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Before Taking FinBefore Taking FinBefore Taking finasteride
- Thread starter Notdifferent
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First things first, you should not take this as direct medical advice. You should speak to an endocrinologist.
With that disclaimer out of the way, I would try to rule out hypogonadism or high E2 before trialing finasteride. If you're in good health I would doubt either of these things are true for you, but it's better to be safe than sorry in my opinion.
An appropriate blood test for this would include the following, in my opinion.
Total T
Free T
E2
DHT
Prolactin
SHBG
LH
FSH
TSH
Free T4
If you're unfamiliar with hypogonadism, there's two types.
Primary hypogonadism is when your LH and FSH are both high, but your Total T is low. This implies that you have testicular dysfunction, meaning your pituitary system is sending the message to your testes to produce testosterone, but they're not. Secondary hypogonadism is the reverse, meaning that your LH, FSH and Total T is low. This implies you have issues with pituitary function; the message to produce more testosterone is not being sent even though it should be.
It's speculated that people who encounter some of the more common side effects of finasteride such as low libido and erectile dysfunction were hypogonadal prior to administration. In these instances, it was likely their DHT that was responsible for sustaining their male physiological functions (DHT is several times more androgenic than T), and when that was lowered by finasteride, they experienced issues.
High E2 is more straight forward to interpret. When you take finasteride, you'll have a subsequent increase in Total T because less of it is being converted to DHT via 5AR2. A part of that excess Total T is converted to E2 through the aromatase enzyme in a process called aromatization. If your E2 levels were high prior to finasteride usage, the roughly 15% increase in E2 could push you beyond the upper male limits. This will directly cause gynecomastia.
If you live in America, you can order a comprehensive panel from Marek health that'll run you 650 bucks. That's here https://marekhealth.com/product/comprehensive-pre-finasteride-panel/.
On the other hand, if you're like me and you live outside of America, you'll have to fight with doctors to get them to write you a requisition for a proper blood test. This is problematic because prescribing bloodwork is not a standard procedure for a finasteride prescription. In my case, I just kept going to different doctors via telemedicine until I found one who would give me a requisition for the proper blood work.
If you're able to get a hold of an endocrinologist, that's even better, and I would be surprised if they wouldn't be willing to prescribe you at least the above panel.
In my opinion, the fact that a blood test such as the above is not mandatory before finasteride administration is pure idiocy. I would imagine that the incidence of reported side effects would be much lower if this was used as a screening method.
With that disclaimer out of the way, I would try to rule out hypogonadism or high E2 before trialing finasteride. If you're in good health I would doubt either of these things are true for you, but it's better to be safe than sorry in my opinion.
An appropriate blood test for this would include the following, in my opinion.
Total T
Free T
E2
DHT
Prolactin
SHBG
LH
FSH
TSH
Free T4
If you're unfamiliar with hypogonadism, there's two types.
Primary hypogonadism is when your LH and FSH are both high, but your Total T is low. This implies that you have testicular dysfunction, meaning your pituitary system is sending the message to your testes to produce testosterone, but they're not. Secondary hypogonadism is the reverse, meaning that your LH, FSH and Total T is low. This implies you have issues with pituitary function; the message to produce more testosterone is not being sent even though it should be.
It's speculated that people who encounter some of the more common side effects of finasteride such as low libido and erectile dysfunction were hypogonadal prior to administration. In these instances, it was likely their DHT that was responsible for sustaining their male physiological functions (DHT is several times more androgenic than T), and when that was lowered by finasteride, they experienced issues.
High E2 is more straight forward to interpret. When you take finasteride, you'll have a subsequent increase in Total T because less of it is being converted to DHT via 5AR2. A part of that excess Total T is converted to E2 through the aromatase enzyme in a process called aromatization. If your E2 levels were high prior to finasteride usage, the roughly 15% increase in E2 could push you beyond the upper male limits. This will directly cause gynecomastia.
If you live in America, you can order a comprehensive panel from Marek health that'll run you 650 bucks. That's here https://marekhealth.com/product/comprehensive-pre-finasteride-panel/.
On the other hand, if you're like me and you live outside of America, you'll have to fight with doctors to get them to write you a requisition for a proper blood test. This is problematic because prescribing bloodwork is not a standard procedure for a finasteride prescription. In my case, I just kept going to different doctors via telemedicine until I found one who would give me a requisition for the proper blood work.
If you're able to get a hold of an endocrinologist, that's even better, and I would be surprised if they wouldn't be willing to prescribe you at least the above panel.
In my opinion, the fact that a blood test such as the above is not mandatory before finasteride administration is pure idiocy. I would imagine that the incidence of reported side effects would be much lower if this was used as a screening method.
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