Considering TRT for Accutane related hormonal changes

[Frizzle]

Hi guys,

I’m Frank from western Europe and I’m new on this forum. I hope you can share your ideas/experiences about HRT after Accutane.

My story: I took Accutane in 1999 (40mg a day / 5 months). The drug greatly reduced my libido and gave me some mental issues like lower mood, anxiety and reduced verbal fluency (all typical hypogonadism-like symptoms). These side effects are chronic, although I believe they improved a bit over the years. Fertility is still good as I have 3 healthy kids.

A few years ago I underwent a complete medical examination, including neurological and hormonal checks. No abnormalities were found then ('in the range' BS). But nevertheless I believe Accutane caused hormonal changes in my body, as Accutane is known to do. I spoke to a few guys with the same problems, who now use TRT and feel better.

I would like to ask advice on treating these symptoms with HRT/TRT. What can I aspect form HRT/TRT?

Thanks in advance for your responses.

 

[Systemlord]

I would like to ask advice on treating these symptoms with HRT/TRT. What can I aspect form HRT/TRT?

There's no way to give you a definite answer, especially considering we don't know where you hormones levels currently sit.

Your genetics will determine how you respond to androgens.

These DHT blockers are known to cause problems, some men previously on DHT blockers respond to TRT while others do not.

 

[Frizzle]

Yeah I agree for my situation. I have to do new bloodwork first, and then see what happens after HRT.

Nevertheless I would like to hear from other members what they've done to address these Accutane related problems and how HRT works for them.

 

[solothesensei]

I've taken 3 rounds of Accutane in my life and each time I felt my energy levels dwindle a bit more.

Now that I'm on HRT I don't feel good on normal doses (100-150mg test) possibly because of long-lasting 5AR downregulation. I feel like complete crap on those doses.

I need at least 180-200mg to feel good. Interestingly, 150mg testosterone + 35mg masteron takes care of the problem, which further leads me to think DHT is indeed the issue.

 

[Frizzle]

Thanks for your reply. Very interesting information. I've heard from other Accutane users that they also needed a higher than normal dose. But you have low T without TRT?

I'm on clomid + HCG right now, before moving on to TRT. For the fist time in years I'm feeling good again, like normal. Although my T wasn't very low, I also suspect a low conversion of T to DHT.

 

[Frizzle]

Hi guys, finally got some bloodwork done.

Testosterone - 13nmol/l - (range 8,8 - 32,4)
Free testosterone 248 (range 160 - 640)
Estrogen 112 pmol/l (range 0-230)
SHBG 38 nmol/l
Prolactin - 206 me/l - (< 300)
LH 5 E/L

ALAT / GGT / ASAT were all low, so that's good.

Please shed your lights.

 

[Systemlord]

Hi guys, finally got some bloodwork done.

Testosterone - 13nmol/l - (range 8,8 - 32,4)
Free testosterone 248 (range 160 - 640)
Estrogen 112 pmol/l (range 0-230)
SHBG 38 nmol/l
Prolactin - 206 me/l - (< 300)
LH 5 E/L

ALAT / GGT / ASAT were all low, so that's good.

Please shed your lights.

A Total T of 374 isn’t great, most men would have symptoms at these levels.

Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men - PMC

Hypogonadism or Testosterone Deficiency (TD) in adult men as defined by low levels of serum testosterone accompanied by characteristic symptoms and/or signs as detailed further on can be found in long-recognized clinical entities such as Klinefelter ...

www.ncbi.nlm.nih.gov

There is also a recent study reporting increased hypogonadal symptoms in younger men ≤ 40 years with TT below 400 ng/dL (13.9 nmol/L).

 

[Steve78]

Do you have any evidence isotretinoin causes hypogonadism 22 years later?

 

[Frizzle]

Do you have any evidence isotretinoin causes hypogonadism 22 years later?

Did it with you?

For me, damage was done directly after treatment, also more than 20 years ago. Recently I went to a specialized doctor over here, after trying everything under the sun except HRT. He told me he treated more post-Accutane guys, those guys had one thing in common: 'lower testosterone'. My TT/FT levels were also on the lower side. He prescribed me some Androgel, which I tried for 2 weeks. It made me feel worse and I had to stop in order to finish some important work related stuff.
Before that I was on HCG-->Clomid (in an attempt to restore some of my own production, although my LH level of 5 wasn't low to start with). Clomid made me feel better. I experienced mental calmness, ameliorated stress coping and higher libido, but with more ED strangely. Stopped that because of numbness side effects and twitching eyes. Next step will be a serious TRT protocol.

 

[Frizzle]

Are there guys here who have treated Accutane related symptoms of fatigue and sexual issues with success?

 

[Systemlord]

Are there guys here who have treated Accutane related symptoms of fatigue and sexual issues with success?

It's all going to come down to how much damage the Accutane did to your body. Maybe you recover completely, partially or not at all.

 

[Frizzle]

It's all going to come down to how much damage the Accutane did to your body. Maybe you recover completely, partially or not at all.

Yeah, I know. And I'll post my progress to inform others, just curious what other post Accutane sufferers did to help their condition.

 

[Frizzle]

A Total T of 374 isn’t great, most men would have symptoms at these levels.

Recommendations on the diagnosis, treatment and monitoring of hypogonadism in men - PMC

Hypogonadism or Testosterone Deficiency (TD) in adult men as defined by low levels of serum testosterone accompanied by characteristic symptoms and/or signs as detailed further on can be found in long-recognized clinical entities such as Klinefelter ...

www.ncbi.nlm.nih.gov

Beside the lower testosterone, is there anything else that's suspicious?

 

[Steve78]

I know people who say they have anxiety 20 years post accutane but again, it’s a hard thing to prove.

My TT was 384 at age 29, and I wasn’t on accutane

 

[Frizzle]

Indeed after such a long time it's hard to prove this are related / correlated. For me, the side effects started right after finishing the course (only 20! then), so for me it's not that hard to make the connection. Luckily they do not seem to progress and my overall health is still very good. But I would like to address my hypogonadism symptoms due to Accutane.

Are you on TRT?

 

[Steve78]

Indeed after such a long time it's hard to prove this are related / correlated. For me, the side effects started right after finishing the course (only 20! then), so for me it's not that hard to make the connection. Luckily they do not seem to progress and my overall health is still very good. But I would like to address my hypogonadism symptoms due to Accutane.

Are you on TRT?

Yes, and I love it

 

[Frizzle]

Beside the lower testosterone, is there anything else that's suspicious?

a second bloodtest now shows a total T of 550.

 

[Systemlord]

a second bloodtest now shows a total T of 550.

This is nothing more than a daily fluctuation and is perfectly normal. You could get a different result if you tested every day.

The quality of sleep you get, food you eat, exercise activity all affects your testosterone levels.

 

[Forty2]

a second bloodtest now shows a total T of 550.

What other post Accutane symptoms do you have? How does your musculoskeletal system feel?
Does your face look a lot younger than most guys your age?

 

[Frizzle]

My musculoskeletal system is OK, i’m pretty strong actually. And my face looks my age, not younger but also not older. Main symptoms are low libido, low mood and anxiety. I tried TRT gel already, makes me feel better in the beginning but it wears off after a week, maybe the dose was/is too low. Another member advised TRT cream, because of higher DHT conversion after DHT blocker Accutane.