Dealing with finasteride rebound?

[Laurin Poplin]

Hello lads. I stopped taking fin a while back (weaned off) but seem to be dealing with rebound effects almost a year later and not sure where to turn. I saw an endo on the UK/NHS health service but they were rather clueless and gave me tame suggestions of eating more vegetables etc which I already do plenty of. I've had basic bloods done and did the dutch test [below] a few months ago which seem to show highish estrogen, 5ar activity and low cortisol.

Symptoms are things like less exercise endurance than before, hard to get out of bed, dry eyes, memory/mood issues, frequent headaches and so on. What's the course of action here, should this be treated as estrogen dominance and if so will that also fix the low cortisol levels too?

Opinions greatly appreciated, not sure where to go with this from here

 

[Systemlord]

What's the course of action here, should this be treated as estrogen dominance and if so will that also fix the low cortisol levels too?

Fixing estrogen dominance is usually done through diet and exercise -> weight lifting. Lifting weights should increase cortisol.

Your testosterone panel is incomplete.

No Free T or SHBG to calculate the Free T. You only have Total T.

If your SHBG turned out to be high and Free T low, TRT may be challenging with low cortisol.

TRT typically lowers cortisol.

 

[DaveK22]

Are you versed in "PFS"?
https://www.canva.com/design/DAE2ge...U&utm_medium=link&utm_source=publishsharelink

 

[sammmy]

See if you match Addison's disease below. The treatment is cortisol replacement for life - the side effects may be worse than just having low normal cortisol and probably that's why the endocrinologist doesn't want to engage on that.

Your DHEA-S is low - try supplementing with DHEA and see if that makes you feel better.

Addison's Disease: What It Is, Causes, Symptoms & Treatment

Addison’s disease is a chronic condition in which your adrenal glands don’t produce enough of the hormones cortisol and aldosterone. It's treatable.

my.clevelandclinic.org

 

[Laurin Poplin]

Fixing estrogen dominance is usually done through diet and exercise -> weight lifting. Lifting weights should increase cortisol.

Your testosterone panel is incomplete.

No Free T or SHBG to calculate the Free T. You only have Total T.

If your SHBG turned out to be high and Free T low, TRT may be challenging with low cortisol.

TRT typically lowers cortisol.

The thing is with the diet recommendation is I already eat very clean and the usual foods recommended that lower estrogen I already eat in abundance. If that isn't enough then should I look to talk to another endo about the medication route?

Those were 24hr urinary results, I will try to acquire my bloods with SHBG etc

Are you versed in "PFS"?
https://www.canva.com/design/DAE2ge...U&utm_medium=link&utm_source=publishsharelink

I've seen some talk about it in my searches yes, I will dig further

See if you match Addison's disease below. The treatment is cortisol replacement for life - the side effects may be worse than just having low normal cortisol and probably that's why the endocrinologist doesn't want to engage on that.

Your DHEA-S is low - try supplementing with DHEA and see if that makes you feel better.

Addison's Disease: What It Is, Causes, Symptoms & Treatment

Addison’s disease is a chronic condition in which your adrenal glands don’t produce enough of the hormones cortisol and aldosterone. It's treatable.

my.clevelandclinic.org

I don't think so, I do not really fit the symptom profile described for addison's but I will try DHEA, thank you my friend.

Is cortisol replacement the only way to restore cortisol levels? If [post] finasteride has caused low cortisol through raised 5ar/estrogen then wouldn't correcting this activity also restore the cortisol function somewhat or is that not how it works?

 

[sammmy]

Except the 4-point cortisol measurement, the Dutch test looks pseudo-scientific to me and since it is rather expensive, they should provide consultation or at lease have an interpretive guide that you should read.

According to wikipedia, you have symptoms of LOW 5a-reductase, not HIGH as the test claims. Also, if this is really a rebound of 5a-reductase post finasteride, then the most logical conclusion is to get back on it, or a similar reductase inhibitors. See the Inhibition section here:

5α-Reductase - Wikipedia

en.wikipedia.org

 

[Seagal]

How many years did you take finasteride? How about taking a small dose of fina? It might just take very long for your body to completely rebalance.

There are a few other threads about finasteride issues which might be worth reading.

 

[zancek0]

I'd be very much interested to see blood levels (instead/on top of urine levels) of the tested hormones. Is it possible for you to get some blood work done?