PROPECIAHELP: Persistent Finasteride Propecia Proscar side effects info & discussion forum

Forum for men with PERSISTENT sexual, mental & physical side effects which CONTINUE DESPITE QUITTING Finasteride (Propecia, Proscar), a 5AR inhibitor drug for hair loss, prostate enlargement & prostate cancer.
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PostPosted: Mon Jun 21, 2010 9:21 pm 
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http://blog.alanjacobsmd.com/alan-jacob ... eride.html

not really the best of news


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PostPosted: Mon Jun 21, 2010 11:52 pm 
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Quote:
This leads to the question of whether partial androgen resistance is at play.


Indeed, this is still the big question. Until we have been tested for such, it is still a theory. Perhaps Dr. Jacobs can organize such a study on us in the lab.

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PostPosted: Tue Jun 22, 2010 9:11 am 
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He states that many have'normal testosteronelevels but symptoms of hypogonadism which is what androgen resistance is' but many of us have very low or below range readings. I'm not even sure how useful hormones are as there are plenty guys with below range T and only libido problems while others are mid range or higher and have the full gamut of problems. But I digress.

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PostPosted: Tue Jun 22, 2010 10:31 am 
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Quote:
"June 21, 2010

A Proposed Mechanism For Prolonged Sexual Side Effects From Finasteride
http://blog.alanjacobsmd.com/alan-jacob ... eride.html

Several young men seen for hypogonadism (low libido, erectile dysfunction, low energy, etc) after using finasteride have been found to have low-normal levels of bio-available testosterone and LH. This leads to the question of whether partial androgen resistance is at play. It has been shown that androgen insensitivity can occur even without mutations in the genes coding for the androgen receptor1. How then to connect finasteride use to the development of partial androgen resistance, especially outlasting the use of the drug?

In recent years many scientists have looked at the androgen receptor gene with an eye towards a variable length of its structure in one particular region called exon-1. In this region the number of CAG repeats, which code for glutamine (an amino acid-building block for the protein that becomes part of the receptor), vary between approximately 10-25 in different individuals and this variability has been linked to variable effectiveness or potency of androgens (testosterone(T) and dihydrotestosterone (DHT)) in these individuals. In other words, the number of these CAG repeats in the gene for the androgen receptor will effect the functionality of androgens in a man in various tissues in his body and even in his psychological traits2. This variability can cause hypogonadism in men with normal levels of testosterone, which is what androgen resistance is".



So testing for glutamine will give us the answer to what caused our problem and find solutions?.


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PostPosted: Tue Jun 22, 2010 2:42 pm 
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Who is An_22242935 over at webMD? I know its one of you....


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PostPosted: Tue Jun 22, 2010 9:45 pm 
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Guys,

I saw Dr. Jacobs the other day before he posted his latest post. He walked me through his theory. His suggestion was to try increasing T levels every week for a month through T injections, while taking arimidex and see if there is a response. I took the first injection and my T level went to 1475 from 250 and I felt no difference. This week, I am increasing the dose. He said he would not be suprised if I did not see results till I got to T levels of 2500...although after feeling nothing at 1475, for some reason I can't imagine any amount of T is going to make me feel anything...we will see. He did mention that he has had to do the same thing with Thyroid patients and they take 7x the normal range to feel better.

I am waiting to get blood tests back from my andractim test period. I had labs with Adiol G done before, day 5, and day 10. I didn't feel much of a difference during that period, but it turns out it depressed my bio available T levels big time.

Wow...this whole thing is depressing. Non-stop hoping with new protocols, treatments, and always nothing...WTF.

I hope we are getting somewhere with the research side at least. A definite cure would be nice...if it is partial androgen insensitivity, surely there is a way to turn the damn thing on again...just like diabetes type II.

PPS


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PostPosted: Tue Jun 22, 2010 11:53 pm 
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Yeah when I was on a higher dose of clomid (50mg 3x a week) 6 years ago my Testosterone got up to 1390 and still had serious ED.

PPS, what are your thyroid #'s like?

TSH, RT3, Free Uptake T3, Free Uptake T4?


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PostPosted: Wed Jun 23, 2010 12:37 am 
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Please keep this thread on topic. If you wish to discuss Thyroid and other hormone values, pls do so via PM or in a seperate thread.

Thx

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PostPosted: Wed Jun 23, 2010 3:12 am 
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Redirecting focus back to the topic...Regarding CAG repeats, dr. jacobs says that most of us have low bioavailable testosterone after finasteride use..This is true...however, someone like myself who has been on low dose of clomid over the past 4 months has restore healthy-higher normal bioavailable testerone/free testosterone levels and still have erectile problems...(Very normal hormone profile).

Food for thought...


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PostPosted: Thu Jun 24, 2010 4:11 pm 
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Yes, but you achieved normal/high level via medicinal intervention.


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PostPosted: Thu Jun 24, 2010 7:39 pm 
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Yes but I still have ED problems...Something isnt right...I'm now directing attention to hypothyroidsm and see if this will help...


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PostPosted: Sun Jun 27, 2010 4:42 pm 
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anonnn1 wrote:
Redirecting focus back to the topic...Regarding CAG repeats, dr. jacobs says that most of us have low bioavailable testosterone after finasteride use..This is true...however, someone like myself who has been on low dose of clomid over the past 4 months has restore healthy-higher normal bioavailable testerone/free testosterone levels and still have erectile problems...(Very normal hormone profile).

Food for thought...


Yes, but maybe you have to continue on this path for some time longer. It may take many more months for ALL other hormones to also re-calibrate back inline with your new free and bioavailable testosterone levels. It may not be as simple as -raise it high.

I know I know. But hopefully this is clear. It is very clear in my mind.
This may take a coupla years to rebuild a very balanced functioning system again. Just like they say, it is a very carefully balanced system of many many checks and balances.

I would stick with your clomid treatment. It may very well take you someplace if you stick with it, and keep an eye on things. Obviously with the help and guidance of a knowledgeable doctor.


I think there could also be some prostate blockages, which some of you just may not feel for one reason or another.
Apparently my T is VERY LOW according to latest tests, and I will be receiving treatment from Crisler very soon.
But still... One thing is for sure - when my prostate and all digestive symptoms go away, my erections get very good. But normally with all the prostate stiffness and congestion, sexual function is slow!
I wonder if there was some prostae damage?
And if this is affected by androgens, or vice-versa..
If there was cell-death in the prostate, which blocks important androgen pathways!???


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PostPosted: Sun Jun 27, 2010 8:06 pm 
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True...Dr. Crisler is my doctor as well...Correcting my thyroid is the next step..I agree with you, long term low dose clomid is probably best bet..maybe 2 years?

We shall see...


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PostPosted: Tue Jul 13, 2010 5:01 am 
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I was curious what led him (Dr. Jacobs) to consider this:

"I am wondering whether the propensity of finasteride to cause lasting partial androgen resistance in a subset of men relates to the number of CAG repeats in exon 1 of their androgen receptor genes, perhaps those with the greatest number of repeats are at highest risk. "


Could having the greatest number of CAG repeats correlate with having an extremely sensitive or relatively "hyper-active" libido?

I was wondering last year if many people visiting this site were among the kind of men who get aroused and hard extremely easily and have often found themselves hiding erections or avoiding the view of women in public or in an office setting. On the other hand, I had some things happening in my life just prior to taking FIN that caused my libido and overall outlook to head south like nothing previously in my whole life. The FIN made everything worse.


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PostPosted: Tue Jul 13, 2010 6:56 am 
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pps wrote:
Guys,

I saw Dr. Jacobs the other day before he posted his latest post. He walked me through his theory. His suggestion was to try increasing T levels every week for a month through T injections, while taking arimidex and see if there is a response. I took the first injection and my T level went to 1475 from 250 and I felt no difference. This week, I am increasing the dose. He said he would not be suprised if I did not see results till I got to T levels of 2500...although after feeling nothing at 1475, for some reason I can't imagine any amount of T is going to make me feel anything...we will see. He did mention that he has had to do the same thing with Thyroid patients and they take 7x the normal range to feel better.

I am waiting to get blood tests back from my andractim test period. I had labs with Adiol G done before, day 5, and day 10. I didn't feel much of a difference during that period, but it turns out it depressed my bio available T levels big time.

Wow...this whole thing is depressing. Non-stop hoping with new protocols, treatments, and always nothing...WTF.

I hope we are getting somewhere with the research side at least. A definite cure would be nice...if it is partial androgen insensitivity, surely there is a way to turn the damn thing on again...just like diabetes type II.

PPS


Any updates PPS?


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PostPosted: Tue Jul 13, 2010 3:17 pm 
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Hi All,

It's been a while since I posted, but I have some stuff to report that should definitely be of interest:

I got my Adiol G level tested on 05/26 and it was 212 (260-1500 scale), at that same time my DHT was 61 (25-75 scale)

Dr. Jacobs was shocked by this and that is what led him to write those posts.

I then took Andractim alone for 12 days because I was encouraged by JN's posts. I did not take TRT at the time. My DHT level went to 512 (25-75 scale)!! My Adiol G went to 632 (260-1500 scale). It took almost ten times the normal amount of DHT to get my Adiol G level to go to the low end of the normal range. Something is not right there. Unfortunately at that time my T (348 on scale of 250-1100) and Bio available T (93.8 on a scale of 110-575) went way down. I noticed maybe some small, small effect on libido, but hard to say if it really happened and given the fact that my T level went down, it would not be suprising if I didn't have a libido anyway.

I didn't have any of these labs back yet, but Dr. Jacobs felt the best treatment plan was to put me on TRT and keep estrogen low with arimidex, and keep upping the dose every week until I felt something. At this point I had stopped taking the Andractim. I took the first dose (1ml test cyp injection) and my T went to 1475 and my estrogen stayed low. I didn't notice a thing. The next week I doubled the dose (2ml test cyp injection) and my T level went to 4000!!!! I emailed Dr. Jacobs and he said that was a record, which I was really not happy about. Anyway, get this, I didn't notice a damn thing. No change in libido at all. I stopped upping the dose, and stopped TRT all together after that because I don't want to hurt myself.

Two weeks ago I got my CAG repeats tested because of Dr. Jacobs' post. My result came back as 18 on a scale of 10-25 (i think). Nothing unusual there.

So guys, what does all this mean. My DHT/Adiol G is screwed, which might suggest partial androgen insensitivity, but I just took more Testosterone than most people on the planet and it didn't do a thing. I didn't even get irritable or angry or anything.

One thing that is good to know is that Andractim increases Adiol G, but you definitely need to be on TRT.

Maybe that is a last option...taking TRT and DHT at the same time and Arimidex....jesus.

What else could this screwed up Adiol G thing mean apart from androgen insensitivity?


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PostPosted: Tue Jul 13, 2010 3:42 pm 
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Man this is obvious something is seriously wrong. At least if someone takes TRT and Andractim maybe he can get better libidowise.


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PostPosted: Tue Jul 13, 2010 8:51 pm 
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PPS,

Please get a full thyroid panel done. Where trying to narrow things down here...We can't rule hypothyroidism. Your body may not be metabolising efficiently. You may have low T3 and High Reverse T3(inactive). You need to get these tested first and them proceed.

This is a struggle man..I know and beeing dealing with it 8 years....

Lord will he have compassion on us and give us a lift....


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PostPosted: Tue Jul 13, 2010 9:11 pm 
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PPS's example, along with others on this site had me thinking last year that one of the only regimen-oriented solutions for our problems would be to moderately lower testosterone production and/or DHT in an effort to perhaps make the tissues/receptors more sensitive at the lower levels of available androgens---perhaps concurrently running an estrogen blocker. My basic idea was that this would be the opposite kind of treatment to the Finasteride. Maybe I'm looking at it completely wrong though.

I don't know how such a thing would be accomplished through diet or supplementation. I suppose cortisol levels should be a concern too during such a hypothetical regimen.

PPS, do you think you will actually experiment with such combinations in the future?

From what you've posted here, it seems like an inexplicable problem resulting from neurochemical/hormone imbalance in the CNS--or, that's one theory. You're saying that you still felt anhedonia or lack of "good" feelings along with a lack of libido?


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PostPosted: Wed Jul 14, 2010 5:48 pm 
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pps wrote:
So guys, what does all this mean. My DHT/Adiol G is screwed, which might suggest partial androgen insensitivity, but I just took more Testosterone than most people on the planet and it didn't do a thing. I didn't even get irritable or angry or anything.

One thing that is good to know is that Andractim increases Adiol G, but you definitely need to be on TRT.

Maybe that is a last option...taking TRT and DHT at the same time and Arimidex....jesus.

What else could this screwed up Adiol G thing mean apart from androgen insensitivity?

Hey pps, welcome to the club. I have been on the same regiment like you (200% TRT and 200% DHT with Andractim) with the same results. Having been on TRT before taking fin, I know what even small doses of TRT normally feels like: Good. Now, no matter what I take, I feel nothing positive - actually high doses of androgens make my symptoms WORSE. I've also messed with reducing estrogens via Arimidex and even Aromasin. Nada.

For those that have been there, the conclusion is clear: Androgen insensitivity is the only answer. There is no way on this frickin planet that any hormonal "excuses" can even come close to explaining this. If you think about it, what has happened becomes very clear:
  1. 5AR inhibitor massively reduces cellular and circulating DHT levels
  2. AR becomes hypersensitive (google terms androgen receptor hypersensitivity) due to low androgens. This is why we get hypogonadal LH/T values.
  3. Side effects start
  4. We quit 5AR inhibitor
  5. DHT returns full force and hits upon hypersensitive AR (do the math 100% > 30% is a 70% reduction. 30% to 100% is a 333% increase. Combine this with a hypersensitive AR and you get a train crash. This is why the symptoms really go south about 1-2 weeks after quitting.
  6. AR negative autoregulation kicks in an probably methylates some AR regulatory element, effectively silencing the AR signlal

The approach we have to take to this is to understand what changed and try to undo it. Overloading the system with further hormones will not work in many cases. Some guys do indeed seem to be lucky enough to have enough remaining sensitivity to get some benefit from hormones. Most of us, however will not - or even get worse by using them.

Btw, common misconception on this board: Adiol-G is about 75% a marker of AR gene expression and NOT of 5AR activity. 3a-HSD is mainly induced by AR gene expression. The remaining 25% come from direct induction by androgens (likely) or some other hormone (maybe). That is why you can have perfectly good serum DHT values and still have fucked up Adiol-G, because low Adiol-G is mostly telling us something about Androgen sensitivity.

PS: I am referring to 5ARI's in general and not only finasteride. As you probably know from this board SP, dutasteride and isotretinoin lead to the same problems.

Hang in there, we'll get there.


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