Free T, as you may know, is the nonbinding part of testosterone, available in particular for sexual purposes. In my case, finasteride has sharply lessened my free T blood serum level whereas my total T remains quite high. An incredibly knowledgeable guy haunts
www.gynecomastia.org. His name is "Hypo is here". Here are a few answers he gave to my personal messages as I tried unsuccessfully to unravel the "finasteride mystery". You may find valuable info or opinion here and there if you read it thru.
As to avodart, I took some, 2 years ago, and developped a minor case (though permanent as well) of gynecomastia. I would definitely stay away from this crap that suppresses both type I and type II 5 ar reductase enzymes. By using fin, you give yourself one chance at least of producing DHT thru the 5 ar reductase I path, seemingly inactive or non existent in hair follicles if I remember. That may be the cause of a very curious libido surge I felt last year after dropping avo, as my DHTlevel was very high whereas hair did not fall out dramatically, bearing in mind the necessary time lapses to be considered (1 - 4 months). I ascribed it to an increase in DHT type I from the cessation of avo while DHT II was still in check from the use of finasteride I had then resumed.
here are the answers from that guy
Hi,
Yes I remember you….
I'll try and answer your questions as best I can and add what I think you will find pertinent.
1
You would expect DHT to be reduced within a fairly short time frame, within hours and days, certainly within the week. * How much it is reduced and more importantly the level at which it ends up depends upon dosage and individual response to the medication, which itself depends on many factors inherent within each individuals genetics and endocrine system and of course the persons DHT level prior to treatment. *
2
DHT blockers will wear off over time and progressively suppress the hormone to a lesser and lesser extent. *How suppressed the hormone is originally is again down to the dosage and individual response and original level of the hormone
My thoughts;.
It has been noted that sometimes when an individual alters their endocrine balance and the Hypothalamic- Pituitary-Testicular-Axis or HPTA (which is the control mechanism for the endocrine system) that their hormones do not always return to pre-treatment levels. *This means that some people are either permanently or semi-permanently affected by the medications they take while others of course return to pre-treatment levels.
I do not wish to overemphasis the above because many men recover completely to the pre-treatment state, nevertheless I do need to say that for those that do not see a return to such pre-treatment levels a form of hypogonadism is sometimes left as a result. *
http://www.androids.org.uk/stories.html
http://www.propeciasideeffects.com/
This is why I do not agree with the use of finasteride and DHT blocking medication in men except for the treatment of prostate cancer.
Regarding gynecomastia, obviously DHT blockers reduce the androgen to estrogen ratio and in doing so often cause the condition. *For some men coming off such a medication will resolve the gynecomastia, for others it will not and they will be left with gynecomastia as a result.
I hope that helps.
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Hypo-is-here
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« Sent to: brm on: September 03, 2006, 05:14:53 AM »
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On the one hand we know that DHT blockers can cause a difficult to treat form of hypogonadism and gynecomastia of which you have had at least one.
On the other hand you appear to have high DHT despite the fact that you have taken finasteride and you have a very odd looking E2 level.
But you say that your doc doesn't want to have anything to do with the situation so my question is;
Where have you obtained these tests from, can you detail their source and tell me more about them?
I say this because when I see odd results I want to know more about the source of the tests.
Separate from such questions I would say that finasteride can cause some pretty odd reactions and I would be inclined to obtain an appointment with a decent endocrinologist who has an interest in reproductive endocrinology or a decent private doctor who knows what they are doing. *You would then be best placed to come off all endocrine effecting meds for three months with a view to having a proper baseline assessment.
It is important to come of such meds for three months as upping and lowering dosage can have rebound like effects that cause odd results that can give a false impression of what is going on.
You would also be wise to tell the aforementioned doctor of all the medications you have been taking as some may adversely affect the endocrine system and may need looking at.
Does that help a little?
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Hypo-is-here
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« Sent to: brm on: September 06, 2006, 02:04:43 AM »
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Thank you hypo. In fact, I am quite sure I suffer both hypogonadism since the size of my testes has obviously diminished over the past two years. Besides, I had noticed that the testes had reverted to a bigger size 3 months ago, which is now explained by the DHT rise in my blood.
If you suspect hypogonadism then you should get a referral to see an endocrinologist who has an interest in reproductive endocrinology.
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About those rebound effects you mention. Do you know of any substance that can alter finasteride before its assimilation by the body? or something that might prevent its absorption or hinder its effect? I can not get to understand why the effect of a given effective drug can collapse in so little time.
The rebound effects that I mentioned does not relate to your question, as far as your question goes I think that it is a very murky one and one that you will not find an answer to. *What I can say is that each individual has a complex endocrine system of hormones that are often synergistic and dependent upon one another. *
For this reason every individual reacts differently to differing endocrine affecting substances with one medication or dosage having one effect in one person and something entirely different in someone else and these effects can change over time. *
I think your question is very unlikely to be answered any better than that by anyone. *You might stumble on an answer, but you certainly will not find one via any logical means.
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Something else dumbfounders me. My DHEA level is still very low (919 ng/ml). And my free test is roughly 1.7 fold what it was 6 months ago. Why? Since the conversion of Test to DHT has dramatically increased, the free test should have undergone depletion. Likewise, since DHEA is still as low as before, it means it is not able to supply a higher amount of testosterone than before. So my question is: is there another source of production of testosterone than DHEA (some path that would have been reactivated in the meanwhile)?
I think you are spinning around and chasing your tail here, another phrase would be not seeing the wood for the trees. *Given the complexity of the endocrine system this is not surprising. *You are looking for answers to questions that might not even be the answers you are looking for, I know this sounds stupidly cryptic so I shall explain. *
What I mean to say is the bottom line is you don’t want gynecomastia, you want to feel well and you don’t want your hair to fall out and answers to your questions do not really get you any of that, even if such answers were available. *I think your situation can be evaluated far better and you can get nearer to obtaining the answers to the bigger more important issues by having a baseline assessment of your endocrine system in the manner previously mentioned- by coming off all such meds for three months.
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About the odd bloodtest results. Are you suggesting that some results might not be reliable? What can make a DHT bloodtest not reliable (apart from flawed procedure)? *
Bloods can be unhelpful for many reasons. *If your endocrine system is rebounding from alterations in medications and/or dosages the bloods can become somewhat redundant, accurate maybe but redundant all the same as they might not be telling you what is going on. *Equally bloods do not always give us the whole picture due to their limitations- not all tests measure bioavailable hormones, not all assays are accurate etc etc. *This is a very complicated area of medicine. * Trust me when I say that bloods alone do not paint the whole picture.
You need to be off all meds for three months and you then need someone who is competent to evaluate your situation to see if there is anything wrong whether that is hypogonadism, adrenal problems or anything else.
Only by seeing a competent professional in this area when your hormones have been stable for three months can your situation properly be evaluated in terms of bloods, physical examination and assessment of symptoms. *
I hope that helps.
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Hypo-is-here
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« Sent to: brm on: September 12, 2006, 12:09:52 AM »
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The problem is you're in a catch 22 situation. *The only way to get an accurate idea of what is going on is to come off meds for three months and get an accrurate endocrine evaluation. *I do understand- but that doesn't help your situation.