Question about TRT with a 5 alpha reductase inhibitors

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    Question about TRT with a 5 alpha reductase inhibitors


    I am studying TRT. I have seen a number of places that men on 5 alpha reductase inhibitors should receive testosterone even if their level is high. Does anyone know what a reasonable starting dosage would be (assuming the patient wishes to continue taking it)? Would there be any reason to repeat the testosterone level? If so what would I do with it?
    Is there a source that would have had the answer to this question or a standard TRT reference?
    Thank you for your help

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    I have so many questions to ask.....
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    Dr. Bob-

    I am not an expert on this by any stretch of the imagination, but I have heard that men on 5 AR inhibitors should also be on aromatase inhibitors like arimidex, which should increase testosterone by blocking it's conversion to E2 and DHT.

    I also understand it helps with the estrogenic side effects of finasteride, in some people.
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    Quote Originally Posted by Dr Bob View Post
    I am studying TRT. I have seen a number of places that men on 5 alpha reductase inhibitors should receive testosterone even if their level is high. Does anyone know what a reasonable starting dosage would be (assuming the patient wishes to continue taking it)? Would there be any reason to repeat the testosterone level? If so what would I do with it?
    Is there a source that would have had the answer to this question or a standard TRT reference?
    Thank you for your help
    It is good to go by the numbers obtained by blood testing (frequently).

    When one have high DHT but low FreeT he should make sure that his supplemental testosterone comes from shots rather than (DHT increasing) transdermals.

    In my case I used Proscar and (at different time) Avodart while using Androgel.
    My DHT was slightly below low range.
    When I discontinued Avodart, my DHT went up to 3x over the top range (DHT=226).

    Currently I am on Depo_T injection, waiting for blood test results.
    Now, if I am average, my worry will be E2 rather than DHT.
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    Quote Originally Posted by Dr Bob View Post
    I am studying TRT. I have seen a number of places that men on 5 alpha reductase inhibitors should receive testosterone even if their level is high. Does anyone know what a reasonable starting dosage would be (assuming the patient wishes to continue taking it)? Would there be any reason to repeat the testosterone level? If so what would I do with it?
    Is there a source that would have had the answer to this question or a standard TRT reference?
    Thank you for your help
    If im reading this right, your saying that men who take finasteride should be on testosterone replacement, even if they're testosterone level is high already...Why is this so? And where did you find that information?
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    Welcome aboard.

    Dr there are SOOOO many 5 alpha red inhibitors.

    Which one's are you talking about in specific?

    This seems like a feasable idea.

    Best way to go about is to simply monitor DHT levels.

    Remember many on proscar are perfectly fine and never have issues.

    Remember Dr that 5 alpha drugs like proscar do NOT directly affect T levels - they lower DHT levels. When DHT levels are lowered to far, THATS when T levels suffer.

    Dr I think you will be amazed at how mow most men's T levels are when you start running BW
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    Quote Originally Posted by plymouth city View Post
    Welcome aboard.

    Dr there are SOOOO many 5 alpha red inhibitors.

    Which one's are you talking about in specific?

    This seems like a feasable idea.

    Best way to go about is to simply monitor DHT levels.

    Remember many on proscar are perfectly fine and never have issues.

    Remember Dr that 5 alpha drugs like proscar do NOT directly affect T levels - they lower DHT levels. When DHT levels are lowered to far, THATS when T levels suffer.

    Dr I think you will be amazed at how mow most men's T levels are when you start running BW
    So you are saying that not everyone has the issues associated with taking finasteride? I never had any issues when I was on it, except great looking hair. I stopped it a couple of years back after reading all the hype on the net, and my hair has suffered irreparable damage using only topicals (I will never get my hairline back that was saved by finasteride).

    My DHT is naturally at the upper end of the range when not on finasteride. Still, keeping it at the low end of the range using trial and error finasteride doses made the difference in my hair, no question about it. I never suppressed my DHT levels to undetectable levels, just the lower end.

    I've read that the 5 alpha enzyme affects other important biological processes that can lead to other issues, however.

    So what can someone take besides finasteride? Saw Pametto, Nettle, etc?
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    ripped-

    there has been some talk on these boards that pregnenolone and an AI can cause serum DHT levels to decrease.
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    Quote Originally Posted by rippedintexas View Post
    So you are saying that not everyone has the issues associated with taking finasteride? I never had any issues when I was on it, except great looking hair. I stopped it a couple of years back after reading all the hype on the net, and my hair has suffered irreparable damage using only topicals (I will never get my hairline back that was saved by finasteride).

    My DHT is naturally at the upper end of the range when not on finasteride. Still, keeping it at the low end of the range using trial and error finasteride doses made the difference in my hair, no question about it. I never suppressed my DHT levels to undetectable levels, just the lower end.

    I've read that the 5 alpha enzyme affects other important biological processes that can lead to other issues, however.

    So what can someone take besides finasteride? Saw Pametto, Nettle, etc?
    Texas,
    Don't believe all the stuff on the net.

    There are tons of people who have used 5 alpha blockers successfully walking around that have never even turned a computer on, or even know about the side effects. Drugs like proscar also have alot of good for them not just for hair - they keep the prostate from swelling as well.

    As far as other biological processes being affected, Im not really sure. But from an anabolic standpoint, they do lower DHT. Thats why I fell that everyone shiould simply monitor DHT levels and make sure they stay mid range.
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    Quote Originally Posted by plymouth city View Post
    Texas,
    Don't believe all the stuff on the net.

    There are tons of people who have used 5 alpha blockers successfully walking around that have never even turned a computer on, or even know about the side effects. Drugs like proscar also have alot of good for them not just for hair - they keep the prostate from swelling as well.

    As far as other biological processes being affected, Im not really sure. But from an anabolic standpoint, they do lower DHT. Thats why I fell that everyone shiould simply monitor DHT levels and make sure they stay mid range.
    I thought the general message of this board was finasteride=bad, that even the Dr. Johm separated his male patients into the two categories of finasteride user (past or present), and non users? I don't know of any adverse effects that may or may not have occurred as a result of finasteride use that could or might not have been contributed to something else while I was on it. That is to say, I never suspected finasteride to be the culprit in anything I may have experienced in normal day-to-day health fluctuations.

    Be that as it may, from what I understand and have read, 5 alpha inhibitors also inhibit the formation of alloprenanolone, which is a neurosteroid of some sort.
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    Quote Originally Posted by rippedintexas View Post

    Be that as it may, from what I understand and have read, 5 alpha inhibitors also inhibit the formation of alloprenanolone, which is a neurosteroid of some sort.

    Where does alloprenanolone come from and how do neurosteroids effect us? I wonder if this is replacable?
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    i use finasteride,avodart with test and armidex to block estrogen and have to say both an antiaromatase and a 5-alpha blocker used together keeps side very low even on high doses of test!!!
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    Quote Originally Posted by rippedintexas View Post
    I thought the general message of this board was finasteride=bad, that even the Dr. Johm separated his male patients into the two categories of finasteride user (past or present), and non users? I don't know of any adverse effects that may or may not have occurred as a result of finasteride use that could or might not have been contributed to something else while I was on it. That is to say, I never suspected finasteride to be the culprit in anything I may have experienced in normal day-to-day health fluctuations.
    If it looks like a chicken, and acts like a chicken....its probably a chicken. Use your common sense and dont get sucked into the lies the drug manufacturers have to say about it. We know better.
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    Zinc inhibits the enzyme that converts testosterone to DHT, so zinc deficiency increases DHT levels. Selenium protects the prostate from damage, while essential fatty acids decrease inflammation and swelling of the prostate
    check youtr alkalline phosphotase when mine is low less then 65 my dht levels have always been high when my alkaline phosphotase was 80 my dht levels where in check.. kind of intresting that alkline phospotase is a magneium and zinc driven enzyme. High oestrogen tend to lower it due to lack of zinc ..
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    Quote Originally Posted by plymouth city View Post
    Remember Dr that 5 alpha drugs like proscar do NOT directly affect T levels - they lower DHT levels. When DHT levels are lowered to far, THATS when T levels suffer.
    What do you mean here?

    How exactly do T levels suffer when DHT is lowered too far?
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    Quote Originally Posted by galapagos View Post
    What do you mean here?

    How exactly do T levels suffer when DHT is lowered too far?
    This doesnt make sense though cause Finasteride makes T go up, not down.
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    Quote Originally Posted by hardasnails1973 View Post
    check youtr alkalline phosphotase when mine is low less then 65 my dht levels have always been high when my alkaline phosphotase was 80 my dht levels where in check.. kind of intresting that alkline phospotase is a magneium and zinc driven enzyme.
    WHOA...you just described my labs:

    TEST, TOTAL.....342.....(400 - 1080 ng/dL) LOW
    DHT.....565.6.....(155 - 553 pg/mL) HIGH
    ALK PHOS 41 (45 - 129 U/L) L

    Since these labs I have started on 1% Androgel, 5 ml a day AND I have also started taking ZMA at night.

    What do you think?
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    Quote Originally Posted by rick055 View Post
    WHOA...you just described my labs:

    TEST, TOTAL.....342.....(400 - 1080 ng/dL) LOW
    DHT.....565.6.....(155 - 553 pg/mL) HIGH
    ALK PHOS 41 (45 - 129 U/L) L

    Since these labs I have started on 1% Androgel, 5 ml a day AND I have also started taking ZMA at night.

    What do you think?
    Where is your e2 levels? That can depelte zinc..
    i would go 100 mgs for one month of zinc with 2 mgs of copper to offset and imbalances then restest CBC.
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    Quote Originally Posted by hardasnails1973 View Post
    Where is your e2 levels? That can depelte zinc..
    i would go 100 mgs for one month of zinc with 2 mgs of copper to offset and imbalances then restest CBC.

    ESTRADIOL.....35.....(0 - 52 pg/mL)

    OK, I can up the ZMA to 6 caps at night since I get some zinc from my multi.

    Also, if I get 2 mg copper in my multi, is that enough?
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    Quote Originally Posted by jaydee View Post
    This doesnt make sense though cause Finasteride makes T go up, not down.
    Initially threw the feedback loop yes lowering DHT will cause an increase in T.

    However all androgenic hormones tend to work in balance. When any specific one crashes the others follow, like a delicate glass house.

    Take E for example. Now E never converts back into T right? But why does T suffer when E is driven into the ground?

    Same thing with DHT. Let us also not forget that DHT is 10 times more androgenic than T. Bottomed out DHT levels lead to depression, lethargy, weight gain, all which further hack away at precious T. So it may be also an issue of that as well.
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    Quote Originally Posted by rick055 View Post
    ESTRADIOL.....35.....(0 - 52 pg/mL)

    OK, I can up the ZMA to 6 caps at night since I get some zinc from my multi.

    Also, if I get 2 mg copper in my multi, is that enough?
    spread zinc out doing the day away from calcium and iron supplements for absorption
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    Quote Originally Posted by hardasnails1973 View Post
    spread zinc out doing the day away from calcium and iron supplements for absorption
    Yep, I take the ZMA at night, by itself.

    I also get about 30 mg zinc in my multi, although there is a small amount of calcium in my multi.

    That said, why do they put calcium in multis at all? I thought calcium was a large molecule and blocked absorption of a lot of stuff.
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    Quote Originally Posted by rick055 View Post
    That said, why do they put calcium in multis at all? I thought calcium was a large molecule and blocked absorption of a lot of stuff.
    Because they are stupid and just don't know any better.

    Get your Multi's from LEF, a company that uses superior ingredients and knows enough not to cram in calcium.

    I like the 2 a days.
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    Quote Originally Posted by plymouth city View Post
    Because they are stupid and just don't know any better.

    Get your Multi's from LEF, a company that uses superior ingredients and knows enough not to cram in calcium.

    I like the 2 a days.
    Just checked it out, not a bad price, either.

    There is only tiny amount (20 mg) of calcium, too; way less than GNC Mega Man.

    Think it's more absorbable overall?
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    Quote Originally Posted by rick055 View Post
    Just checked it out, not a bad price, either.

    There is only tiny amount (20 mg) of calcium, too; way less than GNC Mega Man.

    Think it's more absorbable overall?
    Way more absorbable. Thats a fraction of calcium, practically nothing.

    Note the ingredients for the minerals, alot of them end in "ate".......In the mineral world, the "ates" are the good stuff.

    Plus, you get a ton of benefits from being a member of LEF. They recently had a end of fiscal year discount sale - and where selling all sorts of stuff at HUGE discounts.

    I picked up their Mega fish Oil caps, 120 in a bottle, for 6 bucks a bottle. Im like "I will take 20 Please"
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    Quote Originally Posted by plymouth city View Post
    Initially threw the feedback loop yes lowering DHT will cause an increase in T.

    However all androgenic hormones tend to work in balance. When any specific one crashes the others follow, like a delicate glass house.

    Take E for example. Now E never converts back into T right? But why does T suffer when E is driven into the ground?

    Same thing with DHT. Let us also not forget that DHT is 10 times more androgenic than T. Bottomed out DHT levels lead to depression, lethargy, weight gain, all which further hack away at precious T. So it may be also an issue of that as well.
    I agree that T crashes once you stop taking the Finasteride. But I dont know why it would crash while your still on it.

    Cept for when you take out DHT - its an E antagonist, so E gets out of control which sends T down hill. But this only seems to happen when you quit the drug. Then also most of the time, DHT levels seem to return to normal so who knows what happens. I would say that its somthing to do with us still not converting to DHT properly....even though it appears we are on blood tests. Peyronnies disease, zero libido in the face of otherwise normal bloodwork.....somthing fishy is going on with the DHT. And why doesnt T and HCG work?......its gotta be DHT.

    I totally agree that bottomed out DHT could give you all those symptoms...no doubt about it. I would go so far as to say that T takes a lot of the credit for DHT.
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