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10-12-2017, 11:25 AM #1Junior Member
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Post Finasteride Syndrome
Hey everybody,
I could really use some help here. I was an awesome guy before this drug hit me like a truck. I took propecia for 3-4 weeks back in May 2017. I got hit with sides pretty much immediately and tried playing with the doses/EOD/E3D....... until I decided it wasn't worth it and stopped.
Here I am now, exactly 4 months 4 days off the drug (18 weeks). Things have pretty much stayed the same for me. I suffer from mostly sexual side effects. Low libido, ED, lower ejaculate, less sensitivity, I feel like my testicles are smaller, unhealthy veins forming on my penis. Mentally, I have some minor cognition/concentration/memory problems but this could easily be related to the massive amount of worrying and research I am doing. I just don't feel as mentally sharp and I have a mentally demanding job, but I do have a lot on my plate. The physical sides are that I pretty much can't lose weight as easily or pack on muscle as easily as before. I also just feel weird a lot of the time, hard to describe the feeling, just off. I am also having some varicose veins/unhealthy veins appear on my penis shaft.
The urologist I saw said that he thinks I have low Total Testosterone . It has been hovering / fluctuating around 9.3 - 12.4 nmol/L. I would say the bottom of the reference range is around 10 nmol/L. My FSH is below the ref. range. LH is bottom of the ref. range. My estradiol has gone from 87 pmol/L to 146pmol/L (top of range is 146 pmol/L) and is now hovering around 120 pmol/L.
I got my DHT tested once. It was about 3082 pmol/L (range 860-3406 pmol/L). Cortisol I only got tested once and it was 395 nmol/L (AM: 138-690 nmol/L PM: Approx 1/2 of AM Values) Vitamin D on a one time test was also relatively insufficient, so not deficient but low. My TSH has also been climbing up each test I take and is now around 2.77. I have read that hypogonadism and high estrogen can cause this, and that by treating the hormone problem you can fix or recalibrate the thyroid problem. I am hoping this is true.
I have attached an excel spreadsheet with all my labs organized. Remember that the reference range for total T is wrong according to my urologist. 5.8 is not an accurate bottom of the reference range.
So with all this in mind. I was thinking of trying some treatment. My urologist I think is going to recommend clomid monotherapy. However, I feel that I want to be a bit more aggressive and do the Mike Scally "Power PCT" protocol. I know this isn't quite the same as having secondary hypogonadism from anabolic steroids , but I know there are a lot of knowledgeable guys out there and I am looking for advice.
The "power pct" is this.
Day 1-20 : 2000iu HCG every other day.
Day 1-30 : Nolva 40mg/day (20mg was taken twice per day) ; Clomid 100mg/day (50mg was taken twice per day)
Day 31-45 : Nolva 40mg/day (20mg was taken twice per day)
Days 1-45: Low dose Aromasin (exomestane) 12.5 mg EOD ( I believe)
It seems a lot of guys don't take the Aromasin however I don't understand how once you stop drugs things will keep running with so much Estrogen. Since Estrogen is so suppressive of the HPTA wouldn't it just cause everything to go back low again. I don't know.
I need to fix this problem guys. It is destroying my life. Feel like crap. Still fighting hard but really need to try and do something.
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10-12-2017, 01:04 PM #2AR Admin
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10-12-2017, 02:29 PM #3
Hi Iron T and sorry to hear about your issues. Right now I'm inclined to believe it's not related to PFS. I'm assuming from your labs and psa that the Finasteride was related to hair loss so your dosage was probably low end, such as 1 mg per day, yes?
12.4 nmol equates to about a 350 ng/dl reading so yes, your T is low. Be nice to know your free T level as this is what works for you. Notice that your TSH level has increased incrementally as has your LH level in effort to compensate. Eventually your LH level will be suppressed if TSH continues to climb. Your body can also begin to respond poorly to LH in this situation.
Know that the TSH level on your labs is old as well. A more modern range is .3 to 3.0. Anything over a 2 should be investigated. I'd be obtaining FT3, FT4, RT3 and Antibodies to evaluate further. Step one here imho would be to address your thyroid first. Hypothyroidism, even sub-clinical can cause this. Fix one and odds are the other is corrected as well.
If that doesn't work I'd only then consider testosterone supplementation in some form. What type would be contingent on your personal life situation, which we don't yet know (age, kids, want kids, etc.) You do not need a Power PCT. If anything at all I'd lean toward clomid pending the progress made from straightening out your thyroid. Clomid stimulates LH/FSH production and does not shut down your HPTA. You can easily come off and then see if higher LH values are restored and sustainable.
Re your DHT, testosterone turns to DHT everywhere in the body except skeletal muscle via the 5-AR enzyme. I'm sure you know that's what Finasteride inhibits via the type II enzyme. It can work up to about 70% or so but obviously less at a lower MPB dosage. It works at much higher than normal testosterone dosages as well for those interested. My DHT on TRT only runs at the top of the scale when not on Fina. I'm on 5 mgs per day due to BPH and it sufficiently crushes DHT levels.
Re your Vit D, optimize it. Scale's normally around 30-100 and you should try to be in the upper 3rd or so based on blood work. Don't guess as it's fat soluble and can actually be toxic if too high a level is maintained for too long a time. Take it wil a large meal as well. Most everyone in N. America can use 5K or so per day. This will ultimately help your Free T as well by reducing your shbg.
Be patient and address one issue, evaluate and move on. If you try to attack to many things at the same time evaluating what works is difficult.Last edited by kelkel; 10-12-2017 at 02:31 PM.
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10-12-2017, 03:19 PM #4Junior Member
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Thanks a lot for the response man. Yes my fin was related to hair loss.
I have never had any issues before taking FIN. Ever. Long term very sexual relationship. No history of thyroid problems in my family. I have done a ton of research and have discovered that hypothyroidism can be cause hypogonadism, however it can also be caused by hypogonadism and high estrogen. Its the chicken or the egg scenario. Persoanally, I think Fin caused me to go hypogonadal with high E2 which can cause your body to become unresponsive to thyroid hormones.
I had my TSH tested a while back by my GP pre-fin and he said it was good. Now you can see I started off at below 2 for TSH and this was 2-3 months after fin cessation, so it could have been lower before. Now it is climbing steadily. I was top athlete on basic military training and was absolutely shredded. So I don't think I had any thyroid problems pre-fin.
I have read that often you can treat thyroid problems as well if you get your hormones straightened out. I am a pilot in the military and cannot take a lot of drugs. Especially life long drugs like thyroid replacement. Could be a career ender. I don't know why I took FIN. It was a mistake to be honest.
Anyways, do you think if I do this PCT. Clomid and Nolvadex , HCG , and an AI. And if it is successful and restores my Testosterone levels and reduces my estrogen levels and restores the proper balance I had pre-fin..... that my thyroid would then sort itself out? My understanding is that thyroid hormones are for life and I don't want to commit to lifelong treatments just yet.
Thoughts?Last edited by iron.triangle; 10-12-2017 at 03:23 PM.
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10-12-2017, 03:22 PM #5Junior Member
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Yes I want kids. Don't have kids and would like to avoid TRT at the moment. Honestly, I was so healthy before and I just want to get back to my old self. Hence the attempt at a power PCT style of treatment.
ThanksLast edited by iron.triangle; 10-13-2017 at 09:43 AM.
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10-13-2017, 08:02 AM #6
First I would run in depth thyroid labs so you at least have a clear picture of exactly whether it needs addressing or not.
Thyroid issues can begin at any age, fin related or not who knows. Just keep an open mind here.
Your Chicken and Egg analogy is very much on point, unfortunately.
Re your estradiol. First and foremost it's the wrong test. You need to obtain a Sensitive E2 Assay for accuracy. Standard estradiol will very often read much higher in men as it's not sensitive enough for a mans lower reading. Who knows if this is the case here or not but regardless you need the correct assay done. It's more expensive and most docs don't understand the unreliability of standard estradiol, unfortunately. Depending on what state you live in you can pull your own blood work relatively cheaply. Take a look at discounted labs dot com or private md labs dot com. They have packages available that may fit your needs. Once you handle it on line you then go to your normal lab (Labcorp) to pull blood.
If in fact your estrogen is elevated based on the correct labs then simply adding a mild AI and lowering this would then elevate your T so some extent. When it comes to a full pct I still don't see the need for it. If anything, and like I said prior I'd opt for simply clomid therapy. If it accomplishes your goals then you can come off and see if it holds. Remember clomid doesn't shut you down, it just stimulates more LH/FSH production by making the hypothalamus think that there no estrogen, thus it ramps up production signalling the pituitary to produce more.
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10-13-2017, 09:35 AM #7Junior Member
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Ok kool. So first I am going to tell a little story about my life to give a bigger picture. Then I have a couple questions. If you don't wanna read the story then just skip to under the line.
First off. I live in Canada. I am not sure what kind of E2 tests they run up here, but with free healthcare it is really hard to convince doctors a lot of the time to order tests for you. I have been so healthy my entire life so this has never been a problem at all. However, I know for a fact finasteride has caused all these problems.
Here is a little history/story of my life:
Finasteride was like a light switch. Before fin, I was in a 4 year stable highly sexual relationship with someone who I was planning on marrying this summer until things crumbled, pilot in a very physically and mentally demanding career, passed about 12 medical tests and a lot of bloodwork, fitness testing, etc at a medical testing facility ( tests were EKG, ECG, retinal scan, corneal topography, chest x-ray, pulmonary volume test, hearing test, standard eye test, blood work, and an interview with the same doctor that does all the medical screening for astronaut candidates.) I was top 3rd athlete and top 3rd overall in a platoon of 50. Extremely high libido and no erectile problems whatsoever.
Parents are both in excellent health. My dad played university level basketball and my mom was an Olympic level runner (until she hurt her knee in a race). They had me when they were 40 and 41 so no history whatsoever of fertility issues, erectile dysfunction, etc. I talked to my dad and he is 70 now and he tells me he has never had a problem getting it up ever. He takes no meds nor does my mother. Both my sisters have 2 kids each so no fertility issues there.
After basic training, I was absolutely shredded. I have never had a problem losing weight ever or packing on muscle. I have two med school buddies who I competed together with in half ironmans and beat both of them. My med school buddy who I beat, I have been sharing my story with him and he has been providing insight. He said there was no way I had low Test prior to finasteride use with my athletic ability and my ability to get shredded with good diet and exercise.
Enter........... Finasteride. Within a week of taking that drug, I felt the life force drain from me. It started with sexual sides. Mainly loss of morning erections/nocturnals. I had a personal trainer at the time because I was trying to get absolutely shredded at the time and wanted to start training back up for marathons because it was my goal to run a sub 1:20 half and I am very close. Finasteride caused me to bloat up and I could not put on muscle or lose any weight. I was working out harder then ever and my diet was clean. It was the weirdest thing. The trainer actually dropped me due to the fact I wasn't losing weight.
So pretty much the sexual and physical sides were too much. Also, my hair started falling out rapidly upon starting a drug for hair loss. Like WTF. I googled this obviously, and read that the shedding phase should happen for about 2 months. If you got an immediate massive shed, this could mean the drug made you hypogonadal and that you should immediately get off. This was at about the 3 week mark that I googled this. So I quit the drug and hoped my body would return to normal. Total time on the drug (11 May 2017 - 07 June 2017)
After quitting, nothing returned. I could still get erections but the venous leakage was the problem and my libido was low so I wasn't really into it. Body composition was still nothing compared to pre-fin and my diet was way cleaner, more exercise, etc. I went to the doctor at this point.
2 months after cessation, TSH was 1.93. Then steadily with each test it is climbing up. I ready that high estrogen and low test can induce metabolic syndrome as your body tries to compensate. I had my TSH tested a while back before all this and my doctor told me everything was good to go.
So this is my story. I love the opinions from everybody, but I know in my heart that the drug did something weird to me. I lost a long term girl right in the heat of a very hard military flying course. The break up was a couple days before a navigation test which I then failed. Anyways, I bucked up and passed the course. After the course, I was on the dating scene again and I had two sexual encounters with 2 women after the breakup and before finasteride usage. Everything worked great and there was no issues other then the fact that I wasn't too into them cuz the break up was fresh. No ED or libido issues.
I had an adverse drug reaction to finasteride. I provide a ton of history because I don't know if stress played a factor? I don't know. I have always handled stress well, but then introduce a synthetic drug that inhibits 70% of an important male hormone and who knows what can happen. I now I feel like goddam Sherlock Holmes trying to solve this bloody mystery. I just want my pre-fin life back. If there is one thing I have learned from this mess....... it is don't take the things you have for granted. I had an awesome life and would get upset over dumb things like not getting the highest grade on a flight, or having a few bad comments on my flight grade card, or only getting gold and not platinum on my fitness test. Now, I would give anything to have my old life back. It really makes you realize that getting the second best grade on your fitness test....... is still really good. When I make it through this, I will look back whenever I don't meet the ridiculously high standard I set for myself and say.... hey it could be worse, you could have post finasteride syndrome again. It really puts things in perspective.
__________________________________________________ __________________________________________________ ______________________________________________
Again, I live in Canada. So I can't just privately pay for my own lab tests. Makes things more difficult.
So my questions. I really don't understand how clomid monotherapy works. Clomid blocks estrogen receptors in the brain stopping the inhibitory effects that estrogen has on the brain in regards to the feedback loop for testosterone . It also blocks estrogen at other areas of the body (like breast tissue hence its treatment for gyno) but also acts as estrogen in other areas (like bone). However, I don't understand how once you remove the clomid, how your T levels remain elevated. With the increase in estrogen, wouldn't the super high levels just inhibit the HPTA axis again and cause a low FSH/LH which will in turn lower test back down. I guess this is why I thought an AI was critical to stop the excess rise in estrogen, so that when you remove everything, your low E2 will keep promoting test production until your body rebalances itself??
Can you confirm the science behind clomid monotherapy? Also in most PCT, guys say you don't need an AI??? Yet again with my understanding I don't get how SERMS maintain a high test level after cessation with skyhigh estrogen levels.
The HCG , I wanted to take prior to the PCT because I feel the months of low test has caused my balls to get smaller. I wanted to restore the leydig cell function pre-SERM to give the best envrionment for test production.?
Kelkel. Could you please explain the science of PCT to me? I have read and read and read, but I still don't understand why an AI is not required for a PCT however most protocols have it optional. Who does an AI benefit and who does it not benefit? Also, I have read the clomid and tamoxifen together is recommended because they are synergistic or work better together? Can you comment.
I guess I am confusedhow after SERM cessation, why very high estrogen levels don't down regulate the HPTA again.
Thanks man. All advice is super appreciated. 1 week until my urologist followup and I am most likely going to start something.Last edited by iron.triangle; 10-13-2017 at 09:48 AM.
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10-13-2017, 05:31 PM #8Junior Member
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Question.
What determines whether or not people use an AI during a PCT. The "POWER PCT" by Mike Scally lists an AI as optional??? When would you elect to throw in 12.5 mg Aromasin EOD into a PCT.
On another note. Spoke to my endo today. He said that he can't help me pretty much. Hormone levels are in the ginormous range that is quote "normal" unquote. Recommended psychotherapy or something to that effect....... which I am definitely not going to do. Rock hard erections..... propecia.......... not rock hard erections. It's not in my head.
He also said my TSH is not something to worry about at this point and they would not treat it. Hopefully, with the clomid/tamoxifen therapy. That will reverse itself. Hopefully.
So hopefully my urologist is going to be super helpful. He has already committed to trying some form of treatment with me. Let's see what he says next thursday.
Staying positive.
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10-14-2017, 12:36 PM #9
I read the whole story. Very, very sorry this occurred to you. It simply sucks big time. Hopefully you can get through this ok. You are doing the right thing by investigating every aspect thoroughly as so many don't and simply take whatever answer their doc gives them, which so often can be incorrect when dealing with hormones.
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10-14-2017, 12:40 PM #10
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10-14-2017, 04:09 PM #11Junior Member
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Kool. I’m gonna read those.
Yah and I get how serms work. I just don’t get how people can restart the axis with a PCT after the remove the serm. Because the serm raises both test and estrogen but blocks the estrogen while on it. However once you remove the serm. Now you have high t and high E. would the E just inhibit the feedback loop again and drop T? That’s where I guess I lose hope. Is this a viable option to jumpstart my own T production and then remove all drugs and be the way I was pre-fin....... or is there no way of going back.
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10-14-2017, 04:27 PM #12Junior Member
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Both this articles make it seem like clomid use is permanent. Darn.
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10-14-2017, 05:02 PM #13
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10-18-2017, 09:55 AM #14Junior Member
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I just got off the phone with Dr. Crisler. It was ok I guess. $250 CAD for a 30 min appointment and a large part of it he just assessed my labs. I wish he would have done that before he called and left more space for my questions etc. Anyways, he didn’t like Mike Scally a lot and pretty much said he’s an idiot haha. Also said you should never take that much HCG and only take 500 iu max. He said it also suppressed the system and if I want to get back my normal hormone pathways he recommends low dose clomid at 12.5 mg ED or 25 mg EOD. He actually recommended the 25 mg EOD as slightly better because it can get the pulsatile response in gonadotropins better or something to that effect. Didn’t recommend anything that further suppressed stuff like AI or HCG. He said my estradiol Test is inaccurate and we can’t go off of it because it’s not unltrasensitive. He said we could potentially take my symptoms into account, the fact I have E.D., a harder time packing in muscle and losing weight around the middle, to say that my E2 is high, but still only recommended the low dose clomid.
I still don’t understand how this will restore normal pathways. It also increases estrogen so I don’t understand how the increase in estrogen won’t just suppress my system again once I stop the clomiphene.
I just want to get back to my old self to be honest. So hopefully this helps.
I guess the entire treatment time will be around 3 months total.
Any questions or advice are welcome. CheersLast edited by iron.triangle; 10-18-2017 at 10:00 AM.
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10-18-2017, 11:31 AM #15
So in other words he essentially backed up what I've stated. That's a relief.
No, he and Scally had a falling out years ago and never got it back together.
Clomid increased E by virtue of increasing T. It's not supraphysiological levels though so E should not be an issue. You need E.
Agree with 25 eod as it will immitate the pulsatile nature of endogenous T production more.
Do it!
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10-18-2017, 01:44 PM #16Junior Member
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I was also gonna ask if my E2 Test is worthless.? If it’s not the ultra sensitive kind is it worthless?
Also with clomid therapy, do you feel the T effects right away often or does it take months of high test to experience the physiological changes. Just like guys who initiate TRT. It often takes a few months to see changes in erectile function.
I also wanted to ask about SHBG. Dr. Crisler said I have low SHBG which is helping me because of my low T but isn’t desired either. He actually wanted this to go up too. Any idea why?
Astor, is a taper of clomid necessary or recommended?
Also, enclomiphene. Is this a thing? Or simply a myth..... something that was trialled but never made it past that.
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10-18-2017, 03:22 PM #17Junior Member
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[QUOTE=kelkel;7332937]
Clomid increased E by virtue of increasing T. It's not supraphysiological levels though so E should not be an issue. You need E.
QUOTE]
Doesn't clomid also increase E via the zuclomiphene component? That is what I am worried about? Too much E which is suppressive of test production once I get off the drug.
I wish enclomiphene was more of a thing. That makes much more sense to me.
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10-18-2017, 06:22 PM #18
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10-18-2017, 06:25 PM #19
[QUOTE=iron.triangle;7332981]Yes, that's the isomer that will cause estrogen expression but that's ok, just monitor your E one way or the other and take remedial action if needed. Even using a combo of 200 DIM and 50 Zinc will help a little. It's sold combined.
Remember, ton's of people use clomid and do just fine.
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10-18-2017, 11:49 PM #20Junior Member
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Any good brands for the dim and zinc mix?
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10-19-2017, 09:32 AM #21
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10-19-2017, 11:45 AM #22Junior Member
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Got prescribed 25mg EOD clomiphene but it has to be made at a compounding pharmacy. My doctor is calling to see if they can just make enclomiphene so that could be interesting.
Also giving me a prescription for arimidex to keep on hand in case.
Thoughts? Is arimidex the best AI to have. I donÂ’t know. Also he is not that keen on regular blood work for some reason. I may have to go through my GP for this.
Yes lots of guys do fine on clomiphene but they arenÂ’t PFS guys. PFS guys from what I have read react differently.
IÂ’m hoping this is just an effed up coincidence and finasteride made me hypo. I hope I donÂ’t have any of that androgen receptor desensitizing or neurotransmitter balogni that others have.
Fingers crossed this works
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10-19-2017, 12:30 PM #23
I prefer Adex but many like Exemestane as well. Read this:
Ancillary Reference Guide
You'll be fine. Be positive.
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10-19-2017, 01:04 PM #24Junior Member
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Thanks a lot for all the info kelkel. Im reading that guide and it’s very good.
Last question. How do you combat the estrogen rebound or is that even a thing? My urologist was saying that he even sees an estrogen rebound with aromasin ? Is this true?
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10-19-2017, 01:39 PM #25
Estrogen, like all hormones seek homeostasis. That said, sure it can fluctuate but normally it's not enough to cause concern or require additional medication. If there's too large a swing in estrogen odds are something was done wrong medicinally. Per your Uro's comment, I'd have to know what type of swing in levels he considers a rebound. Quite subjective.
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10-21-2017, 12:28 PM #26Junior Member
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Kelkel,
I apologize. Trying to get a lot of info again to make sure I don't jump into anything too stupid like I did with finasteride.
There is talk of finasteride being similar to a progestin which means that it effs up progesterone balance, which in turn decreases test, causes estrogen dominance, etc. Progestins are awful for dudes and are even used in sex offenders to lower libido and cause ED, etc
The closest thing I could find to this was nandralone decanoate, which can contribute to what guys call Deca dick. Lower libido, erectile dysfunction, gyno, etc. Deca is highly aromatizing and a progestin. Which is what causes all these problems. Sometimes permanently or extremely long after quitting the steroid .
Have you ever heard of guys recovering from Deca side effects and how did they do it. Some guys recover from deca side effects by using progesterone, and I have read a lot of guys recovering from finasteride side effects by using progesterone creams. Some guys have even gone as far as taking mifeprestone.
Side effects for me on finasteride were immediate. Where as a lot of guys who suffer sides get it years later. For those guys I am thinking that the lack of DHT for extended periods caused a lot of problems down the line somewhere that eventually caught up with them.
However, for me. It did something quite quick. And I am still trying to pinpoint exactly what that is. I have not got my progesterone tested at all.
Lastly, nolvadex vs clomid. I have read your ancillary guide. I still find some guys saying nolvadex others saying clomid is better. Does it really matter? What is better at restoring the HPTA?
An option I am also looking at is just getting on some testosterone replacement and taking that for a while in a low dose. See how I feel and maybe trying to get off it in the future.
Cheers mateLast edited by iron.triangle; 10-21-2017 at 03:22 PM.
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10-22-2017, 04:28 PM #27
No apologies. Conversing about all this helps refresh my old ass memory.....
Anyway, I wouldn't call it similar to a progestin but yes, it can mess up PR balance as it has an inhibitory effect on it. Normally though with Fina use you can see a small rise in T due to less turnover to DHT. Deca is a progestin but is not really that highly aromatizing, actually much less than testosterone which can turn at about a 40% rate. Re most of the problems with Deca (but not all) are due to guys not controlling estrogen which in turn ultimately allows a rise in prolactin. This effect can then cause libido issues. It's why on larger doses of progestins a D2 Agonist is advised. You'll read guys here say that "control estrogen and you'll have no issues on Deca" and that normally holds true but as with anything, not always. I have an interesting study for you to read on Deca and here's one on Fina as well. Click on the hyperlink for the long version of the Fina study:
https://www.ncbi.nlm.nih.gov/pubmed/16834758
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837307/
When it comes to guys recovering from Deca issues it's normally just adding in the proper ancillaries as well as enough time off the drug for the body to find homeostatis. I've not read anything on guys taking PR creame or any type of PR blockers.
Regarding Deca, I've run it at a low dose alongside my TRT for years. Only taking occasional breaks usually prior to BW to make sure it doesn't skew T levels as it can falsely impact them. By low dose I mean 100-125 mgs per week. My doc will write this but my insurance won't cover it so it's just practical that I obtain it myself. Deca is not as bad as it's made out to be. Abuse it and of course the outcome can change.
I'm curious, did you ever test your DHT prior, during or after Fina treatment?
Clomid and Nolva are similar and different at the same time and basically compliment each other, which is why both are used in post cycle therapy after guys finish steroid cycles. Clomid is an anti-estrogen at the pituitary level but not in blood and doesn't block ER's in the body. Nolva effects the pituitary and binds to ER's all over. (ER's Estrogen Receptors.) Ultimately both ramp up LH and thus test production assuming normal testicular function.
I'd still probably opt for simply EOD Clomid to start and evaluate after 4 weeks or so.Last edited by kelkel; 10-22-2017 at 04:31 PM.
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10-22-2017, 06:57 PM #28Junior Member
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No I never got my DHT tester before. My doc didn’t see testing my hormones as necessary before hand. I asked him and he said no. I’m in the military and he’s a ranking officer so I didnt press the issue but now I wish I would have.
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