Quote Originally Posted by LetsGo View Post
Overall, I’ve had some tough days and I need to work on my sleep. But there’s been some promising development on the business front, and the dating front as well.

I’m going to get into some stuff I’ve been reading about, but if I should delete any of this, I will go ahead and do that.

Anyway, on PH, I read about a guy, Apr1989, who apparently cured his PFS relatively quickly (5 or 6 months, after about a year of suffering), using a tribulus cycling protocol that sounds interesting. He also used a microdose of a chemical castration drug called Triptorelin, which in small quantities stimulates your HTPA but in large doses, it overstimulates it and knocks if offline (which is how it’s used for prostate cancer.) It’s bioidentical to the hormone that the body uses to trigger puberty, but it seems scary nonetheless.

I’ve been doing some reading on the active component of tribulus, protodioscin, and it has been shown in animals to increase androgen receptor density and activity in the brain. So it sounds like that would be very helpful for PFS, which is why it was perfect for it to have always been part of the herbal rotation. However… top-quality tribulus could arguably be the most powerful of the herbs, because restoring the androgen receptors in the brain is the hardest and most important part of recovering.

*The major theory on PFS is that somehow, reducing your DHT levels or having them jump back up after quitting a 5AR inhibitor, somehow makes the brain resistent/immune to androgens.* That then causes the *brain fog*, loss of libido, loss of brain-penis connection, loss of ability to feel sexual pleasure and orgasms, hormone dysregulation, etc. This is why artificially targeting specific hormones with various drugs will never work. *You have to restore normal function of the brain’s androgen receptors*, and that’s what the TMO protocol has been able to do over time.

Anyway, Apr1989’s idea was to restart his HTPA, and then use *tribulus to resensitize his androgen receptors*. In the comments on his post, tons of people tried using the wrong brands of tribulus, or took massive doses (which he said not to do,) or didn’t cycle it, or kept fapping while doing it, or didn’t taper up and taper down, etc. Basically 90% of the people ignored his protocol, and 5% accused him of being a scammer or not having real PFS. It seemed like nobody replicated exactly what he did, except that the last 5% of the guys made progress by following what he did with tribulus. I didn’t follow up to see if they made recovery posts or disappeared, but the point is that he wasn’t the only one who started making progress that built on itself over time.

Tribulus
The regular tribulus that you buy inexpensively is made from the fruit of the plant, but it’s low in protodioscin. Protodioscin is only produced in large amounts if the tribulus plant was grown in the Balkans - but the cheap stuff is generally grown in China where the climate and soil are different than in Bulgaria. The protodioscin is mainly found in the aerial parts of the plant (meaning everything except the fruit and roots,) but if you’re making trib pills, it’s incredibly expensive to only use 10% of the plant. That’s why the cheaper stuff is fruit-based China or US-grown tribulus, which is very low in protodioscin and therefore not that effective.

The only company that uses only Bulgarian tribulus, and only the aerial portion of the plant, is Standard Process. There are other brands like Vemoherb and Tribestan that use Bulgarian tribulus, and a mix of aerial and fruit, so it still has protodioscin but it’s not as concentrated as Standard Process. From what this sounds like, basically most tribulus is not going to be very effective compared to this high-potency kind. The normal inexpensive trib will work as part of the overall TMO protocol (I’m sure there’s still some beneficial things in the fruit extract, including small amounts of protodioscin,) but the high-end tribulus should work better.

To order Standard Process Tribulus, you have to get it through a healthcare provider, typically a chiropractor’s office or one of those non-Western medicine types of places. Naturopath doctors, acupuncturists, etc. The founder of the company believed in not compromising on the quality/purity, but also believed you needed to see some type of professional rather than just getting it on your own. The chiropractor’s office near me was willing to place the order without any type of appointment. I have a friend who is a naturopath doctor in Arizona, so she could probably place orders for me in the future. I put in an order of two bottles of the SP trib, but they’re not shipping for about 3 months.

In the meantime, I bought some tribulus: Vemoherb and Tribestan, which are made in Bulgaria and are a mix of fruit and aerial extract. Since I’m waiting a little longer to go back to the gym, I started experimenting with Apr1989’s trib-only cycle and within a couple of days, I started getting random wood during the day (but still no morning wood,) and much higher libido, which was surprising. I feel this tribulus more powerfully than the normal herbal rotation that I’d been on, and this isn’t even the best tribulus.

I’m not recommending that anyone else do this, it was just an experiment as I wait until Monday to get back into the gym. But my experience with tribulus has been very promising. I feel like if I was on this low dose trib cycle during an upswing, man, I’d probably feel like I was cured during that upswing. I don’t see much harm in experimenting with this tribulus cycle, but I wouldn’t recommend it because it doesn’t have much of a track record aside from a few guys. The TMO/CD protocol is the gold standard, and my recommendation would be to consider getting one of the high-end tribulus products to use in your rotation.

My Test Levels?
One of my concerns is that even when I’m lifting regularly and doing the herbal rotation, my testosterone is still low the vast majority of the time. (Morning wood is normally a good indicator of test.) I’ve had many upswings and overall I’m doing much better than I was, and I will get healed eventually, but I don’t expect to make any progress when I’m not working out.d

It’s very annoying to make appointments with local doctors, but I’m thinking about finally getting my testosterone, DHT, etc, re-checked. (I won’t go on TRT or Clomid, obviously.) Mostly it would be so I could retest it 3 - 6 months later and see how much I’m able to boost it. Unfortunately, the at-home testosterone test kit companies do not ship to New York, it’s apparently illegal or something (probably BS lobbying by the doctors.)

I feel like to get my levels consistently up, I might need to do a water fast, since I don’t want to go the pharma route of resorting to a microdose of Triptorelin. I don’t think the juice feast I did shuts down your HTPA like a water fast does, because your calories don’t reach a critically low level where your body starts shutting down “accessories” like your hormones. But that’s what I’m looking for, a HTPA reboot in a low-risk way. Because I feel like slowly raising it like 1% per month or whatever, is not going to cut it. In 2019 after I got mono and fasted, when I ate again, I felt amazing and had consistent morning wood through my upswings and downswings, for over half a year (ending only after several months of not working out at the gym, because it was closed due to Covid.) I feel like if the pandemic didn’t happen, I’d be cured by now.

Next Steps
I’m wrapping up the 8 day tribulus-only cycle. I will jump back into the workouts on Monday after getting my second vaccine dose, and add in HIIT on my off days like I’m supposed to. And then I’m also thinking about experimenting with alternating Apr1989’s tribulus cycle, and doing the TMO herbal rotation in between the trib cycles to see if that works better for me, given how good I’m feeling on the low dose of tribulus. I would do the 8-day trib cycle and then 8 or 13 days of the TMO herbal rotation. Then, when my androsterone arrives, I could do a cycle of that for 4 to 6 weeks, then go back to the TMO and Trib rotations for however long I did the andro cycle. Maybe throw in a water fast depending on how I’m feeling.
Ok so a lot of information to go off here, but I want to make one thing clear, because a lot of what is written on PropeciaHelp is a load of pseudo-scientific nonsense, proposed by people who are either a. scientifically illiterate, b. haven't read any of the studies, or c. both of the aforementioned things. The idea that once the 5 AR inhibition is removed, a deluge of androgenic hormones (in this case DHT) is released, which then causes the now sensitized androgen receptors to shut down and become desensitized makes very little sense. If anything, what has been quantifiably proven is that there are in fact *more* androgen receptors than there were before, i.e. the androgen receptors should be more receptive than they were previously. Also, it doesn't explain why the same isn't true of the type 1 alpha-reductase enzyme, which can also be affected (especially with alternatives to finasteride, such as dutasteride) , and yet doesn't cause a shut down of the GABA A receptor once allopregnanolone floods the brain again.

Therefore, the only reasonable deduction to make as to why androgen receptors are not functioning correctly is that an epigenetic change has occurred, where these receptors have become overly-methylated, and therefore cannot adequately react to hormones. If you believe this to be the case, it can be tested for, I'm pretty sure. Androgen Insensitivity Syndrome (AIS) & Complete Androgen Insensitivity Syndrome (CAIS) can be accurately diagnosed through genetic testing, amongst other biomarkers but I am of the opinion that these receptors aren't methylated in any case.

The reason I bring all this up is that if it is indeed correct that the issue is that the androgen receptors have undergone epigenetic change, then I don't see how Tribulus would be beneficial in restoring proper receptor function, if the main mechanism of action is as you say (and I have read) increasing the number of androgen receptors.

The final point I wish to make is that brain fog is not usually linked with the androgenic changes in the brain (despite brain fog being a common complaint of individuals with low testosterone), but rather the levels of allopregnanolone in the brain. This is why many individuals have seen their brain fog disappear with the alpha-reduced precursor to allopregnanolone, 5a-DHP, and why others have been able to use SSRIs to get rid of their brain fog (SSRIs are also used to increase the conversion rate of 5a-DHP to allopregnanolone). It's also the reason why brain fog, and other cognitive complaints, are rarer in PFS than sexual complaints (i.e. Finasteride preferentially targets the type 2 enzyme in lieu of the type 1)

If you are especially keen on fixing these androgen receptors, I'd have a look at demethylating agents (things like butyrates can be helpful at this), although I would definitely ask a doctor to test you to see whether they have changed in the first place.

Hope I haven't misinterpreted what you've written, and that you're doing ok.