Re: List of treatments for post finasteride syndrome…
u/drwillpowers
r/DrWillPowers2026-04-05T04:43:28Z
Dr Will Powers’ own statements and theorizing
Mentions treatments or doses — not guidance
Summary (paraphrased)
In a reply on his own treatments-list post, Powers states that the mechanism of PFS is, in his view, settled: every PFS patient in his practice shows the same underlying lab pattern with minor variations, which he describes as a near-complete resolution of the "how it happened" question — distinct from the still-open "what to do about it." He lists the tests that demonstrate the metabolite anomalies: 3α-androstanediol glucuronide (3a-ADG), 11-oxo androgens, whole-genome sequencing, and DUTCH testing. He frames the disease as an inborn error of androgen metabolism — different genes, same catastrophe — with the specific defective pathway determining the phenotype (e.g., glucocorticoid-pathway defects producing the "melty skin" phenotype, glucuronidation defects nullifying androgen signaling). He adds that he suspects PSSD is the same disease but lacks sufficient data, noting only two PSSD genomes so far, both carrying ABCC5 variants.
Key points (paraphrased)
- Claimed resolution: the PFS mechanism is "done" — a uniform lab pattern across his practice, with the treatment question still open.
- Diagnostic battery: 3a-ADG, 11-oxo androgens, whole-genome sequencing, DUTCH testing.
- Inborn error of androgen metabolism as the common cause; the defective pathway determines the phenotype.
- Glucocorticoid-pathway defects linked to the "melty skin" phenotype; glucuronidation defects to androgen-signaling nullification.
- PSSD suspected to be the same condition, but on only two genomes (both ABCC5) — evidence base admittedly thin.
Why it’s in the corpus
The single clearest statement of his claimed resolution of PFS and the canonical diagnostic battery list. It also documents the phenotype-follows-pathway framing and his early PSSD-sameness hypothesis together with its admittedly thin evidence base — useful for tracking how the PSSD theory later developed.
Context — the post Powers was replying toVerbatim third-party text, shown for context only — not Powers’ statement. Usernames removed.ShowHide
Powers' comment replies to [username removed], who edited their comment to acknowledge that their framing of the androgen-receptor over/underexpression theory had been incorrect, and that Powers' correction — glucuronidation failure leading to metabolite accumulation, androgen-signaling nullification and gene methylation — had clarified things, while stressing that the post was written with respect and gratitude.
(Parent context recovered from the r.genit.al mirror on 2026-10-09; Powers' comment text itself is from John's user-provided export.)
Some fields on this page come from the release’s Markdown edition, which carries text the JSON edition omits.
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