Advice for PCT? (Post Accutane Syndrome)

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I know you didn’t ask me, and you’ve been on a long journey here to address this, but some of these questions you’re asking can’t be answered. When will your balls return? No idea man, they are YOUR balls, you’ll have to tell us.

HCG is generally not given IM but SQ, likely doesn’t make a difference but the dose will depend on how you are responding. 600iu EOD seems reasonable to start with.

Why stop HCG and run Clomid again? Is this part of your PCT plan? I’d do the HCG for 3 weeks if so, then 4-6 weeks of the SERM.

Good luck

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If you used HCG on your testosterone regimen, there should not have been atrophy of your balls in the first place, something is not right if they did.

When they will return? I don’t know.

How much hCG? Between 250 and 1000 IU 2-3 times per week. I’d go for the lower side of that. Take hCG for 2 weeks, then continue while starting the Clomid for a week, then only continue with Clomid for 3 more weeks.

Clomid 25 mg/day.

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Thanks, now im starting my PCT, my HCG usage is done. It has been a month and 9 days since i quit the Testosterone. I’ve been using HCG in the meantime but with a bit irreguler schedule. Now, that is over too.

I have read that Test can stay in the system up to 10 days so it has been around a month since i quit it and i hope it is not too late for PCT?

Also i remember my FSH and LH levels didn’t go high as expected on Tamoxifen before, should i try Clomid instead then as you said?

Which is a better option for PCT? Usually Tamoxifen seems like a better one due to not causing desensitization on the HPTA, i don’t remember the exact details but remember the study…

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Around 57:30 Dr. Mark Gordon talks about every 3 days of Clomid usage where he experimented with his patients and found out that it was the optimal.

So every three days 50mg would be a better idea or would i need more? My testicles never grew on SERM’s… Maybe i need much higher doses of Clomid to grow my testicles back now?

But im also scared of higher doses, maybe that would damage me more instead…

@lordgains @swoops39 @flappinit @iron_yuppie

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And yeah, as i said before, i took 300iu of Pharma HCG while i was using Test E…

I have no idea why my testicles atrophied. Maybe i needed higher doses of HCG because my body built a tolerance?

Because i did run HCG solo and with Test Cyp and sometimes on and off with Progesterone for few months of time before to this protocol.

Maybe all that different protocols and on and off usage of stuff caused tolerance to HCG?

I have also read that testicle size return can last up to 3 months after cycles? Is that correct? How was your experience like?

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He seems to think so, right? But your balls didn’t grow on SERMs before, why would they now?

My balls returned to larger than normal after every SERM PCT. Not sure that’s helpful for you tho

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I don’t quite understand what are you implying here… Im in a fragile state please be kind.

You mean i should increase my PCT dosage? I don’t understand why it doesn’t work. Maybe my issues restrict proper oxygen and bloodflwo to my testicles?

Well not maybe, it is true because i have shrunken scrotum for years now, some sort of blockage causing lack of bloodflow there. Also this caused my varicose veins i think.

I hope this is all reversible…

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Sorry not trying to be rude.

You posted a video showing that a doctor thinks that a SERM e3d is plenty, but you are uncertain if that is true so you’re asking us? I don’t think anyone here can tell you that.

You said you’ve tried a SERM before, but it didn’t grow your testicles. Would that be different if you took it e3d? Or, after watching that video you think you need to take it more often? Or at a higher dose? We wouldn’t know that.

I don’t know the answer to that question and I think that you’re going to have to just try it, as you’ve been trying other things, for a period of time and assess your benefits. You are scared of higher doses, you think lower doses may be better, I don’t know. Give it a shot and report back for your benefit and ours.

I really hope you have success with it. Good luck

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Luckily my testicles has recovered with 20mg Tamoxifen, taken every other day. It is bac/ close to pre TRT size.

Now im gonna do a SIBo breath test. And focus on auto immune issues as my problem is clearly about my gut and auto immune. Also heard that SIBO can create chronic prostatitis. Bingo.

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If you have SIBO what are you going to do against it?

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Turns out i HAVE IT! My Methane test turned out to be 65, normal max range being 10ppm. Hydrogen is healthy range.

@lordgains

I damaged myself with these hormonal protocols… I can’t believe what i have did, the answer was much more simple… There are several PSSD cases who recovered their exact symptoms after treating their SIBO!

I shed happy tears yesterday after finallying finding something. I knew it was about my gut when i did the water fast and realized some sensations and bloodflow is recovering… That’s why Progesterone injections helped me! Apparently, they lower inflammation and beneficial for gut health!

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Great to hear! Please keep us updated.

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No you most likely didn’t. I’d even go as far as saying: no you didn’t!

Chill out. Your trial and error was what it was. You are after all searching for a needle in the hat stack while not even knowing if it’s there.

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Yeah i think i had to go through this route before realizing it was all about my gut. The water fasting i did should have made me realize it before the TRT trial.

Anyways, only thing i have to do is to find a proper protocol for my issue.

Although my Zonulin levels showed healthy ranges i believe i have leaky gut too. My dybiosis index was 15 out of 30, 30 being worse and two main bacterias for intestinal mucosa\ barrier, Akkermansia and Prevotella was very low!

I think this is my issue: SIBO+ Leaky Gut= Auto Immune Response and+ or inflammation on nearby organs.

This caused pelvic floor dysfunction and prostate inflammation. This is why i still have high libido with numb genitals. This explains it all…

Now, the hardest part is to fix it, i have an another PAS friend who told me he had complete reversal of his similar sexual issues on his 5th water fast! But then regressed back to numb state after the fast, breaking it with proper foods.

Also, on my first and only 14 day water fast last winter, i also had bigger scrotum bloodflow and better sensitivity although the sensitivity part was very minimal. Went from %5 to %30 out of 100% being healthy normal i would say.

After breaking the fast i ate gluten free diet with Akkermansia and Prevotella increasing foods, like berries and such. I also took special leaky gut supplements to heal my barrier.
I took really good stuff on high doses along with the pre- biotics my naturopath gave it to me. So pro and pre biotics with lots of good gut health supplements for like 2 months…

However i didn’t experience benefits that much… Scrotum fullness stayed a bit and then disappeared. Sensitivity was still bad\ same. This was almost a year ago. Now this experience makes me scared a bit because how hard it seems to heal the gut but maybe that was because i didn’t include a sibo treatment along with it. I didn’t know i had sibo back then…

I also tried Rifaximin only (Usually Neomycin or Flagyl is taken together to beat Methane SIBO, i didn’t have those in the pharmacy.) for 2 weeks before getting the sibo test, and i had die off symptoms, my issues worsened as well as insomnia and obsessive thoughts were more present!

I have a feeling that i will fix all of my issues, including my acne problem and my PAS once i heal my gut.

But i lack scientific knowledge on auto immune diseases. Can Accutane caused a direct effect on my auto immune health, therefore causing my gut issues? Or is it vice versa you’d say? @lordgains

Accutane damaging something in my gut and thus causing auto immune response is more likely to me…

Anyways, is there any info you can share with me so i can use it in order to recover?

I am thinking about doing a second 10 day water fast for a clean start. And then doing a special diet for SIBO. (Maybe Flagyl+ Rifaximin combo again if this fails, a guy on Reddit (lastround360) recovered with this combo, he had similar issues from Anti Depressant drugs.)

No anti- biotics, no pro- pre biotics! Just diet. (Maybe that’s why my first water fast trial was a failure.)

Because a Dr. guy in our telegram group explained how probiotics and anti- biotics can worsen the SIBO and it is best to stick with diet only. Is this true?

One more thing, i can test some auto immune antibodies like ANA, ENA etc. in a hospital as seeing some other members in my group showed positive results for other antibodies like muscarinic receptor antibodies or something…

But i find that test couldn’t provide me anything useful? I mean only way to treat auto immune issues is IVIG, Plasmapheresis etc. which costs a fortune!!! I better try to fix the root cause manually, i guess rather than focusing on auto immune antibody tests and treatments? (You guys can search: ‘‘PSSD Auto Immune results’’ on Reddit for a reference.)

Thanks for everything guys, especially to @lordgains, over the years (wow!) you helped me a lot in this journey. Thank you for your time, i hope someday i can help you with something else.

I am finally confident about my findings. I just need a very good plan to beat this. Anyone who can share his opinions or knowledge, please do.

One last question, @lordgains can auto immune issues exist locally, like in my case? I don’t have general auto immune symptoms, my issues locate only on lower half of my body. Gut, prostate, bladder, genitals and that’s it. Is this possible or auto immune issues are always systemic?

So maybe i have inflammatory type of issues rather than auto immune maybe? But can this explain my numbness issues?

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@lordgains Any ideas if you are there? :slight_smile: Btw i talked with my Gastro again and i will have a ‘‘short colonoscopy’’ on monday. He also said if i have local auto immune issues, i should have intestinal symptoms which i don’t have any serious ones like he described. But he might be wrong, because i know people can have asymptomatic SIBO, and other asymptomatic issues. Which, i am one of them.

He also said SIBO tests are not reliable much, but i don’t think he is up to date with new articles over the last years. I hope i can get a small intestine scan, like endoscopy too, i don’t understand why he just ordered small colonoscopy (Openings of the left side of colon and rectum area.) which he said will be enough… Anyways he sounded like he know what he is talking about though. Lots of medical terms i missed when he explained it to me.

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Accutane can have a wide variety of effects on many organs. There are so effects on the immune system though not many on lymphocytes as far as I’m aware. In the end, I don’t know.

I don’t have any info on leaky gut. It’s a topic I tried to understand years ago but realized it’s just either not understood enough or not happening as it is purported to be. I’ve not researched it more since.

I think this is very plausible.

Yes.

Yes, they often exist locally (or let’s rather say they manifest locally).

Inflammation is ALWAYS combined with the 5 signs of inflammation. If they are not there, there are no cytokines that attract enough immune cells and so on. So no, I don’t think you have an “inflammation issue”, but auto immune issues ARE by nature inflammatory. One should be able to see an inflamed gut by colonoscopy. I hope you don’t have that.

He is describing and testing for M. Crohn and Colitis. You very likely won’t have that.

Taken together, I tried answering what I could, but all in all I believe you are going deeper and deeper into pseudo scientific areas. There’s a lot of people profiting from people like you. Likely all the doctors think you have a case of Hypochondria. I’m honest with you here. I don’t know what’s going on with your dick. I don’t think the way to go is to try everything that’s out there, especially not all kinds of overpriced diagnostics and side effect-rich treatments.

I hope for you that you have these things in order for at least a year now:

  1. A consistent sleep schedule of 8 hours
  2. Sports 2-3 times per week of moderate intensity
  3. A diet that gives your body all building blocks it needs and enough micronutrients
  4. A goal to strive for that is outside of yourself, like a job or a course of studies where you pursue a long term goal
  5. Some creative endeavor like music or art that compliments your life for a few hours per week
  6. A restriction of dopamine releasing unnatural stimuli
  7. Family and good friendships to enjoy

If you don’t have all of these in your life, then please before pursuing more and more treatments, get these in order and focus on something and people outside of yourself. 90% of the things you call symptoms will then sort themselves out and what’s left you can treat with common medical approaches. The obsessiveness over your health status is taking a detriment on your life and I hope you can see that.

I hope you get better, but again, please don’t solely focus on what symptoms you can find on your body.

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Hi @lordgains its been a longtime, thank you for your message.

Yes i’ve been doing these things already, but it does not affect my situation. Im mentally better and over some things, i believe i will fix my physical side effects soon too. I had ‘‘short colonoscopy’’ btw and they didn’t see anything alarming, but Dr. said i had problems on my muscles that ‘‘push out’’ on my pelvic area, which makes sense.

Anyways, i have an another concerning question to ask you, i hope you can give me the answer i seek.

So it’s been almost a year since i stopped my 500mg a week for 3 months TRT+ HCG trial, although my testicles grew back mostly, they still seem smaller than pre TRT.
From my estimation, i would argue they are smth like 10ml each now, while before they were 13.5 each (Ultrasound results in hospital, before TRT.)

I am confident that once i fix my gut and root cause, they will grow back, as it did on other cases, but my situation is handicapped; because now im afraid if i damaged my testicles and leydic cells permanently with my TRT trial. On top of my PAS disease causing other types of problems on them already.

I used Clomid for 4 weeks as you said after finishing the TRT cycle. But maybe i should have done more? **Should i try it again now?

My question is this: Does our bodies have a time stamp of some sort for possible recovery windows after cycles? Or can i still trigger the testicle growth a year after, from a failed PCT attempt?

So, is there any chance that i permanently damaged my testicle’s response to LH and FSH? Will they ever grow back again with a higher dosage even a year has passed and they are not looking fully back to PRE- TRT levels? Anyone experienced this kind of thing before?

Can i still grow my testicles back to normal and then above their previous state with proper healthy state and protocols or there is a time stamp\ limiting window for recovery?

Even before TRT, as you can remember, when i used HCG and Tamoxifen, my testicles never got any bigger. I think this is because my impaired blood supply and nerve health due to my disease. After fixing the root cause, i will do an another PCT with Enclomiphene this time. But i wonder if a failed PCT attempt (I don’t know why exactly.) may be a permanent situation or not.

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I can almost guarantee that if you take high doses of an estrogen receptor blocker/modulator like Clomifen or Tamoxifen that your balls will swell from the high amount of LH stimulation they get. If this then remains permanently the case is another thing entirely. In animals they remain enlarged over most/all of their lifetime after high dose Tam exposure. If you’ve taken hCG with your test, there shouldn’t have been much shrinking at all if your hCG was real.

If I were you I would leave it alone. Your PCT was fine if your hormone output is fine and I would not worry about ball size. Be happy if they have a rather normal size and leave them alone. Who wants his balls to hang lower than his dick?

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Crap, that’s not normal? :joy::rofl:

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@Coopper How are you doing man? Last time I read your telegram channel you were doing something for the gut right?

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