New PFS Sufferer, Mental Sides Only

[TTorque]

I'm another user of finasteride that had a bad experience.

Only used for 1 week, and was hit immediately with cognitive issues. Mainly, brain fog. I'm unable to think clearly, my stress tolerance is zero, and I have waves of anxiety and panic attacks at random. Never in my life did I experience any such issues before. And as with most PFS victims, things don't effect me the same way anymore. caffeine, alcohol, other drugs. Nothing.

Psilocybin, LSD/MDMA, Opioids literally do nothing, or don't hit the same.

I've been off for 7 months now, and the entire time I've been researching and trying to understand what exactly happened.

I'm currently peating, and I've attempted extended water fasts, intermittent fasts and other dietary changes. Nothing seems to touch this fog from a diet perspective.
I've tried raising my T via Clomid, no change. My DHT/T/E2 seems to have ZERO bearing on my cognitive function.

Virtually any supplementation that totes it self as a "mood" or "cognitive boost" has yielded nothing.
My current tackle is on allop/neurosteroids, doing hcg x3 @ 250-300iu and low-dose prozac (2.5mg/daily). Along with heavy weight lifting. So far it's been a month with zero improvements.

Even though my DHT is at the upper range, Proviron was going to be my next trial...

Attached is my bloodwork, I had a good baseline before starting fin, so the only thing that really stands out is my SHBG has doubled, and remains that way. The other is my 24hr cortisol, my DHEA (saliva) is way off the chart but actual cortisol looks good. (Maybe too low?)

I'm at a complete loss - PFS is obviously such a fickle thing, and everyone ends up down different paths. But I can't find a single angle I should hit this from...
I would kill just to be able to think again, it's completely ruined my life.

If anyone has absolutely any sort of ideas on what avenue I should try next, please.
Thanks

 

[Charger]

Former PFS guy here. That aside, I also have high shbg and low cortisol. Both of these can have an effect on your emotionality and thinking abilities in their own way. Cortisol itself can lower shbg and contribute to emotions/thinking/memory. If your shbg is too high it could be suppressing your free T regardless of how high your total is.

Basically your assumption is correct that you could have an issue with cortisol or shbg contributing to these symptoms.

 

[LLight]

Did you try (prolonged) dry fasting?

 

[Ignoramus]

Hey and welcome.

My sides were: depression, crazy long refractory periods/extreme post-ejaculatory sadness, blurred vision, apathy and brainfog. I think I'm basically 'cured' now, but maybe I won't ever be the same as pre-fin. I think I have to live in a pretty specific way now in order to manage myself, but I've gotten used it. It makes me wonder what could have been if I had implemented this same life style before fin (though I wouldn't have discovered RP had I not used the drug).

Anyway, here's what works for me:

-Eat a huge amount of cholesterol. I don't need it so much now, but if I ever feel that old familiar weakness then I eat a lot of free range eggs. Duck eggs seem to be especially potent. Peat himself recommends cholesterol for post-fin people. If eggs give you insomnia then maybe your iron is too high or something, and you could use butter instead. Don't worry about calories and stuff during this recovery period; just eat so you feel good.

-No gluten or PUFA at all. Well-cooked potatoes and bananas work for me as carb sources. Juices don't seem super good for me.

-NoFap, no porn. I know it's controversial, but it doesn't hurt to try it. I think prolactin might be implicated somehow in this. I try to ejaculate only once per week these days. Sex doesn't seem to cause the same issues, however (I feel like the post-sex cuddling is restorative or something?)

-Quit caffeine. This was a huge game changer for me. My vision, sleep, cognition and mood improved soo much since quitting. Maybe the liver gets damaged so it can't clear the caffeine very quickly? I think cortisol is an issue in post-fin ppl, so it should be kept low.

-Nicotine for cognition/focus. I use oral pouches. Obviously it's highly addictive and has sides. Ginseng tea seems to help me too.

-Experiment with small amounts of Progest-E (fin is kinda like progesterone, so I think maybe prog becomes down-regulated?) and Pansterone/pregnenolone and dhea. I only use Pansterone really occasionally (topically on balls or shoulders or one drop orally); it makes me feel quite manly and alive.

-Creatine makes me feel good.

-Red meat as main source of protein. Maybe zinc is an issue.

-Change your life and mange your expectations. Don't pine over who you used to be; just do your best and keep looking forward. Maybe this thing is a spiritual sign that might make you consider quitting your job to follow your dream or whatever. You might need to make a lifestyle change that you know you 'should' do, but haven't, for whatever reason

Good luck bud!

 

[TTorque]

Former PFS guy here. That aside, I also have high shbg and low cortisol. Both of these can have an effect on your emotionality and thinking abilities in their own way. Cortisol itself can lower shbg and contribute to emotions/thinking/memory. If your shbg is too high it could be suppressing your free T regardless of how high your total is.

Basically your assumption is correct that you could have an issue with cortisol or shbg contributing to these symptoms.

Hey man, I actually have been reading a lot of your posts prior to registering.
Another user here was attempting to control his cortisol with some luck, and with something like hydrocortisone I should be able to give it a slight bump, and that should additionally lower my SHGB?

Did you try (prolonged) dry fasting?

I did not, I'm already severely underweight. But I would assume you could really only manage (and safely) do 24 hours?

Hey and welcome.

My sides were: depression, crazy long refractory periods/extreme post-ejaculatory sadness, blurred vision, apathy and brainfog. I think I'm basically 'cured' now, but maybe I won't ever be the same as pre-fin. I think I have to live in a pretty specific way now in order to manage myself, but I've gotten used it. It makes me wonder what could have been if I had implemented this same life style before fin (though I wouldn't have discovered RP had I not used the drug).

Anyway, here's what works for me:

-Eat a huge amount of cholesterol. I don't need it so much now, but if I ever feel that old familiar weakness then I eat a lot of free range eggs. Duck eggs seem to be especially potent. Peat himself recommends cholesterol for post-fin people. If eggs give you insomnia then maybe your iron is too high or something, and you could use butter instead. Don't worry about calories and stuff during this recovery period; just eat so you feel good.

-No gluten or PUFA at all. Well-cooked potatoes and bananas work for me as carb sources. Juices don't seem super good for me.

-NoFap, no porn. I know it's controversial, but it doesn't hurt to try it. I think prolactin might be implicated somehow in this. I try to ejaculate only once per week these days. Sex doesn't seem to cause the same issues, however (I feel like the post-sex cuddling is restorative or something?)

-Quit caffeine. This was a huge game changer for me. My vision, sleep, cognition and mood improved soo much since quitting. Maybe the liver gets damaged so it can't clear the caffeine very quickly? I think cortisol is an issue in post-fin ppl, so it should be kept low.

-Nicotine for cognition/focus. I use oral pouches. Obviously it's highly addictive and has sides. Ginseng tea seems to help me too.

-Experiment with small amounts of Progest-E (fin is kinda like progesterone, so I think maybe prog becomes down-regulated?) and Pansterone/pregnenolone and dhea. I only use Pansterone really occasionally (topically on balls or shoulders or one drop orally); it makes me feel quite manly and alive.

-Creatine makes me feel good.

-Red meat as main source of protein. Maybe zinc is an issue.

-Change your life and mange your expectations. Don't pine over who you used to be; just do your best and keep looking forward. Maybe this thing is a spiritual sign that might make you consider quitting your job to follow your dream or whatever. You might need to make a lifestyle change that you know you 'should' do, but haven't, for whatever reason

Good luck bud!

Thank you for the long response! I haven't tried large portions of cholesterol, or Nicotine.
And NoFap for sure improves my sexual function, I would agree. I've tried (oral) progesterone standalone, but never heard of Progest-E. Sourced from here?

Dr. Peat's Progest E Oil Complex, 34 ml

Kenogen Progest E by Ray Peat is a natural bioidentical progesterone oil derived from wild yam. The best there is! Buy yours today with Free Shipping!

www.longnaturalhealth.com

 

[Charger]

I wouldn't recommend

Hey man, I actually have been reading a lot of your posts prior to registering.
Another user here was attempting to control his cortisol with some luck, and with something like hydrocortisone I should be able to give it a slight bump, and that should additionally lower my SHGB?

Maybe, I have no experience with hydrocortisone so I can't speak to it or recommend it. Licorice root is a supplemental option for increasing cortisol if that is your issue.

Increasing androgens exogenously or using something like Proviron is another option to knock SHBG down.

 

[LLight]

I did not, I'm already severely underweight. But I would assume you could really only manage (and safely) do 24 hours?

It's not a good idea if you are severely underweight or are already too much stressed but I think someone with enough fat can go safely for at least 4 days.

2 studies have been made with people dry fasting for 5 days and that were fine.

But not a good idea in your case. Sorry.

 

[wildworld1992]

Former PFS guy here. That aside, I also have high shbg and low cortisol. Both of these can have an effect on your emotionality and thinking abilities in their own way. Cortisol itself can lower shbg and contribute to emotions/thinking/memory. If your shbg is too high it could be suppressing your free T regardless of how high your total is.

Basically your assumption is correct that you could have an issue with cortisol or shbg contributing to these symptoms.

Hi Charger, how did you recover from PFS? I would like to see more of your story.

 

[Mister]

First of all stop using Prozac are any other anti depression meds. (Look up PSSD, it's not only SSRI's that cause it btw)

And yes, proviron or other dht derivative steroids seem to be a good choice for you, especially with your shbg being high. (and please check if you have legit proviron, many fake sh*t)

Keep us updated

 

[TTorque]

Just wanted to provide an update for the past ~4 months. I have some new bloodwork below.
Sorry for the long post, would appreciate any insight!

What I was doing:

Gluten free diet - Feel no different. Still sticking with it.
4 months of hcg (250-500iu x3/wk) - This fixed my sleep, and insomnia has yet to return. It also corrected my fatigue.
Dropped it.

Proviron and DHT cream (2.5%) - Nothing. Used anywhere from 25mg-100mg, and the andractim seems to ruin my sleep. It also did not increase my sexual function like I assume it would on a "normal" person.
Dropped it.

Klonopin: Just .25-.75mg/d - Really just use it when I know i'll be around many people and my disassociation will spike causing a panic attack. (Once again, this has NEVER happened pre-fin)

Lamotrigine: Titrated to 150mg, then started to feel more depressed and anxiety. Tapering down now. Tried to use as an off-label antidepressant, and if excessive glutamate caused my brain issues.

Metformin - I used this to help correct any insulin resistance brought on by fin, and help with my "gut lining" and inflammation. Which I got the idea from moreplatesmoredates 500-1000mg daily. Did nothing really, but I have ZERO bowel issues now.
Dropped it after taking for 3 months.

Low-dose prozac. This was iffy, i know, it did disturb my sexual function and made me sort of numb (typical SSRI stuff). But did nothing for my disassociation/cognitive problems.
Dropped it.

Progesterone, both oral and rectally. And Prog-E. All did the same thing, at high doses I became extremely sedated and had wonderful sleep. No improvement in cognitive function. Lower dose prog-e helped elevate mood slightly however. I assume this means it's being converted into allop, and don't have any issue with low prog or allop (?)
Which I still continue to take. (Prog-E)

Pregnenolone Cream: Didn't really try for very long. Made me lose pretty much all sensitivity, and inability to orgasm.

Supplements: Acetyl L-Carnitine, Zinc, Vitamin D, SIGMA (by Gorillia Mind, T Booster, and should of lowered SHGB). No change in anything. However magnesium also helps me sleep. So I take that on occasion and cycle SIGMA

L-DOPA (99%) - This stuff was intense, I worked up to 500mg and at first it gave me energy for literally days, brought on insomnia etc. Almost like taking high dose adderall. It eventually wore off, and now does nothing. I might try cycling it. It did improve my disassociation (the only thing ever) very slightly.

Nootropics - SEMAX, SELANK, Phenibut, Bromantane. Literally felt nothing.

Micro dosing Psilocybin - Nothing. Higher dosage I started to get "high", which just emphasizes my disassociation.

Here's my latest labs, after HCG.
Pretty much nothings changed. my Free T is in the gutter, and my SHGB is still highly elevated, and my DHEA-S is through the roof. SIGMA did not bring down my SHGB, and my E2 looks pretty good. Sexual function is iffy, but not impotent. My LH returned to baseline (pre-fin) after HCG.

T, FREE	8.6pg/mL	8.9-25.1 pg/mL
T, TOTAL	451 ng/dL	264-916 ng/dL
DHEA-S	605 ug/dL	138.5-475.2 ug/dL
SHBG	47.8 nmol/L	16.5-55.9nmo/L
Estradiol, Sensitive	15.3 pg/mL	8-35 pg/mL
TSH	1.9 uIU/mL	0.45-4.5 uIU/mL
LH	2.2 mIU/mL	1.7-8.6 mlU/mL
Prostate Specific Ag	1.6 ng/mL	0-4 ng/mL
Insulin-Like Growth Factor I	142 ng/mL	101-307 ng/mL

What I'm wanting to do now:
TRT - I feel like shooting my total T to super physiological levels might help something with my AR? And get my free T up high enough for my body to actually utilize it? This would be via a clinic to monitor my bloodwork.
T4 - Not sure on this one. Not sure how to relate my thyroid function to all of this.
Carnivore Diet - Minimum of 100g protein, low carb, and zero sugar and processed anything.
Possibly Intermittent Fasting - Don't feel like this would do much for me, depending on how much meat I could eat during my time window.
HITT - I workout, but it's mainly cardio and some weight lifting.

If DHEA-S is high, does that mean it's "backed up" and thus my 5ar is still dysfunctional? My serum DHT is very high. So plasma levels of the enzyme are working. It seems to be tissue specific 5ar that's failed. (My brain?) my Total T matches my pre-fin total T. But again, my SHGB and Free T is far off from prefin. Would this also indicate a failure in 5ar? Excuse the ignorance, this is all new to me. This is why I thought TRT is the next best route, I'm not concerned of the "life long commitment" right at this moment. I just really, really, need my brain back to continue my life! I'm losing relationships, my job, etc...

Would dopamine, serotonin, etc play a roll in all this? I don't believe that should have a bearing on my free T/SHGB/DHEA

My absolute main issue is disassociation - I feel like I'm dreaming. Especially with a lot of stimuli. But my brain fog is gone, I can think and do some more complex tasks. But when I step back, the world looks so off. It makes driving and doing the things I enjoy very difficult. I don't think it's emotional blunting, it's like my world perspective is slower. I still get huge bouts of anxiety and can't deal with outside stressors, which induces depression. But I believe it completely stems from not being able to view the world as I once did. I'd take depression/anxiety any day, over feeling like i'm stuck in lala land.

Once again, long post, but would appreciate anyone's recommendation or insight.

 

[TTorque]

Don't mean to bump my own thread, but I wanted to post that I recently started TRT + HCG.
No AI right now. Will report on changes.

Testosterone Cypionate 200 mg/ml – inject 0.8ml IM/SQ once weekly
Pregnyl 400iu SQ twice weekly to reverse/prevent testicular atrophy

I also received a GI-Map test, I need to find someone to help me interpret the results. But points to gluten issues and inflammation, I think.

 

[Mister]

Don't mean to bump my own thread, but I wanted to post that I recently started TRT + HCG.
No AI right now. Will report on changes.

Testosterone Cypionate 200 mg/ml – inject 0.8ml IM/SQ once weekly
Pregnyl 400iu SQ twice weekly to reverse/prevent testicular atrophy

I also received a GI-Map test, I need to find someone to help me interpret the results. But points to gluten issues and inflammation, I think.

Interesting @Cooper started the same regime although much higher test dosage.

Keeps us updated man!

Edit; interesting just today someone also posted a recovery thanks due to trt
View: https://www.reddit.com/r/PSSD/comments/www21k/recovery_at_80/

 

[TTorque]

I am now on my third week of TRT + HCG and I noticed a few things:

The day of the injection (Sunday), and subsequent 3-4 days I have increase energy, but it tapers off by the end of the week. Is this normal?
My libido is higher, erections are bigger and generally "feel" better

However, the bad. Absolutely zero change in my ability to "think" clearer. The foggy thinking is there, my well being is better, but the lucid thinking is just not there still.
But - some PFS victims feel bad with TRT/HCG right from the git go, which I am not experiencing.

Plan to check RT3/RT4 and thyroid after 11 weeks of TRT.

Fingers crossed after dialing this in, i'll be able to think again...

 

[Mister]

I am now on my third week of TRT + HCG and I noticed a few things:

The day of the injection (Sunday), and subsequent 3-4 days I have increase energy, but it tapers off by the end of the week. Is this normal?
My libido is higher, erections are bigger and generally "feel" better

However, the bad. Absolutely zero change in my ability to "think" clearer. The foggy thinking is there, my well being is better, but the lucid thinking is just not there still.
But - some PFS victims feel bad with TRT/HCG right from the git go, which I am not experiencing.

Plan to check RT3/RT4 and thyroid after 11 weeks of TRT.

Fingers crossed after dialing this in, i'll be able to think again...

3 weeks is literally nothing, most people only start to feel changes after 8-10 weeks. But still great you already notice better libido, etc.

And you only inject once a week? Yeah that's not enough imo, atleast 2 or better even 3 times a week to have more stable serum levels, that's why your energy levels decline later in the week. Injecting more frequent is probably the most common advice for men on TRT. What testosterone ester do you take?

Anyway seems you're doing well man, continue with it and don't expect massive changes so soon, for most men improvements come slowly after months of use.

 

[TTorque]

3 weeks is literally nothing, most people only start to feel changes after 8-10 weeks. But still great you already notice better libido, etc.

And you only inject once a week? Yeah that's not enough imo, atleast 2 or better even 3 times a week to have more stable serum levels, that's why your energy levels decline later in the week. Injecting more frequent is probably the most common advice for men on TRT. What testosterone ester do you take?

Anyway seems you're doing well man, continue with it and don't expect massive changes so soon, for most men improvements come slowly after months of use.

Thanks for the reply man, that's what ive generally heard. I went with Test Cypionate. I'd also like to still have children one day so I didn't want to blast too much from the beginning. But I still want my levels to reach super physiological eventually. After the next round of blood, I'll add another injection. Will keep this thread updated for any future on lookers suffering from this junk.

 

[TTorque]

Wanted to bump this with my current TRT results. (3 months on TRT)


T, FREE 40.4 7.7-25.1 pg/mL
T, TOTAL >1500 264-916 ng/dL
DHEA-S 493 138.5-475.2 ug/dL
SHBG 29.6 16.5-55.9nmo/L
Estradiol, Sensitive 31.9 8-35 pg/mL
TSH 1.44 0.45-4.5 uIU/mL
RT3 17.2 9.2-24.1 ng/dL
FT3 3.8 2.0-4.4 pg/mL
DHT 150 30-85 ng/dL

Prostate Specific Ag 1.7 0-4 ng/mL
Insulin-Like Growth Factor I 203 101-307 ng/mL

This is interesting. My Free T is over doubled, and my SHGB is back at my pre-fin baseline. But I feel absolutely NO different, mentally.
Easier muscle in the gym, and a better body. But no change cognitively.

So hormonal wise, like most with PFS, isn't fixing me. I'd like to stay on the TRT+HCG as it is providing other benefits, but I absolutely cannot track down where my issue is for my brain fog. I continue to shape my diet around peat principles, and hope that provides some relief.

I was going to take small amount of NDT or T4 to bring down my TSH under 1 as well. And DHT cream to keep my E2 in check, instead of any AI.
Anyone have any other ideas on how I can improve my cognitive baseline?

Thanks!

 

[MCurtone]

I'm another user of finasteride that had a bad experience.

Only used for 1 week, and was hit immediately with cognitive issues. Mainly, brain fog. I'm unable to think clearly, my stress tolerance is zero, and I have waves of anxiety and panic attacks at random. Never in my life did I experience any such issues before. And as with most PFS victims, things don't effect me the same way anymore. caffeine, alcohol, other drugs. Nothing.

Psilocybin, LSD/MDMA, Opioids literally do nothing, or don't hit the same.

I've been off for 7 months now, and the entire time I've been researching and trying to understand what exactly happened.

I'm currently peating, and I've attempted extended water fasts, intermittent fasts and other dietary changes. Nothing seems to touch this fog from a diet perspective.
I've tried raising my T via Clomid, no change. My DHT/T/E2 seems to have ZERO bearing on my cognitive function.

Virtually any supplementation that totes it self as a "mood" or "cognitive boost" has yielded nothing.
My current tackle is on allop/neurosteroids, doing hcg x3 @ 250-300iu and low-dose prozac (2.5mg/daily). Along with heavy weight lifting. So far it's been a month with zero improvements.

Even though my DHT is at the upper range, Proviron was going to be my next trial...

Attached is my bloodwork, I had a good baseline before starting fin, so the only thing that really stands out is my SHBG has doubled, and remains that way. The other is my 24hr cortisol, my DHEA (saliva) is way off the chart but actual cortisol looks good. (Maybe too low?)

I'm at a complete loss - PFS is obviously such a fickle thing, and everyone ends up down different paths. But I can't find a single angle I should hit this from...
I would kill just to be able to think again, it's completely ruined my life.

If anyone has absolutely any sort of ideas on what avenue I should try next, please.
Thanks

Hello my friend. I suffer from pfs cognition issues like you, from 2016, however I have made significant improvements, and virtually all of those improvements come from dealing with stress better and living a happier lifestyle.

It is my strong belief based on a lot of research I've done, that those who have persistent cognitive issues from pfs, is that they are in a state of PTSD/trauma.

Time and time again, every single person I know who came down with pfs, particularly with cognitive issues, had 1 or a combination of the following:

1. Pre-existing mental disorders (before fin) ranging from mild to severe. This includes anxiety, panic attacks, depression, OCD, self-esteem issues, confidence issues, over-thinking, over-worrying.

2. Developed an issue with any of the above while on finasteride, and particularly panic attacks.

Whether you find yourself in number 1 or number 2, the pattern usually consists of stress that goes unresolved, anxiety that builds and eventually leads to a panic attack. The panic attack is what triggers the "PFS crash" and leaves your cognition in a state of dysfunction. The crash itself is very traumatic and lasts for weeks or months in some cases, which in itself can easily be considered a form of torture over a long period of time -> PTSD. Remember, because you are on finasteride, you actually have no way to combat this panic attack or bounce-back to equilibrium due to the 5ar inhibition.

This all happens because whether you were case #1 or case #2, both, yes both have lower 5ar in the brain. People who never took finasteride but have any of the issues mentioned in #1 above, have similar cerebral spinal fluid levels as those who have full blown PFS. Low allo, low 5ar, etc.

Based on my research the last couple years, I can only conclude that the reason these persistent effects remain is because the brain, specifically the limbic system has been damaged and is in a state of dysfunction due to the trauma. A trauma-loop you can call it. Add to the fact that those with cognitive issues tend to then develop additional issues as time goes on, such as chemical sensitivities, food allergies, gut issues, these "cascading" type of symptoms are indicative of limbic system dysfunction.

Additionally, people forget that finasteride also inhibits adrenaline production, preventing the conversion of noradrenaline into adrenaline. This is very important. High levels of noradrenaline over a long period of time can trigger PTSD. Add to the fact that with 5ar inhibited, you cannot fully metabolize cortisol to THDOC, and obviously no allopreg. All this together makes it virtually impossible to handle stress and people with any type of neuroticism will eventually encounter a panic attack.

The panic attack or overwhelming stress is what causes the brain to "shutdown". Brain fog appears, depersonalization/derealization, dissociation, anhedonia, low or no emotions etc. I personally believe that these symptoms, especially DP/DR is the brain's coping mechanism to no longer feel pain.

HCG is great because it forces 5ar and all steroids to be made, even in a stressed or traumatized state. However, going back and correcting the trauma, living a happy, stress-free lifestyle over a long period of time is key to recovery.

I hope this helps.