8 hours ago, guitarman01 said:

@mariovitali
I might be done looking at k2, mk7 for the moment or at least taking a break. I don't like how its been affecting my stomach. It causes bloating that I thought my stomach would adjust to but hasn't, even after many months of supplementation. i'm not sure if there is a previous underlying cause, but I'm going to take a break from it and wait and see.

I'm still not done looking at vitamin K though because here is another striking paper. I'm going to try mk4 for a period of time (15 to 45 mg) in the near future and see how I respond as compared to mk7.

https://www.ncbi.nlm.nih.gov/pubmed/28012893

Life Sci.2017 Mar 1;172:55-63. doi: 10.1016/j.lfs.2016.12.011. Epub 2016 Dec 21.

Matrix gla protein: An extracellular matrix protein regulates myostatin expression in the muscle developmental program.

Skeletal muscle development involves interactions between intracellular and extracellular factors that act in concert to regulate the myogenic process. Matrix gla protein (MGP), a well-known inhibitor of calcification in soft tissues, has been reported to be highly up-regulated during myogenesis.

I had the bloating side effect and also i was feeling less hungry.

How much are you taking? Also, have i looked at your DNA Data?

On 11/13/2017 at 5:09 AM, Togg said:

Hi guys. I crashed hard again. Have more symptoms then ever. I realized I have been clinging to hope for too long. I don't want to fool myself anymore. Really, I've been getting worse and worse as time goes on with only week hints to what has helped me or what hasn't.

Been going through my things and I realized I used to be so full of life and love, so easy going and fun. I loved life. I actually told a friend once "I think it is impossible for me to be depressed". I long for those days.

I was such a good kid too. Eagle scout and honor student, and full of stupid jokes... I'm no longer that stupid lovely boy anymore. Accutane has change me, changed me while I was on it, and especially changed me when I came off it. Now I am a shell of myself, animated mostly by habit and coping mechanisms.

Joint/bone pain is about to put me in a wheel chair...

Saw a photo of me and my twin brother today, we look nothing alike anymore. in 7 months post tane, I have aged a decade. "Like a meth addict" as a friend put it.

Worst of all, the other day when I was real bad, I was looking at my mom and I realized I felt nothing. No love, just unbearable pain and anxiety. My own mother.

I fear it is to late for me. Maybe some people get better, maybe I will, maybe one day a cure will be found. But every night while I should be sleeping but can't, I hear trains going through town. More and more I am tempted to walk to the tracks and lay my neck on the line. I don't want to, especially during the holidays, I don't want to do that to my family, or even the train conductor. But I fear I have made my peace. Truth is, the Tanner I knew died a long time ago, and it seems unlikely he's coming back.

One day I'm probably going to end it. I try to fight it. For now I only live so that I can stay with my family for thanksgiving and Christmas. I want to spend the time I have left being the best son and brother I can be, with what little of me is left. Hopefully I can make it that long. But come another 'crash' like a just had, I may fail.

I want to ask, can I talk about suicide on this forum? If I fall weak one day and do end it, I want to know what write to my family. Maybe this isn't the place, but I don't know of many places to discuss this. If anyone has any advice and wisdom on what I should say to my family if the time comes, please. PM me maybe. I don't think I am in the right mental state to know these things right now. And hell, I'm still a kid, hardly even 20.

I just miss them so much already. These past days I can't feel love really anymore, but at least I can remember the feeling. Maybe I will have another upswing. They always seem to follow the downswings. At least for today I can cry.

keep fighting people. I wish you all the best.

As requested - Toggs post

On 1/20/2018 at 2:19 AM, Perene said:

Please read this post before what I am going to say next... I don't want to repeat a ton of information.

More about my case, concerning libido loss:

I got my last blood test results... any thoughts if further tests are needed?

Spermogram: the urologist said there's nothing wrong. Note: all Google Drive links are from the lab. They are written in portuguese.

[Edited link out]

STD tests taken 2 months after the last time I had sex (I waited all this time to make sure they would be accurate). Herpes igG is positive, but I never had any symptoms - it's only there like it is in 2 thirds of the population.
[Edited link out]

First blood tests from August:
[Edited link out]

Second blood tests from November, 2017 (remember: I took Accutane for months during 2011):
[Edited link out]

And now the last tests:
[Edited link out]

From January 15, 2018.

Let's see:

All OK:

Uric Acid, Creatinine, Glucose, Complete Blood Count (why it showed Eosinophilia now? Will check that later), Lipid profile, Free T4, Urea, Aspartate transaminase, Alanine Aminotransferase and Thyroid-Stimulating Hormone (TSH). All of them in the reference ranges from the lab.

************ RELEVANT RESULTS *********

1) Total testosterone:
I said 3.09 in the 1st test, and 4.19 in the 2nd after 3 months taking vitamin D. I am still taking, this time 7000 UI/week and not 14000, for another 3 months (but I have plans to stop taking the supplement, and spend more time outside in the morning).

Now: 357 ng/dL. Lab ranges: 175 - 781 ng/dL

2) Free testosterone: 7.21. Lab ranges: Since 2011 it's calculated according to total test. and SHBG levels. According to Vermeulen, A. ET AL., 1999, the ref. ranges are 4.58 - 18.33 ng/dL for men, and 0.03 - 0.95 ng/dL for women.

3) SHBG (1st time I did this test): 32.6 nmol/L. Lab ranges: men from 20 to 50 years old: 13.2 - 89.5 nmol/L.

4) Vitamin D: still at 40's. Now 42.4 ng/mL.

5) Vitamin B-12 (1st time): lag ranges for men: 81 - 488 pg/mL. My result: 449 pg/mL.

6) FSH (1st time): 6.54 mUI/mL. Lag ranges for adult men: 1.27 - 19.26 MUI/ML

7) LH (1st time): 4.61 mUI/mL. Lag ranges for men: 1.24 - 8.62 MUI/ML

8) Gamma-Glutamyl Transferase (GGT) - 1st time: 18 U/L. Ranges: 7 - 45 U/L

9) Prolactin: 28.51 ng/mL. Ranges for men: 2.60 - 13.10 ng/mL. Previous results: 25-25. Once again high prolactin.

10) Zinc (1st time): still waiting for results

Note:

Months ago I also did these two, and they came back OK:

- Abdominal Ultrasound and MRI scan - sella turcica

About additional tests, I am asking if these are necessary to investigate what sort of damage Accutane did, since we are talking about sexual dysfunction:

- Dihydrotestosterone (DHT)
- E2, which measures the amount of estradiol, a form of estrogen
- DHEA-S (dehydroepiandrosterone sulfate)
- Progesterone
- IGF-1 (Insulin-like Growth Factor-1)

Like I said, I am going to get to the bottom of this. I was even thinking of testing for other vitamins besides D-3 and B-12...

However I don't know if doing all or any of these is necessary.

*
And now I see the Wikipedia article has been updated on this matter:

* WIKIPEDIA: ACCUTANE *

Isotretinoin is also associated with sexual side effects, namely erectile dysfunction and reduced libido.

https://www.medicines.org.uk/emc/medicine/15655

In October 2017, the UK MHRA issued a Drug Safety Update to physicians in response to reports of these problems.

>>>>>> "Drug Safety Update - Latest advice for medicines users - October 2017" (PDF). MHRA. 3 October 2017.
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/655127/DSU-Oct-pdf.pdf

This was in response to an EU review, published in August 2017, which states that a plausible physiological explanation of these side effects "may be a reduction in plasma testosterone".

http://www.ema.europa.eu/docs/en_GB/document_library/Periodic_safety_update_single_assessment/2017/08/WC500234071.pdf

The review also stated that "the product information should be updated to include sexual dysfunction including erectile dysfunction and decreased libido as an undesirable effect with an unknown frequency".

http://www.ema.europa.eu/docs/en_GB/document_library/Minutes/2017/09/WC500235426.pdf

There have also been reports of spermatogenesis disorders, such as oligospermia. 27 cases of sexual dysfunction report either negative dechallenge or positive dechallenge.

http://www.ema.europa.eu/docs/en_GB/document_library/Periodic_safety_update_single_assessment/2017/08/WC500234071.pdf

* WIKIPEDIA: ACCUTANE *

This link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472884/

Says the following:

>>>>>> Diagnosis of Hypogonadism: Clinical Assessments and Laboratory Tests

In males, serum testosterone levels show a circadian variation, with the highest levels in the morning and lowest levels in the late afternoon. In young men, the variation in testosterone levels is approximately 35%. Although the normal range for serum testosterone might vary between different laboratories, the normal range for early morning total testosterone in healthy adult males is approximately 300 ng/dL to 1000 ng/dL.

If that's the case then my blood tests indicate I have normal levels. But that doesn't mean IDEAL LEVELS, which I assume are in the middle (500, 600), and never 300, 400.

Let's continue:

Prepubertal: Secondary hypogonadism is associated with low levels of testosterone and normal to low levels of LH and FSH.

The signs and symptoms of low testosterone in postpubertal adult males can be more difficult to diagnose and might include loss of libido, erectile dysfunction, diminished intellectual capacity, depression, lethargy, osteoporosis, loss of muscle mass and strength, and some regression of secondary sexual characteristics.

At the initial visit, the first objective is to distinguish between primary gonadal failure, in which low testosterone is accompanied by increased FSH and increased LH, and hypothalamic-pituitary disorders (secondary hypogonadism), with low testosterone and low to normal FSH and LH levels. *

Do I fit in the latter case? Low testosterone levels and LOW TO NORMAL LH and FSH levels?

* Initial laboratory testing should include early morning (8:0010:00 AM) measurement of serum testosterone, prolactin, FSH, and LH levels. For the diagnosis of primary hypogonadism, FSH measurement is particularly important because FSH has a longer half life, is more sensitive, and demonstrates less variability than LH.

The aging male patient can present with signs and symptoms of low testosterone, including loss of libido, erectile dysfunction, diminished intellectual capacity, depression, lethargy, osteoporosis, and loss of muscle mass and strength. At the initial visit, laboratory testing should include early morning (8:0010:00 AM) measurement of serum testosterone. In elderly men, testosterone levels decrease between 15% and 20% over the course of 24 hours. *

OK, I did all those tests early in the morning. I had to wake 2 hours earlier (I usually wake at 8:00 AM), but that was not an issue. As for all low testosterone symptoms I don't think I have any of these, including fatigue. Except for loss of libido. And depression was a symptom I had for a few years after the Accutane treatment. Now it's totally gone.

Total testosterone levels might be normal with hypogonadism if the SHBG levels are increased. Levels of SHBG increase with age, causing a decrease in bioavailable testosterone. If testosterone levels are low-normal but the clinical symptoms and signs indicate hypogonadism, measurement of serum total testosterone levels should be repeated and an SHBG level should be determined. With the total testosterone and SHBG levels, a bioavailable testosterone value can be calculated. A bioavailable testosterone calculator is available at www.issam.ch/freetesto.htm.

It is usually not necessary to determine FSH or LH levels in the aging male. ***

And the article continues, explaining more about total/free test. and SHBG.

* In selected patients, FSH, LH, and prolactin can be measured. If the FSH and LH levels are raised, this suggests a primary testicular cause, and if levels are low or normal, a hypothalamic or pituitary cause should be considered. A raised prolactin level suggests that further investigation of the pituitary gland should be undertaken. *

The FSH and LH levels are not high. So that rules out the first suggestion.

"A hypothalamic or pituitary cause should be considered" (if the levels are low or normal - THEY ARE NORMAL). What kind of tests should I do to investigate this?

"A raised prolactin level suggests that further investigation of the pituitary gland should be undertaken." (3 different blood tests show exactly THAT. Not that high (25), yet still high for a man).

Hypothalamic or pituitary deficiency might be transitory or permanent. Transient secondary hypogonadism might be related to malnutrition or stress states and can be diagnosed by physical examination and evaluation of the patients growth chart. If permanent hypothalamic or pituitary hormone deficiency is suspected, serum levels of pituitary hormones and magnetic resonance imaging of the brain and pituitary should be obtained to screen for hypothalamic or pituitary disease. **

Malnutrition or stress states?

Does that mean if I change my diet (which is not bad, still I have an appointment with a nutritionist this month, to do a complete overhaul - plus another specialist, to do the same for my workout routine, I go to the gym every day in the morning) I can fix this?

And stress might be related to sleeping 1, 2 hours less? If this is the case, then I can't neglect to inform that I was doing this in the past weeks, prior to this blood test.

"can be diagnosed by physical examination and evaluation of the patients growth chart" (Growth chart?)

"If permanent hypothalamic or pituitary hormone deficiency is suspected, serum levels of pituitary hormones" (Again, what kind of exam? To check these serum levels of pituitary hormones?)

"and magnetic resonance imaging of the brain and pituitary should be obtained"

Didn't I do that already? I said I did a "magnetic resonance imaging of the sella turcica region". Does that cover this suggestion?

"...to screen for hypothalamic or pituitary disease."

*
Although the normal range for serum testosterone might vary between different laboratories, the normal range for early morning testosterone in male adults is approximately 300 ng/dL to 1000 ng/dL. An early morning total serum testosterone level of less than 300 ng/dL clearly indicates hypogonadism, and under most circumstances benefit will be derived from testosterone replacement therapy. A healthy male adult patient with a serum testosterone level greater than 400 ng/dL is unlikely to be testosterone deficient, and therefore clinical judgment should be exercised if he has symptoms suggestive of testosterone deficiency.
*

I get it, I predict my testosterone levels will fall in the range of 400 ng/DL in the coming months when I change my lifestyle and spend more time outside (for vitamin D, since this also raises test. levels). I understand that TRT has a lot of issues and should be THE LAST RESORT. Only when all other options have been eliminated, and for TRT if the levels are even lower than mine. I heard people explaining that it's an artificial increase that will trick the body and prevent a natural improvement, it will probably need to continue for the rest of one's life, and there's the expenses and
dependency of taking another S.HIT.

The thing is: my actual testosterone levels are not OK by a long shot and anyone that says they are should get punched in the face. Testosterone levels now are lower than ever before:
http://thechart.blogs.cnn.com/2011/08/18/modern-life-rough-on-men/

Countless sources will tell that. Meaning we can't say this is OK just because most men are weaklings, because today standards of how masculine (and healthy) we are not the IDEAL ones.

* Hypogonadism can be of hypothalamic-pituitary origin or of testicular origin, or a combination of both, which is increasingly common in the aging male population. It can be easily diagnosed with measurement of the early morning serum total testosterone level, which should be repeated if the value is low. Follicle-stimulating hormone, LH, and prolactin might also need to be measured. If the clinical signs and symptoms suggest hypogonadism but the serum testosterone level is near normal, then assay of serum testosterone should be repeated in conjunction with SHBG because serum testosterone might be normal in the presence of hypogonadism if the SHBG level is raised, which commonly occurs in elderly male patients. ****

Did you actually get a spermogram or did the urologist just brush you off?

Just because he say everything is ok - doesn't meant it is ok.

Doctors say accutane doesn't cause suicide, suicidal ideation or sexual problems - are they right ? NO THET ARE NOT!
If you didn't actually have the test done then please see if you can fight for it.

22 hours ago, flynn said:

Have you ever tried RU-486/mifepristone?

Dont have sexual sides, so no.

wouldnt touch it anyway, abortion drug isnt it?

For me Im looking at other areas away from supplements and drugs- given all the tests Ive done that dont conclude anything, given all the other stuff that others have taken that at best provides like 5% relief Im wanting to head in another direction, I think its now obvious theres no answers in supplements or prescription drugs unless you get a clear cut diagnosis on something.....Crohns for example

Yes Ill continue to eat right and exercise- that needs to happen regardless of being a tane victim. I want to head back to doing more subconscious work to unblock anything that has me stuck right now as a victim, for me this will be working with a professional Kinesiologist.

I think theres power in this approach and in a nutshell could explain why some people who go on Tane dont have any nasty side effects whilst others such as us get messed up and seemingly stuck in the post tane condition.

Yes, this approach will call for investigating past trauma of some description but it has to be done!!

@hatetane all my blood tests were posted. Re-read the post and you'll see there's a link for the spermogram, too.

The urologist said it's OK because that's what the semen analysis revealed:

1. Volume

How many milliliters were produced? Normal is between 1.5 5 mL, or between 1 teaspoon. Low volumes can indicate a blockage or dysfunction in the seminal vesicles or prostate.

My result: 3.0

2. Concentration

How many million sperm per milliliter were produced? The normal is approximately 15-20 million or higher. Lower numbers may indicate that sperm is being blocked from coming out, or that the testicles are not producing sperm they way they should.

My result: 49.7

Among other things... I believe the only thing in that result that is not explained is "viscosity increased". The other results seem to indicate there's nothing wrong in this area. I'll visit the urologist again to a) ask if everything is OK with these results, and b- to clarify if the way I did the procedure in the room was adequate and couldn't alter the results. I remember I did everything correctly and didn't touch the inside of the bottle (which a link says would contaminate it), but you never know.

******
And for the record the blood test on ZINC came today. And this was the result:

111,2 mcg/dL MCG/DL

Lab ranges: 70,0 - 120,0 MCG/DL

So we can rule this one out, too.

Reason to test this one:

Zinc and hypogonadism

Zinc is an essential dietary mineral. You need zinc for your immune system to function properly and for cell division. Zinc helps enzymes break down food and other nutrients. It also plays an important role in enzymes that build proteins. It can be found in certain foods, but its also available in supplements and even certain cold medications.

Having a zinc deficiency can lead to low testosterone. Exactly why a lack of zinc impacts testosterone levels isnt fully understood. The mineral may affect the cells in the testes that produce testosterone.

Also:

>>>>>>>> Zinc status and serum testosterone levels of healthy adults:
>>>>>>>> https://www.ncbi.nlm.nih.gov/pubmed/8875519

"Low testosterone is commonly associated with zinc deficiencies as androgen receptors are often altered in zinc deficient individuals. Adding zinc to the diet has been shown in various studies to increase levels of luteinizing hormone, a pituitary hormone that stimulates testosterone production. Studies have also shown zinc to be a strong aromatase inhibitor, which can block the conversion of testosterone to estrogen."

Suggested Intake: 30 mg daily"
******

And the ones that came normal: abdominal ultrassound and the MRI scan (I forgot to post the links):

[Edited link out]
[Edited link out]

ISOs from the CD-ROMs with images from both:
[Edited link out]
[Edited link out]

Like I said in previous posts it was reported (see the Wikipedia article ACCUTANE) that the treatment leads to "lower testostone levels". If that's the case then we need to do all sorts of tests to rule other causes.

The only blood tests I still wonder if are necessary or not at this point are:

- Dihydrotestosterone (DHT)
- E2, which measures the amount of estradiol, a form of estrogen
- DHEA-S (dehydroepiandrosterone sulfate)
- Progesterone
- IGF-1 (Insulin-like Growth Factor-1)

The more data we have about the side effects of this poison, the better.

https://rxisk.org/accutane-30-years-of-trading-our-sex-lives-for-clear-skin/

*
About high prolactin: I'll check with a nutritionist the supplementation with vitamin B-6. That ebook from Dr. Pezzi explains the following about it:

*
Accutane: what to do to solve the loss of libido:

- Try relatively high-dose supplemental vitamin B 6 (but avoid excessive doses that may induce a peripheral neuropathy; see the vitamin B 6 section for more information).
*
Now, what about vitamin B-6? Pay attention to this part:
*

***************************************************
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***************************************************
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Vitamin B 6 : High doses of vitamin B 6 can improve libido by reducing prolactin secretion in both sexes. B 6 can also improve the quality and intensity of sexual pleasure in some people who have poor genital sensation. An average dose for these applications is 25 mg three times daily. Vitamin B 6 is excreted soon after absorption, so it is preferable to take a smaller dose of B 6 three times daily rather than one large dose. Taking too much B 6 can cause insomnia and overly vivid dream recall, so if those side effects develop you should reduce your dose or at least reduce your supplementary intake later in the day.

Doses over 200 mg daily can result in neurological disorders if taken for several months. These disorders include a loss of position and vibration sense in the legs, and sensory ataxia (incoordination due to loss of proprioception, which is joint position sensation) which worsens when the eyes are closed. Recovery from this condition is slow and may be incomplete, so it is important to avoid potentially toxic levels of B 6 . If you take fairly high amounts of B 6 , you and your doctor should be on the lookout for any early signs of toxicity.

In males, B 6 supplementation has a greater effect in stimulating libido than in women. Vitamin B 6 contributes to an increased serotonin level in specific sites in the brain (thus explaining the apparent contradiction between this and the fact that a global increase in serotonin impairs libido), which in turn causes a down-regulation of type 2A serotonin receptors (5-HT 2A receptors).

Particularly in males, lower numbers of 5-HT 2A receptors are associated with increased libido. In some men, this increase in libido can be dramatic. The downside of this is that the effect is rather transient, lasting for a week or less.

Normalizing B 6 intake for several weeks can restore some of the potential for a male to libidinally respond to future high dose B 6 regimens. However, the greatest bang for the buck (no pun intended) will be obtained during the first few times it is consumed. By the way, if you try this do not look for an immediate boost in your libidoit typically takes 3 to 5 days for an effect to be manifested.

Why doesnt B 6 cause a sustained boost in libido? One explanation is that pyridoxal 5'-phosphate (PLP), the biologically active form of vitamin B 6 , affects steroid-induced gene expression. A study * performed at the University of North Carolina at Chapel Hill found that PLP decreased transcriptional (gene) responses to androgens (e.g., testosterone), estrogens, progesterone, and glucocorticoid (e.g., cortisol) hormones. In contrast, cells deficient in B 6 were more responsive to steroid hormones. This might suggest that the way to build bigger muscles or improve libido is to dutifully avoid B 6 since a B 6 deficiency would heighten the androgen response. However, things arent that simple since B 6 also decreased the response to some hormones, such as estrogen, that tend to counteract the effects of testosterone.

* Modulation of steroid receptor-mediated gene expression by vitamin B 6 . Tully DB, Allgood VE, Cidlowski JA. FASEB J 1994 Mar 1;8(3):343-9.

Furthermore, B 6 has a number of other effects in the body, many of which are conducive to sex and pleasure. For example, dopamine (a neurotransmitter involved in the perception of pleasure) is synthesized using a PLP-dependent enzyme.

With so many variables and so many ways to hash the data, its more helpful to focus on what people experience when they take B 6 . The bottom line is that B 6 can temporarily stimulate libido in some people. Failure to respond to B 6 might indicate that an individual manifested less suppression of estrogens than androgens, that their initial prolactin level was not sufficient to dampen libido, or several other things. Complex stuff? You bet, but the take-home message is clear: B 6 might stimulate libido. If it works, do not take high-dose supplements of it continuously for that purpose; the dose previously mentioned (25 mg three
times daily) is a high-dose regimen that is considerably above the recommended daily allowance of about 2 mg.

Men who are deficient in vitamin B 6 sometimes notice a significant increase in their flaccid penile size when their deficiency is corrected. The reason for this may seem obscure but, as we will explore later in this book, vitamin B 6 can reduce the homocysteine level. Since homocysteine interferes with the production of nitric oxide (NO), and nitric oxide influences penile blood flow, it is easy to understand the link between vitamin B 6 and penile size. Correcting a B 6 deficiency can increase the size and stiffness of erections, too, but stiffness will increase more than size. **

** To understand why stiffness increases more than size, try the following experiment, or just follow along conceptually. Take a 6-inch length of an old bicycle inner tube and seal it off on one end (the inner tube is hydraulically similar to the fibrous capsule that envelopes the penis), then blow some air into the other end. You will notice that the inner tube will be floppy until it is almost full of air (in this experiment, air is analogous to blood). Once the tube is almost full, adding just a bit more air can make the tube noticeably stiffer and harder, but the size of the tube does not increase by much.

The size of the penis in its flaccid state may seem like a trivial matter, but its not. If you respond to supplementation with B 6 (or B 12 or folic acid, which well discuss later in the book), that might be a tip-off to a deficiency you might not otherwise notice. Because vitamins B 6 , B 12 , and folic acid play important roles in homocysteine metabolism and homocysteine influences your risk of cardiovascular disease, anything that alerts you to such a deficiency is worth its weight in gold. If you think that an average doctor has even the slightest clue as to the adequacy of your B 6 , B 12 , and folic acid levels, youre overestimating the competency of most doctors.

My brother developed profound weakness and numbness, and four physicians (two ER, one family practitioner, and even a neurologist) told him he had carpal tunnel syndrome in spite of the fact that his signs and symptoms were not consistent with carpal tunnel disease. In reality, his problem was due to a deficiency of vitamin B 12 that caused his spinal cord to degenerate like a piece of Swiss cheesehardly a problem that doctors should overlook or pass off as carpal tunnel syndrome.

Even if your diet contains a normal amount of vitamin B 6 , a deficiency may develop due to malabsorption, hyperthyroidism, diabetes, excessive loss, alcoholism, smoking, or the use of various drugs (e.g., corticosteroids [anti-inflammatory steroids], penicillamine, isoniazid, cycloserine, hydralazine, and some anticonvulsants). Studies in the 1960s and 1970s suggested that more B 6 is needed by women taking estrogen or oral contraceptives, but the latest research did not show any particular benefit for women taking those drugs.
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These links suggest the same thing:

https://testosteroneresource.com/tboosting-ingredients/vitamin-b6/
https://forums.steroid.com/anabolic-steroids-questions-answers/523806-forget-caber-prami-tren-try-b6.html
https://www.thundersplace.org/male-supplements/cheap-dostinex-megadosis-of-vitamin-b6-and-e-personal-experience.html
https://www.steroidology.com/forum/anabolic-steroid-forum/638726-b6-prolactin-supression.html
[Edited link out]
http://forums.rxmuscle.com/showthread.php?63970-B6-and-lowering-prolactin

The latter says:

***************************
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High levels of the hormone prolactin are a major cause of low testosterone levels,low sex drive, erectile dysfunction and impotency in men. A surge in the hormone prolactin after sexual orgasm is the reason why men need a refractory period before they can go again.

Many men trying to lower prolactin levels choose to use the prescription drugs Bromocriptine and Dostinex (Cabergoline) but, although these drugs are effective at suppressing prolactin, they are expensive and many men experience a host of side effects whilst using them.

This natural prolactin inhibitor supplement stack will lower prolactin levels in men suffering from high prolactin levels.
In contrast to prescription prolactin inhibitor drugs, these supplements are extremely cheap and will not cause side effects in the vast majority of users.

Primary Prolactin Inhibitor Supplements:
1) Vitamin B6
2) Vitamin E
3) SAM-e

Secondary Prolactin Inhibitor Supplements:
1) Ginseng extract
2) Maca powder
3) Ashwagandha
4) Mucuna pruriens
5) Zinc
6) Ginkgo Biloba

(...)

Side effects:

High doses of B6 taken for many months can cause nerve problems such as tingling in the fingers and numbness in the toes (peripheral neuropathy); B6 can also worsen sleep quality in some people and cause vivid dreams. Fortunately, these problems completely resolve once B6 supplementation is stopped and, since it is water soluble, this wont take too long.

Ways around these side effects:

One way to avoid the finger tingling that high dose B6 can cause is to take the activated form of B6 called Pyridoxal-5-Phosphate (P5P) - the activated form of B6 does not cause these nerve issues. In fact, the reason that high dose B6 causes nerve problems is that the body cant always process very high B6 doses properly and this creates a deficiency of the active form of B6, P5P.

Recommended dosage:

To lower prolactin levels I would recommend you take 50 to 200mg of P5P a day, in divided doses. If you want to take regular B6, which as I've mentioned can sometimes cause minor side effects, take 300 to 1000 mg per day in divided doses. Read the label before you buy B6 because the Pyridoxine Hydrochloride type of B6 (in most supplements) has been shown to be a prolactin inhibitor but Pyridoxal hydrochloride has been shown to be ineffective at lowering prolactin (6) make sure you buy the right type!
***************************
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That's EXACTLY what I am going to check if it's going to solve this side effect from Accutane. I said earlier that taking another drug was going to be necessary for a long time or indefinitely, and there was a risk of the same side effects returning once the treatment stops. At least vitamin B-6 would be a better choice.

Among all the discussions there was a quote that caught my attention. It seems to confirm what a member said previously: increasing testosterone won't solve this issue if we don't deal with the high prolactin at the same time:

[Edited link out]

Here's what the message said:

****************
****************
****************
1. Accutane works on and significantly impacts Dopamine receptor D2 gene:

Chambon, et. al. Regulation of dopaminergic pathways by retinoids: activation of the D2 receptor promoter by members of the retinoic acid receptor-retinoid X receptor family. Proc Natl Acad Sci U S A. 1997 Dec 23;94(26):14349-54.

Dopamine is a neuromodulator involved in the control of key physiological functions. Dopamine-dependent signal transduction is activated through the interaction with membrane receptors of the seven-transmembrane domain G protein-coupled family. Among them, dopamine D2 receptor is highly expressed in the striatum and the pituitary gland as well as by mesencephalic dopaminergic neurons. Lack of D2 receptors in mice leads to a locomotor parkinsonian-like phenotype and to pituitary tumors. The D2 receptor promoter has characteristics of a housekeeping gene. However, the restricted expression of this gene to particular neurons and cells points to a strict regulation of its expression by cell-specific transcription factors. We demonstrate here that the D2 receptor promoter contains a functional retinoic acid response element. Furthermore, analysis of retinoic acid receptor-null mice supports our finding and shows that in these animals D2 receptor expression is reduced. This finding assigns to retinoids an important role in the control of gene expression in the central nervous system.

http://www.ncbi.nlm.nih.gov/pubmed/9405615?dopt=AbstractPlus

2. Dopamine has a direct connection with Prolactin levels:

Dopamine (DA) holds a predominant role in the regulation of prolactin (PRL) secretion. Through a direct effect on anterior pituitary lactotrophs, DA inhibits the basally high-secretory tone of the cell. It accomplishes this by binding to D2 receptors expressed on the cell membrane of the lactotroph, activation of which results in a reduction of PRL exocytosis and gene expression by a variety of intracellular signalling mechanisms.

http://jop.sagepub.com/content/22/2_suppl/12.abstract

3. Let's say reduced Dopamine levels result in sustained elevated Prolactin, what would that mean over time?

Elevated serum prolactin levels create two problems that are inimical to sexual potency. With high serum prolactin levels, normal pulsatile GnRH and LH secretion does not proceed. This is why nursing mothers stop menstruating. Without pulsatile LH release, a mans testicle is stranded without adequate stimulation and cannot produce its full ration of testosterone. Serum testosterone levels then fall. But giving more testosterone is not the remedy because elevated serum prolactin levels also prevent the body from responding normally to testosterone.

---

Here's where my own personal experiences and thoughts come into play...

I've had my T tuned for some time, taking DHEA, estrogen's in check. And yet I still have inconsistent issues with sexual performance and my mood is either dull or depressed. Surprisingly what made the connection for me was after every time I drink/smoke, the day after my sexual performance is immediately elevated. I could never understand why, it wouldn't last more than a day though. But within that was the key...

What does drinking and smoking do to the brain?

They both increase dopamine.

What does dopamine do again?

Regulates Prolactin.

What does Prolactin do again?

Suppresses male androgens.

Bingo!

Just to add to this re: mood. Always thought I had low serotonin so I would take 5HTP. 5HTP would make my sexual performance non-existent and also result in racing thoughts and terrible anxiety. I learned over the years 5HTP was a big no-no for me. I just assumed then I did not have low serotonin. In retrospect, serotonin is said to counter-balance dopamine and lower it. Was I just driving my dopamine further down? I digress...

If Accutane potentially reduces dopamine (cat goes away), Prolactin can shoot up (mice will play!), wreaking havoc on your endocrine system from there on out. I haven't gotten too far into it, but I will be pursing the idea that without dopamine, prolactin surges, potentially resulting in a pituitary tumor (prolactinoma) that could in turn impact other hormones. In my case my adrenals aren't doing much either (cortisol, aldosterone, dhea). I haven't gotten too far into how and if this relates however, just androgens.

But administering dopamine surrogates will shrink said tumors:

Three medications, bromocriptine (Parlodel), pergolide (Permax), and cabergoline (Dostinex) have doparninelike properties, and any of them can be an effective dopamine surrogate. When hyperprolactinemic men or women are treated with bromocriptine (Parlodel), pergolide (Permax) or cabergoline (Dostinex), serum prolactin levels promptly return to normal. Continued treatment is required to keep prolactin levels fully suppressed.

This treatment has been effective in two respects. Lowering serum prolactin levels to normal restores sensitivity to the sexual effects of testosterone. As serum prolactin levels fall, serum testosterone levels increase and potency returns. Bromocriptine (Parlodel) or cabergoline (Dostinex) treatment also decreases pituitary tumor size and shrinks prolactin-secreting tumor tissue.

****************
****************
****************
Sorry to hog the thread but a lot of this is coming together now and I just want to try to clarify and put everything in order of effect. So we know that:

1. Accutane results in lower IGF-1
2. Lower IGF-1 results in less p450scc and therefore lowered cortisol (and dhea) produced via blunted response to ACTH
3. Reduced dhea results in reduced testosterone which results in reduced dht
4. Reduced 5 Alpha Reductase activity (mainly type1) results in reduced DHT and a reduction in sebum
5. Lower cortisol results in a) lower dopamine levels and b -low metabolic rate via lowered T3 uptake
6. Low dopamine leads to low mood and elevated prolactin which leads to sexual dysfunction
7. Low metabolic rate causes chronic fatigue and hypothalamus reduces GH,LH
8. Low GH causes reduction in T3 to T4 conversion

I believe that this is how Accutane works and affects us.

From the blood tests I have had done I know that I have low cortisol and lowish dhea. I also know that my T4 (top quarter of range) and TSH levels are good however my T3 level is lowish (bottom quarter of range). I have a low metabolic rate and have been diagnosed, via my symptoms, by a thyroid specialist, as being hypothyroid despite T4 and TSH levels being spot on. For the last month I have been taking T3 meds but it has had little effect, even at 80mcg per day which indicates to me that my low cortisol is the culprit in low metabolic rate. I can guess that my ACTH response is blunted due to slight hyperpigmentation (red face after short exposure to sunlight).

Has anyone here had their IGF-1 tested and know their levels?
****************
****************
*******************

That's what we all need to remember:

"But giving more testosterone is not the remedy because elevated serum prolactin levels also prevent the body from responding normally to testosterone."

Found this on the internet:

One hundred and twenty cases of enduring sexual dysfunction following treatment.
[Edited link out]
It's that classic study from 2014, where it's said:

*********
(...)
Efforts to manage post SSRI Sexual Dysfunction (PSSD) have focussed on manipulating the sero-tonergic and dopaminergic systems, but to little avail. These have included 5HT-1 agonists like buspirone, as well as 5HT2 and 5HT-3 antagonists like trazodone and mirtazapine. These latter two drugs can induce priapism and increased libido respectively in normal people but have little effect in PSSD.

Affected subjects also report trying dopamine agonists such as pramipexole and cabergoline along with buproprion, dexamphetamine and other stimulants but to no avail. In addition patients have tried sildenafil, vardenafil and related drugs as well as testosterone but with little benefit.

These failures in part have perhaps contributed to proposals that the enduring difficulties are tied to epigenetic changes, but such proposals have not led to any treatment leads so far.
**********

And this one:

***
Isotretinoin associated with erectile dysfunction
DOI owner: Springer-Verlag
Journal: Reactions Weekly

Year:2015, Month:7, Day:?, Volume:1560, Issue:1, First page:5, Last page:5
ISSN: 0114-9954(p)
1179-2051(e)
***
Reactions 1560, p5 - 18 Jul 2015
***
Isotretinoin associated with erectile dysfunction
******

Seven cases of isotretinoin-associated erectile dysfunction were reported to the Netherlands Pharmacovigilance Centre Lareb between September 2000 and December 2014. Erectile dysfunction is not mentioned in the Summary of Product Characterisitics(SmPC) of oral isotretinoin formulations on the Dutch market or on the US market.

The manufacturer of isotretinoin has received more than 150 reports of male reproductive system disorders including 32 reports of erectile dysfunction. Erectile dysfunction has also been reported in patients receiving other retinoids (acitretin and etretinate). Database reports of isotretinoin-associated erectile dysfunction include the seven cases reported to Lareb,
132 cases reported to the WHO database and 61 cases reported to Eudravigilance, the database of the European Medicines Agency.

Reduced testosterone levels have been reported during treatment with isotretinoin. In addition to erectile dysfunction, clinical manifestations of low testosterone levels include gynaecomastia and decreased libido, both of which have been reported to Lareb (6 and 3 cases, respectively), WHO (102 and 77 cases, respectively) and Eudravigilance (30 and 42 cases, respectively).

"Our data suggests that treatment with isotretinoin can cause erectile dysfunction, possibly by causing testosterone deficiency," concluded Lareb. "The association of erectile dysfunction with the use of isotretinoin is a new signal," said Lareb, and it should be mentioned in the SmPC.

Lareb. Isotretinoin and erectile dysfunction. Lareb Quarterly Report : 21-25, 15 May 2015.

Available from: URL (now it's a dead link):
[Edited link out]

On 1/24/2018 at 7:59 AM, Perene said:

Found this on the internet:

One hundred and twenty cases of enduring sexual dysfunction following treatment.
[Edited link out]
It's that classic study from 2014, where it's said:

*********
(...)
Efforts to manage post SSRI Sexual Dysfunction (PSSD) have focussed on manipulating the sero-tonergic and dopaminergic systems, but to little avail. These have included 5HT-1 agonists like buspirone, as well as 5HT2 and 5HT-3 antagonists like trazodone and mirtazapine. These latter two drugs can induce priapism and increased libido respectively in normal people but have little effect in PSSD.

Affected subjects also report trying dopamine agonists such as pramipexole and cabergoline along with buproprion, dexamphetamine and other stimulants but to no avail. In addition patients have tried sildenafil, vardenafil and related drugs as well as testosterone but with little benefit.

These failures in part have perhaps contributed to proposals that the enduring difficulties are tied to epigenetic changes, but such proposals have not led to any treatment leads so far.
**********

And this one:

***
Isotretinoin associated with erectile dysfunction
DOI owner: Springer-Verlag
Journal: Reactions Weekly

Year:2015, Month:7, Day:?, Volume:1560, Issue:1, First page:5, Last page:5
ISSN: 0114-9954(p)
1179-2051(e)
***
Reactions 1560, p5 - 18 Jul 2015
***
Isotretinoin associated with erectile dysfunction
******

Seven cases of isotretinoin-associated erectile dysfunction were reported to the Netherlands Pharmacovigilance Centre Lareb between September 2000 and December 2014. Erectile dysfunction is not mentioned in the Summary of Product Characterisitics(SmPC) of oral isotretinoin formulations on the Dutch market or on the US market.

The manufacturer of isotretinoin has received more than 150 reports of male reproductive system disorders including 32 reports of erectile dysfunction. Erectile dysfunction has also been reported in patients receiving other retinoids (acitretin and etretinate). Database reports of isotretinoin-associated erectile dysfunction include the seven cases reported to Lareb,
132 cases reported to the WHO database and 61 cases reported to Eudravigilance, the database of the European Medicines Agency.

Reduced testosterone levels have been reported during treatment with isotretinoin. In addition to erectile dysfunction, clinical manifestations of low testosterone levels include gynaecomastia and decreased libido, both of which have been reported to Lareb (6 and 3 cases, respectively), WHO (102 and 77 cases, respectively) and Eudravigilance (30 and 42 cases, respectively).

"Our data suggests that treatment with isotretinoin can cause erectile dysfunction, possibly by causing testosterone deficiency," concluded Lareb. "The association of erectile dysfunction with the use of isotretinoin is a new signal," said Lareb, and it should be mentioned in the SmPC.

Lareb. Isotretinoin and erectile dysfunction. Lareb Quarterly Report : 21-25, 15 May 2015.

Available from: URL (now it's a dead link):
[Edited link out]

Comes too late for many, who were convinced by docs of only "minor" and always transitory side effects... now they are lifelong disabled. It's very likely this is far more common, but simply not reported.

http://www.ema.europa.eu/ema/index.jsp?curl=pages/about_us/general/general_content_000537.jsp

This is the committee making decisions about acuutane.
How hard would it be to send a group email?
Tell them about your sides, how this drug has impacted you and how there is no help available.
We got to do what we can to protect future victims.
It is so wrong what is happening and because not enough people report; victim numbers keep rising!

Theyd only argue that for the hundreds who get side effects theres hundreds of thousands who dont have any issues.

Thats the standard response Ive come to expect from medical community, its one that even my GP says to me - Technically shes right but that doesnt help us does it.

My GP said she recently put someone on an antibiotic and they developed an infection- basically she said it can happen but for the hundreds of others theres been no problem

These are the percentage risks that play out daily in the medical world, even in surgery there are risks, thats how it works.

On 1/21/2018 at 11:26 PM, mariovitali said:

I had the bloating side effect and also i was feeling less hungry.

How much are you taking? Also, have i looked at your DNA Data?

I had been steadily taking 360 mcg mk7 for quite some time.
For the majority of the time I had taken a k2vital based formula (synthetic), then switched to jarrow mk7 which is natto based, with soy removed.
I ended up getting the flu last week, 103 temp that im just now getting over, had to miss a day of work and it wrecked my weekend.

Looking at if mk7 was involved or just a coincidence.
Ive mentioned this before looking at k2's possible interaction with bacteria.
One concern I had was, can certain types of k2 fuel bacteria infections?
on the other hand,

"There is increasing evidence that vitamin K has a significant role in bone metabolism, energy metabolism, spermatogenesis, apoptosis and innate immunity, in addition to blood coagulation."

So k2 could also possibly provoke an immune response, to something that was already there.

They have shown k2 mk7 to increase cardiac output, which it definitely can get the heart going, and give insomnia if not careful with the dosage. (at least the mk7 form)
This being said this could be important for fatigue and proper blood flow throughout the body.
So Im not done looking at this yet.

In dogs, testicular atrophy was noted after treatment with oral isotretinoin for approximately 30 weeks at dosages of 20 or 60 mg/kg/day (10 or 30 times the recommended clinical dose of 1.0 mg/kg/day, respectively, after normalization for total body surface area). In general, there was microscopic evidence for appreciable depression of spermatogenesis but some sperm were observed in all testes examined and in no instance were completely atrophic tubules seen. In studies of 66 men, 30 of whom were patients with nodular acne under treatment with oral isotretinoin, no significant changes were noted in the count or motility of spermatozoa in the ejaculate. In a study of 50 men (ages 17 to 32 years) receiving Accutane (isotretinoin) therapy for nodular acne, no significant effects were seen on ejaculate volume, sperm count, total sperm motility, morphology or seminal plasma fructose.

14 hours ago, TrueJustice said:

Theyd only argue that for the hundreds who get side effects theres hundreds of thousands who dont have any issues.

Thats the standard response Ive come to expect from medical community, its one that even my GP says to me - Technically shes right but that doesnt help us does it.

My GP said she recently put someone on an antibiotic and they developed an infection- basically she said it can happen but for the hundreds of others theres been no problem

These are the percentage risks that play out daily in the medical world, even in surgery there are risks, thats how it works.

You may be right. I have decided that we should all keep quite. Rxisk should shut down too , no point in having them.
No one should ever take legal action - no point in that.
I think we should all encourage the use of accutane so the roche get really rich.

Yipeeee

11 hours ago, guitarman01 said:

I had been steadily taking 360 mcg mk7 for quite some time.
For the majority of the time I had taken a k2vital based formula (synthetic), then switched to jarrow mk7 which is natto based, with soy removed.
I ended up getting the flu last week, 103 temp that im just now getting over, had to miss a day of work and it wrecked my weekend.

Looking at if mk7 was involved or just a coincidence.
Ive mentioned this before looking at k2's possible interaction with bacteria.
One concern I had was, can certain types of k2 fuel bacteria infections?
on the other hand,

"There is increasing evidence that vitamin K has a significant role in bone metabolism, energy metabolism, spermatogenesis, apoptosis and innate immunity, in addition to blood coagulation."

So k2 could also possibly provoke an immune response, to something that was already there.

They have shown k2 mk7 to increase cardiac output, which it definitely can get the heart going, and give insomnia if not careful with the dosage. (at least the mk7 form)
This being said this could be important for fatigue and proper blood flow throughout the body.
So Im not done looking at this yet.

In dogs, testicular atrophy was noted after treatment with oral isotretinoin for approximately 30 weeks at dosages of 20 or 60 mg/kg/day (10 or 30 times the recommended clinical dose of 1.0 mg/kg/day, respectively, after normalization for total body surface area). In general, there was microscopic evidence for appreciable depression of spermatogenesis but some sperm were observed in all testes examined and in no instance were completely atrophic tubules seen. In studies of 66 men, 30 of whom were patients with nodular acne under treatment with oral isotretinoin, no significant changes were noted in the count or motility of spermatozoa in the ejaculate. In a study of 50 men (ages 17 to 32 years) receiving Accutane (isotretinoin) therapy for nodular acne, no significant effects were seen on ejaculate volume, sperm count, total sperm motility, morphology or seminal plasma fructose.

Some of these stats are completely useless. For instance many men only suffer the sexual sides after stopping accutane not during.
I wish I could get hold of the Mexican trial which reported 6 men out 18 experienced erectile dysfunction after just 6 weeks of use, a whopping 33%. It was covered up and obviously never followed up. 6 weeks is a relatively short amount of time for accutane but I don't know what the dose was.
I wonder if anyone reported it?

18 hours ago, TrueJustice said:

Theyd only argue that for the hundreds who get side effects theres hundreds of thousands who dont have any issues.

Thats the standard response Ive come to expect from medical community, its one that even my GP says to me - Technically shes right but that doesnt help us does it.

My GP said she recently put someone on an antibiotic and they developed an infection- basically she said it can happen but for the hundreds of others theres been no problem

These are the percentage risks that play out daily in the medical world, even in surgery there are risks, thats how it works.

Comparing the risk of an antibiotic, and a chemo/cancer drug which nobody knows how it works, is a bit off. Tane alters things on very basic cellular and even genetic level for some cells, affecting division death etc.

Short and especially long term risks are very understated.

I do not advocate bannign accutane, but truthfully representing long term risks, which is often avoided. Obviously, if you have neuroblastoma you will take it as you could die otherwise.

On 1/23/2018 at 8:45 AM, TrueJustice said:

Dont have sexual sides, so no.

wouldnt touch it anyway, abortion drug isnt it?

It's a drug that has multiple uses, one being for Cushings Disease which I've seen some have been diagnosed with post accutane, and mifepristone is prescribed to lower cortisol. It's only an anti-abortion drug if used in a very high singular dose.

Interestingly one of the guys on HackStasis completely cured his CFS when he took it.

Check out this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969503/

4 hours ago, fiksi said:

Comparing the risk of an antibiotic, and a chemo/cancer drug which nobody knows how it works, is a bit off. Tane alters things on very basic cellular and even genetic level for some cells, affecting division death etc.

Short and especially long term risks are very understated.

I do not advocate bannign accutane, but truthfully representing long term risks, which is often avoided. Obviously, if you have neuroblastoma you will take it as you could die otherwise.

Youre preaching to the converted here!

Make no mistake, I fucken hate Roche and I hate Roaccutane, I was merely making the point that risks come with all prescription drugs, I was hardly comparing tane with an antibiotic, my point was about how people react to what doctors give them. I dont hate my Dr cause she says these things, Ill argue with her but I respect her overall.

This is how the medical world works, at times I dont agree with it but thats the reality we have to deal with, for every person who took tane and is fucked up, there are 100 people who arent, thats why I find it hard debating our issues with any of them.

I remember when my partner told me she took tane, I nearly fell over, here I am on forums and with cupboards full of supplements etc and she just looks at me going why do you take all this stuff.

9 minutes ago, TrueJustice said:

Youre preaching to the converted here!

Make no mistake, I fucken hate Roche and I hate Roaccutane, I was merely making the point that risks come with all prescription drugs, I was hardly comparing tane with an antibiotic, my point was about how people react to what doctors give them. I dont hate my Dr cause she says these things, Ill argue with her but I respect her overall.

This is how the medical world works, at times I dont agree with it but thats the reality we have to deal with, for every person who took tane and is fucked up, there are 100 people who arent, thats why I find it hard debating our issues with any of them.

I remember when my partner told me she took tane, I nearly fell over, here I am on forums and with cupboards full of supplements etc and she just looks at me going why do you take all this stuff.

We have people here who have lost, or about to lose all hair due to tane... the effect continues long after stopping tane. Doctors convinced them it won't happen or is only short term. Only, it isn't- and it's irreversible now.

The incidence of problems in tane is far more than 1%, and most are likely underreported. Some may occur much later. Given accutane works on such a cell level, it's very unpredictable in effects. Even if, in reality, each effect is only eg 5% likely, with 200+ of them, people should know long term risks they may sign up for. Sexual effects, fi, have been denied for quite some time.

This is my point.

3 hours ago, tanedout said:

It's a drug that has multiple uses, one being for Cushings Disease which I've seen some have been diagnosed with post accutane, and mifepristone is prescribed to lower cortisol. It's only an anti-abortion drug if used in a very high singular dose.

Interestingly one of the guys on HackStasis completely cured his CFS when he took it.

Check out this study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969503/

It could work, but it's another systemic drug, that could add to trouble of strained body from accutane, and even make thigns worse.

On 1/23/2018 at 9:56 PM, Perene said:

@hatetane all my blood tests were posted. Re-read the post and you'll see there's a link for the spermogram, too.

The urologist said it's OK because that's what the semen analysis revealed:

1. Volume

How many milliliters were produced? Normal is between 1.5 5 mL, or between 1 teaspoon. Low volumes can indicate a blockage or dysfunction in the seminal vesicles or prostate.

My result: 3.0

2. Concentration

How many million sperm per milliliter were produced? The normal is approximately 15-20 million or higher. Lower numbers may indicate that sperm is being blocked from coming out, or that the testicles are not producing sperm they way they should.

My result: 49.7

Among other things... I believe the only thing in that result that is not explained is "viscosity increased". The other results seem to indicate there's nothing wrong in this area. I'll visit the urologist again to a) ask if everything is OK with these results, and b- to clarify if the way I did the procedure in the room was adequate and couldn't alter the results. I remember I did everything correctly and didn't touch the inside of the bottle (which a link says would contaminate it), but you never know.

******
And for the record the blood test on ZINC came today. And this was the result:

111,2 mcg/dL MCG/DL

Lab ranges: 70,0 - 120,0 MCG/DL

So we can rule this one out, too.

Reason to test this one:

Zinc and hypogonadism

Zinc is an essential dietary mineral. You need zinc for your immune system to function properly and for cell division. Zinc helps enzymes break down food and other nutrients. It also plays an important role in enzymes that build proteins. It can be found in certain foods, but its also available in supplements and even certain cold medications.

Having a zinc deficiency can lead to low testosterone. Exactly why a lack of zinc impacts testosterone levels isnt fully understood. The mineral may affect the cells in the testes that produce testosterone.

Also:

>>>>>>>> Zinc status and serum testosterone levels of healthy adults:
>>>>>>>> https://www.ncbi.nlm.nih.gov/pubmed/8875519

"Low testosterone is commonly associated with zinc deficiencies as androgen receptors are often altered in zinc deficient individuals. Adding zinc to the diet has been shown in various studies to increase levels of luteinizing hormone, a pituitary hormone that stimulates testosterone production. Studies have also shown zinc to be a strong aromatase inhibitor, which can block the conversion of testosterone to estrogen."

Suggested Intake: 30 mg daily"
******

And the ones that came normal: abdominal ultrassound and the MRI scan (I forgot to post the links):

[Edited link out]
[Edited link out]

ISOs from the CD-ROMs with images from both:
[Edited link out]
[Edited link out]

Like I said in previous posts it was reported (see the Wikipedia article ACCUTANE) that the treatment leads to "lower testostone levels". If that's the case then we need to do all sorts of tests to rule other causes.

The only blood tests I still wonder if are necessary or not at this point are:

- Dihydrotestosterone (DHT)
- E2, which measures the amount of estradiol, a form of estrogen
- DHEA-S (dehydroepiandrosterone sulfate)
- Progesterone
- IGF-1 (Insulin-like Growth Factor-1)

The more data we have about the side effects of this poison, the better.

https://rxisk.org/accutane-30-years-of-trading-our-sex-lives-for-clear-skin/

*
About high prolactin: I'll check with a nutritionist the supplementation with vitamin B-6. That ebook from Dr. Pezzi explains the following about it:

*
Accutane: what to do to solve the loss of libido:

- Try relatively high-dose supplemental vitamin B 6 (but avoid excessive doses that may induce a peripheral neuropathy; see the vitamin B 6 section for more information).
*
Now, what about vitamin B-6? Pay attention to this part:
*

***************************************************
***************************************************
***************************************************
******************************************************
Vitamin B 6 : High doses of vitamin B 6 can improve libido by reducing prolactin secretion in both sexes. B 6 can also improve the quality and intensity of sexual pleasure in some people who have poor genital sensation. An average dose for these applications is 25 mg three times daily. Vitamin B 6 is excreted soon after absorption, so it is preferable to take a smaller dose of B 6 three times daily rather than one large dose. Taking too much B 6 can cause insomnia and overly vivid dream recall, so if those side effects develop you should reduce your dose or at least reduce your supplementary intake later in the day.

Doses over 200 mg daily can result in neurological disorders if taken for several months. These disorders include a loss of position and vibration sense in the legs, and sensory ataxia (incoordination due to loss of proprioception, which is joint position sensation) which worsens when the eyes are closed. Recovery from this condition is slow and may be incomplete, so it is important to avoid potentially toxic levels of B 6 . If you take fairly high amounts of B 6 , you and your doctor should be on the lookout for any early signs of toxicity.

In males, B 6 supplementation has a greater effect in stimulating libido than in women. Vitamin B 6 contributes to an increased serotonin level in specific sites in the brain (thus explaining the apparent contradiction between this and the fact that a global increase in serotonin impairs libido), which in turn causes a down-regulation of type 2A serotonin receptors (5-HT 2A receptors).

Particularly in males, lower numbers of 5-HT 2A receptors are associated with increased libido. In some men, this increase in libido can be dramatic. The downside of this is that the effect is rather transient, lasting for a week or less.

Normalizing B 6 intake for several weeks can restore some of the potential for a male to libidinally respond to future high dose B 6 regimens. However, the greatest bang for the buck (no pun intended) will be obtained during the first few times it is consumed. By the way, if you try this do not look for an immediate boost in your libidoit typically takes 3 to 5 days for an effect to be manifested.

Why doesnt B 6 cause a sustained boost in libido? One explanation is that pyridoxal 5'-phosphate (PLP), the biologically active form of vitamin B 6 , affects steroid-induced gene expression. A study * performed at the University of North Carolina at Chapel Hill found that PLP decreased transcriptional (gene) responses to androgens (e.g., testosterone), estrogens, progesterone, and glucocorticoid (e.g., cortisol) hormones. In contrast, cells deficient in B 6 were more responsive to steroid hormones. This might suggest that the way to build bigger muscles or improve libido is to dutifully avoid B 6 since a B 6 deficiency would heighten the androgen response. However, things arent that simple since B 6 also decreased the response to some hormones, such as estrogen, that tend to counteract the effects of testosterone.

* Modulation of steroid receptor-mediated gene expression by vitamin B 6 . Tully DB, Allgood VE, Cidlowski JA. FASEB J 1994 Mar 1;8(3):343-9.

Furthermore, B 6 has a number of other effects in the body, many of which are conducive to sex and pleasure. For example, dopamine (a neurotransmitter involved in the perception of pleasure) is synthesized using a PLP-dependent enzyme.

With so many variables and so many ways to hash the data, its more helpful to focus on what people experience when they take B 6 . The bottom line is that B 6 can temporarily stimulate libido in some people. Failure to respond to B 6 might indicate that an individual manifested less suppression of estrogens than androgens, that their initial prolactin level was not sufficient to dampen libido, or several other things. Complex stuff? You bet, but the take-home message is clear: B 6 might stimulate libido. If it works, do not take high-dose supplements of it continuously for that purpose; the dose previously mentioned (25 mg three
times daily) is a high-dose regimen that is considerably above the recommended daily allowance of about 2 mg.

Men who are deficient in vitamin B 6 sometimes notice a significant increase in their flaccid penile size when their deficiency is corrected. The reason for this may seem obscure but, as we will explore later in this book, vitamin B 6 can reduce the homocysteine level. Since homocysteine interferes with the production of nitric oxide (NO), and nitric oxide influences penile blood flow, it is easy to understand the link between vitamin B 6 and penile size. Correcting a B 6 deficiency can increase the size and stiffness of erections, too, but stiffness will increase more than size. **

** To understand why stiffness increases more than size, try the following experiment, or just follow along conceptually. Take a 6-inch length of an old bicycle inner tube and seal it off on one end (the inner tube is hydraulically similar to the fibrous capsule that envelopes the penis), then blow some air into the other end. You will notice that the inner tube will be floppy until it is almost full of air (in this experiment, air is analogous to blood). Once the tube is almost full, adding just a bit more air can make the tube noticeably stiffer and harder, but the size of the tube does not increase by much.

The size of the penis in its flaccid state may seem like a trivial matter, but its not. If you respond to supplementation with B 6 (or B 12 or folic acid, which well discuss later in the book), that might be a tip-off to a deficiency you might not otherwise notice. Because vitamins B 6 , B 12 , and folic acid play important roles in homocysteine metabolism and homocysteine influences your risk of cardiovascular disease, anything that alerts you to such a deficiency is worth its weight in gold. If you think that an average doctor has even the slightest clue as to the adequacy of your B 6 , B 12 , and folic acid levels, youre overestimating the competency of most doctors.

My brother developed profound weakness and numbness, and four physicians (two ER, one family practitioner, and even a neurologist) told him he had carpal tunnel syndrome in spite of the fact that his signs and symptoms were not consistent with carpal tunnel disease. In reality, his problem was due to a deficiency of vitamin B 12 that caused his spinal cord to degenerate like a piece of Swiss cheesehardly a problem that doctors should overlook or pass off as carpal tunnel syndrome.

Even if your diet contains a normal amount of vitamin B 6 , a deficiency may develop due to malabsorption, hyperthyroidism, diabetes, excessive loss, alcoholism, smoking, or the use of various drugs (e.g., corticosteroids [anti-inflammatory steroids], penicillamine, isoniazid, cycloserine, hydralazine, and some anticonvulsants). Studies in the 1960s and 1970s suggested that more B 6 is needed by women taking estrogen or oral contraceptives, but the latest research did not show any particular benefit for women taking those drugs.
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These links suggest the same thing:

https://testosteroneresource.com/tboosting-ingredients/vitamin-b6/
https://forums.steroid.com/anabolic-steroids-questions-answers/523806-forget-caber-prami-tren-try-b6.html
https://www.thundersplace.org/male-supplements/cheap-dostinex-megadosis-of-vitamin-b6-and-e-personal-experience.html
https://www.steroidology.com/forum/anabolic-steroid-forum/638726-b6-prolactin-supression.html
[Edited link out]
http://forums.rxmuscle.com/showthread.php?63970-B6-and-lowering-prolactin

The latter says:

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High levels of the hormone prolactin are a major cause of low testosterone levels,low sex drive, erectile dysfunction and impotency in men. A surge in the hormone prolactin after sexual orgasm is the reason why men need a refractory period before they can go again.

Many men trying to lower prolactin levels choose to use the prescription drugs Bromocriptine and Dostinex (Cabergoline) but, although these drugs are effective at suppressing prolactin, they are expensive and many men experience a host of side effects whilst using them.

This natural prolactin inhibitor supplement stack will lower prolactin levels in men suffering from high prolactin levels.
In contrast to prescription prolactin inhibitor drugs, these supplements are extremely cheap and will not cause side effects in the vast majority of users.

Primary Prolactin Inhibitor Supplements:
1) Vitamin B6
2) Vitamin E
3) SAM-e

Secondary Prolactin Inhibitor Supplements:
1) Ginseng extract
2) Maca powder
3) Ashwagandha
4) Mucuna pruriens
5) Zinc
6) Ginkgo Biloba

(...)

Side effects:

High doses of B6 taken for many months can cause nerve problems such as tingling in the fingers and numbness in the toes (peripheral neuropathy); B6 can also worsen sleep quality in some people and cause vivid dreams. Fortunately, these problems completely resolve once B6 supplementation is stopped and, since it is water soluble, this wont take too long.

Ways around these side effects:

One way to avoid the finger tingling that high dose B6 can cause is to take the activated form of B6 called Pyridoxal-5-Phosphate (P5P) - the activated form of B6 does not cause these nerve issues. In fact, the reason that high dose B6 causes nerve problems is that the body cant always process very high B6 doses properly and this creates a deficiency of the active form of B6, P5P.

Recommended dosage:

To lower prolactin levels I would recommend you take 50 to 200mg of P5P a day, in divided doses. If you want to take regular B6, which as I've mentioned can sometimes cause minor side effects, take 300 to 1000 mg per day in divided doses. Read the label before you buy B6 because the Pyridoxine Hydrochloride type of B6 (in most supplements) has been shown to be a prolactin inhibitor but Pyridoxal hydrochloride has been shown to be ineffective at lowering prolactin (6) make sure you buy the right type!
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That's EXACTLY what I am going to check if it's going to solve this side effect from Accutane. I said earlier that taking another drug was going to be necessary for a long time or indefinitely, and there was a risk of the same side effects returning once the treatment stops. At least vitamin B-6 would be a better choice.

Among all the discussions there was a quote that caught my attention. It seems to confirm what a member said previously: increasing testosterone won't solve this issue if we don't deal with the high prolactin at the same time:

[Edited link out]

Here's what the message said:

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1. Accutane works on and significantly impacts Dopamine receptor D2 gene:

Chambon, et. al. Regulation of dopaminergic pathways by retinoids: activation of the D2 receptor promoter by members of the retinoic acid receptor-retinoid X receptor family. Proc Natl Acad Sci U S A. 1997 Dec 23;94(26):14349-54.

Dopamine is a neuromodulator involved in the control of key physiological functions. Dopamine-dependent signal transduction is activated through the interaction with membrane receptors of the seven-transmembrane domain G protein-coupled family. Among them, dopamine D2 receptor is highly expressed in the striatum and the pituitary gland as well as by mesencephalic dopaminergic neurons. Lack of D2 receptors in mice leads to a locomotor parkinsonian-like phenotype and to pituitary tumors. The D2 receptor promoter has characteristics of a housekeeping gene. However, the restricted expression of this gene to particular neurons and cells points to a strict regulation of its expression by cell-specific transcription factors. We demonstrate here that the D2 receptor promoter contains a functional retinoic acid response element. Furthermore, analysis of retinoic acid receptor-null mice supports our finding and shows that in these animals D2 receptor expression is reduced. This finding assigns to retinoids an important role in the control of gene expression in the central nervous system.

http://www.ncbi.nlm.nih.gov/pubmed/9405615?dopt=AbstractPlus

2. Dopamine has a direct connection with Prolactin levels:

Dopamine (DA) holds a predominant role in the regulation of prolactin (PRL) secretion. Through a direct effect on anterior pituitary lactotrophs, DA inhibits the basally high-secretory tone of the cell. It accomplishes this by binding to D2 receptors expressed on the cell membrane of the lactotroph, activation of which results in a reduction of PRL exocytosis and gene expression by a variety of intracellular signalling mechanisms.

http://jop.sagepub.com/content/22/2_suppl/12.abstract

3. Let's say reduced Dopamine levels result in sustained elevated Prolactin, what would that mean over time?

Elevated serum prolactin levels create two problems that are inimical to sexual potency. With high serum prolactin levels, normal pulsatile GnRH and LH secretion does not proceed. This is why nursing mothers stop menstruating. Without pulsatile LH release, a mans testicle is stranded without adequate stimulation and cannot produce its full ration of testosterone. Serum testosterone levels then fall. But giving more testosterone is not the remedy because elevated serum prolactin levels also prevent the body from responding normally to testosterone.

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Here's where my own personal experiences and thoughts come into play...

I've had my T tuned for some time, taking DHEA, estrogen's in check. And yet I still have inconsistent issues with sexual performance and my mood is either dull or depressed. Surprisingly what made the connection for me was after every time I drink/smoke, the day after my sexual performance is immediately elevated. I could never understand why, it wouldn't last more than a day though. But within that was the key...

What does drinking and smoking do to the brain?

They both increase dopamine.

What does dopamine do again?

Regulates Prolactin.

What does Prolactin do again?

Suppresses male androgens.

Bingo!

Just to add to this re: mood. Always thought I had low serotonin so I would take 5HTP. 5HTP would make my sexual performance non-existent and also result in racing thoughts and terrible anxiety. I learned over the years 5HTP was a big no-no for me. I just assumed then I did not have low serotonin. In retrospect, serotonin is said to counter-balance dopamine and lower it. Was I just driving my dopamine further down? I digress...

If Accutane potentially reduces dopamine (cat goes away), Prolactin can shoot up (mice will play!), wreaking havoc on your endocrine system from there on out. I haven't gotten too far into it, but I will be pursing the idea that without dopamine, prolactin surges, potentially resulting in a pituitary tumor (prolactinoma) that could in turn impact other hormones. In my case my adrenals aren't doing much either (cortisol, aldosterone, dhea). I haven't gotten too far into how and if this relates however, just androgens.

But administering dopamine surrogates will shrink said tumors:

Three medications, bromocriptine (Parlodel), pergolide (Permax), and cabergoline (Dostinex) have doparninelike properties, and any of them can be an effective dopamine surrogate. When hyperprolactinemic men or women are treated with bromocriptine (Parlodel), pergolide (Permax) or cabergoline (Dostinex), serum prolactin levels promptly return to normal. Continued treatment is required to keep prolactin levels fully suppressed.

This treatment has been effective in two respects. Lowering serum prolactin levels to normal restores sensitivity to the sexual effects of testosterone. As serum prolactin levels fall, serum testosterone levels increase and potency returns. Bromocriptine (Parlodel) or cabergoline (Dostinex) treatment also decreases pituitary tumor size and shrinks prolactin-secreting tumor tissue.

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Sorry to hog the thread but a lot of this is coming together now and I just want to try to clarify and put everything in order of effect. So we know that:

1. Accutane results in lower IGF-1
2. Lower IGF-1 results in less p450scc and therefore lowered cortisol (and dhea) produced via blunted response to ACTH
3. Reduced dhea results in reduced testosterone which results in reduced dht
4. Reduced 5 Alpha Reductase activity (mainly type1) results in reduced DHT and a reduction in sebum
5. Lower cortisol results in a) lower dopamine levels and b -low metabolic rate via lowered T3 uptake
6. Low dopamine leads to low mood and elevated prolactin which leads to sexual dysfunction
7. Low metabolic rate causes chronic fatigue and hypothalamus reduces GH,LH
8. Low GH causes reduction in T3 to T4 conversion

I believe that this is how Accutane works and affects us.

From the blood tests I have had done I know that I have low cortisol and lowish dhea. I also know that my T4 (top quarter of range) and TSH levels are good however my T3 level is lowish (bottom quarter of range). I have a low metabolic rate and have been diagnosed, via my symptoms, by a thyroid specialist, as being hypothyroid despite T4 and TSH levels being spot on. For the last month I have been taking T3 meds but it has had little effect, even at 80mcg per day which indicates to me that my low cortisol is the culprit in low metabolic rate. I can guess that my ACTH response is blunted due to slight hyperpigmentation (red face after short exposure to sunlight).

Has anyone here had their IGF-1 tested and know their levels?
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That's what we all need to remember:

"But giving more testosterone is not the remedy because elevated serum prolactin levels also prevent the body from responding normally to testosterone."

Firstly, sorry to have to post this again as its super long.

Much appreciated on the detail here but can I ask in relation to your Accutane summary, which part explains:

Chronic dryness - like permanent?
Excessive sweating?
Thinning hair?
Stiff joints?
Eye floaters?

Is this dopamine related, testosterone related?

No one has ever been able to explain these things, especially the chronic dryness coupled with the excess sweating??

On 25/01/2018 at 2:21 AM, guitarman01 said:

I ended up getting the flu last week, 103 temp that im just now getting over, had to miss a day of work and it wrecked my weekend.

GOOD 🙂

This is the first step towards Recovery @guitarman01 !!

Question : Where you getting sick every year after you got Post-Accutane? Why do other people get sick every single year? This is the natural thing to happen, it is not natural to never get the flu.

Recall that many ME/CFS Patients (i would also expect many Accutane Users) stop getting the flu after they got sick.

This has nothing to do with an "over active immune system". This is because N-Linked Glycosylation is working again and viruses use this pathway to Thrive. This is why we don't get sick when he have these Syndromes, it is not because Immune system over-activation (My Hypothesis) it is just that the Viruses do not find the correct environment to replicate.

Yeah its weird how we dont get the flu or colds as much post tane.

I do say as much cause I did get the flu about 7 years ago - bed ridden with all the aches and pains.

Colds have been few and far between, even though I sneeze quite a bit and Ive always got phlegm year on year.

Thx for offering what might be going on post tane - I had no idea why we skip most colds....

9 hours ago, mariovitali said:

GOOD 🙂

This is the first step towards Recovery @guitarman01 !!

Question : Where you getting sick every year after you got Post-Accutane? Why do other people get sick every single year? This is the natural thing to happen, it is not natural to never get the flu.

Recall that many ME/CFS Patients (i would also expect many Accutane Users) stop getting the flu after they got sick.

This has nothing to do with an "over active immune system". This is because N-Linked Glycosylation is working again and viruses use this pathway to Thrive. This is why we don't get sick when he have these Syndromes, it is not because Immune system over-activation (My Hypothesis) it is just that the Viruses do not find the correct environment to replicate.

Low testosterone (high estrogen) can also help fight off colds/flu. Because I got sick early January and fought it off in like 2 days.. where it would normally take a week and a half!

Why don't we have doctors like this in the UK? Mentions accutane and towards the end he recommends Niacin for leaky gut etc

Anybody tried good quality Lions Mane?
my jaw fucking hurts from all the dopamine

18 hours ago, TrueJustice said:

Yeah its weird how we dont get the flu or colds as much post tane.

I do say as much cause I did get the flu about 7 years ago - bed ridden with all the aches and pains.

Colds have been few and far between, even though I sneeze quite a bit and Ive always got phlegm year on year.

Thx for offering what might be going on post tane - I had no idea why we skip most colds....

I bet were too messed up for the flu to enjoy. Kinda like how ants avoid processed food.