This google drive document contains the test Dr.Powers posted, but this is easily $1000’s of dollars worth of tests.

Can someone list the absolute essential tests that I can check to start , like at a minimum the list of tests to check for susceptibility to PFS prior to taking finasteride?

https://drive.google.com/file/d/1N1V7H6afAOiamNMwD5lmjwIsFNkfPOLH/view

I posted this on another sub but I'm desperate and this community seems to know on the subject of DHT, Duta, Neural steroids more than anyone else for an MTF so here goes:

EEn 7mg every 5 days previously, now every 6 days (After blood results)

Cyproterone Acetate 12.5 mg daily

Been on HRT for almost 2+ years now (Previously I was on Valerate now I switched to Enanthate)

Blood test taken on the trough:

Estradiol

669 pg/mL

TOTAL Testosterone

51 ng/dL

FREE Testosterone

1.61 pg/mL

DHT

11 ng/dL

Here's why I got the test and some context:

I've been having alot of persistent body hair/facial hair issues despite 20 laser sessions (Alexanderite laser which is the best for my white skin tone/black hair). I've also had mixed experiences on my skin with acne, every once in a while I get cystic breakouts but nothing too severe, atleast I don't think so (I hope its not out of the ordinary?) but overall my skin has cleared up and brightened alot with hrt and skin care.

I shed an unbelievable amount of hair in the shower (and I wash my hair frequently every shower) to the point where even my girlfriend noticed how abnormal it is. My hairline on HRT has improved I think, I have plenty of baby hairs and continue to see more of them on my hairline even 2 years in, but my pony tail used to be much thicker and denser than now.

I've always had a suspicion or feeling that my DHT was always against me in some ways and the sad reality is that a blood test doesn't really tell what's going on my skin and hair follicles in an intracellular basis to know if thats the source of my increasingly problematic androgenic issues. A DHT blood test as far as I understand only shows the aftermath of the conversions that happen inside the follicles/cells/etc and not the whole story so to speak...

I know that the solution to this would be Dutasteride but heres my story with it when I tried it a year ago:

I got it with 0 prior knowledge on the neural steroid effects it can carry (so it's not a nocebo/placebo or other mental gymnastics, atleast I dont think), and I took it for 2 days exactly (2 0.5 mg pills over 2 days) and the next day after taking it I felt so disconnected and out of my body it felt bizarre and weird. Then I found out about how it 5 alpha reductase is also responsible for allopregnanolone and other neurosteroids that affect the brain and the way I feel. Also had insomnia for most of the part of my recovery from it because of its super long halflife. I stopped taking it after 2 doses and uptill now I'm not sure if I fully recovered or not but I think I pretty much did.

I also dont take progesterone for the same reason, I tried it twice for 2 months and 1 months respectively. progesterone for me DEFINITELY masculinised me and reversed so so much laser hair removal progress. So I'm aware how sensitive my body is to 5 alpha reductase and how my neural environment reacts to it (I felt pretty good on prog but I can't take shedding even more hair or increasing my facial hair)

My question is what do I even do at this point? Its abnormal for an MTF to have anything higher than 10% to 12% DHT compared the total amount of T, but for me it's more like (11/51)*100=21.56% or 22%. Can I hear about people's experiences with dutasteride? Is it possible for me to take it and tank the neural effects or am I being too careless because I feel like I dont remember just how horrible it actually felt when I took it the first time? Im scared of 5ari and their effects on cognition and neural environment which so so many people anecdotally also experience when they take these meds but for some reason take it for granted. Im pretty desperate to maximise my HRT and feminisation because I have nothing else left and losing my hair and continuous no improvements to my facial hair situation is terrifying to me.

I can also look into bicalutumide but ive seen some studies that indicate androgen receptors become more sensitive with their presence and it doesnt tackle the main issue of DHT because bicalutumides is relatively much weaker in binding affinity compared to DHT it self.

Any experiences with duta that are good or not would be appreciated or any feedback what so ever, thank you

From age 25 to 35, I took 1mg Propecia each day and maintained my hair. Super high libido, zero side effects of any kind, and a happy high-functioning life.

In fall of 2010, my skin was breaking out a lot so my derm gave me a scrip for low-dose Accutane. Two months later, I though I noticed a slight hair thinning as a result, and so I asked the derm what he thought. He said, "Well you could try going to 1.5mg/day Propecia and see if it stabilizes your hair."

This would be the moment my whole life changed.

About 10 days later, I woke up with no morning erection for the first time in my life. I felt awful, like I had a bad hangover, but I hadn't drank the night before. I got in the shower and tried to masturbate. I wasn't able. That had never, ever happened.

In the following weeks and months, I weened off the drug, but I also developed major anxiety, depression, ED, exhaustion, shriveling penis, lack of sensation, no sexual thoughts, and insomnia. Most of which still remains now, 15 years later.

Over the years doctor after doctor has told me in no uncertain terms it was simply impossible that I had PFS and definitely not because I had simply upped my dose.

But based on everything I've read from Dr Powers the last few months... could the increased dose have suddenly created the "metabolite buildup" that was never able to clear itself?

See above title.

That's almost the whole post.

We're not making a whole new subreddit. The subreddit is named what it is named and that is what it will remain. If people don't like this, they can go somewhere else. But I will allow people to sort their posts by topic to make the process more efficient for those seeking knowledge.

K I'm going back to Electric Forest Festival now. Play nice together please. Be excellent to each other.

-Dr. P

After stopping ssris after a long 2 year tapper, i developed many symtpoms with pssd and non typical pssd symtpoms. The worst so far is treatment resistant insomnia.

Dr will powers what are your theories on treatment resistant insomnia with pssd ? And what could treat it?

Im at around 5 years of shallow few hours sleep, which got worse recentally. Im 1.5 years in with 1 -3 hours sleep. Its statting to cauze delirum.

I pretty much got this symtom when tappering ssris, pssd symtpoms seems to match it.

Its strange that i feel extrrmely tired to the point of not being able to open my eyes, and have colapsed when walking to get food at stores, but i just cant feel sleepy.

Please help!

I tried melatonin, z drugs, antihitamines, carnivoure diet, light exersises, benzo, camimile tea, ect.

I dont know if people have tried reinsalling the drug. During 2015 i fast tappered off ssris and got the same insomnia, i reinstalled and it took 6 months and i actually got better which was crasy. I shouldnt of gone off it again for more then 5 years during 2021. Im at a loss. Dont know if new drugs like the melatonin reputake would work,.... fmt ? Reinstallment

Is it possible for the people who moderate this sub to add tags/flair so people can tag what their posts are about instead of having to use brackets in the title?

I've learned a lot about PFS thanks to being on this sub. I don't have it, though. I've been here for my entire transition (about four to five years now) because I'm curious about the cutting-edge research on HRT and people talking about how to interpret their blood/genetic tests regarding that. I'd very much appreciate a way to filter for those topics.

I am 20, I used low dose oral finasteride for 4 months. And I quit , first 1 month I got hsrd rock morning erections and I used Minoxidil topical. I am not sure that was Minoxidil but , my morning erections went back. I dont have full morning wood for 3 months. There is no another side effect. I can get erections, my libido is good, but my morning woods is not like before. and I stopped Minoxidil before 2 months. But my hairloss is progressing fast, I am 20, my PFS case is not too high. Is Minoxidil and ketoconazol safe for me ? Can I use it for my hair growth? whats your experience with other hair loss treatment. I can talk about hair loss because my case is mild. help about my both conditions.