28 replies to this topic

[dannyfc]

Right, l'll try to keep this concise as no-one wants to read a convoluted self-pitying story. I'm suffering a range of persistant side-effects since coming off the drug Finasteride (Propecia). It appears to be quite a common problem (see: PropeciaHelp.com), and there's so much conflicting information on how to treat it.

I'm feeling a little lost at the minute, and would really appreciate any advice on how I can restore how I used to be.

Symptoms;

- Anhedonia (emotional bluntless, lack of excitement)
- Fatigue/Muscle Tiredness
- No morning erections or spontaneous erections
- Cognitive impairment (difficulty comprehending tasks)

Possible root causes;

- Depleted testosterone
- Adrenal fatigue
- Low dopamine levels
- Damaged GABA receptors

My free testorone tested at 5.55 pg/ml [range 8.8 - 27], and I'm waiting to hear from an Endocrinologist to see how to rectify that. However, I get the impression low testosterone is symptomatic rather than the root cause, so am unsure whether to go ahead with HRT. (I'm only 22 years old) An MRI scan showed my Pituitary is working fine, and I get the results from my Synacthen and Cortisol tests this Friday, which should indicate more about my adrenal functioning.

The other two (GABA and Dopamine) are simply what I have deduced from my own research, but my limited medical knowledge means they're little more than pure guesswork. In the past I've noticed I'm very sensitive to both dopamine and GABA agonist drugs, I've experienced withdrawal from both Phenibut and Xanax from doses that wouldn't have effected most people.

What I've tried so far;

-Ashwagandha & Maca Root (supposedly support adrenals and hormonal balance)
-Eliminated carbohydrates (definitely noticed an improvement from this)
-Lifted weights 3x a week (in 3 months this has had no impact on my testosterone levels)
-Zinc, Magnesium, Vit C/D, L-Tyrosine, Alpha-GPC,
-L-Glutamine

I also have access to GHB which I'm still undecided about. On one hand it may offer some restorative sleep that could aid recovery, other sufferers have had success from it. Alternatively, it could negatively effect cortisol and adrenals make me worse off in the long-run. I don't know how it effects dopamine. I understand there's an initial rebound, but what about long-term production? Abuse tends to lead to dopamine depletion, but could careful use 'kickstart' production again?

It's been 6 months since I last took Propecia and the side-effects have no subsided. Any advice or direction you have would be GREATLY appreciated, as this has all been hugely distressing and left me in utter despair. Thanks.

Initial test results May 2013;

Free Testosterone - 5.55 pg/ml - [reference range 8.8 - 27]
25 OH Vitamin D - 55 nmol/L - [reference range 50 - 200]
Folate (serum - 15.1 ug/L - [reference range 4.6 - 18.7]
Thyriod Stimulating Hormone - 1.55 mIU/L - [reference range 0.27 - 4.2]
Free Thyroxine - 16.7 pmol/l - [reference range 12 - 22]
Free T3 3.2 pmol/L - [reference range 3.1 - 6.8]
Follicle Stim. Hormone 5.1 IU/L - [reference range 1.5 - 12.4]
Luteinising Hormone - 2.6 IU/L - [reference range 1.7 - 8.6]
Prolactin - 117 mIU/L - [reference range 86 - 324]
Cortisol - 141 nmol/l - [reference range 171 - 536]
Growth Hormone - 0.6 ug/L - [reference range 0 - 0.8]
Vitamin B12 - 71.6 pmol/L - [reference range 25.1 - 165]

[Sholrak]

.Waht's your age? That seems pretty low free test. Go see an endrocrin.

Edited by Sholrak, 18 July 2013 - 11:48 AM.

[dannyfc]

22 years old and I already am. (Both points stated in first post)

Edited by dannyfc, 18 July 2013 - 02:36 PM.

[Introspecta]

Dude. Tongkat Ali. Barlowes Herbs. 200:1 formula. Trust me. You'll feel better within a week or maybe longer in your case but its scientifically proven and proven by people over and over again. Hands down the best natural test boosting herb on the planet. Maybe add 25 mgs of dhea. Its strange with you being young but like you said could be side effects from fina. Why were you on Fina anyway? Were you juicing too? Anyways just try tongkat and for dopamine add DLPA. While your at it Buy Suma root with the Tongkat. If this doesn't work i'd be very very surprised. 3-4 capsules a day of tongkat. If you can handle more without getting super aggressive and anxious then you could go up to 5 but starting at 3 a day gives a dramatic boost to Test.

A doctor will probably try to put you on Hormone replacement which is sad. Message me if you have any questions. If you order Tongkat and are impatient and want to try it right away go to a Vitamin Shoppe if they have them and try the Source naturals brand. Its not as strong but still works. Not all are created equal. Someone recommended tongkat to me raving about it. I kept an open mind and was surprised at the power it had. Felt like I was on steroids at first and had to lower the dose.

Your cortisol levels were low too. Licorice Root, grapefruit juice, Rhodiola Rosea should all help with that.

Do you sleep good? Do you sleep with the TV on? Do you leave lights on?

Edited by joelski28, 20 July 2013 - 04:14 AM.

[Major Legend]

Dude. Tongkat Ali. Barlowes Herbs. 200:1 formula. Trust me. You'll feel better within a week or maybe longer in your case but its scientifically proven and proven by people over and over again. Hands down the best natural test boosting herb on the planet. Maybe add 25 mgs of dhea. Its strange with you being young but like you said could be side effects from fina. Why were you on Fina anyway? Were you juicing too? Anyways just try tongkat and for dopamine add DLPA. While your at it Buy Suma root with the Tongkat. If this doesn't work i'd be very very surprised. 3-4 capsules a day of tongkat. If you can handle more without getting super aggressive and anxious then you could go up to 5 but starting at 3 a day gives a dramatic boost to Test.

A doctor will probably try to put you on Hormone replacement which is sad. Message me if you have any questions. If you order Tongkat and are impatient and want to try it right away go to a Vitamin Shoppe if they have them and try the Source naturals brand. Its not as strong but still works. Not all are created equal. Someone recommended tongkat to me raving about it. I kept an open mind and was surprised at the power it had. Felt like I was on steroids at first and had to lower the dose.

Your cortisol levels were low too. Licorice Root, grapefruit juice, Rhodiola Rosea should all help with that.

Do you sleep good? Do you sleep with the TV on? Do you leave lights on?

Great i'll try this out, instead of having to increase my dosage of clomid.

[dannyfc]

Bought some Tonkat Ali, cautiously optimistic!

Is it generally considered that HRT is counter-intituitive in the long run?

[Jembe]

What's your estradiol level?

[nowayout]

Bought some Tonkat Ali, cautiously optimistic!

Is it generally considered that HRT is counter-intituitive in the long run?

No, it's not, but they should try to fix any fixable problem first if possible. But if you need testosterone, you should definitely take testosterone, or your body will just get run down more and more.

They should figure out if you are primary or secondary hypogonadic. If you are secondary (pituitary does not send sufficient luteinizing hormone signal) then Clomid should help a lot by stimulating your pituitary to make more LH.

If your luteinizing hormone is fine but T is low, then you are primary hypogonadal, which means the problem lies with your testicles. In this case Clomid won't help much, and you will need to take supplementary testosterone, either topically or as injections.

Some people are just hypogonadal without any good reason, so there is not necessary an underlying problem to fix. You may be one of them. It is very unlikely finasteride would have made you hypogonadal, so I would stop stressing about that. Finasteride causes problems for some people but via other mechanisms - they have problems DESPITE their testosterone being normal. Finasteride doesn't make people hypogonadal.

Some people get hypogonadal because of other drug use. Antidepressants, opioid painkillers, some sleep meds, ADHD meds, steroids, and various recreational drugs can make you hypogonadal, in most cases temporarily. Are you on any medications or have you been on any meds besides finasteride.

Thyroid problems can also cause hypogonadism, but the endo will surely check that.

Stay away from the herbals (Tongkat Ali, etc.). They don't do shit, not for the magnitude of problem that you have, and will just muddle the waters.

STAY AWAY FROM GHB. You are likely to fuck yourself up further.

All your symptoms can be ascribed to hypogonadism so just fix that first. Don't muddle the waters by bothering with neurotransmitters etc. now.

DON'T EXPERIMENT ON YOUR OWN WITH e.g. CLOMID OR OTHER DRUGS OR SUPPS - IT WILL MAKE IT IMPOSSIBLE FOR THE ENDO TO FIGURE OUT WHAT IS WRONG. Make sure to stop anything you have been using at least a month before you see the endo.

Edited by nowayout, 22 July 2013 - 08:20 AM.

[dannyfc]

Xyrem (GHB) is prescribed for Nacrolepsy so it's uses are entirely recretional. I used GBL in the past so I'm fully aware of the abuse potential, and never intended to use it as a permanent aid. However, it does have proven benefits at promoting restorative sleep so shouldn't be written off. I tried it Saturday night, and woke up with an erection so I'm intrigued. Might leave it a while before I try again.

Endocrinologist phoned today to say my testorone was in normal-high level so HRT is off the cards. Cortisol was within 300-400, and the Synacthen/MRI Scan were both fine. Don't know where I go from here.

[Introspecta]

So does that mean your test went up from the previous test you posted? To the guy who said stay away from tongkat ali I really can't see the harm in trying if low free test was the problem because there are reports of people coming off HRT and using Tongkat instead with results. But now Danny your saying your test is fine? But you still feel like shit, tired, no libido?

Edited by joelski28, 22 July 2013 - 08:33 PM.

[MasterHerb]

Bought some Tonkat Ali, cautiously optimistic!

Is it generally considered that HRT is counter-intituitive in the long run?

HRT will reduce your sperm count.

[nowayout]

I'm confused. Do you have low T or not? Had you been taking Clomid amy time before going to the endo, because that wpuld have messed up the tests, even if you stopped it a couple of months before.

I'm confused. Do you have low T or not? Had you been taking Clomid amy time before going to the endo, because that wpuld have messed up the tests, even if you stopped it a couple of months before.

[dannyfc]

No not touched Clomid

So does that mean your test went up from the previous test you posted? To the guy who said stay away from tongkat ali I really can't see the harm in trying if low free test was the problem because there are reports of people coming off HRT and using Tongkat instead with results. But now Danny your saying your test is fine? But you still feel like shit, tired, no libido?

I've not seen the exact numbers yet. Initially my testosterone was low (13 nmol), but is now in the standard range (23nmol). My free testosterone was VERY low from another doctor, but my endocrinologist doesn't consider it a reliable test so hasn't taken it again. Either way he came to the conclusion that HRT was inappropriate and I agree.

Unfortunately I still feel the same as I have been for the past 8 months despites these results, and this is common from a lot of people suffering from the drug. This to me, would suggest is a neurological problem rather than a hormonal one.

[abcmanomandriepunt1]

I think eating saturated fats might be good for you. They're good for adrenal fatigue, and they raise free testosterone. Maybe add coconut oil & grass fed buter/ghee to your diet? A good diet and a low stress life are key if you have adrenal fatigue. If a low carb diet worked for you i would stick with it . other possible ways to combat anhedonia besides dopamine agonists, is the use of antioxidants, a solid dose NAC, ALA,ALCAR(works on dopamine and choline so be carefull if sensitive), Selenium, Tocotrienols, vitamin C, milk thistle, green tea extract, resveratrol. to name a few, can help with depressed feeling. Maybe you can try out if it works for you and then make a schedule for cycling. 3 weeks on 1 week off. good luck!

[nowayout]

If ypu suspect finasteride you're more likely to.find something useful at propeciahelp.com than here. Just be aware that some guys there are quite hysteric so dont get too caught up.in the panic.

Edited by nowayout, 23 July 2013 - 11:23 AM.

[dannyfc]

I think eating saturated fats might be good for you. They're good for adrenal fatigue, and they raise free testosterone. Maybe add coconut oil & grass fed buter/ghee to your diet? A good diet and a low stress life are key if you have adrenal fatigue. If a low carb diet worked for you i would stick with it . other possible ways to combat anhedonia besides dopamine agonists, is the use of antioxidants, a solid dose NAC, ALA,ALCAR(works on dopamine and choline so be carefull if sensitive), Selenium, Tocotrienols, vitamin C, milk thistle, green tea extract, resveratrol. to name a few, can help with depressed feeling. Maybe you can try out if it works for you and then make a schedule for cycling. 3 weeks on 1 week off. good luck!

Yeah I'm working up upping my fats, used coconut milk tonight actually. Of all the things diet has been most effective suprisingly.

Is cortisol the clearest indicator of adrenal fatigue? I don't have my exact numbers yet, but I was assured it was sufficient.

And is the choline in ALCAR synonymous with the choline in Alpha-GPC? I have the latter but haven't taken it recently, will it improve endogenous dopamine production?

If ypu suspect finasteride you're more likely to.find something useful at propeciahelp.com than here. Just be aware that some guys there are quite hysteric so dont get too caught up.in the panic.

The problem with PropeciaHelp is it's 90% self-pitying, paranoia and pseudo-science. I came here as if it's neurological problem then maybe I'd find some expertise, and a pro-active solution that I could at least try.

[swich401]

Hey dannyfc,

I think you are taking the wrong approach to solving this problem (I don't think a specific supplement for increasing dopamine is going to benefit you to a huge degree at this time - there will be compensation and you'll find yourself in the same state that you are currently in).

Let me know all the supplements you are currently taking and I will suggest a regimen to bring your body back to a homeostatic level.

What I'll be suggesting may actually make symptoms worse for a short while, but you want this - the body will compensate over time, then when you stop taking my regimen hopefully your body will know how to more properly regulate production of neurotransmitters and neurosteroids needed to give you the drive and motivation that you are searching for.

[abcmanomandriepunt1]

I dont know how alcar works on dopamine and choline. But for me it feels more like a choline effect. I tend to feel a little bit depressed on it that's why i'm stoppig it. Well ive suffered with adrenal fatigue-burn out for a long time. I crashed 1.5 year ago and my cortisol has notnbeen tested low yet. But i am diagnosed with a burn out which is considerd more of a mental problem in my country( i dont dissagree with that completely but heres more to it).So i dont think cortisol is the clearest indicator for adrenal fatigue.I think it's more a problem of an overstimulated cns. Which drains the adrenals and mitochondria functions gets low. So working on a good diet, low stress life is key. If u suspect low mitochondrial function maybe try some mitchondrial support like d-ribose, alcar, q10, pqq, ALA to name a few. They might help a lot.

[dannyfc]

Hey dannyfc,

I think you are taking the wrong approach to solving this problem (I don't think a specific supplement for increasing dopamine is going to benefit you to a huge degree at this time - there will be compensation and you'll find yourself in the same state that you are currently in).

Let me know all the supplements you are currently taking and I will suggest a regimen to bring your body back to a homeostatic level.

What I'll be suggesting may actually make symptoms worse for a short while, but you want this - the body will compensate over time, then when you stop taking my regimen hopefully your body will know how to more properly regulate production of neurotransmitters and neurosteroids needed to give you the drive and motivation that you are searching for.

Sounds interesting, I'm intrigued.

Currently taking;

Ashwagandha
Maca Root
Zinc
Magnesium
Fish Oil
L-Tyrosine
Tongkat Ali
L-Glutamine.

Also just wanted to re-iterate that libido is the least of my worries, it's just the symptom thats most obvious and objective. My main problem is the emotional blunting, as it's really effecting how I interact with people and being able to work.

Edited by dannyfc, 24 July 2013 - 08:52 AM.

[nowayout]

Too much fish oil can cause loss of libido snd possibly other issues. Be cateful regarding other supps lkke maca too. For example, there is a theory that maca helps some people by reducing cortisol, which is the opposite of what someonevwith adrenal problems wants

[Jembe]

What's your estradiol level?

Gotta reiterate this question. I'm currently on Letrozole against high estradiol, and it's helping.

[Psionic]

What I'll be suggesting may actually make symptoms worse for a short while, but you want this - the body will compensate over time, then when you stop taking my regimen hopefully your body will know how to more properly regulate production of neurotransmitters and neurosteroids needed to give you the drive and motivation that you are searching for.

I am also interested what your regimen will looks like..

[FunkOdyssey]

Too much fish oil can cause loss of libido snd possibly other issues.

+1 to dose-dependent obliteration of libido by fish oil. Doesn't affect everyone this way, but a sizable minority is hit hard by it. Takes several days to develop and then to resolve, probably due to long half-life.

Edited by FunkOdyssey, 25 July 2013 - 04:40 PM.

[dannyfc]

So I just found out my SHBG is abnormally high. (70 nmol) This would explain why despite my testosterone returning to normal levels I've gotten no relief.

Whats the protocol in reducing SHBG? My GP said there's nothing you can do, but a cursory search on google directs me to Mesterolone (Proviron). Does anyone have any experience with this drug? Are there any other methods of lowing SHBG?

[nowayout]

There are some medical reasons why SHBG may be high. One is hypERthyroidism. Another is liver problems. Rather find the underlying problem than treating SHBG directly. Proviron is not a standard of care for that, since it may damage your liver, make you loae hair etc.

[dannyfc]

I feel lost to be honest. When my GP told me, he effectively shrugged his shoulders when I asked what can be done to reduce it. Even my Endocrinologist didn't bother to raise it as an issue.

I might give Proviron a go just to see. I'm out of ideas otherwise, I've spent £2000 on MRI scans, blood tests. I don't have any more money to investigate my liver. I just don't understand why doctors aren't in the least bit interested when the tests clearly show abnormal results? There's an argument that hormones will regulate themselves eventually, but when? Do I wait 10 years for things to go back to normal, and if they don't what am I left with.../rant

Edited by dannyfc, 01 August 2013 - 01:51 PM.

[nowayout]

In addition to hyperthyroidism, SERMs like Clomid are infamous for raising SHBG significantly, as does your own estrogen if it is elevated for some reason. After a SERM it may take some months for SHBG to drop again, so that may be something you should keep in mind if you took Clomid. If your estrogen is elevated, you can indierectly lower SHBG by treating estrogen by losing fat or with with an aromatase inhibitor - that should make SHBG fall over a few months. Also, low T itself tends to raise SHBG - it is a response of your body to try to hold on to the T you have - if your bioavailable T is low even if total T is high, you may indeed have hypogonadism. In this case, supplemental testosterone (TRT) will cause SHBG to drop over the course of a few months as long as the T dose is sufficient.

Proviron does not directly treat SHBG, it just occupies some of your SHBG leaving more testosterone and estrogen free. An OTC medication that does a similar thing that you might try is stinging nettle - here anecdotal accounts I have read suggest that low doses are better than higher.

BUT the problem with treating SHBG this way is that your HPT axis will just compensate for the increased bioavailable testosterone and estrogen by reducing the signal to your testes to make T. So lowering SHBG will work for a few days and then your T will drop to compensate, your bioavailable T will be low again, and you will be back to where you started with low bioT. This is why treating SHBG itself seldom works for more than a short time. Proviron may mask this problem of lower T somewhat because it is itself an androgen. So proviron is really a form of TRT - an unsafe form - so if you are going to go that route you might as well play it safer and do real TRT with testosterone.

Liver supps like milk thistle may improve the picture as well. You might as well try one for a few months - it can't hurt.

Edited by nowayout, 02 August 2013 - 06:27 AM.

[dannyfc]

In addition to hyperthyroidism, SERMs like Clomid are infamous for raising SHBG significantly, as does your own estrogen if it is elevated for some reason. After a SERM it may take some months for SHBG to drop again, so that may be something you should keep in mind if you took Clomid. If your estrogen is elevated, you can indierectly lower SHBG by treating estrogen by losing fat or with with an aromatase inhibitor - that should make SHBG fall over a few months. Also, low T itself tends to raise SHBG - it is a response of your body to try to hold on to the T you have - if your bioavailable T is low even if total T is high, you may indeed have hypogonadism. In this case, supplemental testosterone (TRT) will cause SHBG to drop over the course of a few months as long as the T dose is sufficient.

Proviron does not directly treat SHBG, it just occupies some of your SHBG leaving more testosterone and estrogen free. An OTC medication that does a similar thing that you might try is stinging nettle - here anecdotal accounts I have read suggest that low doses are better than higher.

BUT the problem with treating SHBG this way is that your HPT axis will just compensate for the increased bioavailable testosterone and estrogen by reducing the signal to your testes to make T. So lowering SHBG will work for a few days and then your T will drop to compensate, your bioavailable T will be low again, and you will be back to where you started with low bioT. This is why treating SHBG itself seldom works for more than a short time. Proviron may mask this problem of lower T somewhat because it is itself an androgen. So proviron is really a form of TRT - an unsafe form - so if you are going to go that route you might as well play it safer and do real TRT with testosterone.

Liver supps like milk thistle may improve the picture as well. You might as well try one for a few months - it can't hurt.

Thanks, your explanation makes a lot of sense. I bought some Proviron but I'll probably give it a miss now. So, even a short-term dose would be more harmful than beneficial?

Basically I need to get my estrogen tested, and if high use an aromatase inhibitor.

Edited by dannyfc, 02 August 2013 - 08:35 AM.

[swich401]

You could also try using diindolylmethane (DIM):

http://www.dimfaq.co...te/articles.htm

http://examine.com/s...indolylmethane/

http://en.wikipedia.org/wiki/3,3'-Diindolylmethane