u/Normal-Enthusiasm790

Disclaimer: this is not medical advice, I got my doctor to try the castration method with me. 6 weeks of relugolix with 2weeks of hydrocortisone (same time starting after 2weeks of relugolix).
I used AI to write the summary about me below but I entered all the data myself.
I will update you guys every two weeks.
Now I got only sexual symptoms like PFS but first 6 month was so many symptoms I don’t have the patience to write them out.
—————- Summary starts:
Patient: 26-year-old male
Crash: 5 years ago — anastrozole + exogenous testosterone (anabolic steroids), alongside ketoconazole shampoo and minoxidil. Not finasteride-triggered. Supraphysiological T converted to DHT via fully intact 5-alpha reductase; anastrozole blocked the aromatase escape valve; genetically impaired clearance system overwhelmed by the substrate load. Result: zero libido for 5 years, diffuse frontal hairline thinning (crown/mid-scalp/sides preserved, non-Norwood pattern, follicles present but miniaturized), watery/reduced semen quality, standard hormone panels reported as normal.
Genetics (consumer SNP array):
SLCO1B1 — homozygous *5 (rs4149056 TT) — most severe finding, clinically validated
UGT2B17 — likely heterozygous deletion (rs4440295 no-call)
UGT2B15 — multiple indels
UGT2B7 — deletion indels
ABCC2 — rs717620 CC, reduced expression (Powers flags this as a top-tier PFS gene independently)
SLCO1B3 — heterozygous, partial backup capacity
COMT — homozygous Met/Met (rs4680 AA) — slow, clinically validated
DBH — heterozygous at two functional sites
Unrelated but noted: APOE e3/e4, both Lp(a) risk tag SNPs, heterozygous MTHFR (both C677T and A1298C)
Labs: Progesterone recalled as medium-range (older test, not yet repeated). No formal 3α-ADG, Dutch Complete, DOC/corticosterone, or bile acid panel yet — ordering as baseline before relugolix.
What worked:
HCG 1500 IU — complete symptomatic normalization, but only ~3 days per injection, tracking HCG's pharmacokinetics exactly; required reinjection every 3 days; effective for ~4 months total before it stopped working; second attempt 6 months later — no effect at all
Calcium-D-glucarate, 2 weeks (tried after the SERM course) — temporary libido increase and stronger erections; ejaculate volume/force improved and persisted even after the libido effect faded
What didn't work / made things worse:
Testosterone injections — zero effect on libido or overall feeling
Anabolic steroids, DHEA, pregnenolone — no meaningful effect
Clomid + tamoxifen, 45 days — libido significantly worse, persisting 1+ year and ongoing
Current plan: Relugolix (chemical castration 6weeks) with a 2-week hydrocortisone course (30mg/day, split 3×10mg),for glucocorticoid metabolite clearance; CDG as clearance-support adjuncts; creatineongoing for COMT support.
I never crash I always endup with slightly lower libido that comes to the low baseline after some time.
u/drwillpowers Thank you for everything you do. Do your patients use hydrocortisone in the beggining mid or end of castration?