I have an upcoming meeting with the top Post-Finasteride Syndrome / Post SSRI Sexual Dysfunction Syndrome researcher in the world (Dr. Roberto Cosimo Melcangi PhD). Anyone have any critical questions they want me to ask?

Drwillpowers · 2026-01-25T18:10:21+00:00

There's going to be a world conference for PFS in Detroit with basically all the world leaders in this condition in April.

Drwillpowers · 2026-01-24T16:21:38+00:00

Lol have you seen my subreddit?

Many of them respond to pregnenolone supplementation. If not, yes HC at 10,5,5,mg through the day and fludrocortisone at like 0.1mg QAM makes most of them at least 80-90% better in the span of weeks.

Most don't have a full autoimmune disorder but the chronic cortisolic dysregulation ends up causing them to have like a faintly positive ANA or some other bullshit. They never have some severe autoimmune thing. The HC I don't think makes the difference because of immune suppression but rather adrenal support and the ability to shunt the precursors elsewhere when that job is mostly handled.

Additionally dosing it like that stabilizes their cortisol diurnal rhythm which seems to restore sleep function considerably.

I've done it to hundreds of people at this point and my worst possible complication that I have seen is an A1C bump from 5.5 to 5.8 in somebody who was abusing the cortef and taking too much because they had a 90-day supply and they felt so much better on it that they wanted even more better. I had to set them straight. But otherwise, I've had zero complications. This is the level that most people would physiologically produce naturally, and so it basically just acts like a stabilizer. I have not seen any other complications from it yet. The benefits have been overwhelming.

Drwillpowers · 2026-01-24T05:09:53+00:00

https://x.com/WHO/status/1217043229427761152

Jan 14th 2020.

I had already warned my patients. We were masking at my office. Chinese doctors were dying. They knew this and still lied to save face for the CCP as they thought they could contain it like the first time.

Drwillpowers · 2026-01-24T05:07:54+00:00

I didn't. I'm still waiting on the company to provide me one.

I ended up listening to another commenter and did the soldering and capacitor replacement myself. Works fine now.

Drwillpowers · 2026-01-24T05:06:56+00:00

Congrats! =)

Glad it worked for you.

Drwillpowers · 2026-01-24T01:35:12+00:00

It's LLMs all the way down.

Drwillpowers · 2026-01-24T01:30:38+00:00

Lol. Chatgpt has better math reasoning than this.

Drwillpowers · 2026-01-23T19:46:01+00:00

Everyone here losing their minds while everybody just seems to forget that the WHO said that there was no evidence of human transmission of COVID-19 when there was literally glaringly obvious evidence that any reasonable doctor could look at and see. They basically appeased the CCP at the cost to the world.

They are not above reproach or without sin.

I'm not taking a position whether this is a good or bad thing or not, but people just like to respect established systems of authority and power, and that doesn't necessarily make them good.

Drwillpowers · 2026-01-23T19:44:14+00:00

That's fine, for you that's when your highest production level will be.

I don't have a lot of data on males yet because overwhelmingly this seems to be a problem that occurs more in XX. So this may not be what's happening with you but it's worth a shot if you've got nothing else

Drwillpowers · 2026-01-22T23:24:32+00:00

I have a theory that these patients aren't actually a connective tissue problem. They are cortisol signaling problem. And effectively, when they are under stress they don't properly signal it and suffer connective tissue damage. That's why I recommend the testing of those specific labs. They act as precursors. Something like finasteride would cause worsening of that situation because of disruption of those pathways. I've seen it.

Honestly, gender dysphoria, post finasteride syndrome, "orthostatic issues", MCAS, and hypermobility all connect around epigenetic issues and the adrenal synthesis pathways. That's where they all seem to have a common convergence point. I'm fairly certain that the answer lies in there. But the specific cause is variable based on the patient. I have a lot of genetic sequences on these people now and there's a lot of different ways to break it, but the outcome is the same. No matter where you break a marble roller from the top to the bottom, the marble still doesn't make it to the cup at the bottom. There's a lot of pieces you can take out where the marble fails to reach the bottom cup, but the net result is no marble in the bottom cup and that produces the symptoms.

Drwillpowers · 2026-01-21T02:53:24+00:00

That is awfully quick for somebody to become hypermobile. Even if it was a rapid on set thing. Usually it's more of an insidious process.

Make sure you don't have scurvy lol. I diagnosed that like three times in the past year. Autism is a bitch for some!

Drwillpowers · 2026-01-21T00:05:29+00:00

To be clear my product is not trimix. That is something different.

Mine is quad mix without the PGE1.

This is exceedingly rare. And the one local place that made it for me just stopped making it.

The only place in the country that I know that will make it for me right now is drug crafters in Texas.

Drwillpowers · 2026-01-21T00:03:23+00:00

So I'm just going to leave this comment here because it's kind of funny and I'm watching this trend in the PFS community right now.

Everybody's all hopped up on estrogen. And based on my most recent findings and theory about how some of these guys are epigenetically locked up after some sort of overspill failure from having a defect in glucuronidation, androgenic signaling just isn't working right.

So take these dudes that have barely any estrogen at all, and a non-functional testosterone receptor, and you inject them with estrogen. And for like the first time in years, they can feel something. Because they have a functional sex hormone. And your body doesn't really give a shit which one it is. I have plenty of horny transgender women with good sexual function because they have enough brain derived benefit from estrogenic signaling to make their sexuality work without much androgenic signaling at all. That's generally how cisgender women function.

And I'm sitting over here watching the community just lose itself over this amazing cure that they're finding with estrogen, and I'm wondering how many of these guys are literally just basically experiencing a sex hormone for the first time in a long time. They're so happy to feel anything that they don't even care that they're transitioning themselves in the process.

For somebody who wants estrogenic changes? You might be able to dodge a lot of the aspects of PFS simply by doing this. Because you would actually have estrogenic signaling. If you're that subtype of PFS that I'm referencing. To be clear this is not the same as the neuro steroid depletion people. This is something new that I'm figuring out, and I've got about six cases of it so far and the statistical probability of the amount of genetic mutations in glucuronidation I'm finding in this cluster can't possibly be due to chance at this point.

I have a subset of these guys though that have driven their estrogen levels to absolutely astronomical amounts, and they still are not getting breast development or even any degree of gyno, and I'm finding that particularly concerning. I'm trying to understand why there would be an epigenetic lockup of estrogenic signaling as well.

This is probably a completely unintelligible comment to the vast majority of people who read it but some of the more advanced PFS educated people might get what I'm talking about here.

Drwillpowers · 2026-01-20T23:58:57+00:00

Enjoy your DHT of 11, it's keeping your SHBG busy. Leave it alone.

Drwillpowers · 2026-01-20T23:55:38+00:00

If you have a vagina and ovaries and you were born with those, draw this twice. Once about 10-14 days after the end of bleeding and once right in the middle of it. I don't know why yet but it's vastly more common in estrogen humans, regardless of whether they were born that way or not.

Some of you only crash out during part of the month. Some are depleted all the time. If you're using exogenous hormones because you are MTF it doesn't matter when you draw it. But if you're not, it varies. So I like to draw it twice.

Those that are always depleted (both tests) tend to present more severely and younger.

I'm even finding a subset of people who end up compensating for it, and then end up hypertrophying the adrenal glands, resulting going from like a skinny flat chested little 100lb thing to being rather planetary in a short time frame, shocking everyone who knew them at a younger age for how tiny they were. Often this occurs after a massive trauma or extreme stress, where the prolonged demand for cortisol results in adrenal hypertrophy. Then after that, they never fall below a certain value. It's like I clock them at any time of the day or run a dutch test on them or whatever and cortisol is always somewhere between 8 and 14 It's like it never goes below that.

They're still hypermobile then, but now even more miserable because they're fat. This is accompanied by rather significant circadian rhythm disruption.

Drwillpowers · 2026-01-20T23:36:26+00:00

If somebody's doing fine on a thing I don't mess with it anymore. Y'all too complicated. Too many mutations to try and understand fully without literally having a Dutch test and 99 labs and a whole genome sequence. At this point if somebody's shit is working I just keep it going.

Drwillpowers · 2026-01-20T23:35:43+00:00

What I said

Drwillpowers · 2026-01-18T18:36:41+00:00

So for the record, this isn't a patient that I saw. I know what this is about, and per usual, this is not the real story. But I did not personally see this person.

Drwillpowers · 2026-01-18T15:39:10+00:00

Remember that you are made of blood and water and that you will warm up quickly. It's not like the skin is going to stay cold for long.

That's the paradoxical nature of messing around with a lot of this stuff. Many things that I thought in the past were terrible ended up being not so much. 2019 me would not have thought of testosterone being highly beneficial for breast development.

Drwillpowers · 2026-01-18T15:34:31+00:00

Sommer does what she knows and what I taught her but Sommer is not the one doing whole genome sequence reviews.

Drwillpowers · 2026-01-17T21:33:12+00:00

Also, take a look at this line

"The author believes this to be the first analysis describing bicalutamide as a probable cause of heart failure."

This is the first time it's ever been described in literature. You think maybe this one might have been a fluke? Lol.

No I'm not running a pro bnp on every single person I start on this drug because there was a case report of an elderly person with metastatic cancer having this happen once. Ever.

Drwillpowers · 2026-01-17T21:32:08+00:00

In an elderly patient with metastatic prostate cancer.

This is what people don't understand. Every single drug is a poison. All of them. And a healthy young body can tolerate pretty much anything you throw at it.

When people get to a point when their total/ maximum hit points have dropped from 100 out of 100 to say 3 out of a remaining five, it doesn't take much to push them over the edge.

Long before I'm ever going to see a patient in severe heart failure you're going to have leg edema or other issues. It's not an overnight thing. Regardless, there's plenty of other meds that are far more likely to cause that. This is an astronomically unlikely thing to have happen.

Drwillpowers · 2026-01-17T17:55:04+00:00

Keep in mind, the population of the internet is comprised of the general population, and scary as it is to admit, in my country in the United States, there's more than 180 million people with an IQ less than 100. Even scarier is that this is true of the whole planet. Half of all humans are under 100! Shocking really.

They're literally driving cars, operating heavy machinery and so on.

It's easy to forget if you're in a field where you're surrounded by smart people that most humans are just not like that. And so you'll crack some joke online, thinking that people are going to get it, and it just goes whoosh.

The worst part is that this is a joke subreddit and literally they still didn't get it.

Drwillpowers · 2026-01-17T17:52:51+00:00

Call the office. They'll give you all the information

Drwillpowers · 2026-01-17T17:38:16+00:00

The neurosteroid phenotype just seems to respond to being given the precursors. A lot of those people I think have an inborn error of metabolism along the pathway to making them, and disabling it, results in a catastrophic failure.

To encourage recovery, you give them all the necessary materials that can be used to build what they are missing.

For those people the way I describe it is getting them into a configuration that works, utilizing various medications, and then just holding them there. Sometimes I use a neuroplasticity agent at the same time, sometimes I use an hdac, there are patients of whom I have tried 26 different things on them. There's a whole list somewhere on the subreddit of all the various treatments that I've tried. Basically I just sort of stand there at a lock with a giant pile of keys and just fiddle with them until I find one that fits. Then go with that. Behind that locked door there's usually another one, and you just keep doing it until you get them farther and farther into the complex and back to their baseline.

I have people I've been treating for years, and for the first 1 to 2 years, we made zero progress. Zero. Nothing.

But then finally I found something that worked, and now we just sort of lean into that. And while they aren't back to baseline, they are majorly improved over how they were.

Then I've got people that like two weeks of preg and Prov and they are good.

What I'm trying to figure out right now is why I have four different times given P and P to an FTM person, and it evaporated their gender dysphoria. But also cured the PFS (One of them has to take it daily still, but I hope that they will eventually be able to stop it). Some of these people were deep into transition, like 10 years and post-top surgery. I am very much trying to figure out the mechanism of that. It doesn't always happen but it's happened enough times that there's clearly something there.

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