Looking for help with PFS

[edoos]

Hi guys,

I have PFS now for 10 years. I started propecia back in 2009 for 1 years and got terrible sides after 9 months. Since then, I recover quite well from sexual sides and decided to re-try topical finasteride in 2016 a big mistake. I didn't impact a lot of my libido, but it gave me anhedonia, terrible anxiety that result in panic attack, insomnia and just being unable to cope with any normal life external stressor.

I tried keto diet for like a 1y going hard core keto, but it didn't help it make things quite worst. Now I'm back on a normal diet since quite 2y but I'm still struggling from bad anxiety and depression.

I made some blood test recently and here are the result.

Prolactin => 24,4 ng/ml
Cortisol => 623 nmol/L
T => 5,36 ng/ml
Free T => 74pmol/l
Biodispo T => 4,4nmol/l
DHT=> 1,1 nmol/L
T4 free => 15,2ng/l
T3 free => 4pg/ml
TSH => 2,35mUI/l

I know from another test that I also have low serotonin. I would like to focus on lowering the prolactin to see if it get better first and then focus on testosterone.

Thanks for your help.

 

[ChemHead]

Before I say this, I'm going to preface this with the disclaimer that I can't guarantee that this is going to work. However, I have good reasons to believe that it may.

I recovered from PFS a few years ago and I am now currently recovering from it again because I (foolishly) tried to use finasteride in topical microdoses to see if I could get away with it. Instead of writing out this whole story again, I'll just give you a link to a thread I started about a possible fix for PFS. It doesn't seem like anyone actually cares much about PFS on this particular forum, but here it is:

PFS and the Dopamine-Prolactin connection

Recently, I came across the thread where a new treatment is being discussed that involves antagonism of prolactin and/or the prolactin receptor. I was intrigued by the relationship between dopamine, prolactin, and their receptors and decided to do a little research because of the connection with...

www.hairlosstalk.com

Essentially, the treatment is to take 500 mg of pure l-dopa daily. It's also been brought to my attention that Parkinson sufferers now supplement with thiamine in order to attenuate possible toxicity due the metabolism of dopamine and noradrenaline into aldehydes before elimination. It seems that thiamine is used in one of the steps of dopamine metabolism and this can cause it levels to become depleted. So, it's probably a good idea to supplement with thiamine.

Anyway, there may be some details left out. If you have any questions, just let me know.

 

[MitchMitchell]

your TSH should be below one. As of now, your T3 in the serum may look good but because of various potential factors (reverse T3?) your intracellular T3 is insufficient. Consider supplementing T3 at 25 mcg daily for a start. That will be amazing for your energy levels.

As of the hormones, you need more dopamine and proper enzymatic stimulation. I say go for HCG and vitamin B6/E.

 

[GenericName86]

Essentially, the treatment is to take 500 mg of pure l-dopa daily. It's also been brought to my attention that Parkinson sufferers now supplement with thiamine in order to attenuate possible toxicity due the metabolism of dopamine and noradrenaline into aldehydes before elimination. It seems that thiamine is used in one of the steps of dopamine metabolism and this can cause it levels to become depleted. So, it's probably a good idea to supplement with thiamine.

Anyway, there may be some details left out. If you have any questions, just let me know.

Interesting, would Mucuna pruriens be a decent substitute if l-dopa isn't available?

 

[ChemHead]

your TSH should be below one. As of now, your T3 in the serum may look good but because of various potential factors (reverse T3?) your intracellular T3 is insufficient. Consider supplementing T3 at 25 mcg daily for a start. That will be amazing for your energy levels.

As of the hormones, you need more dopamine and proper enzymatic stimulation. I say go for HCG and vitamin B6/E.

I agree with you. However, I think the elevated TSH is a result of the lack of dopaminergic activity. Dopamine will directly effect TSH and thyroid hormones. It seems they are involved together in a feedback loop. When dopaminergic activity is low, the body will call for higher TSH. When dopamine is elevated, TSH and thyroid hormones will be lowered.

While I believe that hCG could help, I would recommend trying to increase dopamine production first in order to narrow down the genesis of PFS. I believe the heart of the issue may be dopaminergic deficiency brought on by finasteride induced hyperprolactinemia.

When I recovered from finasteride the first time, I didn't use hCG or really any type of steroid or pharmaceutical. I believed that my recovery was brought on by my strict dietary protocol and I still believe that it was important in the process. However, I hadn't realized that in the month leading up to my full PFS recovery, I had been taking pure l-dopa. I didn't realize this because I had thought that I was taking mucuna pruriens. In all likelihood, the packaging of the l-dopa I was using likely said that it was derived from mucuna pruriens, but, at the time, I didn't know much about mucuna pruriens or l-dopa. I only came to this realization because, as I was backtracking everything I had been doing at the time of my first recovery, I decided to buy mucuna pruriens as it was one of the things I was using at the time (so I thought). When I got it, I was expecting a pure white powder and instead it was sort of brownish. Also, I distinctly remember getting a headache when using l-dopa and that wasn't happening with the mucuna pruriens I had purchased. So, I thought maybe there were different varieties of mucuna that are different colors or maybe they're processed or refined differently. I didn't realize until some time later that what I had actually used was, in fact, l-dopa and not mucuna pruriens and so I decided to source pure l-dopa in order to replicate what I had previously done to recover.

Now, having been using l-dopa for the past month, I'm starting to experience the same symptoms that occurred leading up to my first recovery from PFS. Coincidence? It could be. It may just be that my diet and lifestyle are paying off again like in my first recovery, but if the l-dopa did play a critical role, I'd like to know because I would hate to let an opportunity to encourage others to try this go to waste. This is a nasty condition and there are quite a few people suffering from it.

Do I think there are other ways to recover from PFS? Yes, but I believe they are all doing the same thing and my opinion, at the moment, is that they're stimulating the restoration of proper dopaminergic function. I believe 5AR expression may be regulated by dopaminergic function or at least involved in the signaling cascade produced by dopamine.

Consider this: the first time I recovered from PFS I had decided to use finasteride again for about 3 days a few months prior to my recovery and then quit because I decided I wasn't going to continue subjecting myself to that poison. As of now, it's been about 2.5 years since I last touched finasteride and I'm still not completely recovered. So, the first time I recovered, I was using l-dopa and had used finasteride a few months prior. This time around it's been 2.5 years, but I didn't use l-dopa. That's not a coincidence I'm willing to overlook. Especially considering the connection to finasteride and hyperprolactinemia and l-dopa's ability to lower prolactinogenic activity directly through producing dopamine.

 

[ChemHead]

Interesting, would Mucuna pruriens be a decent substitute if l-dopa isn't available?

No. The only reason I say this is because I've used mucuna pruriens and it wasn't anywhere near the same physiological response I got from pure l-dopa. If you would like to know what it felt like and what I experienced in the month leading up to my recovery, let me know and I'll try to describe it.

 

[Unknownuser]

Before I say this, I'm going to preface this with the disclaimer that I can't guarantee that this is going to work. However, I have good reasons to believe that it may.

I recovered from PFS a few years ago and I am now currently recovering from it again because I (foolishly) tried to use finasteride in topical microdoses to see if I could get away with it. Instead of writing out this whole story again, I'll just give you a link to a thread I started about a possible fix for PFS. It doesn't seem like anyone actually cares much about PFS on this particular forum, but here it is:

PFS and the Dopamine-Prolactin connection

Recently, I came across the thread where a new treatment is being discussed that involves antagonism of prolactin and/or the prolactin receptor. I was intrigued by the relationship between dopamine, prolactin, and their receptors and decided to do a little research because of the connection with...

www.hairlosstalk.com

Essentially, the treatment is to take 500 mg of pure l-dopa daily. It's also been brought to my attention that Parkinson sufferers now supplement with thiamine in order to attenuate possible toxicity due the metabolism of dopamine and noradrenaline into aldehydes before elimination. It seems that thiamine is used in one of the steps of dopamine metabolism and this can cause it levels to become depleted. So, it's probably a good idea to supplement with thiamine.

Anyway, there may be some details left out. If you have any questions, just let me know.

I always knew dopamine must be some key element in pfs. Especially the lack of motivation, goals in life and the depression I ever since have. I was looking for ways to increase dopamine. But tyrosine gives me heavy migraines. I started taking Choline but with not much effect so far.

So you took L Dopa for just a few months until recovery and then stop? I am afraid to take that stuff. Can it cause permanent damage like finasteride did already? I remember reading that after some years (5 years?) l Dopa stops working for people with parkinsons.

Edit: we have levodopa 200mg here in the pharma. I guess it's the same? But 500mg sounds like a very high dose?

 

[ChemHead]

I always knew dopamine must be some key element in pfs. Especially the lack of motivation, goals in life and the depression I ever since have. I was looking for ways to increase dopamine.

It really does fit very nicely. Again, I can't guarantee that this is exclusively the reason why I recovered the first time because there are quite a few things that I was doing. However, I've been doing all of those things for the past 2.5 years with the exception of l-dopa and I haven't made a full recovery. Now that I've begun using l-dopa, I'm experiencing parallels with my first recovery.

So you took L Dopa for just a few months until recovery and then stop? I am afraid to take that stuff. Can it cause permanent damage like finasteride did already? I remember reading that after some years (5 years?) l Dopa stops working for people with parkinsons.

I only took it for about a month and I'm not sure how much I used because I either don't remember or didn't regulate how much I used the first time due to lack of any real knowledge about l-dopa. I have been using l-dopa now for about a month, but I was using a very small dosage (maybe 50-100 mg) and only in the past week I decided to use a higher dose.

l-dopa does stop working for Parkinson sufferers. However, they take very high doses (in some cases, multiple grams) for months to years. Also, there's been a more recent discovery that supplementing with thiamine helps to keep l-dopa working.

In my experience with using l-dopa, I've not suffered any kind of permanent damage. I have not used l-dopa for multiple months or years, but, if it really does work, it shouldn't take much longer than a month because that's about how long I used it before I recovered the first time around.

 

[ChemHead]

Edit: we have levodopa 200mg here in the pharma. I guess it's the same? But 500mg sounds like a very high dose?

I don't think it would hurt to start around 200-250 mg (perhaps lower if you really want to be cautious) and gradually titrate up. And if you have a doctor that is willing to monitor you through the whole process... even better. It's nice to have an understanding doctor that wants to help you and will actually put forth effort by going outside of the domain of their typical "symptom chart lookup" drug prescriptions.

 

[Unknownuser]

It really does fit very nicely. Again, I can't guarantee that this is exclusively the reason why I recovered the first time because there are quite a few things that I was doing. However, I've been doing all of those things for the past 2.5 years with the exception of l-dopa and I haven't made a full recovery. Now that I've begun using l-dopa, I'm experiencing parallels with my first recovery.



I only took it for about a month and I'm not sure how much I used because I either don't remember or didn't regulate how much I used the first time due to lack of any real knowledge about l-dopa. I have been using l-dopa now for about a month, but I was using a very small dosage (maybe 50-100 mg) and only in the past week I decided to use a higher dose.

l-dopa does stop working for Parkinson sufferers. However, they take very high doses (in some cases, multiple grams) for months to years. Also, there's been a more recent discovery that supplementing with thiamine helps to keep l-dopa working.

In my experience with using l-dopa, I've not suffered any kind of permanent damage. I have not used l-dopa for multiple months or years, but, if it really does work, it shouldn't take much longer than a month because that's about how long I used it before I recovered the first time around.

Thanks. That sounds promising. I might buy some tomorrow. Tried a lot of things. I recovered in December 2019 for 4-5 days when I took bpc 157 wich fixes dopamine issues. The same time I also took dhea and pregnenolone. So I cant tell wich one did what. But for 4-5 days I felt like how I felt before fin. It was magical. Horny all day. Huge load. Could have sex 3-4 times a day and still horny. Brain function back. Goals and motivation to wake up. Happy feelings.

I guess the bpc 157 effect weaned off after 4-5 days. And another injection did not bring the same effect.

I tried 4 months of mono hcg. Joekools protocol from this forum. It made me even worse. I am ever since aphatic. No feelings. Now I am 10 weeks on TRT without any effect so far. I would describe my situatuon as mental CFS. İt's like super slow brain function and feeling as if I need to sleep all day.

I tried about 0.5g thiamine daily for a week but had no effect. But somehow my weekly migraines stopped after taking thiamine, wich is a huge gain in life quality.

 

[Charger]

Your prolactin and cortisol are way too high, DHT too low.

T3 would lower the tsh, and help lower prolactin and cortisol, while boosting DHT.

Herbs like Ginkgo, Catuaba Bark, Vitamin E, etc. would all be helpful for prolactin. Phosphatidylserine should be helpful for cortisol as well. But with where your prolactin and cortisol numbers are, more information such as Estradiol Sensitive , Progesterone, and SHBG labs would be helpful as well. High estrogen could be contributing to elevated prolactin and cortisol, so you could focus on lowering estrogen itself if that's the case.

 

[GenericName86]

No. The only reason I say this is because I've used mucuna pruriens and it wasn't anywhere near the same physiological response I got from pure l-dopa. If you would like to know what it felt like and what I experienced in the month leading up to my recovery, let me know and I'll try to describe it.

Unfortunate that mucuna can't be a substitute, L-dopa isn't going to be easy to get a hold of, at least where I am. I'd like to hear about your experience. Where did you source yours from?

 

[ChemHead]

Thanks. That sounds promising. I might buy some tomorrow. Tried a lot of things. I recovered in December 2019 for 4-5 days when I took bpc 157 wich fixes dopamine issues. The same time I also took dhea and pregnenolone. So I cant tell wich one did what. But for 4-5 days I felt like how I felt before fin. It was magical. Horny all day. Huge load. Could have sex 3-4 times a day and still horny. Brain function back. Goals and motivation to wake up. Happy feelings.

I guess the bpc 157 effect weaned off after 4-5 days. And another injection did not bring the same effect.

I tried 4 months of mono hcg. Joekools protocol from this forum. It made me even worse. I am ever since aphatic. No feelings. Now I am 10 weeks on TRT without any effect so far. I would describe my situatuon as mental CFS. İt's like super slow brain function and feeling as if I need to sleep all day.

I tried about 0.5g thiamine daily for a week but had no effect. But somehow my weekly migraines stopped after taking thiamine, wich is a huge gain in life quality.

I'm not sure what "bpc 157" is, but the fact that you took a drug that alters dopaminergic function and it helped is just another indication to me that prolactin and dopamine are the source of the PFS problem.

When I recovered the first time, I felt beyond incredible. I hate saying this because it doesn't reflect who I am in any way and I don't actually believe this, but I felt like a god when I was recovered.

I shudder every time I read someone talk about "evil" DHT or 5AR. 5AR is such a critical enzyme for a multitude of bodily processes and these drugs are just cutting off and entire metabolic pathway. It's insanity.

 

[ChemHead]

Your prolactin and cortisol are way too high, DHT too low.

All problems due to insufficient dopaminergic activity. 5AR is such a vital enzymatic pathway that it isn't just involved in the synthesis of DHT in sexual tissues or neurosteroids. It's also critical in the regulation of glucocorticoids and mineralocorticoids.

In fact, I believe that 5AR inhibitors can cause insulin resistance. I would bet a lot of money that finasteride and dutasteride users have a problem with insulin resistance. The reason I say this is because without 5AR, the body cannot properly metabolize and deactivate glucocorticoids like cortisol in the liver and you end up with insulin resistance.

 

[ChemHead]

Unfortunate that mucuna can't be a substitute, L-dopa isn't going to be easy to get a hold of, at least where I am. I'd like to hear about your experience. Where did you source yours from?

There are two places I'm aware of to purchase l-dopa. One is called CurEase and the other is NutriVitaShop. There may be other places. I would just do a search for 100% l-dopa or levodopa.

 

[Charger]

All problems due to insufficient dopaminergic activity.

They are antagonists to dopaminergic activity itself. But we need to know why they're elevated or if they're being elevated due to other hormones such as high estrogen or lowered progesterone. I get that L-Dopa has brought you relief, but there's more to consider, otherwise you're potentially treating a symptom and not the root.

 

[Charger]

T4 free => 15,2ng/l

Can you clarify whether or not this is a typo? If this was supposed to be ng/dL, it's way too high.

 

[ChemHead]

I'd like to hear about your experience.

In the few weeks to a month leading up to my recovery here are the things I experienced:

-I began experiencing heart palpitations and the type of fight or flight anxiety during and after eating. I haven't figured this out 100% yet, but I believe that it's due to the direct influence of l-dopa on adrenal steroid synthesis, but also the fact that as 5AR expression returns, receptor expression for 5a-reduced steroids is elevated due to their chronic deprivation. Then when 5AR expression returns, you suddenly have a high expression of receptors and a massive flood of activity at these receptors because the body is slow to adjust to these changes. The same goes for adrenal steroids and their receptors. Eventually the heart palpitations, elevated heart rate and blood pressure was attenuated and I was just left feeling incredible.

-Frequent intermittent testicular pain. These pains were either in one testicle or the other, but never at the same time if I recall correctly. They were quick sharp pains, as well as longer lasting dull pain (as if they were being squeezed or stepped on) and these pains continued to get more intense leading up to the recovery.

-Scrotum got tighter to the point where it felt like there wasn't enough room to contain my testicles and it became mildly uncomfortable, especially while trying to sleep. This was accompanied by gradual increase in testicle size and scrotal volume.

-I began experiencing frequent wet dreams and nocturnal erections. Eventually, the erections became so intense that I would wake up almost every single night because they were so hard that it was actually kind of painful.

-Eventually, I began walking around all day at work with an almost permanent erection. Even my leg brushing up against my gear would stimulate an erection.

-My physical reflexes became incredible.

-Looking a woman would produces this incredible electric feeling that I could feel inside my head going straight to causing an erection. Also, outside of the purely physical manifestation of sexual desire, I just had this incredible mental desire for women that I hadn't felt for a very long time. I felt like an animal lol.

-This one might seem a little unbelievable to some: I woke up one day with significantly improved muscularity. I hadn't worked out at all to achieve this and it was really almost overnight... just one of those things I noticed when looking in the mirror after waking up one morning. It makes sense, though. When you fix this problem, you restore 5AR expression and you get not only more DHT synthesis, you get higher overall steroid synthesis.

-My skin was incredible. Part of this is due to the fact that my body was synthesizing more steroids and I believe the other part of it was due to my diet. Without the dietary component, I would have likely ended up with skin that was irritated like it was before I had ever taken finasteride.

-I began smiling and laughing at things for no particular reason. I'm sure they were comical in nature, but it's just something that didn't happen before. I'm sure people that heard me randomly giggling were probably wonder wtf was wrong with me, but my happiness was really uncontainable.

-Improved memory and cognition. I remember be so amazed at my ability to respond to a question or perhaps a joke directed at me with incredible speed and wit. When it happened, I would think to myself, "did I just do that??" It may sound odd to some people, but when your brain feels like mush, it's really incredible when you realize that it's not actually you and it's not your fault that you're slow and literally cognitively disabled. It's purely biochemical, neurochemical dysfunction.

There are plenty of other positive changes that occurred. These are just what I could think of at the moment.

edit: forgot to mention another obvious change: my voice dropped an octave... it became significantly deeper and my mucosal tissues and digestion became much better.

 

[GenericName86]

In the few weeks to a month leading up to my recovery here are the things I experienced:

-I began experiencing heart palpitations and the type of fight or flight anxiety during and after eating. I haven't figured this out 100% yet, but I believe that it's due to the direct influence of l-dopa on adrenal steroid synthesis, but also the fact that as 5AR expression returns, receptor expression for 5a-reduced steroids is elevated due to their chronic deprivation. Then when 5AR expression returns, you suddenly have a high expression of receptors and a massive flood of activity at these receptors because the body is slow to adjust to these changes. The same goes for adrenal steroids and their receptors. Eventually the heart palpitations, elevated heart rate and blood pressure was attenuated and I was just left feeling incredible.

-Frequent intermittent testicular pain. These pains were either in one testicle or the other, but never at the same time if I recall correctly. They were quick sharp pains, as well as longer lasting dull pain (as if they were being squeezed or stepped on) and these pains continued to get more intense leading up to the recovery.

-Scrotum got tighter to the point where it felt like there wasn't enough room to contain my testicles and it became mildly uncomfortable, especially while trying to sleep. This was accompanied by gradual increase in testicle size and scrotal volume.

-I began experiencing frequent wet dreams and nocturnal erections. Eventually, the erections became so intense that I would wake up almost every single night because they were so hard that it was actually kind of painful.

-Eventually, I began walking around all day at work with an almost permanent erection. Even my leg brushing up against my gear would stimulate an erection.

-My physical reflexes became incredible.

-Looking a woman would produces this incredible electric feeling that I could feel inside my head going straight to causing an erection. Also, outside of the purely physical manifestation of sexual desire, I just had this incredible mental desire for women that I hadn't felt for a very long time. I felt like an animal lol.

-This one might seem a little unbelievable to some: I woke up one day with significantly improved muscularity. I hadn't worked out at all to achieve this and it was really almost overnight... just one of those things I noticed when looking in the mirror after waking up one morning. It makes sense, though. When you fix this problem, you restore 5AR expression and you get not only more DHT synthesis, you get higher overall steroid synthesis.

-My skin was incredible. Part of this is due to the fact that my body was synthesizing more steroids and I believe the other part of it was due to my diet. Without the dietary component, I would have likely ended up with skin that was irritated like it was before I had ever taken finasteride.

-I began smiling and laughing at things for no particular reason. I'm sure they were comical in nature, but it's just something that didn't happen before. I'm sure people that heard me randomly giggling were probably wonder wtf was wrong with me, but my happiness was really uncontainable.

-Improved memory and cognition. I remember be so amazed at my ability to respond to a question or perhaps a joke directed at me with incredible speed and wit. When it happened, I would think to myself, "did I just do that??" It may sound odd to some people, but when your brain feels like mush, it's really incredible when you realize that it's not actually you and it's not your fault that you're slow and literally cognitively disabled. It's purely biochemical, neurochemical dysfunction.

There are plenty of other positive changes that occurred. These are just what I could think of at the moment.

Thanks for the detailed response, it all sounds pretty amazing, a few of those points I've managed to experience myself when trying things to help my recovery, oddly the best results I got was when I fasted for a few days and then spent the next few days only consuming water and coconut oil.

I'm in Australia so it would be very hard to find a source of l-dopa and get it in, I can get mucuna pruriens easy enough but like you said it it's not the same as taking l-dopa

 

[ChemHead]

They are antagonists to dopaminergic activity itself. But we need to know why they're elevated or if they're being elevated due to other hormones such as high estrogen or lowered progesterone. I get that L-Dopa has brought you relief, but there's more to consider, otherwise you're potentially treating a symptom and not the root.

What I've been able to conclude from the literature is that dopaminergic activity and thyrotropic activity are part of the same regulatory feedback loop. I get that the literature out there says that thyroid hormones are antagonists to dopaminergic activity, but the research conducted was not done on dopaminergically deficient mice. So, of course if you push dopaminergic activity beyond its normal physiological limits, the reaction is for the body to lower TSH and the reverse is true... when dopaminergic activity is low, TSH is elevated. However, someone that is dopaminerically deficient is not going to lower their thyroid hormone levels by bringing that activity up to where it should be.

There certainly may be more to consider and very likely there is more to consider. However, I think that those who are suffering from PFS should give this a try. I'm certain that my second recovery is very near, but, unfortunately, I can't be sure that it will be due to l-dopa simply because I have been slowly improving due to my dietary and lifestyle habits. If others give this a shot and it works, then I'll be certain that l-dopa played a role in accelerating my recovery and it will also help a lot of people that are suffering from PFS.