Advice for PCT? (Post Accutane Syndrome)

  1. No it does the opposite of suppression
  2. Yes it will increase E as well as T, most of the time no problem there
  3. Yes both lower when you quit but hopefully not back to the point where you were.

That is a theory but there’s also the theory it is about epigenetic changes in different genes. Then there’s still the neurotransmitter issues with deca and SSRIs. Maybe we can’t lump them together or the components are of different amplitude.

I think I wrote something on here about Post Finasteride Syndrom about a year ago. Try to find that.

I think Clomid monotherapy would be a good try for the next 6 weeks. 25 mg per day. Try it and report back. It should get your FSH up and with that your semen volume.

Are you German?

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Hello again @lordgains, thanks a lot for your information! You are really helping me. I have German roots but im currently in Turkey.
So, i think Clomid alone seems the most safe option for me too. I think it also creates a gap between Free T and Total T though. And increase in SHBG.

I thought about throwing in 25mg Proviron with Clomid in order to make Proviron bind to SHBG and E and control them. But it might be a stupid idea because Proviron also lowers Total T… I guess the best is to go Clomid alone with gym then… (Btw i heard Nolva is better and safer than Clomid, is that also true? Maybe i should use Nolva?)

So after Clomid, the increase in E will lower with T too? I want high T (700-800) with the ideal E2 (25?) Is there a way to hit that spot?

If increasing my androgens won’t cure my PAS, i think im going to try 200mg Proviron for 7 weeks to reset my Androgen Receptors. There is no option left for me. Last chances.

(I did 4 weeks of 75mg cycle and waiting for the results, no improvements yet, worse state of my life, it made me worse while using it and after but 2 more weeks to go to see if i can improve.)

@iron_yuppie I have read my comments i posted years ago and it made me cringe, i really apologize for my attitude sir. I should have listened to you and try the Clomid years ago. I wasted my years. I was scared, hopeless and angry at the world. So thanks if you come back and share your opinions about this post, it means a lot to me. Best regards.

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Don’t worry about my man. The only thing that matters is getting you better. Clomid monotherapy is the right call here. If the Clomid causes side effects you can lower the dose or dose less frequently (like eod instead of ed). If they persist you can try nolva (tamoxifen). It’s not as good for monotherapy (which is strange because it’s a superior PCT drug), but it can also work. Just don’t ever give up.

PS Clomid can lower IGF-1. Be mindful of that when starting. If you’re going back to working out you may not feel as good or recover as well as someone your age should. The reason will be the Clomid and lower IGF. So don’t despair if that’s the case. You can deal with that issue later on. It goes back to normal once you stop, but your levels are low to begin with, so it could make things a little worse on the meantime.


Thanks a lot man.
Well yes im a little concerned about that igf-1 decrease. Just to make it clear, as you said it will it go back to normal after cessation, right? I looked up some articles but they didn’t say what happened to igf-1 levels after the treatment.

Also igf-1 decreases due decrease on GH as i can see. Are my igf-1 low though? I thought it was in the mid normal range. I hope having these levels and PAS didn’t affect my height and facial\masculine development… (I took this drug when i was 16… My biggest concern is that if it did affect my development…) Thanks. I will try a SERM as soon as possible.

By the way, should i have to use MK-677 after Clomid? To increase igf and gh back? My gh seems low but igf-1 is pretty healthy i guess? Thanks a lot @iron_yuppie !

Yes, you can throw in proviron any time but not at the beginning. Your strategy always has to be to try one drug alone first to see what it does to your mood, sexual function and other problems. Proviron will complicate things in more than one dimension. I don’t think proviron is a good idea right now.

Tamoxifen is a bit safer than Clomid with eye issues and other side effects (mood seems to be less of an issue. As the guy in the other thread said: Clomid will make you emotional. That could be a problem since it could make you feel worse.), so I guess since Clomid is better for monotherapy, you gotta try if you got mood issues on it. If yes, then change to tamoxifen.

Regulating your E2 is NOT your job with normal T levels. Tour body will do that on its own.
T as well as E2 will decrease after cessation of Clomid. How much depends on your body.

Good idea. Maybe. You’d have to try.

It’s not your last chance, my man. You got a lot of years to try shit and improve. With time comes healing.

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One thing I to point out is that you seem very focused on your androgens but isotretinoin has a completely different mechanism of action (I know you know that). There’s theories about epigenetic changes in various cells, for example sperm producing cells which could cause this.

What I’m trying to get at is that you got many more options because you specifically did not fuck with your androgens. You fucked with gene transcription and expression through other mechanisms (and for the targeted receptor there are many!). So your solution might be another than for PFS which might be another than for SSRIs.

I also think you could damage yourself and hamper your recovery by now messing with your androgens with stuff like proviron. That in and of itself can cause problems.

Tamoxifen has its side effects but it should not have sexual side effects, so I would try that (or Clomid mono).

I want to stress one point: homeostasis. Did you read about TRT? The guys on often report that their sex drive and their sexual function first decreases and then when they are on one protocol for MONTHS get the desired effect. If you throw in proviron for 6 weeks, you are missing that part.
The body is extremely good at regulating itself. It sometimes does not a great job but even with epigenetic changes it is good in adapting.

Since the genetic line is the last resort, changes are slow but they come especially if the adaptation stress is there for a long enough time.


First off, this might be go a little off topic. But this message means a lot to me, exactly like what i looked for and to discuss. And i really need to hear your thoughts. I want to start by asking the biggest concern of mine about this disease:

Well, i really don’t have a proper knowledge about the genes and how things work there. But yes i heard about that epignetic damage thing. Is there a chance of taking Accutane only for 3 days at 16, could have impaired my height and bodily development as a man? (This is impossible for normal people but im asking this, regarding that i developed PAS from that 3 doses.)

We know Androgens play a big role on that aspects. I have read papers that state that the jaw growth continues up to age 25 and the most significant part is between 18-20. I basically had a shitty sexuality at those ages. Numb orgasms, watery semen etc.

Was it the low T levels in general (im not sure how few doses permanently lower my baseline thyroids.) or spesific cell or receptor damage? I have no idea and that’s the problem.
I don’t really feel comfortable in my own body, this is so traumatic. Only thing i think is: What would i look like if i never took the drug? Would i be taller more masculine looking? Etc. I feel like my genetical programming is halted. (Just a feeling, im at the same height as my dad.)

And the only way out from this loop is to think about the ‘‘tissue spesific damage’’ theory. As you also stated, if i understand this correctly, is there a chance that, let’s say, Accutane only damaged my Prostate tissue (Receptors, cells?) and the rest of my body was untouched or undamaged by this drug? Maybe it didn’t lower my LH or T permanently and only damaged spesific AR tissues?
My uncle was also used this drug for long periods and he is the tallest in family… i really don’t understand this. On the other hand i get PAS with only 3 doses.

I keep holding to this dream. That the issue might be tissue and cell spesific. (Some PFS sufferers can build muscle but have still ED etc.) My problems very similar to Prostatits sufferers. I wish it is somehow more possible and true. If not, do you think if i recover soon, could my body re-open its true genetical potential and programming and hit a semi second puberty at 22? I have no idea if Accutane damaged my LH and GH levels permanently, many people said it can’t do this. But they didn’t consider the negative AR feedback to HPTA which is explained in the link i’d share.

For the other things, im thinking to heal myself with GYM and low dose clomid support. Beginning next week. I don’t know if there is anything else to do at this moment. I don’t have any mental issues like SSRI’ sufferers.
Again and again, i really thank you for your time, you have no idea how much you are helping me right now. This really means a lot!! When you have time sir, im here.

Here is an article which may help you to understand this disease better, if you care to check: Here there are some sentences about isoforms, spesific isoforms, is this corraltes with the tissue spesific damage thing?

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Btw, Reduction of growth hormone secretion following clomiphene administration - ScienceDirect This article doesn’t talk about if those decrease on GH returned to normal or not. But on the other hand, this one claims it increases GH if im not mistaken, and decreases igf-1: Effect of Clomiphene Citrate on Insulin/IGF-1 and GH Levels in Mice Offspring
I still going to try Clomid for sure. But i kinda concerned about this too. Because i already have low GH (?) Thanks.

Hey man, no problem.

This week I’m gonna be very short on time, it’s packed lol
So I’m gonna answer all of that to the best of my knowledge the week after and I’m gonna read up some stuff that I’m asking myself about this issue. If I got some hours left the week after, I’ll get back to you.

I want to give you one thing to remember for your clomid monotherapy trial.

  1. It has a long half life
  2. It has emotional side effects. So don’t be surprised if you’re crying or are sad easily. Don’t do anything stupid, stick it out or switch to Tamoxifen.
  3. I’d go lower dose like 12.5-25 mg per day or even three times per week. Don’t fool yourself, it will work well at those doses. It also minimizes the direct estrogen side effects.
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Just a quickie… I wonder if it is smart to use aromatese inhibitor with Clomid… I have 30E2 and im kinda scared it will increase even more alongside with T on clomid…
How a person can find its own sweet spot E2:T?

Maybe i should use something like DIM with clomid to control my E2 down?

I don’t have any literature regarding how fast the bounce back is for IGF-1 or GH after ceasing Clomid. But we can infer from the results of the steroid using community, the group that consumes the most Clomid outside of oncology, that if it permanently lowered those two growth factors we’d see more guys in their 20’s who both used Clomid and had lower levels years after the fact.

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No it isn’t. Your E2 will probably not shoot way too high, it it does then you would get blood work first to confirm because the mental side effects could also come from the SERM.

It will and should increase but in relation to T which is good.

Very difficult to find the sweet spot. People in the TRT section are searching very long time for their sweet spot.

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I will give you two things I thought about today.

  1. What is the best option to treat you?

In my opinion it is very very likely this from another Thread that popped up today. I wanted to write it myself but I can just copy that so look here:

The points 1-5 are what WILL help you. Epigenetic changes can have a long time span to change but what will change epigenetics is a different “environment”. You can induce that with TRT for example but you can also induce it with another stable condition, taking nothing. I would very strongly imply that that is what you need. But I can understand how you feel so I’ll give you another thing to get more understanding of these matters. That will maybe calm you down a bit.

  1. Here’s my old post about PFS

My opinion in the last two sentences is not the same as it was then.

Read the study. Try to understand the concepts and read up, if you have questions, I’m here.

I give you an advice that differs too. If you are depressed (look up the symptoms, if you say yes to the list, you are!) you should try an antidepressant, because there are good ones that don’t hamper sexual function but they increase it. Trazodone or Tianeptine are examples. You could even try St. John’s Wort first if you’re scared. It works too.

They’ll maybe get you mentally out of a bad space and they do more. They stop neuron degeneration induced by stress for example. They provide positive epigenetic changes and changes in expression of different receptors and proteins and get the brain working. Yes they can have side effects but if you are depressed it’s nearly always worth it. Look above at the points: you’ll be less stressed, sleep better and probably sort out the psychological course.

So I’d take either nothing or if you’re depressed just one antidepressant that’s fitting. That would be my advice to you now.


Thanks a lot, if you have answers for my prior questions (the long post), i would like to hear them too.

So, what i understand is, now you are changed your mind for me to use Clomid? Why is that?

I have been suffering for 5.5 years now and i don’t think being positive or staying healthy can help me. I didn’t suffer from depression, there were long periods i forgot this disease… It did not help. @lordgains

No, you started down that path, you’ll finish your “PCT”. After that you stop.

I’ll get to the long post soon.

The antidepressant trazodone would probably have extreme benefits on sexual function. Look into it.

Good you’re not depressed. I get that you’re suffering, really. You’ll get better.


Thanks, i found enclomiphene citrate and ordered it from India. I hope it arrives here. This is the best version i can get as a pct because there is no zuclpmiphene in it. Btw, my total T came out 360 yesterday and my urolog prescribed me TRT! i won’t do it of course.

Will my T levels drop to baseline when i quit the enclomiphene? I want to sustain my T levels in (600-800) range. I pray to universe to finally recover with this. Wish me luck.

Hey Coopper,

first off, T levels and thyroids are generally not the same thing. Thyroid hormones are T4 (thyroxine) and T3 (triiodothyronine). T is testosterone.

I think there could be some validity to looking different if you do dumb stuff during your development. I for example did a ketogenic diet for about 1 year at 1900 kcals at 17 years old whilst training 6 times two hours per week. I’ve never had the same recovery ability as I had before that. I never had the same stress tolerance as before. So I know what you mean but in your case, if it’s about looks, then there could be an easy way to find out.

Take a picture of your face from the front and the side, compare it to the pictures of your parents. If your dad and mom have a chiseled jaw line but you don’t look anything like it, then there you could have evidence. But I actually think this part of your struggle is a mental one. You must first in your journey accept yourself. You don’t have to think you’re an Adonis but you have to be comfortable with your looks. We are not all having model faces and that’s ok. Especially for man, there’s more than looks, man’s worth is not defined by his looks. Our worth is defined by our capabilities. So don’t stress over looks. Yes, optimize them. Dress well, workout, shower, smell nice. But don’t ask yourself “what if I looked like Zac Efron?” That’s unmanly.

You actually doubt your theory yourself since you stated you know you reached the hight you were expected to reach.

You got 2 problems on hand. One is physical (watery semen), one is mental (how would I look like?). Sort out the mental one, even if you doubt yourself right now and you don’t trust your body. Just be ok with your looks and your state right now. There’s much truth in “being ok with what you are but trying to get better”. Implant that in your mind. You’re ok as you are. You are enough. Think like a man and you shall be one.

For the tissue specific damage thing, I gotta take some time.
Just here today to support you mentally. It’s a struggle mentally and physically but it’s easier if you accept your body first as it is and then change it.

Edit: height and jaw line are not defined and influenced by the same hormones, shouldn’t come off as that


Damn man, I want that enclomiphene. I only got it as a mix.

Yes they could but the hope always is they don’t. You’ll see how you react once you are done. I’m glad they found a hormonal problem you can attack.

Good luck brother.

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Just a little update. So i have Tamoxifen, Aromasin (AI) in my hands. Also waiting for my Enclomiphene to arrive.

So im trying to find out the best protocol. Im kinda on a impatient state. Enclomiphene should also increase E2 levels due to increase on T, right?

Nolvadex does the same? I wonder what is the difference between Tamoxifen and Enclomiphene, especially on E2 levels.

One more thing i wonder is that should i use an AI at the end of my pct? (I see people do that here.) Just like a single low dose maybe? To prevent e2 spike? What’s the logic of it? Thanks.

[Wikipedia info states that: Enclomiphene acts as a Estrogen Receptor antagonist on the Pituitary Gland. On the other hand, Tamoxifen: ‘‘Tamoxifen acts as a selective estrogen receptor modulator (SERM), or as a partial agonist of the estrogen receptors (ERs).It has mixed estrogenic and antiestrogenic activity, with its profile of effects differing by tissue. For instance, tamoxifen has predominantly antiestrogenic effects in the breasts but predominantly estrogenic effects in the uterus and liver. In breast tissue, tamoxifen acts as an ER antagonist so that transcription of estrogen-responsive genes is inhibited’’.]

@iron_yuppie A side question, i literally searched every topic and study on internet about IGF-1 decrease. Looks like no one knows if igf-1 levels come back to normal after cessation of a SERM. Do you guys have any personal experience or info about this? (Im using Mk- 677 and will use it along with my PCT.)


Tamoxifen does that too. Otherwise it wouldn’t work for PCT purposes.

I don’t think that there is a difference in that regard. Both will increase T and with that E2. The differences between the two are big in other tissues but good luck finding a definitive source. It’s complex. I’d probably take the enclomiphene and if I had reactions I’d switch to tamox.

No and I don’t know why you would and why you are so scared of estrogens. Why?

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