Advice for PCT? (Post Accutane Syndrome)

Pharma
82

You’re getting a small bit of info from a specific point in time. LH normally goes up and down very sharply throughout the day, so one blood test showing that it is lower doesn’t mean a ton. It could be staying constantly at that lower number now (and producing more T because it’s staying there) where before it had one spike in the mornings and then dropped down much lower the rest of the day.

It could be that SHBG has gone up so total T has gone up and free T has gone down. That is common with people taking Clomid for example.

Lots of possibilities. I don’t have an answer you’re going to accept, though I honestly suspect no one else has one either.

83

High E2 was expected, high prolactin is possible, FSH and LH is my problem here. I’ve never seen people take tamoxifen and their LH going down. LH should be up all. Also, you didn’t stop Tamox so you took it at the latest one day before the blood was taken.

I first thought you got fake TAM, but that’s improbable and the other test results indicate it’s real, see further down.

Your T was raised, ok. But not like I expected.

I’d do this:

  1. Check if you’ve got real tamox or get new tamoxifen from another source. (I actually don’t think people fake this)

  2. Stop TAM for 3 weeks (Just my opinion to give your body a bit of rest). Then up the dose. You could also just up the dose now to 20 mg/d.

  3. For prolactin I’d take P5P (Vitamin B6). It’s effective and it’s nearly impossible to take too much as it is water soluble and you piss it out. So not much risk.

  4. If you don’t got problems because of your higher E2, let it be. It’s out of range because of the therapy (that’s why I think you actually got real tamoxifen). You shouldn’t worry about bitch tits as you take an antagonist for that already.

  5. Cortisol is interesting; that can happen with Tamox. Another reason to think it’s real.

I think these results indicate your HP parts don’t react the way we wanted to. So I’d try giving them a bit more time and another run of TAM.

This study

shows that even in men taking 20 mg/day LH only rises moderately. So you are probably one of the lower responders. You also said you feel like you are taking placebo, so I’d up the dose.

See here for prolactin (comes close to your situation) Improvement in semen quality in infertile males after treatment with tamoxifen - PubMed

You can do that too, but keep in mind that FSH gets lowered with hCG which you don’t want for semen quality. You could take with hCG an FSH analogue that fixes it. HCG is in my opinion good to raise T and keep the boys hanging low but not optimal for your purposes.

You can do that. I’d add one drug at a time so you know what worked. Keep a detailed log of what you’re doing and how you’re feeling.

Merry Christmas everyone!

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84

IGFBP-3= 4,5 3,4 - 7,8
Progesterone= 0,52 ng/mL
DHEA= 511 ugdL 85- 690
Free T= 20,004
SHBG= 30,3 10- 57
IGF- 1= 159 (Has any healthy person tested their IGF-1’s before? Isn’t this is low for a 22 year old? My original level was 212 though.)

These are the last ones. IGF-1 lowered much more than i expected even though i use L- arginine etc. Free T is actually 2 points lower than my summer test! Wtf! How it is not increased with my TT increase?

It’s been a week since i quit Tamoxifen so it should be completely out of my system tomorrow. And yes, it is real, i bought it from the pharmacy.
However, im at total loss, the results are confusing and im confused for my next step. People are living their lives, dedicate themselves to their dreams, i have huge dreams and i am talented artist, but these days everything seams so bleak, dedication needs a clear head and satisfaction about your health= life. I have neither of those. I hope i will sooner or later, because i just can’t go on like this anymore.

So, im still expecting something to happen, maybe a considerable improvement… If nothing happens in next weeks, that means i shouldn’t cycle Tamoxifen i guess.
I think im gonna use Genotropin for a month and then start HCG+ MK- 677.

Happy new years :\

85

Nolva has been known to do this

86

Nolva also raises SHBG, which binds to TT and lowers your FT

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87

I don’t think the ones you’ve listed are confusing at all: TT went up but FT went down (normal), IGF-1 went down (normal), and you still feel like crap and confused (normal).

At least you gave this therapy a solid go and you can check it off the list

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88

It takes way longer than this to be out. But since you’ve been taking low doses effective concentrations shouldn’t be there for long.

The only thing I think is confusing is that your LH and total T aren’t higher. I would up the dose if you want to try again with Tamox. Otherwise you could wait longer how your body reacts to being off and see if you’re feeling better than before treatment.

How did you get to HGH?

I’m really sorry for your situation man. If you feel depressed maybe there are things that could help get your mental side back on track.

I think these things can be reached without fixing your other symptoms. You could think about doing that

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89

Thanks @lordgains, trying my best.

Ordered online from a steroid site, seems legit, researched the fake packages and compared.

I am not sure if i should try Tamox again, if the Free T won’t go up, it won’t change anything i think. Maybe 2-3 weeks 20mg for the last time, i can do that before HCG.

  • I am thinking to use 1-2 units of my Genotropin to see how i feel. My question is, are there any risks of damaging or reducing my own natural production of Growth Hormone?
    Can it cause permanent reduciton in my body? I would rather use Mk-677 if it is going to damage my natural GH level secretion…

  • About HCG, should i take FSH with it? Does FSH affect semen volume or only sperm cells? I don’t need sperm, i just want a healthy prostate with proper semen production.

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I haven’t gone through all your posts.
Did you ever try the clomiphene as recommended?

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Apart from the treatment topic, i also want to ask something about development again, you know good information about genetics and hormones. This depresses me deeply and i need some clarity.

Im trying to cut this as short as possible. I talked with my Endocrinologist when i gave my last bloods and asked about, whether Post Accutane Syndrome could have damaged my development or not. As far as i remember the convo:

Me: Is it possible that PAS damaged my development due to low T levels? As i know, genetics control the hormone secretion, when to secrete and at what amounts, (He nods his head as yes.) so, if my T levels supposed to rise up to 700 at 16-17 but then i took Accutane and it damaged my body and my levels got stuck at 500’s… Will this cause developmental issues? Also can PAS cause GH or GH receptor damage?

Doc: Actually, yes. If it did made your T levels stuck or damaged your gonadrotopins persistently, then you developed on the low side of your genetic variant. Our looks come from both genes and exegenous affects. However, the genetic variant for height for example, is in between 5 cm. So maybe, you grew 2-3cm’s instead of 5 from that time. But maybe it didn’t damage you, we can’t say for sure. And i don’t think it can cause GH damage, Accutane can have an effect on Gonadrotopins but not GH spesifically, i think… And your igf-1 levels look fine with all other hormones.

Me: I see, what about epigenetic changes?

Doc: I don’t know, it is so rare, these things can happen but it is rare and i can’t say anything more about it.

Me: Can i grow my genetics back after i recover if it did damage my outlooks or bones? (At this point, i brought up the study i shared here, about the late pubertal boys who took TRT at 16 and below and experienced a catch up growth of the jaw bone.)

Doc: After those ages we don’t see any changes on the face. I doubt it. That was a experimental study and was a good age range. I have patients who use very high doses of T levels and we didn’t notice any changes.

Me: But doc, those people are already healthy and reached to their genetical potential, so they already completed their genetic coding, but i am different, i had epigenetic- hormonal change at 16 and and i can reverse this.

Doc: At this age i don’t think TRT would change anything on you. (Stupid me, didn’t ask ‘‘why’’ here. Is it the bones response to hormones or the age of the bones? We know bones always change and get renewed… Trans people on reddit support this claim. I have read someone grew a brow ridge with TRT at late age.)
The more effective hormone is GH, if i gave you GH right now, your Zygomatic bones would grow and get thicker for example. But the outcome would not match to your facial symmetry…

At this point conversation changed to other things. I don’t remember much.

So, i researched a bit and learned more about the Phenotype and Genotype. My fear is that could PAS affected my phenotype? Would i look different if i never took this drug in a parallel universe? I wonder what you think about the conversation @lordgains. Also, now i want to ask you few more things with my little black dots again :slight_smile:

So i talked with a guy from Raypeat, a pfs case and he is not a doctor but he assured me that, if i recover, expect from my height, i can unlock my full genetical potential again. Penile development and facial bones etc. I look at some actors which i can track back to their 16 year old photos and their jaw bones seems very improved by age, it didn’t happen on me. For example, Timothee Chalamet or Ezra Miller has a prominent difference on their jaw structure between 16- 20. Im not comparing myself with models, im just looking the age related growth of the jaw.

But he also thinks that fortunately, PAS can’t have an effect on my development, especially on the bones. He said 500ngdl levels of T is sufficent enough to reach my body to its genetical coding and grow my bones.

He too thinks it can’t affect the GH or its receptors and said gonadrotopin damage would show up on bloods if you had one. :slight_smile:
He said the issue is mostly on the bowel, bad bacteria build- up or on the prostate, spesific damage. Rather than general hormonal deficiency. He also thinks my penis will grow even above my Pre-Pas size when i recover if i lost some development. He said the penile growth is only due to the increase of T- DHT on the puberty. So if i recover soon, my body will produce DHT and grow it just like my facial bones. That was his thoughts, i wonder what you think.

  • Can i reach even above my pre pas penis size if i recover? Shouldn’t i need pubertal levels of hormones again or more of it? I hears steroids can grow a healthy persons penis for example.

  • Can a slight reduction in T levels cause me to grow to least of my genetic variant? (remember the height variaton example.) Or we can even reach to our maximum genetics variation with moderate amounts? I mean even exercise and sports in youth can grow our height more, so even sports and diet can affect our phenotype, therefore, i think PAS definitely affected my phenotype badly!! Ah, this was so hard to swallow!! Please help me. I hope you can somehow answer all of this mess one by one, i wrote a lot, sorry.

@myoscholar No but i took Tamoxifen, which actually a better option.

92

Doesn’t sound like it worked for you. Why is it a better option?
You read some side-effects and scared yourself into trying another SERM at an extremely low dose, and got inferior results.
You need to restart HPTA? Clomid.

93

Have you considered or already tried just regular ol TRT to increase your free T? Even just as a short term’ish trial, that could at least help tell you whether increasing your free T levels is going to do what you want it to do IMO.

Then you can always go back to what you’re doing now to try to “naturally” increase your production if you find out that it works.

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No no, you got me wrong haha. I mean, how come you now want to try GH? What’s the reasoning? Because of the jaw?

I’ll link some people with personal experience: @mnben87 and @studhammer

You could take FSH (expensive). I thought your point was your ejaculate is ‘watery’? That would be fixed with more sperm in it and therefore FSH would help. The prostrate produces only fluid. Did your ejaculation volume rise on Tamox?

I’ll answer later on your second post.

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95

This is the most important point coming out of the talk with your Doc. He doesn’t know, nobody knows.

Yes, the phenotype which comes out of your genes varies depending on individual circumstance. There’s no such thing as androgen receptor damage. Because the receptors themselves get “recycled”. Destroyed and new ones synthesized.

Steroid receptors have relatively short half-lives, indicating that the amount and duration of steroid receptor ligand effect in cells are regulated by systematic protein activation and degradation.

The half-life of AR protein varies depending on the context of the cell environment. Androgens have been reported to stabilize AR protein in various cell contexts (91). The half-life of AR in LNCaP cells is approximately 3 h in the absence of androgens and is longer than 10 h in the presence of 10 nM DHT.

The synthesis of these proteins is dependent on how well your genes express the protein. The body can switch genes on and off depending on outside influence. Extreme examples of this are children that were born during the Great Depression.
The regulation can in fact happen at the genetic level (epigenetics), at the mRNA level or at the protein level.

See for example here:

The AR gene contains a CpG island that covers the proximal promoter region and the first exon (72, 85). Hypermethylation of the CpG island in the promoters has been associated with transcriptional inactivation (86).

That example is epigenetic.

Here’s reading for you, if you really wanna dive deep on the knowledge, start there:

https://academic.oup.com/jcem/article/88/9/4043/2845674

I wouldn’t recommend it, my next post contains my recommendation.

Look, if you wanna test this hypothesis: run a (light) cycle. Inject Test at 300 or 500 mg per week, that will put you way above natural levels and if something grows; good for ya!

I won’t answer everything one by one, as it would be the same answers over again.

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So @Coopper, I’ll give you my solution for this problem now and I really hope you take that to heart.

You have got to fix the problems that really are problems and leave the other stuff alone. Or you go and try to fix everything you imagine and you’ll test yourself through a lot of shit and probably not be happy even if you find something. Because:

You can be happy with your looks right now. What do you think really ugly people do? Or what do you think Asians with small dicks do? Cry all day? Maybe. But you said you are far from ugly and you know what? It doesn’t fucking matter. What do you hope will happen if your jaw bone grows three inches and you look like Crimson Chin? More girls? More happiness when you ask “mirror mirror at the wall…”? Wouldn’t it be way better you start accepting your looks and stop searching months and years for a solution to what may or may not even be something you can change? If you wanna look better just go Workout. There’s an upgrade to your looks guaranteed!

What problems do you have as I see it?

  1. Jaw and face looks and penis size? Solution above. No problem anymore. Otherwise you could spend thousands of dollars on HGH, which damages your blood sugar control, try all kinds of doses, then run steroid cycles which damage your cardiovascular system, then go on TRT and try to figure out a good schedule for you. That takes YEARS of your life. For what?

  2. Dick not working? Problem. Let’s tackle that. Cialis is good, also having functional neurotransmitters and good hormone levels.

  3. No fertility and no semen? Problem. Let’s tackle that. Tamoxifen or LH+FSH are good.

  4. Low testosterone? Problem. TRT, Tamox/Clomiphen or HCG are options. But you aren’t really low T, you are average.

  5. Depressed? Big problem. Solutions are psychotherapy and medication, best done in that order.

  6. Feeling like shit? Get a good sleep schedule, healthy food, something worthwhile to do, stop living for dopamine kicks like porn or drugs, read something, get hobbies where you can improve yourself and then enjoy the rest of your time.

I gave you reasonable advice. I would really prefer for your well being and the time of the people who try to help you to FOCUS ON THE PROBLEMS YOU CAN SOLVE FOR SURE.

I’m not trying to be mean but I’m trying to get this point in your head.

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97

I believe that the addition of any exogenous hormone will cause shutdown of natural production. Is it permanent? I doubt it.

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98

You won’t “feel” any different on GH. I took it because of severe sleep apnea and I knew that it was affecting my own natural GH production. I stayed on it for quite a while due to the fat loss it provided in the beginning and the improved sleep. After time, I reduced my dose to 2 iu/day for maintenance and due to my age of 55. I recently stopped cold turkey to see what would happen and to be honest, its all been rather non-remarkable.

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I am running mk-677, and it isn’t mind blowing, but I’ve noticed a few things. Joints feel much better on it. Now it could be training differences, but I seemed to always have sure joints, and now I never do. I haven’t gotten igf-1 blood work to confirm how much actual levels have gone up. I’ll post that when I do get it.

A huge benefit is the price. It is like $20/ month to run it. The liquid stuff tastes absolutely terrible. It is on par with the time I got gasoline in my mouth syphoning gas. I recommend getting something in your mouth before the mk, and swallow quickly. That had eliminated the taste issue.

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100

Did you get bloods to see if and when natural production set back in?

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I’d love to see that!