PFS has altered neurohormone levels and 5AR2 methylation alterations (studies). PAS might too.

[BD_Acc]

Altered methylation pattern of the SRD5A2 gene in cerebrospinal fluid of post-finasteride patients: a pilot study.
https://www.ncbi.nlm.nih.gov/m/pubmed/31272082/

Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients. https://www.ncbi.nlm.nih.gov/m/pubmed/28408350/?i=2&from=/31272082/related

These studies find big drops in CSF levels of oestradiol and DHT in CSF (together responsible for libido/sexual function) and also dihyrdoprogesterone (not sure what this does).
The top one also finds altered methylation of the 5AR2 gene in half of the PFS patients.

I don't know where we would have to send CSF samples to have these tests done. Figuring that out is the next step.

 

[Alex Jaramillo]

Dihydroprogesterone is also a major precursor to allopregnenolone which probably accounts for the lowered mood and suicides associated with 5 alpha reducatse inhibitors such as finasteride and accutane.

 

[BD_Acc]

Have been thinking more about this. If you had a tube running through your skull into the CSF you could run a slow infusion of DHT, E2 and whatever else is affected directly into your CSF. This could be a viable treatment option if receptor numbers are still fine and they are responsive.

Definitely seems worth getting CSF testing done.

 

[Alex Jaramillo]

That would be interesting to see

 

[Dubbya_B]

Yes. Would be interesting.

 

[jammy0]

Altered methylation pattern of the SRD5A2 gene in cerebrospinal fluid of post-finasteride patients: a pilot study.
https://www.ncbi.nlm.nih.gov/m/pubmed/31272082/

Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients. https://www.ncbi.nlm.nih.gov/m/pubmed/28408350/?i=2&from=/31272082/related

These studies find big drops in CSF levels of oestradiol and DHT in CSF (together responsible for libido/sexual function) and also dihyrdoprogesterone (not sure what this does).
The top one also finds altered methylation of the 5AR2 gene in half of the PFS patients.

I don't know where we would have to send CSF samples to have these tests done. Figuring that out is the next step.

I would happily donate some money to get some CSF tests done. Is there a way to find out how much one of these tests costs?

 

[Dubbya_B]

This would most likely need to be done in the context of research. There is no test available to clinicians to perform such a procedure.

 

[BD_Acc]

Would have to contact researchers and ask how they did it. Then pay to get an LP, have it sent to a lab or the researchers themselves and pay to have the same tests done.

I am now not sure if CSF hormone levels are an accurate reflection of what is going on in the brain.

https://www.sciencedirect.com/science/article/pii/S0163725814001041

This study explains that drug delivery from the CSF to the brain is minimal relative to vascular drug delivery because of the slow rate of diffusion into the brain and the rapid CSF turnover. This means CSF hormone levels also would more strongly reflect blood levels than brain levels (by my understanding).

 

[Dubbya_B]

A spinal tap to test for levels of obscure hormones for an unverified condition might require the approval of an ethics board. It's a painful and potentiallly dangerous procedure, unlike a simple blood test. I doubt any doctor would perform this outside of a study. It sucks. Ethics boards stand between us and finding evidence of harm from a drug produced by an unethical company.

 

[jammy0]

A spinal tap to test for levels of obscure hormones for an unverified condition might require the approval of an ethics board. It's a painful and potentiallly dangerous procedure, unlike a simple blood test. I doubt any doctor would perform this outside of a study. It sucks. Ethics boards stand between us and finding evidence of harm from a drug produced by an unethical company.

True but there must be many doctors around the world, particuarly those in less regulated countries like South America or India, who would be more than happy to do it if the fee was high enough

 

[jammy0]

I will look to see if this procedure is possible. does anyone know who we could send a sample to for analysis?? are there any private companies?

 

[BD_Acc]

Best bet would be to email the authors of the Finasteride study (Melcangi et al.) and ask who did it for them and if it's likely possible to be repeated for a fee.

I am sure a private clinic would take a sample for you if you explained why (that it was for your own private testing you had organised). I don't see why that would need IRB approval given no university staff are involved.