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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Propecia thoughts
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<blockquote data-quote="Nelson Vergel" data-source="post: 155436" data-attributes="member: 3"><p>Blood tests may not reflect the finasteride syndrome. Here is interesting data using two tests using CSF samples.</p><p></p><p>Endocr Connect. 2019 Aug 1;8(8):1118-1125. doi: 10.1530/EC-19-0199.</p><p>Altered methylation pattern of the SRD5A2 gene in the cerebrospinal fluid of post-finasteride patients: a pilot study.</p><p>Melcangi RC1, Casarini L2,3, Marino M2,3, Santi D2,4, Sperduti S2,3, Giatti S1, Diviccaro S1, Grimoldi M5, Caruso D1, Cavaletti G6, Simoni M2,3,4.</p><p></p><p>Abstract</p><p>CONTEXT:</p><p>Post-finasteride syndrome (PFS) occurs in patients with androgenic alopecia after suspension of the finasteride treatment, leading to a large variety of persistent side effects. Despite the severity of the clinical picture, the mechanism underlying the PFS symptoms onset and persistence is still unclear.</p><p></p><p>OBJECTIVE:</p><p>To study whether epigenetic modifications occur in PFS patients.</p><p></p><p>METHODS:</p><p>Retrospective analysis of a multicentric, prospective, longitudinal, case-control clinical trial, enrolling 16 PFS patients, compared to 20 age-matched healthy men. Main outcomes were methylation pattern of SRD5A1 and SRD5A2 promoters and concentration of 11 neuroactive steroids, measured by liquid chromatography-tandem mass spectrometry, in blood and cerebrospinal fluid (CSF) samples.</p><p></p><p>RESULTS:</p><p>SRD5A1 and SRD5A2 methylation analysis was performed in all blood samples (n = 16 PFS patients and n = 20 controls), in 16 CSF samples from PFS patients and in 13 CSF samples from controls. The SRD5A2 promoter was more frequently methylated in CSF of PFS patients compared to controls (56.3 vs 7.7%). No promoter methylation was detected in blood samples in both groups. No methylation occurred in the SRD5A1 promoter of both groups. Unmethylated controls compared to unmethylated SRD5A2 patients showed higher pregnenolone, dihydrotestosterone and dihydroprogesterone, together with lower testosterone CSF levels. Andrological and neurological assessments did not differ between methylated and unmethylated subjects.</p><p></p><p>CONCLUSIONS:</p><p>For the first time, we demonstrate a tissue-specific methylation pattern of SRD5A2 promoter in PFS patients. Although we cannot conclude whether this pattern is prenatally established or induced by finasteride treatment, it could represent an important mechanism of neuroactive steroid levels and behavioural disturbances previously described in PFS.</p><p></p><p>KEYWORDS:</p><p>5 alpha-reductase; epigenetic changes; finasteride; neuroactive steroids; side effects</p></blockquote><p></p>
[QUOTE="Nelson Vergel, post: 155436, member: 3"] Blood tests may not reflect the finasteride syndrome. Here is interesting data using two tests using CSF samples. Endocr Connect. 2019 Aug 1;8(8):1118-1125. doi: 10.1530/EC-19-0199. Altered methylation pattern of the SRD5A2 gene in the cerebrospinal fluid of post-finasteride patients: a pilot study. Melcangi RC1, Casarini L2,3, Marino M2,3, Santi D2,4, Sperduti S2,3, Giatti S1, Diviccaro S1, Grimoldi M5, Caruso D1, Cavaletti G6, Simoni M2,3,4. Abstract CONTEXT: Post-finasteride syndrome (PFS) occurs in patients with androgenic alopecia after suspension of the finasteride treatment, leading to a large variety of persistent side effects. Despite the severity of the clinical picture, the mechanism underlying the PFS symptoms onset and persistence is still unclear. OBJECTIVE: To study whether epigenetic modifications occur in PFS patients. METHODS: Retrospective analysis of a multicentric, prospective, longitudinal, case-control clinical trial, enrolling 16 PFS patients, compared to 20 age-matched healthy men. Main outcomes were methylation pattern of SRD5A1 and SRD5A2 promoters and concentration of 11 neuroactive steroids, measured by liquid chromatography-tandem mass spectrometry, in blood and cerebrospinal fluid (CSF) samples. RESULTS: SRD5A1 and SRD5A2 methylation analysis was performed in all blood samples (n = 16 PFS patients and n = 20 controls), in 16 CSF samples from PFS patients and in 13 CSF samples from controls. The SRD5A2 promoter was more frequently methylated in CSF of PFS patients compared to controls (56.3 vs 7.7%). No promoter methylation was detected in blood samples in both groups. No methylation occurred in the SRD5A1 promoter of both groups. Unmethylated controls compared to unmethylated SRD5A2 patients showed higher pregnenolone, dihydrotestosterone and dihydroprogesterone, together with lower testosterone CSF levels. Andrological and neurological assessments did not differ between methylated and unmethylated subjects. CONCLUSIONS: For the first time, we demonstrate a tissue-specific methylation pattern of SRD5A2 promoter in PFS patients. Although we cannot conclude whether this pattern is prenatally established or induced by finasteride treatment, it could represent an important mechanism of neuroactive steroid levels and behavioural disturbances previously described in PFS. KEYWORDS: 5 alpha-reductase; epigenetic changes; finasteride; neuroactive steroids; side effects [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
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