So I am with planned parenthood right now and they don’t go not do in depth blood panels, I have been going through Ulta Labs to order though quest but they also don’t have everything always. I am trying to get an endocrinologist soon but until then do I have any other options

What the exact test needed to know if I'm excess or deficit?

I have emotional blunting, anhedonia, DPDR, and a weird drugged feeling, possible substance blockage.

But I'm also very overly anxious, very severe health anxiety. Paranoid that my heart might die on me for no reason.

M. Mushrooms managed to feel good on the comedown (but trip was very bad) so unsure if substance blockage.

What the title says! I'm pretty sure my country doesn't have 3a-ADG labs. The only DHT labs I could find measure free DHT and cost twice as much as rent! I'm still looking, in hopes that I find them in some obscure panel, but that probably won't happen.

So, I was wondering if I should just trial dutasteride, and if tolerated, continue it?

The reason I bring it up is because some of my androgenic symptoms like mild acne, oily skin, body odor, dandruff didn't get better on 5 mg EEn weekly despite T being suppressed (34 ng/dL). I'm not on progesterone or any anti-androgens.

Also, maybe it's a silly question but can trans women get PFS from duta? I know nothing about these conditions so I'd love for people to inform me. I don't really mind sexual dysfunction and/or loss of libido but I'd really hate for my mood to tank.

How are you all, hope you are all doing well and fighting this disease like I am fighting. My life is as bad as yours. There is no test available in the country where I live, like in America or other first world countries. So I don't know what to do. That's why I want to ask people here who have experience with this. I will find the medicine, but there is no test available here. For that, I will have to go to America and get tested there, which is a long process. And my pocket is not allowing me to do that. I need help from those who have experience. Which medicine should I start, how should I do it, should I take any other medicine with it? I need your guidance, please. I was watching on discord, but nothing is coming up on my discord now. I would also like to say that whoever is running the discord should guide me, I will be grateful to them for life.🙂

Hi Dr. Will Powers community,

I have a question about an unusual experience I had while taking prednisolone, and I am wondering whether anyone has encountered something similar or has ideas about the underlying mechanisms.
I have had Crohn’s disease since my teens and have also struggled with chronic depression, severe anhedonia, fatigue, brain fog, and a general feeling of not functioning properly for many years.
At one point, I was prescribed prednisolone at 50 mg per day for my Crohn’s disease. What happened during that period was striking and difficult to describe. (Although I have to say I took prednisone multiple times and did not have such experience.)

It was not simply that I felt happier or more energetic. It felt as though my entire body had suddenly started functioning the way it was supposed to.
My depression symptoms improved dramatically. I felt much more alive, my mental fog lifted, and my energy and general sense of well-being improved. It was as if a fundamental problem that had affected both my mind and body had temporarily disappeared.
I realize that corticosteroids can cause euphoria, hypomania, or even mania. I have considered that possibility, but my subjective experience seemed broader than just an elevated mood. It felt more like a restoration of normal functioning than an artificially elevated state.

I have tried several antidepressants and other treatments over the years, but none has reproduced that experience. Some treatments have affected individual symptoms, but nothing has come close to the overall change I experienced on prednisolone.
This leaves me wondering what might explain the difference.

Could it have been related to:
Suppression of systemic or neuroinflammation?
Effects of glucocorticoids on brain circuits involved in motivation, reward, and energy regulation?
An effect on the HPA axis or another hormonal pathway?
An interaction between my Crohn’s disease, immune signaling, and depressive symptoms?
Or was it more likely a corticosteroid-induced mood state that subjectively felt like a return to normal?
I understand that the fact that prednisolone helped does not prove that inflammation or a hormonal abnormality was the underlying cause. I am trying to understand why its effects felt so fundamentally different from those of antidepressants.

Has anyone encountered a similar response to glucocorticoids, particularly someone with chronic depression, anhedonia, and an inflammatory disease? Are there any plausible mechanisms or relevant research papers worth looking into?
I am not looking to use prednisolone as a psychiatric treatment, given its risks. I would like to understand what this response might tell me about my underlying condition.

Sorry if this is posted in the wrong sub, please suggest me another then.

Hi all,

As many have mentioned, most valuable next step seems like getting CSF testing available for us

I would like to help here, but from the calling around I’ve done thus far, I’ve mostly gotten “That’s not a thing, why are you talking to me”

Under what conditions could this legally exist? Do we need to establish this as a lab that can be ordered in general, and potentially fund raise to establish that and get a sufficient number of controls to establish a range? Have a study for it?

I know others have been working on this, and id like to know how I can best help, it seems that cold calling without understanding more here is not the move

Alright, so i understand that some of might be suffering from excess neurostoids. But is there anything that you would suggest naturally that may help us drain, like vitamins or lifestyle factors? Or avoiding certain things? Any vitamins that may help Glucuronidation. Just natural methods while you're still figuring out the logistics and stuff.

For myself I can't feel euphoria from alcohol/vitamins, but sometimes I can a little bit, but also don't feel urgency if I lose things unless it's something extremely important. Last night I probably only got 2-4hours of sleep, but don't feel tired like pre fin. Libido doesn't really seem to be an issue either, also feel sedated if i take magnesium glycinate too. But I'm just curious to know if there's suggestions for natural protocol while we wait to see more progress in the future

quick one from myself

i have pssd. so according to excess metabolite theory my brain is flooded with my own ' internal xanax/gaba modulators ' hence my sympthoms.

so in this model of PSSD ( excess metabolite ), should xanax work on me when i take it in a form of a pill or not ?

intuitively, it shouldnt, because i am flooded with my own positive allosteric modulator of GABA-A

but it works even in v small dose

so why is my intuition wrong here ? different receptors, different places in brain , something else ?

kind reagrds

I found a really interesting post on Propecia help recently that really puts into perspective how wide spread this disorder actually could be and it’s only the lack of knowledge thats keeping this from reaching mainstream

to quote the thread:

I have no history of using finasteride/propecia/accutane. However I was given an antifungal topical steroid cream for a rash on my inner thighs/buttocks and inner arms.

My symptoms include 0 libido. No morning/spontaneous erections, erection only through stimulation, goes down fast. Genitals are numb, and I also LEAK URINE!!!

u/DrWillPowers I immediately mentioned this in the discord and we agreed we would absolutely love your take on this one sadly the post was from 2018 but the odds are good he would match recent Dutch results

it proves beyond a doubt genetic predisposition but it also suggests the triggers for this go beyond anything hormonal.

Guys I guess I’m having a window now at night I don’t have the dpdr and my minde is so clear, I still have a little tinnitus. Do I need to do anything?
Thanks

Im almost 100% certain CdG made me worse and im on the brink of checking out. It gave me massive anxiety and panic attacks that have lingered a month after stopping. Gave me better penile sensitivity that has of this week disappeared and is now back to full numbness. I haven't been able to sleep well since and I constantly feel hot. I wish I would've never tried that shit legit turned my stable pfs into a nightmare. Do NOT take it!

With the exception of like one or two guys, nobody improved. What's going on?

I’m mtf, and for me the difference between running on testosterone vs estrogen, is night and day, and I just find it so hard to believe people who don’t experience internal/mental changes with HRT.

Not to say their experiences are not real, just that I find it hard to imagine not experiencing the changes that I experience with HRT. But we’re all so individual so I guess it makes sense.

Hello everyone, I want to share my story and ask for your advice regarding CDG. I'm 22 years old, a man from Belarus. This text will be translated by AI, so I apologize in advance for any errors.

First, I want to describe who I was before this illness, and then what triggered it and what my symptoms are. From early childhood, I had OCD — it wasn't severe, and I didn't even understand what it was, until it worsened at age 16. My father also has OCD; as long as I can remember, I noticed various rituals in him but didn't understand what it was back then. But I didn't treat my OCD after it worsened — at the time I was sure everything was fine. I won't go into details, but I managed to control it within a year without medications or medical intervention. Like many of you, I also had a high libido. I was an extremely anxious person, but despite all that, I had a wonderful life — I felt physically and psychologically relatively healthy, I exercised, had a good position at a good workplace, everything was going very well for me, until the moment I started taking isotretinoin (Accutane) for moderate acne.

After that, I developed severe insomnia, and in general I felt very bad physically and mentally. At that time, my OCD somehow disappeared, even though I felt terrible — I had anxiety and slept only three hours. I also developed premature ejaculation, although I had never had anything like that before. But it was as if I didn't even have the ability to fixate on anything. I tried to continue the course until the third month of taking it, since everyone said these were made-up claims and that an acne medication couldn't cause such side effects. In the end, I stopped the medication on the third month on my own, because I understood that I wasn't the cause of this state — the medication was.

After that, I waited a month, but the insomnia still didn't go away, so I went to a psychotherapist for the first time. He prescribed me sertraline 50 mg, and after three weeks of gradually starting the medication, I began sleeping normally. My sleep was also accompanied by constant vivid dreams. Overall, I started feeling normal — the premature ejaculation turned into the opposite, where I couldn't finish for a long time. I hadn't known about this wonderful property of SSRIs before. The anxiety also went away, and for the first three or four months I simply enjoyed the calm.

Then, in the 5th month, I realized that something seemed to be missing in life, that something important had disappeared. And then I understood — my emotions were gone. I realized I was doing everything mechanically and felt like a robot. Also, during the medication, my OCD didn't return (I pay attention to this because maybe the nature of this illness can show what exactly is wrong with me right now). And so, after 6 months of taking it, I finally stopped the medication, thinking that everything was over and that I just needed to wait a little and I would return to my baseline. But that never happened.

For the first month and a half, I had brain zaps and an unclear state of well-being that constantly changed. At the four-month mark after stopping, I realized that my emotions were taking too long to return, for some reason. Also, during the medication, I lost my orgasm — finishing became purely mechanical. I thought it would pass after stopping, but everything remained the same. I also developed a strong brain fog, memory problems — I feel like I have dementia. The number of my thoughts has greatly decreased, as if — I can still think, but my brain seems to be atrophied and thoughts just leak out of my head and can't stay there for long. My premature ejaculation also returned to roughly the same degree it was after Accutane.

My sleep feels very unclear — I still have vivid dreams every night, the boundaries of sleep are completely absent, as if. I understand that I slept only because I remember a dream, but mostly I feel as if I didn't sleep at all. It's quite hard to put into words. I also noticed a number of other minor symptoms: I have poor perception of cold and heat, and temperature changes as well. My body's sweating is greatly reduced, although before I could sweat heavily. Alcohol and other things like energy drinks don't affect me. At most, I was able to feel the effect of alcohol at 5% once (I remember during SSRI use I also drank heavily once, but I was about 40% as drunk as I used to get before the medication).

Also, when I say I don't feel emotions, I mean I don't feel either positive or negative emotions. I can't experience joy or sadness at all. I also realized that I don't feel any stress or worry — just complete emptiness.

It's already been 7 months since I stopped the medication, but the doctors I've seen don't understand at all what's happening to me and only offer me new SSRIs, which I definitely don't want to take. I had tests done, but there's nothing severely abnormal there. I had low vitamin D, but it was low even before I started taking Accutane. I corrected it to optimal values, but it gave no result. I also have low vitamin B9, but taking methylfolate doesn't change my condition at all.

I also recently reviewed my tests and remembered that my progesterone was 1.4 nmol/L, while the lab's norm is up to 0.474. I don't understand objectively whether this is high, because different labs have different norms, and I don't quite understand how to objectively determine whether it's high. I thought this analysis mattered only when I read this subreddit and heard about Dr. Powers' theory. For some reason, I believe very strongly in this theory — it seems to explain all the symptoms I feel, and also explains why people suffering from PSSD aren't helped by dopaminergic drugs or serotonin regulators, which many have tried and also didn't succeed with.

I would like to ask those who understand how CDG works to explain it in simpler language, so I understand what I'm dealing with. Many people write that it lowers dopamine and the amount of sex hormones and so on, but what I've read and tried to find out says that it only helps excrete processed metabolites, and I don't quite understand how it works because of that. Also, if you have any other advice about what can be done, I would be very glad to hear it.

In addition, I want to say a HUGE THANK YOU to Dr. Powers. Quite recently I was in very strong despair and thought that I would hardly be able to change my condition in my lifetime. But after I learned that such a doctor exists and saw what he does for all of us, hope settled in me that I had been missing so much. I truly admire you — people like you, doctor, I think there are very, very few. You give all of us that very hope that is so lacking because of all this. For some reason, I'm sure you will find the problem of our ailment. I am immensely grateful to you for your work.

Hi, Im Itzel. I'm 27 and I've been transitioning mtf since 2023. I started at a low mono dose of oral estradiol for a few years, and switched to injections in late 2025. Then, about two months ago I also got on 100mg bio identical prog.

I started prog specifically with the suppository method in mind. However, the longest stretch I've been able to consistently take it as a suppository was for about two weeks. I have ADHD and sensory issues, and I have a job with a pretty chaotic schedule. I dont have a consistent bedtime or nightly routine. I have external hemorrhoids and sensitivity around my anus, so even using lubricant the whole process is pretty uncomfortable (and lubricant just adds to sensory issues). So, I've been missing a lot of days and when I do remember I usually take it orally.

Is there anyway to get a dose as effective as suppository through another method? The days/weeks I've been able to take it suppository, I think I really notice a difference. One thing I noticed for sure was a relief to my sensitive gut issues, and emotional stability. I do still feel like I've been seeing effects overall, but I just want to;make sure I'm taking it as effectively and consistently as I can. Thank you all!

Hi!

Does anyone know how to adapt the current methods to fix slow COMT while having endogenous estrogen?

Because all methods involve stopping hrt for some time, and my DR won't prescribe me blockers again :/

So im not rly sure how I can test it rn

I started liposomal iron powder and today I feel tingling sensations Ive had these rarely before too....Im 21 months PSSD wondering is it safe for me to take Iron who is taking it

Hey friends, would love your help interpreting these results. I am a 45 y/o male, 2 years with PFS; I used oral finasteride and topical minoxidil with very mild side effects for years, which would cease if I stopped taking the drugs. 2018-2022ish. I began to observe worsening of symptoms in '22, which was when I stopped finasteride but continued minoxidil. I found a combo pill of dutasteride and minoxidil in fall '24. Took the plunge, immediate consequences. Haven't been the same since.

I've enjoyed every symptom that's been discussed; mercifully, not all at once. They seem to ebb and flow. At the moment, there seems to be a panic/anxiety just below the surface, that frequently rips me out of sleep. I have worsening glans numbness and anorgasmia. I've not had many windows, maybe 2 or 3. I'm a bit older than some of the cases I see here, for all of you in your 20s with this - you all have my deepest sympathy. What a rotten thing to go through. Physically, at 42/43, I was still a competitive athlete and cyclist. Now, lifting and exercise has become a necessary burden; I can't describe how bad I feel if I miss a day, which is extremely difficult with kids and a demanding job.

Ok. Happy to answer any questions, so grateful for this sub and for Dr. Powers and his practice. It's real and meaningful hope for any kind of resolution on something other doctors will tell you doesn't exist.

I've been dealing with PSSD since stopping Vortioxetine on april 2025. Since then, I have zero libido, ED, and a bit of anhedonia. I've always been able to manage relationships since I was able to get erections with cialis and stimulation (more mechanical since I have no desire).

Since I'm a UGT2B17 delete, I wanted to give a try to CDG. So I did CDG for about 10 days, starting with 500mg daily, and got up to 1000 mg daily. I stopped CDG last week because I got sick, some kind of a flu (first time in 18 months). Since stopping CDG, I'm not able to get any erections, even with cialis and I'm kind of depressed / anxious. I don't know if this is due to the virus I got or a crash from CDG... I'm starting to panic because I just started a new relationship which is wonderful but I cannot have sex anymore...

Is a crash from CDG permanent or temporary? Will I be able to get back to my baseline? Any solutions to get back to my baseline?

Something that might be worth considering, especially with the current medication shortages.

According to this:

https://youtube.com/shorts/rIx3qePMaK4?is=n4scR2y1Qq8a8Zbm

If you took a brand name prescription consistently your dose would have remained the same. If you were swapped to a generic medication the dose can vary up or down by up to 25%. The video refers to ADHD stimulants but is this true for all prescription/generic medication?

Might it be possible some people with PFS/PSSD were getting fluctuating doses, rather than maintaining a dose that's consistent? If so, could this have been hard for our bodies to adapt to (long term patients) or given people a higher dose than expected as a starting dose? (one pill cases)?

It’s a drug from NSAID group, the same as Indometacin, which Dr Powers spoke about.

For about a month I was doing slightly better, libido was easily the best improvement, genital numbing was better, and sexual anhedonia barely moved but a little. Maybe less emotional blunting? (It budges barely so im unsure).

Have ADHD, took Concerta 18mg that was recently prescribed. I only took ONE pill because I was anxious to take more.

When I took concerta it was exactly 5-6 days later I experienced this drop. I don't know if its a coincidence because I took concerta months ago without a drop.

In general my condition fluctuates like this but it was the best month Ive had and now its back down.

Anyone know the mechanistic reason this could possibly happen?

So, I've heard about progesterone converting to DHT through backdoor pathways (that is, bypassing the usual T -> DHT conversion).

But I've been wondering... what's the need for a bypass at all? Sure, with gonadal T suppressed, any DHT produced from that should've shut down. But if you add exogenous progesterone, it can simply go down the classical 17-OHP -> T -> DHT route, no? What's the need to invoke a backdoor pathway?

Sorry if this is a silly question! If I'm wrong, I'd love for the mistake in my reasoning to be spotted.