Dr john Crisler Discusses his fears on finasteride

barcafan

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Here are a few questions to ask yourself, to rule out AF:

Extreme difficulty arising in the morning, irrespective of time in bed - Check

Surprisingly good energy levels at night - Check


Afternoon "crash" - Check




Any idea WHY we have good energy levels at night?
 

Mens Rea

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Dr,

you probably missed my other post in the myraid of other things

Could you qualify your comment RE- people with high testosterone yet exhibiting hypgonal symptons?

Are you talking about people with in range T/E etc or, broadly?

For people with high T but higher E2 for instance, people having ED issues etc can be attributable to high estrogen levels. Estrogen is an erection killer and T/E imbalances (doesn't matter if T is high) can compromise sexual performance and also serve to distort other balances. Right?

Simple example - if someone has developed high E2 levels and say high SHBG (as a byproduct) and low DHT levels, surely its not that complicated? High estrogen - lower androgen levels = these famous symptoms. Low DHT and or low free testosterone levels (eg- due to high SHBG levels), can cause penile shinkage. Most of these things are clear.

Is there a distinction between this and more "complicated" cases? You say these guys are "screwed up" but i reckon many just need the right hormonal assistance to rebalance things. Even people with skewed DHT metabolism- we never ( i bet?) have baseline ratios. Considering these guys all have hairloss already perhaps their ratios were always less than normal.

Many thousands of men suffer from ED and other similar symtons due to hormonal imbalances not induced by finasteride (including more complex side effects that people wrongly associate just with finasteride - e.g. atrophy, depression etc etc). In many cases, i believe, these guys are no different than guys who have high e2 etc as a result from finasteride. In both cases, trying to rebalance is the obvious answer or at very least - first base.

I agree that in the more extreme of cases (Several on propeciahelp) it gets more complicated than that. That;s not to say the initial imbalance didn't cause it, but the effects of this may be more complex for some. I also agree there may be some "residual" damage. For someone with messed up ratios for a prolonged period of time, may impact their entire body, at least semi-permanently.


What im saying is. If every PFS sufferer had unlimited resources to work on tailored HPA resets with very frequent bloods and tweaking, to normalise their levels (where clear imbalances exist, that is), i reckon the success rate would significantly higher.

The reality is most PFS victims are banding about from one half assed regimen to the next - some using arimidex and lowering their E2 way too low before concluding (wrongly) that it wasn't the answer for example. Usless.

I'm sure even you find it difficult to give any one patient the level of intricate consideration that they probably need.
 

Mens Rea

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Dr. John Crisler said:
I'm trying to get you to drop this ratio concept. Not doing doing a very good job, I see. There is NO set ratio. The variation across the population, amongst healthy, happy men, is vast.

Obviously there is "no set ratio" that we all share but that means little. When myself and Enden speak of "T/E ratios" we speak of each person's unique optimum levels.

Just like we know a young man in his 20's should have T in the upper quartile or atleast third, we know that mid-range E2 appears to be closer to optimum for most males, than high out of range E2.

It's not an exact science and that's why, as i mentioned in my last post, most people are screwed because they dont have the resources to get expert consideration that applies to them.


I do not see a bunch of elevated E from finasteride use. And I have looked at--literally--hundreds of lab printouts from them.

IF it were simply a matter of controlling estrogen (and in the patients who present that way, surely do) it would be a snap. There is something much more ominous going on.

I can control estrogen at will. It's total level, the amount of a given estrogen, the ratio between different estrogens, Phase I and Phase II metabolism, etc. Thus far no such pattern has arisen.

I accept this, of course.

But surely if someone has high E2 levels, they need to atleast try surpress them. Even if high E2 is caused by something else, the fact that one has high E2 is damaging in itself and needs redressed.



Good T levels, with E in place, yet hypogonadism symptoms means there is some sort of androgen resistance at work.

Yes, good T levels and E in place.

Obviously we have to get to that stage first. For most PFS sufferers they aren't even in that realm. The ones that are. Well first i reckon they need to ensure, via trial and error i guess, that their T/E levels are as optimum as possible.

Obviously if they have decent T/E levels and still exhbit these problems, something else is at play. You of all people will appreciate how sensitive some people will be to hormonal imbalance., though. Swiftly concluding androgen resistance is potentially a dangerous leap of faith IMHO.

If you do reach the point with a patient whereby their ranges all appear fine, including DHT, SHBG, T, E, Prolactin, Cortisol etc, then perhaps it does get messy. But i reckon 99% of PFS sufferers just arent there..

And even when you do get this circumstance, i reckon its more to do with DHT metobolism. If someone is pissing out too much DHT metabolites then doesn't that alone speak volumes? This is different to androgen resistance, right?
 

Mens Rea

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And just out of interest, Dr, in respect to androgen resistance of some sort

do you reckon the people that recover or atleast partially recover, someone lose resistance over time. Or that their body somehow adapts?


Because i think we can both agree that the most common element of "recovery stories" appears to be time.
 

Mens Rea

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Perhaps. Ultimately hormonal inbalances are almost the norm for PFS sufferers.

I reckon, atleast a good degree of reprieve will be enjoyed if you can normalise these. Any further recovery may be necessitated by time and good living (exercise etc). 100% recovery seems difficult. I would be happy with 85-90%.

The caveat is there there is always a few more sinister cases that dont seem to respond to anything. I'm not oblivious to this.
 

He-Bat

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DR. First I'd like to thank you for taking the time and inform us about the dangers of finasteride. I was wondering if you could help me, is it true that Zinc can be used as an aromatize inhabitor, I have heard many body builders talk about that. Also, is it true that Zinc can limmit 5-alpha reductase and therefore lowering your DHT? I used to be Zinc deficient, I wonder if that increased my DHT and resulted in early male pattern baldness. I hope you can hep me. Thanks so much for your time Dr.
 

He-Bat

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Dr. John Crisler said:
[quote="He-Bat":1658trbo]DR. First I'd like to thank you for taking the time and inform us about the dangers of finasteride. I was wondering if you could help me, is it true that Zinc can be used as an aromatize inhabitor, I have heard many body builders talk about that. Also, is it true that Zinc can limmit 5-alpha reductase and therefore lowering your DHT? I used to be Zinc deficient, I wonder if that increased my DHT and resulted in early male pattern baldness. I hope you can hep me. Thanks so much for your time Dr.
My pal Dr. Mark Gordon uses 160mg zinc citrate, in divided doses, to control estrogen in his TRT patients.

Zinc canot, however, lower E sufficiently for those on steroid doses.

No, you did not make yourself sick by treating zinc deficiency.[/quote:1658trbo]
I, what about Zinc and DHT, does Zinc limmit DHT? Is it true that low Zinc causes high DHT?
 

Ende

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Dr. John Crisler said:
I consider the forums profoundly important to the evolution of cutting edge medicine.

First is the medium for afflicted individuals to share their experiences. It's like gathering medical histories on thousands of new patients. That is how I have gathered the background to develop several new treatment protocols, now successfully used by doctors all over the world.

Certainly the sense of community is comforting for those whose state of being is painfully denied by all others.

Sometimes a guy on a forum will write something in some way that just strikes me in a new way; from that I gain some insight into the condition.

And without these clearing houses, if you will, where people with similar issues gather, I wouldn't even know the problems existed (like the ignorant and closed-minded conventional medical doctors who would rather see their patients suffer than open their minds).

Next, hundreds and hundreds of times forum members have posted studies I would not have had the time to find myself. It's great!

The time reading from the bodybuilding boards has been extremely rich for me and my patients. For, as my buddy Dr. Ronald Rothenberg (who I consider overall the best Anti-Aging Medicine doctor in America) astutely observed: "The bodybuilders figure out what works; but they take ten times too much, and kill themselves. Then the Anti-Aging Medicine doctors figure out how to do it right, and help people. THEN the Endocrinologists see the success we have, do it too--and take ALL the credit!"

LOL

Because the conventional medical community discounts (even insults) the message board community, it is missing a valuable resource; this is part of the arrogance which leaves their patients unhealthy and unhappy.

Sure, I help everyone I can. But I am happy to admit I have gotten far more from the forums than I have given, due to the above facts.

Besides, isn't this the Information Age? This is one more way we move electrons to better humanity.
This is an attitude which I like! There are too many know-all, arrogant pricks who doesn't listen to anything you say, and don't care whether you live or die, as long as they manage to save their pride when they feel threatened by questions which reveals their incompetence. Respect.
 

Ende

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Dr. John Crisler said:
I'm trying to get you to drop this ratio concept.

I do not see a bunch of elevated E from finasteride use. And I have looked at--literally--hundreds of lab printouts from them.

IF it were simply a matter of controlling estrogen (and in the patients who present that way, surely do) it would be a snap. There is something much more ominous going on.
When you get side effects from finasteride, symptoms of DHT deficiency and excessive estradiol reveal themselves. This is how it all begins. I've been experimenting with AI's and steroids (I'm on TRT, btw), and I've been able to manage all side effects but the sexual function properly. Your libido and erections are so damn sensitive to the testosterone/estradiol ratio, that it's very difficult to maintain without sufficient amounts of DHT, because it's the body's estradiol antagonist. Most doctors won't acknowledge the importance of the T/E ratio. The only one I've seen do so, is Dr. Shippen.

Have you seen any results from bloodwork done when patients quit Propecia? Take a look at Shma's example, and see how it evolves.
 

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Ende

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Regarding the Proviron experience;

Dr. John Crisler said:
He crashed because his body recognized the extra T, and subsequently reduced output, putting him back at baseline.
This isn't the way I see it. If you're DHT deficient and excessive estradiol is suppressing your testosterone production, Proviron should increase your testosterone production by suppressing estradiol. We're talking about enough mesterolone to replace the natural amount of DHT. Maybe your HPTA will respond by initially reducing secretion of GnRH, but eventually it should normalize if you don't overdose. The amount of mesterolone would have to be reduced according to the raising endogenous DHT level to avoid suppression.
 

Ende

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This is my hypothesis. Revealed publicly for the first time.

Enden said:
About
Finasteride inhibits 60 - 70% of DHT. The clinical trial showed that the testosterone- and estrogen level were increased by 15%, but remained within normal range during the whole trial. No other changes were noted, including changes to LH. 2% of the subjects got side effects. All returned to normal when they quit the drug. However, post marketing experience shows that this isn't the case for everyone, and no one knows why.

Hypothesis, advancing side effects
In some cases, the estrogen level continues to raise. When that happens, the DHT level decreases further - to the point of deficiency. The estrogen level is then out of control. LH takes a dive, and the testosterone level gets reduced. Estrogen increases the SHBG level, which reduces the DHT- and testosterone level further, and enhances the estrogenic effects on the body. Estrogen also increases the prolactin level, which reduces the dopamine level. It's a vicious circle which eventually leads to secondary hypogonadism and several other conditions associated with it. In worst case scenarios, it seems to mimic 5-ARD. It's a genetic problem which certain males are born with, but DHT deficiency creates the same enviroment. In the end, you're probably stuck with elevated estrogen-, prolactin- and SHBG level, and supressed DHT-, testosterone- and dopamine level.

Hypothesis, persistent side effects
When someone quit the drug, the testosterone level decreases further because of conversion to DHT. I believe that, if this wave of DHT isn't enough to counter the excessive estrogen, the side effects will persist. DHT produced afterwards, isn't enough to restore the balance.

Evidence
I've done several experiments on my own body. An early experiment with Proviron revealed drastic, positive changes within one week (it has been replicated in a couple of other guys later). I quit in fear of hair loss. I've been able to manage side effects from finasteride since march 2010 (I was using Propecia continously from march to december 2010. I had been on and off treatment with 0.25 mg finasteride a day for 1 1/2 years before that). It's all about estrogen management. Recently, Shma on hairlosstalk.com's forum revealed series of blood tests. The last test was done january 2010, and he's still suffering from side effects. It seems to support my hypothesis. A lot of people at propeciahelp.com have reported improvent after quitting the drug, before they suddenly crash and are worse off than they were.
 

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Ende

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Dr. John Crisler said:
That simply is not how the negative feedback system works.

I'd suggest less emphasis on DHT vs. Estrogen.
What you're saying is that DHT isn't the estradiol antagonist, and excessive estradiol isn't suppressive to your testosterone production?
 

He-Bat

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Dr. Crisler, what about Zinc and DHT, does Zinc limmit DHT? Is it true that low Zinc causes high DHT?
 

Ende

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Dr. John Crisler said:
IF "libido and erections are so damn sensitive to the testosterone/estradiol ratio", as you claim, then why would it be often men can have wicked sexual function after missing a dose of a TD--when T is tanked and E is soaring? Mere changes in hormone levels--in any direction--can profoundly affect sexual function--in either direction.
If a patients sexual function improves when he misses a dose of TD, I would say that estrogen was too low in relation to the androgen levels. TD's are known to increase the DHT level more than shots, which brings me back on the antagonist track. A lot of people in the BB community has experience with this. When overdosing AI's, libido diminishes, and they get erectile dysfunction. Morning erections, which is the main indicator of a healthy T/E ratio, disappear. The same thing happens when they're using large amounts of testosterone which increases the aromatase activity too much. In other words, too much estrogen in relation to androgens.

Dr. John Crisler said:
Finally, you are attributing the negative side effects of finasteride to hormone levels which are not borne out in actual clinical practice. In short, "feeling like" a given hormone level is not the same as actually possessing that hormone level. I have--literally--hundreds of 24 hour urine panels which prove you are not really on the right track. But I applaud your sincere desire to solve these issues.
I've felt the changes on my own body, and I've been monitoring them closely. I've reversed and managed a lot of symptoms successfully. For me, it's a matter of life or death. Have you ever stopped to think that something essential is missing in relation to what doctors are learning about andrology at medical schools? I appreciate your support in our case, and I mean no disrespect. In Europe, they're so incompetent that they treat hypogonadism by giving you a testosterone shot if it's below what they define as normal range, and they don't give you another shot before your testosterone level drops below that threshold again. It's like getting hypogonadism over and over again.
 

Ende

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Dr. John Crisler said:
I know Dr. Shippen well, and am quite familiar with his work. He does not portray this magical T/E ratio as you are trying to.
I've read parts of his book, "The Testosterone Syndrome".
I had to open it again.

Dr. Shippen said:
About testosterone and estrogen
"In the bodies of both men and women, the balance of these two hormones is critical".

About estrogen
- "It is certainly important in influencing certain natural sexual functions through its effects on the brain chemistry. Too little estrogen will neuter a man just as effectively as too little testosterone."
- "When it comes to estrogen, the window of optimum effectiveness in the male body is very small".
- "Too much estrogen will switch off activities".

About reasons for estrogen elevation
- "Overweight men almost invariably show signs of an unfavorable testosterone/estrogen ratio."

About DHT
- "The penis itself requires DHT for full activity. Consequently, complaints of impotence are frequent among Proscar users."
Now, it seems to me, that he's well aware of the significance of the T/E ratio. He doesn't seem to be aware of DHT as the estrogen antagonist, but he does mention that your penis needs DHT. Bodybuilder's use AI's or DHT derivatives to manage estrogen on heavy testosterone cycles, and I've experience with both Proviron and Andractim myself, so the significance of DHT in relation to estrogen is very clear to me. I believe that DHT is what maintaines the T/E ratio. According to Dr. Shippen, it seems like too low estrogen level, after using AI's, impaires your sexual function via brain chemistry. I don't know about DHT, but I get more aggressive and have voilent and sexual dreams regularly when it raises.
 

Ende

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One more thing; you're studying wrecked endocrine systems. I've observed the process, and I'm telling you that it begins with DHT deficiency and excessive estrogen.

Btw, which other hormones does finasteride affect directly by binding to 5AR Type 2? Mew has been talking about a couple of neurohormones, but from what I've read, they're made by 5AR Type 1. I've asked Mew about this a couple of times, but he doesn't answer.
 
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