TRT Therapy after finasteride caused low testosterone?

[SteveUrkel02]

Hey, guys. I started finasteride about 1 year ago. Before I started taking it , I had morning wood everyday and a high sex drive. Now I can definitely say that my test levels have decreased. I have a low sex drive and basically no morning wood. Is it possible to go on TRT to increase test levels to normal range while still on finasteride ? 
I would appreciate any help

[Melvin- Admin]

@win200 was on testosterone, even higher than TRT dosage amounts. He was able to keep his hair with dutasteride. It depends on your sensitivity.

 

[sunsurfhair]

2 hours ago, The comeback king said:

Did you test your test before taking finasteride ? Because with 5ar blocker you increase test slightly

Finasteride will sometimes raise T due to the blockage of DHT (amongst several other key 5AR metabolites), but at the same time, it will raise Estradiol (E2) due to the T aromatizing further into E2 since the DHT pathway is blocked. This is why guys on Fin could end up with feminizing effects: gynocomastia, low libido, ED, headaches, mood issues etc etc. It’s the loss of DHT and the rise of E2 which can cause so many issues and the loss of other critical neuro-steroids, primarily allopregnenolone which regulates GABA in the central nervous system and brain (brain fog, anxiety, panic, depression, CNS health). It’s a slight misconception that Fin raises T because it does this almost as a side effect of blocking DHT, but you get the effect of then T raising slightly along with E2. 

Some men with low T induced by Fin usage have done well with TRT and or a combo of TRT + HCG, mitigating the side effects the OP suggested and some men don’t do well with HRT and are just stuck with a lasting condition - the Post Finasteride Syndrome. Latest news on this btw is that the researchers really digging into this have identified the genes that have been altered due to Finasteride usage and are going to publish this data at some point soon. University of Milan is doing some quite deep research into the root of this problem. 

I’ve always stuck to my guns that I believe there is a strong genetic component that predisposes men to an either mild, moderate, or severe form of damage from Finasteride. Some recover, and some sadly never do. 

PFS Is ‘Clearly a Problem,’ ‘Warrants Intervention’ and Is ‘Inappropriate to Dismiss,’ Says New USC Research

https://www.pfsfoundation.org/news/pfs-is-clearly-a-problem-warrants-intervention-and-is-inappropriate-to-dismiss-says-new-usc-research/

Edited October 14, 2022 by sunsurfhair

[John1991]

Not getting morning wood and/or having ED problems doesn't necessarily (in fact, it probably doesn't) speak to low-T.  Now the low libido does, but I just wanted to mention that because there seems to be a misconception around that subject at times. I had the same sex drive and same ability to gain muscle/strength when my ED was at it's absolute worst.  I'm just putting this out there because it's worth noting.

[arthurSam]

18 hours ago, The comeback king said:

Peoples biology will dictate whether they get side effects or not . Everyone reacts differently to drugs which is why some people even get side effects from taking something like a pain killer . Vast majority of men take finasteride and have no problems while some are just very sensitive to the drug . I even don’t like reducing my dht systemic so much, despite no side effects on oral which is why I’m experimenting with dr mwambas topical formulation and  to see if it does indeed not reduce my serum dht as much . In regards to T you make a good point which is why I checked my hormones before and I had  A good profile of high t and in range estrogeon and also high free t and my Shbg which is important for test being available for your body . I recheck these every 3 months and my all pretty much similar. My lh and fsh is also healthy . I suspect men who get sexual side effects have a bad balance of hormones in relation to test and estrogeon and the drop in dht exacerbates this , but I’m only making an assumption and it may not play a part at all . But all the fitness guys I follow who use trt with fin and dut  have no problem which supports this notion , because their free t is so high. With regards to cognition how does finasteride exactly affect that because the research is bit unclear ? 

Hello, mwamba formulation contains a lot of biotin which render blood test inaccurate so how do you do to be sure about your level ?

A lot of people say that T and dht vary a lot along a day and even ones who take fin have dht and T going up on their blood test comparing before and after medication... it seems it is impossible to really have a good indicator of dht and T progress with blood test the only way would be to test on folicul 

Edited October 14, 2022 by arthurSam

[sunsurfhair]

On 10/13/2022 at 11:40 PM, John1991 said:

Not getting morning wood and/or having ED problems doesn't necessarily (in fact, it probably doesn't) speak to low-T.  Now the low libido does, but I just wanted to mention that because there seems to be a misconception around that subject at times. I had the same sex drive and same ability to gain muscle/strength when my ED was at it's absolute worst.  I'm just putting this out there because it's worth noting.

John - everything you describe above are classic symptoms of let’s call it a hormone imbalance. Low DHT, Low T, High (or even low Estradiol) Low Free T due to elevated SHBG, etc. Even thyroid issues although this is more classically associated w T/DHT/E2. 
 

When I got on TRT due to Finasteride induced hypogonadism (low T) my morning erections came back with a vengeance. I had forgotten  what it was even like lol. Morning (and nocturnal) erections are critical to penile health since they induce vascular blood flow into the penis causing an erection and it’s this continued pattern of blood flow that helps to reduce or prevent penile fibrosis, scarring, Peyronies and ultimately the dreaded ED. 

Edited October 18, 2022 by sunsurfhair

[sunsurfhair]

On 10/13/2022 at 11:11 PM, The comeback king said:

Peoples biology will dictate whether they get side effects or not . Everyone reacts differently to drugs which is why some people even get side effects from taking something like a pain killer . Vast majority of men take finasteride and have no problems while some are just very sensitive to the drug . I even don’t like reducing my dht systemic so much, despite no side effects on oral which is why I’m experimenting with dr mwambas topical formulation and  to see if it does indeed not reduce my serum dht as much . In regards to T you make a good point which is why I checked my hormones before and I had  A good profile of high t and in range estrogeon and also high free t and my Shbg which is important for test being available for your body . I recheck these every 3 months and my all pretty much similar. My lh and fsh is also healthy . I suspect men who get sexual side effects have a bad balance of hormones in relation to test and estrogeon and the drop in dht exacerbates this , but I’m only making an assumption and it may not play a part at all . But all the fitness guys I follow who use trt with fin and dut  have no problem which supports this notion , because their free t is so high. With regards to cognition how does finasteride exactly affect that because the research is bit unclear ? 

I don’t discourage folks from getting a full hormonal profile done pre fin or dut, or while on fin and dut, but TBH it’s essentially useless unless you’re way out of whack prior to going on Fin. For example I had a gorgeous level of T several months before taking Fin and the med really screwed me up badly and despite all natural and healthy efforts, put me into a perma state of hypogonadisim treated with TRT + HCG (keep testicles healthy and fertility). 
 

I almost wonder if the guys who do well on Fin actually had low T and low E2 but high DHT, which is why they tolerate the med so well. Another possibility but I still in my heart believe there is a strong genetic predisposition. 

[sunsurfhair]

On 10/13/2022 at 11:11 PM, The comeback king said:

Peoples biology will dictate whether they get side effects or not . Everyone reacts differently to drugs which is why some people even get side effects from taking something like a pain killer . Vast majority of men take finasteride and have no problems while some are just very sensitive to the drug . I even don’t like reducing my dht systemic so much, despite no side effects on oral which is why I’m experimenting with dr mwambas topical formulation and  to see if it does indeed not reduce my serum dht as much . In regards to T you make a good point which is why I checked my hormones before and I had  A good profile of high t and in range estrogeon and also high free t and my Shbg which is important for test being available for your body . I recheck these every 3 months and my all pretty much similar. My lh and fsh is also healthy . I suspect men who get sexual side effects have a bad balance of hormones in relation to test and estrogeon and the drop in dht exacerbates this , but I’m only making an assumption and it may not play a part at all . But all the fitness guys I follow who use trt with fin and dut  have no problem which supports this notion , because their free t is so high. With regards to cognition how does finasteride exactly affect that because the research is bit unclear ? 

Cognition or the colloquial “Brain Fog” which is now applied to Long Covid survivors and many chronic not well understood conditions, occurs with Fin / PFS due to several possibilities

- Metabolic imbalances in the body now 

- Low T can cause fatigue and brain fog and concentration issues 

- Low DHT can cause weakness fatigue and brain fog 

- The great loss or imbalance of an extremely critical neurosteroid called allopregnanolone. This is so critical, it’s now in 2nd or 3rd stage trials with several pharma companies  for treating many neuropsychiatric disorders. When approved, it could be a potential great tool to combat PFS and other conditions.  

Allopregnanolone helps the body properly utilize GABA. Think of GABA as the brakes and Glutamate as the gas. When the gas is slammed forward (little GABA) the brain and body goes apeshi$ - panic anxiety depression and it’s so powerful, excessive glutamte is neurotoxic meaning it can permanently destroy brain and CNS neurons. Fin blocks the synthesis of allopregnanolone (which itself synthesized from progesterone).
 

 Allopregnanolone possesses a wide variety of effects, including, in no particular order, antidepressant, anxiolytic, stress-reducing, rewarding,^[17]prosocial,^[18] antiaggressive,^[19]prosexual,^[18] sedative, pro-sleep,^[20] cognitive, memory-impairment, analgesic,^[21]anesthetic, anticonvulsant, neuroprotective, and neurogeniceffects.^[9] Fluctuations in the levels of allopregnanolone and the other neurosteroids seem to play an important role in the pathophysiology of mood, anxiety, premenstrual syndrome, catamenial epilepsy, and various other neuropsychiatric conditions.^[22][23][24]

Finasteride is a 5α-reductase inhibitor that blocks the biosynthesis of endogenous neurosteroids such as allopregnanolone and related 5α-reduced steroids [32,33]. Consistent with animal studies, patients treated with finasteride had significantly reduced levels of neurosteroids [39].Jul 24, 2012

 

Edited October 16, 2022 by sunsurfhair

[sunsurfhair]

[sunsurfhair]

10 hours ago, The comeback king said:

You can’t have low t and high dht because i they are correlated lol. Dht is a by product of testosterone and hence more t more dht not vice versa . I really don’t see how fin tanked  your t tbh , but hey everyone’s biology different. But yeh low t will cause the symptoms you experienced no Doubt 

It’s not an exact science my friend. There are guys who have super high T and moderately low DHT. Genetics is always at play in terms of how well those 5AR conversion enzymes run. Trust me, you would shi$ yourself if you saw my post fin labs. It looked see saws across the board. T and DHT are most definitely correlated, but that doesn’t mean the ratio will always equate properly. 
 

Source:

Boston University Medical Center

Summary:

Men with benign prostate enlargement who used finasteride to treat their condition, experienced worsening erectile dysfunction that did not resolve with continued treatment. In addition, they experienced a reduction in their testosterone levels leading to hypogonadism -- little to no production of sex hormones. However, men who used tamsulosin experienced none of these adverse side effects.

Edited October 16, 2022 by sunsurfhair

[sunsurfhair]

https://www.southbayretina.com/finasteride/

[NARMAK]

On 10/13/2022 at 11:24 PM, SteveUrkel02 said:

Hey, guys. I started finasteride about 1 year ago. Before I started taking it , I had morning wood everyday and a high sex drive. Now I can definitely say that my test levels have decreased. I have a low sex drive and basically no morning wood. Is it possible to go on TRT to increase test levels to normal range while still on finasteride ? 
I would appreciate any help

What you're describing imo isn't a symptom of low testosterone necessarily but a side affect of the medication. Lower libido is something that can be quite commonly experienced on this medication but unless it's causing you actual ED when you need to perform, most people seem to accept it as a tolerated side affect. 

Age also tends to play a factor and overall health for men. So some men may have age related things happen but boogeyman the medication as the cause. 

This is why it's always a good idea to be fully informed about your health via blood tests before and during the treatment as well as factoring in for not just physical health, but mental health as well. 

[sunsurfhair]

On 10/16/2022 at 5:19 AM, NARMAK said:

What you're describing imo isn't a symptom of low testosterone necessarily but a side affect of the medication. Lower libido is something that can be quite commonly experienced on this medication but unless it's causing you actual ED when you need to perform, most people seem to accept it as a tolerated side affect. 

Age also tends to play a factor and overall health for men. So some men may have age related things happen but boogeyman the medication as the cause. 

This is why it's always a good idea to be fully informed about your health via blood tests before and during the treatment as well as factoring in for not just physical health, but mental health as well. 

Dude…. With all due respect, you seriously have to stop. You’re dangerous with your advice and so up and down with your fin theories and commentary it’s almost bizarre.  I’ve seen others mention this behavior you’re displaying on fin commentary being so back and forth as well. Clearly this guy is having a bad reaction to Fin - what a shock. What’s wrong with you man are you a Merck shill or something or just in total complete denial. How old are you? Low libido is accepted? By who, an 80 year old? I’ve literally never met anyone in more denial about the effects of this medicine, it’s actually quite astounding. And this gentleman is clearly referencing low libido and loss of morning erections - which are hallmarks of classic fin symptoms - go read above if you don’t understand the importance/significance of morning erections for penile vascular health. 

Edited October 18, 2022 by sunsurfhair

[NARMAK]

3 hours ago, sunsurfhair said:

Dude…. With all due respect, you seriously have to stop. You’re dangerous with your advice and so up and down with your fin theories and commentary it’s almost bizarre.  I’ve seen others mention this behavior you’re displaying on fin commentary being so back and forth as well. Clearly this guy is having a bad reaction to Fin - what a shock. What’s wrong with you man are you a Merck shill or something or just in total complete denial. How old are you? Low libido is accepted? By who, an 80 year old? I’ve literally never met anyone in more denial about the effects of this medicine, it’s actually quite astounding. And this gentleman is clearly referencing low libido and loss of morning erections - which are hallmarks of classic fin symptoms - go read above if you don’t understand the importance/significance of morning erections for penile vascular health. 

OP mentioned that:

On 10/13/2022 at 11:24 PM, SteveUrkel02 said:

Now I can definitely say that my test levels have decreased

When has it been proven that Finasteride lowers your testosterone? Go on. I'll wait. Go pull one of your million studies that's actually reliable to show Finasteride definitively lowers Testosterone in men. You won't be able to, because it doesn't. In fact, it's been shown in studies that DHT suppression leads to a slight increase in Testosterone. That doesn't mean at all that the medication isn't a factor and nowhere in my comments did i ever say it wasn't. So if anybody is actually on here giving misleading and biased informational takes, it's you. 

You seem to cite your own anecdotal experiences with your own dermatologist as if it's a fact that Oral Minoxodil for example is significantly safer to where people should pop it like candy and without fear compared to Finasteride. You seem almost entirely willing to gloss over the known side affects of that medication yet consistently rail against Finasteride. So if i'm accused of being a shill for Merck which i'm not and anybody sensible with reason can tell my comments are generally measured, telling people to get full in depth health checks done and stop if they experience anything they're unhappy, or adjust dosages with whilst on Finasteride, how is that me being a shill? 

You seem to have a a warped view against Finasteride and its abundantly clear no matter what anybody else says, you won't change your opinion and that's fine. However don't act like nobody else has the right to their opinion to support a medication that's helped millions more men keep their hair and just get on with their lives. If it was up to people like you, they'd be bald and suffering other depression issues most likely because you decided to get Finasteride and Dutasteride banned worldwide. I am grateful that it isn't up to you or those of similar ilk. 

[SteveUrkel02]

5 hours ago, NARMAK said:

OP mentioned that:

When has it been proven that Finasteride lowers your testosterone? Go on. I'll wait. Go pull one of your million studies that's actually reliable to show Finasteride definitively lowers Testosterone in men. You won't be able to, because it doesn't. In fact, it's been shown in studies that DHT suppression leads to a slight increase in Testosterone. That doesn't mean at all that the medication isn't a factor and nowhere in my comments did i ever say it wasn't. So if anybody is actually on here giving misleading and biased informational takes, it's you. 

You seem to cite your own anecdotal experiences with your own dermatologist as if it's a fact that Oral Minoxodil for example is significantly safer to where people should pop it like candy and without fear compared to Finasteride. You seem almost entirely willing to gloss over the known side affects of that medication yet consistently rail against Finasteride. So if i'm accused of being a shill for Merck which i'm not and anybody sensible with reason can tell my comments are generally measured, telling people to get full in depth health checks done and stop if they experience anything they're unhappy, or adjust dosages with whilst on Finasteride, how is that me being a shill? 

You seem to have a a warped view against Finasteride and its abundantly clear no matter what anybody else says, you won't change your opinion and that's fine. However don't act like nobody else has the right to their opinion to support a medication that's helped millions more men keep their hair and just get on with their lives. If it was up to people like you, they'd be bald and suffering other depression issues most likely because you decided to get Finasteride and Dutasteride banned worldwide. I am grateful that it isn't up to you or those of similar ilk. 

LOL 

[Xanadu]

I agree with this guy re finasteride:

 

[NARMAK]

2 hours ago, SteveUrkel02 said:

LOL 

Thank you for quoting me and adding to the knowledge of this forum with that contribution

 

[GoliGoliGoli]

 

Anecdotal, but according to @mustangFin can lower T. He also mentions some studies showing similar results. 

[Xanadu]

Fin gives higher Test because the whole mechanism of fin is that it stops some of the testosteron from being transformed into DHT. If less t is transformed, then there will be more left.

Edited October 18, 2022 by Xanadu

[GoliGoliGoli]

1 minute ago, Xanadu said:

Fin gives higher Test because the whole mechanism of fin is that less test is transformed into DHT. 

It appears not to be as simple as that

Seven hundred men participated in the study. Of those, 470 (mean age 58) took 5 mg of finasteride each day. The remaining 230 men (mean age 63) took 0.4 mg of tamsulosin. The men were followed for up to 45 months.

Every three months, and at follow-up appointments, the men’s testosterone levels were checked. Participants also completed the International Index of Erectile Function (IIEF) questionnaire at these points.

Over time, IIEF scores declined for men taking finasteride, indicating poorer erectile function. This worsening of ED did not resolve over time. In contrast, the men taking tamsulosin did not experience any worsening of ED.

Also, total testosterone levels decreased for the men taking finasteride. This did not occur in the tamsulosin group.

“Since sexual function is considered an integral part of overall health, it is important that physicians are aware of the adverse side effects of this class of drugs on human health in general and on sexual function in particular,” said corresponding author Abdulmaged M. Traish, MBA, PhD in a Boston University Medical Center press release.

“Our study emphasized that the effect on erectile function is a serious concern and needs to be considered more carefully,” Dr. Traish added.

Experts caution that the findings should be interpreted cautiously given the retrospective design and lack of matched groupings.  Some results, including testosterone also are contrary to other published, randomized controlled trials, and may present potential confounding variables.  These all suggest the need for ongoing study to address this important topic.

The study was first published online in June in the journal Hormone Molecular Biology and Clinical Investigation.

Resources

Boston University Public Relations

“Erectile Dysfunction Worsened, Testosterone Levels Decreased by Some Drugs for Treatment of Prostate Enlargement”
(Press release. June 12, 2015)

[Xanadu]

Research generally has found side effects in 1-3% of individuals (above the control group). 

Meanwhile many mention that there could be a nocepo effect happening in 10-15% in individuals who get scared on the drug.

What does this mean? It means that people who go out of their way to create fear (under the guise of spreading information) are the part of a bigger problem than the actual medical side effect percentage. 

The conclusion from the Hair Transplant Channel (linked above) to these people is: "Shame on you".  He might not be wrong....

Edited October 18, 2022 by Xanadu

[SteveUrkel02]

1 hour ago, NARMAK said:

Thank you for quoting me and adding to the knowledge of this forum with that contribution

 

I don’t even know who you are. I just posted that I felt like my test is down because of the side effects I am experiencing. Jesus Christ some people really search for arguments. Argue with people who actually want to, kid. 

[Z--]

it's legit impossible to have a discussion on finasteride here without people getting mad at each other.

yes, it can save your hair.

yes, it has bad side effects.

yes, most ppl don't get sides.

yes, the side effects are real.

yes, there are some ppl with nocebo.

yes, some sides can be permanent.

done.

[Pbaird98]

1 minute ago, Z-- said:

it's legit impossible to have a discussion on finasteride here without people getting mad at each other.

yes, it can save your hair.

yes, it has bad side effects.

yes, most ppl don't get sides.

yes, the side effects are real.

yes, there are some ppl with nocebo.

yes, some sides can be permanent.

done.

Damn straight, this should be stickied 👍🏿

[NARMAK]

1 hour ago, SteveUrkel02 said:

I don’t even know who you are. I just posted that I felt like my test is down because of the side effects I am experiencing. Jesus Christ some people really search for arguments. Argue with people who actually want to, kid. 

That's true, you don't. I tried to assist you in some ways but you took an entire post i made responding to another user and just use the word "LOL". 

I think you should stop the medication and get blood tests to help see if the doctor is willing to prescribe you TRT and then maybe try topical Finasteride to reduce systemic sides. 

I'm not trying to argue with anybody but that's the way i took the single word reply. 

40 minutes ago, Z-- said:

it's legit impossible to have a discussion on finasteride here without people getting mad at each other.

yes, it can save your hair.

yes, it has bad side effects.

yes, most ppl don't get sides.

yes, the side effects are real.

yes, there are some ppl with nocebo.

yes, some sides can be permanent.

done.

Get out. This simplified truth is too much for people to handle. Clearly we want to argue about this ad nauseum