Attempt to fix my accutane induced hormonal imbalance

[Kirby_]

Hi guys,

1.5 years ago I finished my accutane treatment. During this course I encountered some sexual side effects like low/no libido and erectile dysfunction, but I was told this would go away once done with the treatment. Unfortunately, these side effects have not subsided and I even got some gyno symptoms and loss of testicular fullness afterwards. Mentally, this is really hard situation to be in, but I'm really focused on making sure I will recover. I tried various supplements and diets and although some supps definitely help to some extent, it does not 100% relieve my symptoms.
Recently I did some blood tests and found out that especially my estrogen is way too high and my DHT is too low. However, I could still need some advice regarding the interpretation of my lab results below, as my doctors are not so supportive (they tend to deny the fact that accutane is the cause of my issues)

TSH 1.9 mU/L (Ref. 0.40-4.0)
Free T4 15.4 pmol/L (Ref 10.0-22.0)
LH 3.39 IU/L (Ref. 1.20-7.80)
FSH 4.86 IU/L (Ref. 1.40-15.4)
Estradiol 210 pmol/L (Ref. 37-184)
Testosteron 15 nmol/L (Ref. 8.4-29)
SHBG 22.2 nmol/L (Ref. 6.0-85.0)
Free Testosteron 0.393 nmol/L
Bioavailable testosteron 8.8 nmol/L
DHEA-sulfate 11.1 umol/L (Ref. 3.4-16.7)
DHT 0.73 nmol/L (Ref. 0.91-3.19)
Prolactin 242 mU/L (Ref. 11-424)
Progesteron 2.34 nmol/L (Ref. 0.00 - 6.26)

So what my plan is based on these results is to try low dose HCG and Proviron for a couple of months to see if I can boost my body in balancing my hormones again. With HCG I hope to stimulate my gonads to produce more testosterone. With proviron I want to stimulate my body and androgen receptors to convert the testosterone to DHT instead of Estrogen, which I feel is now happening a lot.

Of course, the one thing I want to avoid is to become dependent on hormonal drugs / steroids, so I'm curious to hear your opinions and suggestions!

Thanks a lot! :)

 

[drwill]

Hi guys,

1.5 years ago I finished my accutane treatment. During this course I encountered some sexual side effects like low/no libido and erectile dysfunction, but I was told this would go away once done with the treatment. Unfortunately, these side effects have not subsided and I even got some gyno symptoms and loss of testicular fullness afterwards. Mentally, this is really hard situation to be in, but I'm really focused on making sure I will recover. I tried various supplements and diets and although some supps definitely help to some extent, it does not 100% relieve my symptoms.
Recently I did some blood tests and found out that especially my estrogen is way too high and my DHT is too low. However, I could still need some advice regarding the interpretation of my lab results below, as my doctors are not so supportive (they tend to deny the fact that accutane is the cause of my issues)

TSH 1.9 mU/L (Ref. 0.40-4.0)
Free T4 15.4 pmol/L (Ref 10.0-22.0)
LH 3.39 IU/L (Ref. 1.20-7.80)
FSH 4.86 IU/L (Ref. 1.40-15.4)
Estradiol 210 pmol/L (Ref. 37-184)
Testosteron 15 nmol/L (Ref. 8.4-29)
SHBG 22.2 nmol/L (Ref. 6.0-85.0)
Free Testosteron 0.393 nmol/L
Bioavailable testosteron 8.8 nmol/L
DHEA-sulfate 11.1 umol/L (Ref. 3.4-16.7)
DHT 0.73 nmol/L (Ref. 0.91-3.19)
Prolactin 242 mU/L (Ref. 11-424)
Progesteron 2.34 nmol/L (Ref. 0.00 - 6.26)

So what my plan is based on these results is to try low dose HCG and Proviron for a couple of months to see if I can boost my body in balancing my hormones again. With HCG I hope to stimulate my gonads to produce more testosterone. With proviron I want to stimulate my body and androgen receptors to convert the testosterone to DHT instead of Estrogen, which I feel is now happening a lot.

Of course, the one thing I want to avoid is to become dependent on hormonal drugs / steroids, so I'm curious to hear your opinions and suggestions!

Thanks a lot! :)

I know that this is tough. Here are some thoughts (and I have personal knowledge of all the meds you mentioned).

The Accutane and the low libido/ED might be unrelated since many people experience ED snd low libido. And without before snd after tests you don’t know if your Hormones have changed because of the Accutsne.

I would not be worried by the Estradiol levels especially if you can increase your test levels.

If you decide to use steroids, that can **** with you down the road. Most of that is because your body down regulates test production. That is true even with proper PST (with HCG). Long term issues are generally only for people who use way too much.

To me, HCG sounds like a good idea. The protocol of 500 mcg a day for ten days was pretty common.

There are a lot of other things to do first.

I would suggest you start lifting weights if you are healthy enough. Compound lifts will increase your test levels. Same with a proper diet. And sleep. All of that is easy to do in theory

Maca is supposed to increase libido (3 g per day). Very safe. Inexpensive. Worth a shot.

ED can be caused by watching too much porn. Try no porn/no fap for a couple weeks. That might be enough.

Cialis works, and a10 mcg shot of PT141 will keep you going for hours. Both are safe; slight risk of being hard for too long.

Proviron can help or worsen ED, depending on the hormonal cause. (The specifics elude me, but I think it isbecause it can push estradiol too low).

 

[Kirby_]

I know that this is tough. Here are some thoughts (and I have personal knowledge of all the meds you mentioned).

The Accutane and the low libido/ED might be unrelated since many people experience ED snd low libido. And without before snd after tests you don’t know if your Hormones have changed because of the Accutsne.

I would not be worried by the Estradiol levels especially if you can increase your test levels.

If you decide to use steroids, that can **** with you down the road. Most of that is because your body down regulates test production. That is true even with proper PST (with HCG). Long term issues are generally only for people who use way too much.

To me, HCG sounds like a good idea. The protocol of 500 mcg a day for ten days was pretty common.

There are a lot of other things to do first.

I would suggest you start lifting weights if you are healthy enough. Compound lifts will increase your test levels. Same with a proper diet. And sleep. All of that is easy to do in theory

Maca is supposed to increase libido (3 g per day). Very safe. Inexpensive. Worth a shot.

ED can be caused by watching too much porn. Try no porn/no fap for a couple weeks. That might be enough.

Cialis works, and a10 mcg shot of PT141 will keep you going for hours. Both are safe; slight risk of being hard for too long.

Proviron can help or worsen ED, depending on the hormonal cause. (The specifics elude me, but I think it isbecause it can push estradiol too low).

Hi Will, thanks a lot for your reply!

I know for one fact that the accutane is related as my symptoms started occuring while on the treatment. Before accutane, I used to have a really high sex drive and would think of having sex with girls like 24/7. Now rationally I want to have sex, but feeling-wise nothing is triggered at all. Also, it is harder for me to get and maintain an erection (although not impossible).

I am a little worried about my estrogen and low dht / free test levels, mainly because I notice my balls are losing its fullness. Besides that, I've tried so much to improve my testosterone. Maca, tribulus, ashwagandha, L-arginine, L-citrulline, magnesium, Vitamin D, vitamin K, Taurine etc. are all supplements I tried already. In addition, I already lift weights 4x a week for several years now and also make sure I eat as healthy as possible. I also use Cialis sometimes. Although I noticed some improvements in my erectile function (not 100% though), my libido is still low as hell. Porn also doesn't it for me anymore for this reason. It seems that my androgen receptors are not responding. It's a terrible situation to be in.

Fortunately though, I know that I'm capable of recovering, even though sometimes PFS/PAS seems permanent, I know that the body is capable of extraordinary things. I am also aware that I really need to look after my mental state as well. I admit that I'm under a lot of stress due to this situation and that is also not helping the recovery.

I appreciate your perspective on HCG and Proviron. It is clear that my hormone production is already downregulated, but of course, I do not want to down-regulate it any further. That's why I'm also cautious about using stuff like HCG and Proviron.

One thing that is a little bit unclear for me reading your comment is: do you advice or not advice trying HCG? If i'm doing that, don't I need something to counteract the aromatising effect of the drug? I thought proviron was quite a safe drug on low doses for this. Besides that, it also might trigger my body to react to DHT again.

 

[youngsinatra]

Have you measured your vitamin D?
Excess retinoic acid can deplete vitamin D big time.
And don‘t guess, really do a blood test. Some people are still borderline deficient with physiological maintenance doses.

 

[Kirby_]

Have you measured your vitamin D?
Excess retinoic acid can deplete vitamin D big time.
And don‘t guess, really do a blood test. Some people are still borderline deficient with physiological maintenance doses.

Yes it was 95 nmol/L.

 

[Nemo]

Hi guys,

1.5 years ago I finished my accutane treatment. During this course I encountered some sexual side effects like low/no libido and erectile dysfunction, but I was told this would go away once done with the treatment. Unfortunately, these side effects have not subsided and I even got some gyno symptoms and loss of testicular fullness afterwards. Mentally, this is really hard situation to be in, but I'm really focused on making sure I will recover. I tried various supplements and diets and although some supps definitely help to some extent, it does not 100% relieve my symptoms.
Recently I did some blood tests and found out that especially my estrogen is way too high and my DHT is too low. However, I could still need some advice regarding the interpretation of my lab results below, as my doctors are not so supportive (they tend to deny the fact that accutane is the cause of my issues)

TSH 1.9 mU/L (Ref. 0.40-4.0)
Free T4 15.4 pmol/L (Ref 10.0-22.0)
LH 3.39 IU/L (Ref. 1.20-7.80)
FSH 4.86 IU/L (Ref. 1.40-15.4)
Estradiol 210 pmol/L (Ref. 37-184)
Testosteron 15 nmol/L (Ref. 8.4-29)
SHBG 22.2 nmol/L (Ref. 6.0-85.0)
Free Testosteron 0.393 nmol/L
Bioavailable testosteron 8.8 nmol/L
DHEA-sulfate 11.1 umol/L (Ref. 3.4-16.7)
DHT 0.73 nmol/L (Ref. 0.91-3.19)
Prolactin 242 mU/L (Ref. 11-424)
Progesteron 2.34 nmol/L (Ref. 0.00 - 6.26)

So what my plan is based on these results is to try low dose HCG and Proviron for a couple of months to see if I can boost my body in balancing my hormones again. With HCG I hope to stimulate my gonads to produce more testosterone. With proviron I want to stimulate my body and androgen receptors to convert the testosterone to DHT instead of Estrogen, which I feel is now happening a lot.

Of course, the one thing I want to avoid is to become dependent on hormonal drugs / steroids, so I'm curious to hear your opinions and suggestions!

Thanks a lot! :)

Kirby, I believe you want to stimulate 5-AR activity:

A List Of Androgens That Stimulate 5-AR Activity

Increasing 5-AR activity has received a lot of interest lately due to its therapeutic effects on mood disorders as well as issues with excess cortisol (5-AR deactivates cortisol). Unfortunately, the official story is that there are no freely available compounds that can stimulate 5-AR activity...

raypeatforum.com

Some of the things you'll find in that thread that work are available at Idealabs.

 

[drwill]

You are doing the right things...

HCG should kick start things if your test production is down. It’s what people use when they stop s steroid cycle to get endogenous production up.

Most worry about high DHT (baldness) not low. DHT is powerful but I’ve never thought about it from the perspective of havin too little.

Proviron won’t make a permanent change in anything, but it might speed up a rebalance. When you stop, you should consider doing a
Cycle of HCG

Some doctors have used clomid to indirectly raise test levels, but there are mixed opinions about this.

PT141 is very effective for ED. Less expensive than cuspid. Takes a few hours to kick on, but you have six with an instant erection. Neither you or your partner get much sleep...

Worth checking if your consuming things tgst lower DHT or raise Estradiol.

 

[Kirby_]

Kirby, I believe you want to stimulate 5-AR activity:

A List Of Androgens That Stimulate 5-AR Activity

Increasing 5-AR activity has received a lot of interest lately due to its therapeutic effects on mood disorders as well as issues with excess cortisol (5-AR deactivates cortisol). Unfortunately, the official story is that there are no freely available compounds that can stimulate 5-AR activity...

raypeatforum.com

Some of the things you'll find in that thread that work are available at Idealabs.

Thanks Nemo! Will take a look at the topic :)

 

[Kirby_]

You are doing the right things...

HCG should kick start things if your test production is down. It’s what people use when they stop s steroid cycle to get endogenous production up.

Most worry about high DHT (baldness) not low. DHT is powerful but I’ve never thought about it from the perspective of havin too little.

Proviron won’t make a permanent change in anything, but it might speed up a rebalance. When you stop, you should consider doing a
Cycle of HCG

Some doctors have used clomid to indirectly raise test levels, but there are mixed opinions about this.

PT141 is very effective for ED. Less expensive than cuspid. Takes a few hours to kick on, but you have six with an instant erection. Neither you or your partner get much sleep...

Worth checking if your consuming things tgst lower DHT or raise Estradiol.

Thanks Will!

If I choose to do an HCG cycle, what cycle do you suggest? You mentioned 500 mcg for 10 days, but I also read a post from JoeKool doing a 6 month course of HCG with 250IU three times a week. He was in a similar situation I was in.

Regarding DHT, because it's a powerful androgen it actually leads to breast development, erectile dysfunction, low libido, and weight gain. All of which I experience atm. You can have normal testosterone levels (because I'm also in range (although low for a 23 year old in my opinion), but with low DHT levels you will still run into these symptoms.

 

[macguffin]

I took Accutane about 5 years ago and I experienced the exact same things you describe, @Kirby_ . It's terrible.

Have you had any luck with getting your libido back? If so, what have you done?