Tapering Finasteride And PFS

Kyle Bigman

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Hello,

I am on finasteride right now and want to find a way to quit that minimizes the risks of developing PFS. The reason I am still on this drug is because I am afraid that quitting cold turkey will induce PFS full-scale.

What are your experiences with quitting and PFS?

Can you help me determine how to taper and/or supplement during this quitting phase?

Thanks for the help.
 

brix

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Taper it. Maybe include a dopamine agonist while you taper. If you are on 1mg, I would do .75mg one week, .5mg the next, etc until you are at 0.
 
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Kyle Bigman

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Hey Brix,

Thanks for the help. Do you recommend any specific dopamine agonists?
 

MrSmart

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Not to scare you, but if you're going to have PFS, then you already do. Stopping the drug just surfaces the symptoms. There is no point to tapering. The quicker you stop, the better. PFS is usually an accumulation of damage and not a withdrawal symptom. Besides, finasteride is incredibly potent at all doses. You'd find the response curve quite steep at some ambiguous point near the 0.01-0.2mg, at least when it comes to organs with low IC50.
 
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Kyle Bigman

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So you are saying that even though quitting the drug will produce symptoms, it is still better to stop taking it? I heard PFS was permanent. Why wouldn't you just stay on finasteride if that was the case?
 

MrSmart

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So you are saying that even though quitting the drug will produce symptoms, it is still better to stop taking it? I heard PFS was permanent. Why wouldn't you just stay on finasteride if that was the case?

It's difficult to say. Because you can still suffer some symptoms while on, and they can get worse when you go off. Or get all the worse when you're on. The survey study done was clear, the PFS was most correlated with time on the drug, independent of the time since quitting, including those still on. However, anecdotal evidence points to an increased incidence of peak PFS soon after quitting. I personally got hit sometime after dropping the dose from 1mg to 0.5mg, stopping a few months later did not improve symptoms much, but I'm better now after almost a year.
 

brix

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PFS is not permanent and people have had success tapering off.
 
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Kyle Bigman

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It's difficult to say. Because you can still suffer some symptoms while on, and they can get worse when you go off. Or get all the worse when you're on. The survey study done was clear, the PFS was most correlated with time on the drug, independent of the time since quitting, including those still on. However, anecdotal evidence points to an increased incidence of peak PFS soon after quitting. I personally got hit sometime after dropping the dose from 1mg to 0.5mg, stopping a few months later did not improve symptoms much, but I'm better now after almost a year.
So you are 100% improved? That's amazing. I think to be safe I will still try to taper, as Brix advises, and will try some dopamine agonists. I am trying to figure out what causes PFS. I read somewhere that it is due to a sudden down-regulation of 5-alpha reductase type 1 or 2, due to the huge flood of DHT as we come back "online," so to speak. So I was thinking of trying to as gradually re-introduce DHT into my system as possible...and if I get PFS, then I pretty much deserve it for going on this drug in the first place :/
 
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dont take testosterone boosting herbs or stuff that increases libido, definetely dont orgasm when you are in a state of increased libido, like if you take a libido booster, dont have an orgasm in that state, drop porn for 3 months, eat peat style
 

MrSmart

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So you are 100% improved? That's amazing. I think to be safe I will still try to taper, as Brix advises, and will try some dopamine agonists. I am trying to figure out what causes PFS. I read somewhere that it is due to a sudden down-regulation of 5-alpha reductase type 1 or 2, due to the huge flood of DHT as we come back "online," so to speak. So I was thinking of trying to as gradually re-introduce DHT into my system as possible...and if I get PFS, then I pretty much deserve it for going on this drug in the first place :/

It has little to do with any enzyme downregulation or even enzymatic mutation. This was studied in PFS patients, and only some of the CSF metabolites were altered, with no conclusive evidence that 5-AR ratio or polymorphisms was the case. Androgen receptor density was increased in some instances, while nerve densities were unchanged in genital skin.

We do not know why exactly it happens, and likely that not all PFS is the same, as reported symptoms vary widely, so the mechanisms are numerous. One of them is damage to the pudendal nerve, others may be due to CNS damage as well, or even neurotransmitter receptor imbalances, as has been shown in rat studies. Certainly, a long time with blocked pathways in the neurosteroid and adrenal systems will lead to severe damage, sometimes persistent for a very long time.

Am I a 100%? No, but I'm working on it. Penile skin sensitivity seems to be the most perverse issue at the moment, I believe due to some glucocorticoid insufficiency days after dropping down the dose. The skin is keratinized with no sensation, not even pain. I'm gradually improving with Tretinoin applications, the thick layer of skin is shedding off.
 

Sexypizza

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OP I have PFS and I browse the propeciahelp forums and the solvepropecia forums a lot. I genuinely think that PFS is really just hypothyroidism and occasionally mixed in with other stuff, most commonly estrogen dominance. I know a number of people who have recovered from PFS just from using thyroid. one guy recovered from using a progesterone based steroid and a few others I remember managed to get their symptoms under control with TRT or DHT (although I don't think that's necessary).

For me personally, I did find that my TSH was 24 which is really high, right after I got PFS. I got it down to zero now with a thyroid supplement but haven't recovered yet because I found out recently that my iron levels are really high and I think that's stopping my metabolism from improving.

The key point to remember here is that if Thyroid is low or reverse T3 is high, DHT is likely to be turned partly into estrogen rather than DHT. I think in PFS the metabolism has basically slowed down and a result of that testosterone is being converted into estrogen which causes the sexual problems associated with PFS.
 

sladerunner69

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OP I have PFS and I browse the propeciahelp forums and the solvepropecia forums a lot. I genuinely think that PFS is really just hypothyroidism and occasionally mixed in with other stuff, most commonly estrogen dominance. I know a number of people who have recovered from PFS just from using thyroid. one guy recovered from using a progesterone based steroid and a few others I remember managed to get their symptoms under control with TRT or DHT (although I don't think that's necessary).

For me personally, I did find that my TSH was 24 which is really high, right after I got PFS. I got it down to zero now with a thyroid supplement but haven't recovered yet because I found out recently that my iron levels are really high and I think that's stopping my metabolism from improving.

The key point to remember here is that if Thyroid is low or reverse T3 is high, DHT is likely to be turned partly into estrogen rather than DHT. I think in PFS the metabolism has basically slowed down and a result of that testosterone is being converted into estrogen which causes the sexual problems associated with PFS.

I did improve significantly after simply taking thyroid as well, but after a few days I had trouble dialing in the dosage. After adding cynoplus t3/t4 I began to experience stranger hyperthyroid sensations and felt very off, had trouble sleeping etc. So I went back to small doses of t3 along with caffeine and dieting for metabolism. After a few years of this I improved remarkably, am now better off in certain areas (such as intelligence and mood) and almost completely in others (my libido isn't where it was in high school) and was able to reduce supplements. Now I drink caffeine and take niacnimide, a little b6, magnesium, and sometimes toy around with things like inosine, lyposomal vit C, progesterone, or DHEA.


I second the notion to get off fin as soon as possible. Better to confront the issue sooner then later, and not risk exacerbating the degree of the problem.

dont take testosterone boosting herbs or stuff that increases libido, definetely dont orgasm when you are in a state of increased libido, like if you take a libido booster, dont have an orgasm in that state, drop porn for 3 months, eat peat style

This is correct, the thing that increases my libido the most, even more so than hormones or diet, is no fap.
 

Sexypizza

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I did improve significantly after simply taking thyroid as well, but after a few days I had trouble dialing in the dosage. After adding cynoplus t3/t4 I began to experience stranger hyperthyroid sensations and felt very off, had trouble sleeping etc. So I went back to small doses of t3 along with caffeine and dieting for metabolism. After a few years of this I improved remarkably, am now better off in certain areas (such as intelligence and mood) and almost completely in others (my libido isn't where it was in high school) and was able to reduce supplements. Now I drink caffeine and take niacnimide, a little b6, magnesium, and sometimes toy around with things like inosine, lyposomal vit C, progesterone, or DHEA.



I second the notion to get off fin as soon as possible. Better to confront the issue sooner then later, and not risk exacerbating the degree of the problem.



This is correct, the thing that increases my libido the most, even more so than hormones or diet, is no fap.


whats your average pulse and temperture?
 

sladerunner69

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whats your average pulse and temperture?

Temps are usually 98.6 or a little more, pulse I try to keep at least 80 but sometimes, as in after waking, I find them as low as 65. I am working on increasing that, and have thought about taking more thyroid hormone but am somewhat concerned about finding the right balance of t3/t4 because I have heard so many different reports of too much t4 screwing people over and too littler t4 also being bad, so I'm been hesitate to bring thyroid back into my regimen.
 
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Kyle Bigman

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It has little to do with any enzyme downregulation or even enzymatic mutation. This was studied in PFS patients, and only some of the CSF metabolites were altered, with no conclusive evidence that 5-AR ratio or polymorphisms was the case. Androgen receptor density was increased in some instances, while nerve densities were unchanged in genital skin.

We do not know why exactly it happens, and likely that not all PFS is the same, as reported symptoms vary widely, so the mechanisms are numerous. One of them is damage to the pudendal nerve, others may be due to CNS damage as well, or even neurotransmitter receptor imbalances, as has been shown in rat studies. Certainly, a long time with blocked pathways in the neurosteroid and adrenal systems will lead to severe damage, sometimes persistent for a very long time.

Am I a 100%? No, but I'm working on it. Penile skin sensitivity seems to be the most perverse issue at the moment, I believe due to some glucocorticoid insufficiency days after dropping down the dose. The skin is keratinized with no sensation, not even pain. I'm gradually improving with Tretinoin applications, the thick layer of skin is shedding off.
So you disagree with @bloom theory about 5-ar1 down regulation in the brain? To me it made sense because only accutane/finasteride users seem to experience PFS. You would expect a drug like dutasteride, which inhibits more DHT, to do the same, unless there was some sea-saw effect of down regulation that occurs with inhibiting only one isoform of the enzyme.
 

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