Gyno from finasteride - Advice please

[123000123]

Hi,

1 Month in to 1.25mg finasteride daily, and already feeling gyno sides.

I've always had mild gyno on the left side, i think leftover form puberty (never bothered me really). But a few weeks worth of finasteride has seemed to aggrivate the sh*t out of it and its enlarged a fair bit. It's also pretty tender/sore when I poke around at it. Right side seems to have enlarged a tiny bit but I never had gyno on that side originally so its fine.

Also, libido is down to zero and very difficult to obtain an erection even while watching pornos. I'm happy to ride these sex sides out a bit longer as I know it may subside, but the gyno sides are scary.

It's disappointing becuse hair shedding stopped almost immediately after starting finasteride.

Any advice/comments please??? What are my options?

Thanks in advance.

 

[Rich78]

Have you tried a zinc supplement ?

 

[123000123]

What would a zinc supp do for gyno?? I'm assiming you mean for libido...
well i take a multivitamin but i'm pretty inconsistent with it.

 

[Brains Expel Hair]

Eat a massive amount of broccoli!
In order to avoid gyno side effects from steroid use, body builders often use either DIM or I3C (3,3-diindolylmethane and indole-3-carbinol respectively). These two compounds derived from cruciferous vegetables (Brassica oleracea) work by kind of influencing the metabolization of estradiol (estrogen) into estrone and estriol (also estrogen), both less potent forms of estrogen (ie: less gyno and less risk of breast cancer as well).

 

[Ende]

viewtopic.php?f=46&t=59803

 

[OzzyB]

zinc supplement of the loss libido

For gyno drop the dosage down to 0.5mg and things should clear up with 3 weeks depending on your age. Also try to reduce your body fat, as people with a high percentage of body fat carry alot more estrogen

 

[Ende]

For gyno drop the dosage down to 0.5mg and things should clear up with 3 weeks depending on your age. Also try to reduce your body fat, as people with a high percentage of body fat carry alot more estrogen

Even 0.25 mg finasteride supresses almost as much DHT as 1 mg does. Reducing the dose didn't work for me. True, about body fat.

 

[123000123]

Thanks for the reply both of you.


Enden, that thread is amazing. Thanks for posting that when you did.

I had no idea zinc was an aromatase inhibitor - this would mean in theory it should help with all estrogen-related sides, including gyno, correct?

With reducing the dose, like Enden said, because it's still reducing DHT, would it actually be worth trying? Especially because i'm on 1/4 Proscar it will be very difficult cutting it up again. Would taking 1.25mg EOD do anything?

I think I may just keep the dose and get all those tests done and see where I'm at. I regret not getting all my blood tests done before starting finasteride.
I still have some results from 1 year before starting finasteride, but only:

Total Testosterone: 19 nmol/L (8.3 - 29)
SHBG: 19 nmol/L (11-71)
DHEAS: 10 nmol/L (2.2-15)
Free Testosterone: 91.8 pmol/L (25-120)

I think the high free test and low SHGB is the reason for my hair loss anyway.. i guess the even further rise in test from finasteride means its all being converted to estrogen which is the reason i'm getting these bad sides.

On an unrelated note, is there a way to raise SHBG levels?? Would that not stop male pattern baldness in its tracks? as i've read studies showing premature baldies have high free test and lower shgb like myself...

Many thanks again

 

[123000123]

Also Enden, i should ask:

From your thread, I understand that if you wanted to you could in fact keep taking finasteride and treat all the major sides with other hormonal medications. In your opinion, though, at what point would/should one stop treating the sides and actually drop finasteride altogether, or would this just be a personal thing..?

 

[Ende]

I had no idea zinc was an aromatase inhibitor - this would mean in theory it should help with all estrogen-related sides, including gyno, correct?

Yes. 100 mg a day with zinc would probably do the job, but your estrogen level is severly elevated when you get gynecomastia, and it's important to recover as soon as possible. You're at high risk of developing secondary hypogonadism at this point. That's why I recommend Arimidex.

With reducing the dose, like Enden said, because it's still reducing DHT, would it actually be worth trying? Especially because i'm on 1/4 Proscar it will be very difficult cutting it up again. Would taking 1.25mg EOD do anything?

My advice is to forget about reducing the dose. It's all about estrogen management. I had severe sides at 0.25 mg a day. I've been using 1.25 mg a day, and even 2.5 mg finasteride for a short peroid since march this year, and have been able to manage side effects. I'm still working on recovering from secondary hypogonadism, and I'm nearly there. Libido is a little tricky.

I think the high free test and low SHGB is the reason for my hair loss anyway.. i guess the even further rise in test from finasteride means its all being converted to estrogen which is the reason i'm getting these bad sides.

On an unrelated note, is there a way to raise SHBG levels??

DHT is, without a doubt, the main reason, but testosterone certainly affects the hair too. Testosterone converting to estrogen is the reason you're getting side effects from finasteride, yes. I don't know that much about SHBG. I know DHT binds stronger to that hormone than testosterone. Maybe you had high DHT level. I've read that estrogen increases SHBG, but I'm not sure. I know estrogen increases prolactin, which also causes alot of trouble.

Also Enden, i should ask:

From your thread, I understand that if you wanted to you could in fact keep taking finasteride and treat all the major sides with other hormonal medications. In your opinion, though, at what point would/should one stop treating the sides and actually drop finasteride altogether, or would this just be a personal thing..?

That's the thought. Actually, you should only need an aromatase inhibitor to manage side effects from finasteride, but you have to recover before you develope secondary hypogonadism. If it gets that far, your problem will be overwhelming. You should stop using finasteride and seek professional help if you get erectile dysfunction, and try once more when you've recovered, with proper adjustment to your regimen of course.

 

[123000123]

I understand.

I just don't get how I could already be experiencing these sides 1 month in. It makes me think I already had some estrogen issues prior to finasteride, perhaps evidenced by my already mild gyno. However my actual blood tests seem to suggest high test if anything..

I'm thinking maybe 50mg zinc plus that Andractim gel you mentioned in the other thread for now. I just can't fathom ANY Doctor agreeing to prescribe Arimidex to combat finasteride sides , WHILE still taking finasteride. With the Arimidex, would you need to take it indefinitely, as long as im taking finasteride?

Enden, do hormone levels fluctuate much (from baseline)?
e.g. does DHT keep decreasing/estrogen keep increasing over time, or are the levels after say the initial dose pretty much your levels forever, assuming you don't change anything?

Also, I know in your other thread you mentioned other benefits from using Andractim gel. Does it just work locally? do i just rub it on my nips?


cheers for all your time/help

 

[Ende]

1 month is plenty. You're not the only one. I did too, but I didn't get gynecomastia before 3 - 4 months in, when I also developed secondary hypogonadism.

With the side effects you're having, I would go with 100 mg zinc every day, if you can't get arimidex. I recommend that you stop using finasteride untill it gets better. Only use andractim if you have lumps. It's absorbed, and works mainly where you apply it, but when the receptors in that area are saturated, it may travel to other parts of your body, like your hair. Nothing to worry about, but I'm just mentioning it. You would probably have to use an aromatase inhibitor for as long as you're going to use finasteride, yes. Arimidex is very potent and hard to dose correctly, so zinc might actually be more appropriate for maintenance.

The thing with hormones is that when you change one level, another is likely to follow, and so on... I think your DHT level is stable within one week after initiating treatment with finasteride, but estrogen will continue to raise. Eventually your testosterone level will decrease because of this, and your levels will most likely be stable.

 

[123000123]

hi enden,

please reply if you can.

so i went back to my derm regarding the gyno and mild libido loss. he's a good guy but basically told me to stop taking it. he actually even brought up the fact that some of these sides had been seen to persist even after stopping treatment.

i was hoping to walk away with a script for arimidex and blood test form but didn't get either - he didn't want to hear anything on the estrogen effect. he did confirm that he could not feel any lumps though, but admitted it looked/felt like "breast enlargement" as opposed to gyno.

just wondering where i go to from here?

to recap issues:
- left breast has been slightly larger than the right for as long as i can remember
- been on finasteride for 40days, since starting both sides have grown larger, so the left is quite enlarged now.
- left nipple is quote puffy
- pain is not so present unless i pinch the whole nipple (with fingers about an inch apart), where i can feel a small hard lump (i think)
- can also feel several distinct lumps AROUND the nipple, i.e. one inch above, below, etc. these almost feel like glands as opposed to hard lumps and are on both sides. they're not painful but "tender"
- no itchiness

- libido seems to be up and down, not too worried about this
- erections are probably 90%

the main issue is the gyno. i'm tempted to buy arimidex online, take 0.25mg twice a week, stop the finasteride in the meantime and see what happens.

i'm hesitant to try zinc because: i prefer a pharmaceutical to treat something (i.e. something that has been tested to work, etc), i heard too much zinc can be toxic, don't know which type of zinc, how much, which brand, etc.

what do you think?

Many thanks

 

[Ende]

It's fascinating how ignorant and careless some doctors are. Your symptoms seems to have improved, according to what you wrote earlier. I believe your estrogen level is moderately elevated, and zinc is more appropriate for your situation than arimidex anyway. 0.25 mg twice a week will drive your estrogen level too low, and believe me, you don't want that. It'll give you worse problems than you're experiencing now. I can relate to what you're saying about supplements and pharmaceuticals, but zinc does work. It's not nearly as strong as arimidex, but that's the beauty of it.

I recommend going to the pharmacy and buy the cleanest, and most expensive brand. Take 50 mg every day, give it a couple of weeks, and see how it goes. You don't need to worry about gynecomastia. IF you develop lumps later on, andractim will take care of that. It's reversible.

 

[123000123]

edit: as you already answered my question in previous post.

thanks so much enden. i agree with you and am going to do exactly what you said and see how i go.

all the best.

 

[123000123]

Just thought I'd give a quick update in case anyone's interested.

It's been 9 days without finasteride and the gyno has definitely subsided. There is now no pain, no sensitivity, and the size has reduced. it's still a little puffy but almost back to where i was pre-finasteride. I've been taking 50mg zinc daily for a few days now which may or may not be doing anything yet.

I'm gonna wait another week and then reassess regarding finasteride. I really want to start taking it again so i'll probably see where I am in a week and then if all's good then I'll start taking 1.25mg finasteride again WITH the 50mg zinc. If that works then that's that. If not, I will probably try 75mg zinc, and if that still doesn't work then I'll try a very low dose arimidex - maybe even something like 0.1mg couple times a week and if need be work my way up from there.

I just hate trying to do all this sh*t without blood tests, basically because I don't trust my own judgement of symptoms.. the mind is a powerful thing. The good news is I know a Doctor so I may be able to get him to issue me with a test, but may not be able to get multiple ones so if i can only get one wondering when I should get it to give me the most info. i.e. while on finasteride or not?

Also just another q for enden if he wants..
is it safe to say all sides from finasteride (gyno/libido/ed) are due to the estrogen effect (i.e. increased estrogen and altered test:est ratio) rather than reduced dht levels directly? do you think reduced dht levels have any direct side effects?


also in case anyone's interested the zinc i'm taking is zinc picolinate 50mg vegetable capsules. basically the most expensive ones i could find.

 

[Ende]

I'm gonna wait another week and then reassess regarding finasteride. I really want to start taking it again so i'll probably see where I am in a week and then if all's good then I'll start taking 1.25mg finasteride again WITH the 50mg zinc. If that works then that's that. If not, I will probably try 75mg zinc, and if that still doesn't work then I'll try a very low dose arimidex - maybe even something like 0.1mg couple times a week and if need be work my way up from there.

Sounds good, but be careful with arimidex. It's very potent, so I recommend trying 100 mg of zinc for a while before you decide to use arimidex.

I just hate trying to do all this sh*t without blood tests, basically because I don't trust my own judgement of symptoms.. the mind is a powerful thing. The good news is I know a Doctor so I may be able to get him to issue me with a test, but may not be able to get multiple ones so if i can only get one wondering when I should get it to give me the most info. i.e. while on finasteride or not?

It's easy; cracking joints, reduced libido and ED indicates too low estrogen level. Reduced libido and ED without cracking joints indicates too high estrogen level, and it's usually very high if you get symptoms of gynecomastia. I recommend doing a blood test when everything returns to normal. Then you'll have baseline values, and something to compare new results with, if you get hit by side effects again.

Also just another q for enden if he wants..
is it safe to say all sides from finasteride (gyno/libido/ed) are due to the estrogen effect (i.e. increased estrogen and altered test:est ratio) rather than reduced dht levels directly? do you think reduced dht levels have any direct side effects?

The side effects are mainly caused by increased estrogen level and decreased testosterone level, but estrogen also raises the prolactin- and SHBG level. Increased level of SHBG enhances the estrogenic effect on the body, because it binds stronger to testosterone than estrogen. The body is unable to use hormones bound to SHBG. Prolactin messes with you sexual function, by reducing dopamine. I don't think reduced DHT level presents any significant problems. I believe it affects you both physically and psychologically, but I don't think it's a problem, besides reduced protection from estrogen. Finasteride doesn't block all the DHT in you body anyway. However, I do believe DHT deficiency may have something to do with ED. For instance, if you're overweight, you'll produce a lot more estrogen than one who isn't, because fat contains aromatase enzymes. Then the 30% of DHT which your body is still producing will be used to counter estrogenic effects on the body, instead of using it to maintain tissue which is dependent on it, like your penis. I believe DHT deficiency leads to softer erections, but I'm still working on my T/E ratio, so it'll take some time before I can confirm or disconfirm that hypothesis.

 

[TheGrayMan2001]

The side effects are mainly caused by increased estrogen level and decreased testosterone level, but estrogen also raises the prolactin- and SHBG level. Increased level of SHBG enhances the estrogenic effect on the body, because it binds stronger to testosterone than estrogen. The body is unable to use hormones bound to SHBG. Prolactin messes with you sexual function, by reducing dopamine. I don't think reduced DHT level presents any significant problems. I believe it affects you both physically and psychologically, but I don't think it's a problem, besides reduced protection from estrogen. Finasteride doesn't block all the DHT in you body anyway. However, I do believe DHT deficiency may have something to do with ED. For instance, if you're overweight, you'll produce a lot more estrogen than one who isn't, because fat contains aromatase enzymes. Then the 30% of DHT which your body is still producing will be used to counter estrogenic effects on the body, instead of using it to maintain tissue which is dependent on it, like your penis. I believe DHT deficiency leads to softer erections, but I'm still working on my T/E ratio, so it'll take some time before I can confirm or disconfirm that hypothesis.

The only thing I'd correct on this is I don't think your psychological feelings are impacted much at all by DHT, but rather by estrogen and another thing people overlook: The other hormones that are 5AR type 2 Reductase. DHT isn't the only one, thought it is the most prominent

 

[123000123]

Thanks guys. It's funny because I think we're led to believe that all the sides are the direct result of the decrease in DHT levels (or at least, this was the impression I always had before really researching sides). It seems that all the warnings, the info from my doctor, the info booklet that comes with the medication etc all give the impression that the sides will be from the reduced DHT levels only.. most don't seem to understand the 'estrogen effect'. As such, the consensus is that if you do happen to get sides from finasteride, the only option is to drop the medication. And this WOULD be the case if the sides were the direct result of the drop in DHT.

But now I realise that the side effects (and I'm talking about the main ones like libido, ED and gyno) are all related to the increase in estrogen and the altered test:est ratio, and so it's possible they can be combated. From what I gather some of the rare sides like decreased penis size and some psychological symptoms could I guess be directly attributed to DHT but I think these sides are so incredibly rare most of us need not worry...

It's easy; cracking joints, reduced libido and ED indicates too low estrogen level.

I know you say this but I've always had cracking joints. For example my right shoulder always cracks when I work out and even sometimes when I move it. I've even had friends comment on it before because its so loud. And this is before I ever took any medication or even knew what male pattern baldness was. And this is why I say its hard to judge, for me at least. But I'm not sure, maybe when you mention cracking joints you mean obvious and loud cracking joints all over your body, all the time. Likewise, mild ED or libido loss for me can occur when I'm a little down or depressed about something. But again, I'm sure you probably mean persistent ED.

Ahhhh i dunno..


Thanks again especially Enden.

 

[Ende]

It's easy; cracking joints, reduced libido and ED indicates too low estrogen level.

I know you say this but I've always had cracking joints. For example my right shoulder always cracks when I work out and even sometimes when I move it. I've even had friends comment on it before because its so loud. And this is before I ever took any medication or even knew what male pattern baldness was. And this is why I say its hard to judge, for me at least. But I'm not sure, maybe when you mention cracking joints you mean obvious and loud cracking joints all over your body, all the time. Likewise, mild ED or libido loss for me can occur when I'm a little down or depressed about something. But again, I'm sure you probably mean persistent ED.

You'll get cracking joints all over the body. The joints will crack very easy, even your hands, just by moving. Continue further, and your joints will begin to ache, especially your knees. Reduced libido and ED may be due to a lot of things, but I believe that the T/E ratio and dopamine controls more than anything. Do you have morning erections? The T/E ratio is probably the cause, if not.