higher side. Have you taken anything to lower that?

Not familiar with this, so Iā€™ve got some reading to do. Hope you get some answers

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#3

Progesterone was very low and then normal. Hm. Could be causing impotence if too low.

Slightly high E2. High E2 can cause impotence too. Be careful with AIs, too much and you will feel even shittier.

Iā€™d have to read up how stable that is. Maybe I got time later.

Iā€™ll link you to a guy who I think does a good job with a similar issue.

@coopper

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#4

Hi Marco welcome to the pharma forum. If you were unlucky and born with the predisposition of male pattern baldness nothing beside hair plugs will work. None of the drugs work for very long and as you have experienced the side effects are not worth it. Learn to live with it or save up for plugs. Now that you have PFS you need to find a good TRT doctor to get your hormones back in order.

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#5

Youā€™re right total test is pg/ml

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#6

No, i havenā€™t taken anything to lower SHGB. I did at some point by a bunch of supplements to tweak whatever what but i stopped doing that one or two months, in my opinion it was just thrown away money.

When the first labs were taken before taking fin my SHGB was also higher than the norm, with high free test and i was feeling absolutely fine, had energy, no boner problems, slept sound and deep and in general was always in a good mood and joking arround even despite having a slightly limp foot from back problems.

#7

I also checked Cortisol and Thyroid, they checked out fine everytime, besides fT3 being minimally raised in the last lab 6.15, range being until 6.10, TSH is 1.6.

Also forgot to mention that i developed one sided persistent Tinnitus a month ago which i never had before. I saw that there are people that have this symptom after or during fin. Tried 2 weeks or Cortisone, didnā€˜t help at all.

Also i canā€˜t get a nice buzz from alcohol anymore like in the past. I was a moderate drinker, like 2 beers or 2-3 glasses of wine per night, never really developed a tolerance to that and would slleep fine afterwards. Now i can actually drink like a fish without feeling it and therefore have a hangover the next morning.

I guess it helps a bit if i whine arround a little, donā€˜t really have anyone to talk about this stuff, my family thinks iā€˜m just depressed, some docs think iā€˜m nuts and wanted to put me on antidepressants, to make sure that my dick is 100% dead lol.

Have been yesterday to an Androlog doc here in Germany who knows about PFS. He did a ultrasound of my gonades, one is shrunken and both show signs of atrophy which in conjunction with the sky high FSH and LH would mean testicular failure.

He also took bloods once again because he doesnā€˜t trust other labs and also wants to determine something called CAG repetitions of the Androgen receptor (marker for damage/insensitivity) and also all the progrsterone metabolites and Neurosteroids affected by 5AR. I actually signed some papers to be included in his ongoing study about PFS.

He said that given my symptoms, regardless of my normal androgen profile, he would recommend high dose test to bring up the free form slightly over the norm in hopes of waking up the receptors. I will be getting a letter from him in 2 weeks he said.

Well, even if nobody here can help me, maybe i will be able to help others afflicted by this shit sharing my journey.

All the best to the guys in my situation.

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#8

Actually didnā€™t write down the right ranges for progesteronefor the first two labs. The range is 0.14-2.06 for men, so my values of 1.02 and 0.98 are normal.

#9

Hi, that actually was the reason i started taking fin, i wanted to do a transplant. Got in touch with 2 surgeons and had to take pictures of my back- and sidehair (donor). I actually realized than that it is indeed also thinning there, something called retrograde alopecia, just like my dad. This probably has been going on for some time but i didnā€™t realize it because of getting regular skin fades, with short hair you couldnā€™t see it. I had to grow it a out a month or two to provide the pictures.

So there advice was to take fin for a year to see if i can thicken up the hair again and than reasses the situation. But doesnā€™t mean that i blame them, not everybody on fin gets PFS i guess.

#10

Iā€™m German too and located in the south. Can you tell me the city where this doc is and his name? Seems to be a specialist on this and this is rare. Also the tests he ordered are extraordinary. You can be very happy about that.

Your situation sounds dull but thereā€™s hope.

Stop drinking altogether please, this makes addressing health issues way more complicated and is a killer for your hormones. You got enough reasons to stop. Donā€™t be another one of these fat German habitual drinkers in their 40s-60s. Thereā€™s enough of us wasting their lives and health already.

#11

Hi, you are right, i should stop the drinking, but itā€˜s a pity because i enjoy it :upside_down_face: and tolerated it well before all this shit happened.

The name of the Doc is Prof. Zitzmann, he is located in MĆ¼nster, at the Uniklinik. I live in Trier so i had to drive like 350km to meet him, consultations are scheduled like a month or two before. He has a interview about PFS, you can find it if you google Zitzmann finasterid.

You will also need a referral letter (Ɯberweisung) from a urologist, also a referral from your primary physician to the urologist.

#12

Oh wow, yes heā€™s the leading doctor on this here.

Cool that you got an appointment. Please report how it is going, Iā€™d be very interested if they have some new ideas there.

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#13

Could wear a wig. Iā€™ve comically tried on some VERY realistic wigs!

#14

This is not about hair anymore, i donā€˜t really care anymore about it.

#15

Thatā€™s the first time I hear about a test for our bodyā€™s efficiency in metabolising androgens I would like to know if there are other tests for that or thatā€™s the only one?

#16

It is rather obscure and not really used mainstream, the enzyme that produces this product is located in the skin, especially the penis skin.
The thing is that it should be directly proportional to your main androgen levels (test, dht, dhea).
In my case it means that my levels should be in the upper range, given that my androgens are also quite high. But instead itā€˜s well bellow the normal range.

This marker is used for the investigation of severe acne and hirsutism (masculine hair growth) in women with normal androgen levels, possibly revealing excessive conversion and therefore higher levels, exactly what i would probably need :grimacing:.

I have a friend who also dod his androgen profile this week, i asked him to do 3a-diol too, iā€˜m curious how his is gonna be.

#17

Note the buzz elicited from alcohol intake can be highly situational in nature. Go to a bar with a few friends after a hard week of work to let off some steam and you might be feeling boisterous, mildly uninhibited and euphoric after a few drinks.

Drink alone to drown your sorrows and that same feeling youā€™ve been looking for after may not eventuate. Instead you might feel numb and sedated.

Alsoā€¦ 3 glasses of wine per night (roughly 3-4 standard drinks) exceeds standard guidelines of what constitutes safe alcohol intake. As a matter of fact new guidelines now dictate more than four standard drinks in one sitting constitutes as binge drinking.

By 4 standard drinks Iā€™m not referring to ā€œfour beers or four glasses of wineā€. Iā€™m referring to four standard units of ethanol (40g).

I believe the upper limit of safe intake is around ten standard drinks per week and no more than four standard drinks per day. Though new data appears to indicate there may be no ā€œsafeā€ level of alcohol comsumption just as there is no ā€œsafeā€ level of tobacco consumption

Should also be noted chronic and regular intake of alcoholic beverages has a net negative effect on endocrine parameters, libido and the likes. Drink if you want, but try to do so in moderation

#18

I know itā€˜s not really optimal to drink as much. But just like many people smoke weed at night, it was my way of relaxing, i would always get slightly euphoric from a few drinks, even being alone and afterwards pleasantly sleepy. Also it didnā€˜t change my body composition or influence my libido or erectile function.

I donā€˜t know but fin did fuck up my sleep big time, which thankfully seems to be slowly recovering. But i still donā€˜t feel normal tiredness, like i did before, especially after drinking, fucked up GABA system? Who knowsā€¦

#19

You shouldnā€™t do this either, unless the cannabis is being used to ameliorate symptomatology pertaining to a medical ailment. The cumulative toxicity mediated through drinking 3-4 standard drinks per night is likely greater than smoking sayā€¦ .25 grams of cannabis every night. I find both cannabis and alcohol make me feel like Iā€™m ā€œin a fogā€ the next morning. Daily use of either leads to a discernible obstruction of my cognitive faculties.

As to cognitive impairment associated, the jury is arguably still out as to which would lead to heftier long term consequence. No judgement on my part, do as you wish so long as you are aware of the potential ramifications/so long as use doesnā€™t impede personal or familial relationships, financial prosperity and the likes. I think itā€™s necessary to note these kind of daily routines can be a slippery slope towards far more sinister patterns of use.

The data regarding PFS is still within itā€™s infancy given the condition has only recently been quasi recognised as legitimate (despite mounds of anecdotal evidence having piled up over the years).

Iā€™m curious as to how your consultation goes! Please do update :slight_smile:

Wish you the best of luck

#20

@lordgains is there an argument for the notion of some sort of partial androgen insensitivity developing after prolonged use of 5ar inhibitors?