In no way am I saying he should be taking it and do not think he should. But to me taking it for vanity sake for hair loss is far more absurd than it is for a doctor wanting your DHT labs back into range.
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My bad I confused the topical with the oral. Either way, as long as someone is on TRT I have never had them report problems on finasteride.
It is not something we suggest to take, but we do not oppose it.
Maybe try looking into the topical that just blocks DHT from the receptor sites.
Yes you can after only one pill, by then the train has already left the station. Finasteride is thought to change gene expression unable to process androgens, often men claim to wake up a completely different person.
Imagine what would happen if you removed the ability of your body to process testosterone, estrogen and DHT, without your hormones you will become someone else. Testosterone makes a man a man, testosterone is what differentiates a man from a women and now PFS patients are unable to use it.
Atypical post-finasteride syndrome: A pharmacological riddle
In January 2010, a 33-year-old adult male presented with a history of hair loss. He was diagnosed to be a case of AGA and was prescribed dutasteride 0.5 mg once a day for a month. During the course of treatment, he complained of generalized itching, burning micturition, abdominal discomfort, and seborrhea. The total serum testosterone level was around 600 ng/dL. He stopped the treatment but the symptoms persisted. These symptoms subsided after the patient resorted to regular exercise. The total serum testosterone level was 495.14 ng/dL in September 2012. In October 2014, the patient returned for the treatment of hair loss. He was prescribed finasteride 1 mg (instead of dutasteride 0.5 mg) once a day. Similar adverse effects such as itching, burning micturition, abdominal discomfort, skin rash, and seborrhea were observed again. Only this time, the symptoms persisted and did not subside even with exercise. The symptoms are so far irreversible in nature.
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Thanks again for your feedback. I had already seen the NCBI and PFS Foundation webpages before I originally created this thread. These 2 sites seemed to be the 2 main places where all this PFS info is coming from ā and then other sites have copy pasted and reposted.
I didnāt recognize the authority of either of these sites.
So I looked thru medical journal entries on the topicā¦and though these pages acknowledge a number of people reporting PFS, (itās estimated world-wide about 1000 men have reported the condition) as of yet there is no scientific evidence that Finasteride is causing the patientās problems.
Which is why I posted this thread - to seek actual experience from other men like me who are trying to navigate a balanced approach to hormones.
In fact I thought Iād include a few other quotes from the NCBI page quoted above to show how much uncertainty there is on the topic.
"Low quality studies neither confirm nor refute the condition as a valid nosologic entity. Therefore, it would be only as inappropriate to dismiss the PFS as nonsensical, as it is to demonize finasteride for the treatment of male pattern hair loss.
The denial of uncertainty, the inclination to substitute certainty for uncertainty, is a remarkable human psychological trait. It is both adaptive and maladaptive, and therefore guides and risks to misguide. "
Thereās more than 1000 patients with PFS worldwide, I believe itās under reported. There have been a lot of guys who did have symptoms while on finasteride and once they stopped the medicine, symptoms resolved, so those are unreported.
Iām not really experiencing any negative side effects from high DHT. After all, from what I understand it doesnāt present that way. What motivated my wanting to lower DHT was that in my last labs the DHT range was 120-650, and mine was at 1740. So my doctor wanted to get that more in range and prescribed Fin.
I use a compounded topical TEST 150mg/g - I apply 3 clicks in the morning - .25g per click - so @ 112 mg/daily.
Iām no expert, but think a direct impact of the cream is an increase in DHT and high levels of DHT are very likely.
Serious question - What was the doctor concerned with having DHT over range? Did he mention any negatives that could happen in your body as a result of such high DHT if you didnāt get back into range?
Correct. The cream does tend to increase DHT more than injections do. That is typically considered a GOOD thingā¦ guys feel great because of it. Great libido, etc.
Soā¦ I understand where youāre coming from regarding fin and all the stuff that isnāt super conclusive about whether PFS is real. I was in the same position once and decided to take the stuff. However, if I could change that, I certainly would.
No, doc didnāt say (other than the obvious - acne, hair loss) what the downside was to having high DHT. I donāt think High DHT presents much. My understanding is that if too much TEST is converted into DHT, itās sort of wasting TESTā¦ so to optimize levels you block the enzyme that coverts TEST to DHT.
All the lab numbers looked so good accept the DHT, and I felt great. Figured the Fin was so widely prescribed that I never considered it might have a down side, figured it would at worst just thicken my hair and Iād be set - so was surprised by the shift in my libido. Wasnāt expecting that.
Obviously, the shift might just be from dropping DHT, and from Fin working as expected, But still the PFS things got me spooked!
Right, and for those guys who resolved after taking, obviously itās not Post Finasteride Syndrome.
The whole premiss of PFS is that it doesnāt resolve.
My doc has the same thought. It didnāt make much sense to me though as DHT is supposed to more potent so why would it matter except to hit a certain number in your T labs? If it is more potent then really you are not āthrowing away Tā.
I may be way off but I also thought it would affect your free t more than total t and that is all my doctor looks at, along with e2. So that did not make sense to me either. I donāt completely understand where exactly in the cycle that conversion takes place, I figured it was from the free T.
Itās how doctors are taught in medical school, everything is about reference ranges. Lab values outside the ranges usually always triggers action even without a single symptom and all the studies show no harm from high DHT.
There is only a downside to treating a lab value with drugs without symptoms, because drugs have side effects and now you have side effects where there were none.
Iām curious if you could share a study you know of where this is shown to be trueā¦ if true itās a really important fact to make my doctor aware of.
The studies on TRT showing only benefit double as confirmation with regards to high DHT being safe, think about it, you increase testosterone to high normal ranges and some above the ranges and one would expect a large portion of those men to have very high DHT, and yet these studies only show benefit.
Youāre doctor is prescribing TRT and the benefits that come with it ~ DHT and he is suppressing it with finasteride removing the benefits of this hormone.
There is only a few side effects of DHT, ache and hair loss which is why finasteride was created, other than that, high DHT is perfectly fine. Men are not dropping dead from high DHT.
If your doctor is insistent on prescribing a drug known to cause endocrine disruption or at least low libido and shrunken testicles, you should find another doctor ASAP.
Lower your dose. Thereās studies showing that .25-.5mg is plenty.
Hey all - Yesterday I called an endocrinologist who specializes in TRT here in Los Angeles to ask about Finasteride and PFS.
This is what I was told.
The endocrinologist reviewed and summarized for me the most comprehensive post-marketing study done on Finasteride and PFS to date.
The study focused on a group of men all of whom were given Finasteride (or placebo) in excess of 200 days. The men were all questioned four years after having stopped taking the drug. What the study found was that @ 3.5% reported experiencing lingering sexual side effects. The interesting part is that half of the men reporting lingering sexual side effects had been taking the placebo. Meaning only @ 1.8% who had taken Finasteride were reporting symptoms that conform to PFS.
Though itās good to be cautions, and no one including me is excited by the idea of Finasteride being a secret poison, by pharmacology standards this is an extremely low incidence.
This doesnāt mean Iām endorsing Finasteride, or that Iām planning to continue taking it. And of course one study (possible there need to be more done) doesnāt completely prove anything. But Iām grateful for all the guys who chimed in here - after all being scared as shit drove me to find out what I originally hoped to learn by posting!
I wanted to share in case itās helpful for anyone else.
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They were all men not on TRT too. When you are on TRT it does not do the same thing.
Curiousā¦ do you know this to be true? Or are you speculating?
Oops wrong thread lol
Yea I worked with some guys from propecia help dot com a while ago and attempted restarts with them.
It used to be a forum.
Here is a great post from that forum I found it:
The theory is that an upregulation of androgen rectors is what causes the crash however it is downregulation that occurs as a result of the crash, which is what PFS is, an insensitivity to testosterone.
We all had a super high libido a few weeks after stopping finasteride, and then crashed after we ejaculated. This is partially what we know and partially me filling in the blanks, but what it seems like happens is while people are experiencing low libido on finasteride, since they are creating such little DHT, their bodies produce an unusually high density of androgen receptors to try to detect the low levels of male hormones, ejaculations cause a huge spike in DHT which is why there is recovery time after an ejaculation, because the body senses the increase in male hormones and realizes that you just had sex and you do not need the effects of androgens at the moment so it down grades your androgen receptors temporarily.
With PFS there are so many extra androgen receptors produced while the person was taking finasteride that when DHT floods back the system thinks there is way too much DHT present and so it down grades the androgen receptors to an extemely low density in response to what the cells incorrectly percieve as an excess of DHT, as the cells try to regulate the androgen receptor feed back loop. The result is the body is stuck in a state of cells stripped of nearly all of their androgen receptors, which is why testosterone shots do not cure PFS
So when you are on TRT you have plenty of T to make DHT so its doubtful this scenario would ever happen, if it did, a reduction in dosage and normalization of DHT would fix it.
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