Muon's Case

[Muon]

And then there are events where you feel systemically drained after orgasm including brain (I think the cause is located in the middle of my head) even if inflammation is mild or barely present. Body is very heavy, constant urge to sit or lay down, loss of power. Libido is killed in this state and has a difficulty to build up (which I don't mind). Standing upright postpones the build up of any libido. Now...I wonder if this state can be reversed rapidly by an adrenaline injection.

Or vasomotor function/vascular resistance takes a hit?

[Muon]

Something is going on near the brainstem (pons/medulla?)

The nucleus of the Cranial nerve VII (bell's palsy) is located at the lower part of the pons. https://en.wikipedia.org/wiki/Facial_motor_nucleus
https://en.wikipedia.org/wiki/Vasomotor_center

Pontine stroke presenting as isolated facial nerve palsy mimicking Bell's palsy: a case report

"Isolated dorsal pontine ischemia presenting as isolated facial palsy is very rare, and a review of the literature disclosed only one previously reported case [8]. Our case emphasizes that isolated facial palsy should not always be attributed to Bell's palsy. It can be a presentation of a rare dorsal pontine infarct as observed in our patient."

[Progecitor]

…Another interesting experiment could be the combination of Aspirin and Tadalafil [Cialis]…

Interesting, Progecitor!

Can you say more? (I take a nightly dose of 81mg aspirin per my cardiologist).

Of course I can't claim this combination to be necessarily useful, only that there are some empirical indications that it may be. It is even more difficult to say why it works exactly. The most likely explanation seems to be synergistic COX-2 inhibition and the consequent reduction in inflammation. Further possibilities can be found, but these explanations may be in association with each other. For example considering aspirin there may be some connection to thick blood as others had said before, but this itself is probably just another aspect of the inflammation. There is actually one study that discusses the combined benefit of tadalafil and aspirin on vascular erectile dysfunction. If we consider aspirin to improve erectile function, then in a way it may be viewed as an aphrodisiac. Contrary to these findings other studies also show that aspirin may be detrimental to testosterone level and sperm vitality. Thus it can't be said that this combination is purely beneficial, and risks need to be weighed against a possible improvement.

Some interesting quotes in this relation:

Tadalafil probably exerts its analgesic effect through the simultaneous inhibition of iNOS, COX-2, and TNF-a, which is not the case with other nonsteroidal anti-inflammatory drugs.
Accordingly, the effect of tadalafil on iNOS highlights the probability that tadalafil exerts its action not by increasing the level of NO, as known, but by regulating its concentration, given that a low concentration of NO upregulates iNOS, while a high concentration has the opposite effect to prevent the overproduction of NO.
Equally, it was proven that sildenafil, another phosphodiesterase 5 inhibitor, exerts its anti-inflammatory effect by suppressing TNF-a production induced by lipopolysaccharide and by decreasing the level of NO instead of increasing it.
Therefore, since tadalafil inhibits the expression of iNOS and not nNOS, the probability that tadalafil exerts its action peripherally during the inflammation process arises. Tadalafil exhibits a similar analgesic effect to that of morphine, implicating that it is a potentially potent analgesic agent.
https://pubs.acs.org/doi/pdf/10.1021/acsomega.2c04761

Tadalafil 5mg once daily significantly improved ejaculation and orgasm, intercourse and overall satisfaction, and erectile function. Men receiving tamsulosin 0.4mg once daily experienced a decrease in both ejaculatory/orgasmic frequency and overall satisfaction vs. placebo, with no significant effect on erectile function.
https://academic.oup.com/jsm/article-abstract/10/3/857/6940023

Successful results were obtained by tadalafil and aspirin monotherapy and tadalafil + aspirin combination therapy in patients with vascular erectile dysfunction (VED). However, the least side effect was observed in the tadalafil + aspirin group. Aspirin can be used alone in the treatment of patients with VED, or combined with tadalafil to reduce side effects and increase success.
PDE5 inhibition does not necessarily spontaneously induce an erection; rather, when coupled with sexual stimulation (visual, cerebral, or physical), PDE5i enhances the capacity to attain and maintain an erection. PDE-5 hydrolyzes cyclic guanylate monophosphate (cGMP) specifically to 5'GMP, promoting successful corporeal vascular relaxation and penile erection during sexual stimulation.
Some studies have shown that platelet activity is increased in vascular ED (VED). However, so far, only one study has been conducted to investigate the efficacy of antiplatelet therapy in VED. Previously, we investigated the efficacy of antiplatelet (aspirin) therapy in VED and demonstrated that aspirin may be an effective and safe therapeutic option especially in patients with high mean platelet volume (MPV). Large platelets are metabolically and enzymatically more active than small platelets and produce more thromboxane, known as the most potent vasoconstrictor agent. Aspirin shows its antiaggregant effect by reducing thromboxane A2 (TxA2) synthesis, which is a strong aggregant and vasoconstrictor agent. It also reduces TxA2 synthesis by irreversibly inhibiting Prostaglandin (PG) H synthase-1 (COX-1) and Prostaglandin H synthase-2 (COX-2) enzyme activities. PGH2 is the precursor of Thromboxane A2.
Bornman et al. reported that platelets might play a significant role in hypercoagulability and fibrin deposition during erection, and could be an important factor in the pathogenesis of aging impotence, and more importantly, aspirin might delay penile atherosclerosis
As a matter of fact, there are some clinical and experimental studies, showing that aspirin increases erectile function. Argiolas et al. reported that aspirin had beneficial effects on erectile function at the peripheral but not central level.
PDE5i and aspirin have partially similar effects at the cellular level. Indeed, the findings obtained from the study of Aversa et al. also show that tadalafil has an antiaggregant effect similar to aspirin in the vascular endothelium.
It was observed that there was a decrease in vascular cell adhesion molecules (VCAM), C-reactive protein (CRP), and Endothelin-1 (ET-1) levels, and there was an increase in the insulin level without any change in blood pressure and other laboratory parameters with the use of tadalafil. The fact that tadalafil leads to a decrease in VCAM indicates that it has an antiaggregant effect.
Aspirin with an antiaggregant effect may also increase penile oxygenation if one of the basic factors in the increase of the penile oxygenation obtained with the chronic tadalafil use is the VCAM, CRP, and ET-1 decreases in the vascular endothelium.
https://sci-hub.st/https://link.springer.com/article/10.1007/s11255-019-02211-4

Polyamines are small cationic molecules present in all mammalian cells, and they can induce cellular proliferation. Inhibition of polyamine catabolism may provide a strategy to inhibit tumour growth. Activity of the spermidine/spermine N1-acetyltrasferase (SSAT) enzyme, involved in polyamine catabolism, has been observed to be reduced in PCa cells treated with aspirin, which supports the possibility that aspirin may mediate some of its chemopreventive actions through abrogation of polyamine metabolism.
Prostate specific antigen (PSA) is produced by luminal epithelial cells of the prostate gland, and its synthesis is increased in a variety of prostatic conditions including PCa, benign prostatic hyperplasia, and prostatitis.
Some studies have shown that aspirin reduces the prevalence of high-grade PCa in some individuals with a concomitant reduction in PSA levels, suggesting that the anti-neoplastic effects of aspirin may potentially be responsible. Alternatively, other studies suggest an increase in high-grade PCa in populations receiving aspirin, which may potentially be explained by aspirin artificially lowering PSA levels, or by aspirin alleviating PCa-related pain, causing a delay in patients investigating their symptoms and an associated delay in diagnosis.
https://www.sciencedirect.com/science/article/pii/S2468294220301027

NSAID use is associated with an increased prostate cancer risk at the population level regardless of the COX-2 inhibition. This may be explained by systematic differences between prescription NSAID users and non-users. In contrast, aspirin use is associated with a decreased overall prostate cancer risk.
https://www.sciencedirect.com/science/article/abs/pii/S0959804912007812

Possible drawbacks of Aspirin:

Calcium chelating effect of aspirin and seminal nitric oxide production was measured spectrophotometrically. Aspirin at both tested concentrations significantly reduced progressive grade-a motility and vitality of spermatozoa. Additionally, aspirin was found to have significant ability to bind seminal calcium ions, but insignificantly reduced the amount of seminal nitric oxide. In conclusion, sperm motility and vitality were reduced in the presence of aspirin at 0.1 and 1 mM in semen. Such reduction may be attributable to the ability of aspirin to chelate seminal calcium ions, but not to an alteration in the amount of nitric oxide produced.
https://onlinelibrary.wiley.com/doi/abs/10.1111/and.13776

Aspirin alters estrogen and progesterone biosynthesis upon chronic administration. Interestingly, aspirin-induced inhibition of prostaglandins synthesis resulted in altered cholesterol metabolism and androgen biosynthesis.
The findings of the present study clearly reveal that subchronic administration (for 30 or 60 days) of aspirin to male rats caused reproductive abnormalities and liver toxicity. However, treatment with aspirin was found to be safe with reference to organs and body weight, except testis, epididymis, seminal vesicle, and ventral prostate. These alterations might be conducted through indirect involvement of inhibition of androgens biosynthesis.
Interestingly, subchronic aspirin administration influenced androgen dependent parameters including that of reduced sperm count, motility, and density. It is speculated that aspirin might have caused reproductive toxicity in male rats through this mechanism, as evidenced by the reduction in androgen dependent parameters.
https://downloads.hindawi.com/archive/2016/6585430.pdf

Aspirin has a negative effect on sperm vitality especially when combined with paracetamol and caffeine (e.g. Excedrin).
https://www.researchgate.net/profile/Utip-Ekaluo/publication/287486001_Sperm_head_abnormality_and_mutagenic_effects_of_aspirin_paracetamol_and_caffeine_containing_analgesics_in_rats/links/56789cfb08aebcdda0ebdf7e/Sperm-head-abnormality-and-mutagenic-effects-of-aspirin-paracetamol-and-caffeine-containing-analgesics-in-rats.pdf?_sg%5B0%5D=started_experiment_milestone&origin=journalDetail

[Prateik_dusseja]

Is it really working ?
Asprin and tadalafil

I remembered , about a week ago, I had tadalafil 5mg and paracetamol before sex and I didn't get any pois symptoms for 2 days but on 3rd day morning I've experienced heavy pois symptoms

[demografx]

Is it really working ?
Asprin and tadalafil

I remembered , about a week ago, I had tadalafil 5mg and paracetamol before sex and I didn't get any pois symptoms for 2 days but on 3rd day morning I've experienced heavy pois symptoms

My thinking is that the tadalafil is possibly more helpful afterwards, including taken for days later. But it’s not for everyone.

[demografx]

…Another interesting experiment could be the combination of Aspirin and Tadalafil [Cialis]…

Interesting, Progecitor!

Can you say more? (I take a nightly dose of 81mg aspirin per my cardiologist).

Of course I can't claim this combination to be necessarily useful, only that there are some empirical indications that it may be. It is even more difficult to say why it works exactly…

In my case, the tadalafil (Cialis) - - taken in the first 2-3 days of POIS - -  improves nerve conduction

And that improvement, I believe, reverses a lifetime of one of my absolute worst POIS symptoms: all 10 fingertips become grossly “flared-up”, causing me severe mental anguish.

My dermatologist told me that there are hundreds of thousands of nerve endings in our fingertips! (But sadly, my seeking dermatology/POIS treatment in the past have proved to be futile).

To younger POISers: don’t give up. I’m 78 and just now might finally have some additional POIS relief! (Testosterone is still my main POIS treatment).

[Progecitor]

Is it really working ?
Asprin and tadalafil

I remembered , about a week ago, I had tadalafil 5mg and paracetamol before sex and I didn't get any pois symptoms for 2 days but on 3rd day morning I've experienced heavy pois symptoms

Do you mean you have taken this combination before O, but nothing afterwards? There may be people here who managed to stop the onset of POIS with specific treatments, but in my case the switch is always turned over after an O. If I took proper supplements then my first day could be quite alright, but if I got slack on the follow-up or ate POIS mimetics then the beast would emerge nonetheless.

As I said this is a prospective combination and you shouldn’t put your expectations too high. My general experience is that POIS is just too damn strong. I have already found many things to be partially useful, however they tend to lose their efficacy due to drug resistance and POIS always wins. This seems to be the case with aspirin as well. Also I haven’t been able to get a prescription for tadalafil as of now. I generally try to avoid paracetamol due to my Gilbert’s disease and I also had an unpleasant reaction to it during a trial. This shouldn’t stop you from trying things though as others had some success with each of these individually. You could use the search box from the home page to find the information. You also need to take into consideration possible side-effects, especially as aspirin and paracetamol could be detrimental for sperm quality.

[demografx]

…You also need to take into consideration possible side-effects, especially as aspirin and paracetamol could be detrimental for sperm
quality.

Excellent advice, Progecitor.

My sperm count went to 0.00 as a result of my POIS/TRT (testosterone relacement therapy) treatment!

[Muon]

I stumbled across my brother's medical data from 10 years ago. I will add it to the first page later. No units or reference values were given. I'm only stating the abnormal values. It's translated from Dutch. Year of birth: 1987

dd/mm/yyyy
22-03-2013 13:01 (F): Growth Hormone 58.9(H)
29-10-2014 12:00 (F): Endogenous creatinine clearance 165(4)(H)
29-10-2014 12:00 (F): Sodium 63(L)
29-10-2014 14:15 (F): Vitamin B6 125(H)
29-10-2014 14:15 (F): IgE 144(H)

[Muon]

I will stop taking Methylene Blue (single dose 15 mg/day) for a moment because other supplements are approaching an expiration date. Trying the POIS cascade stack. Adding Zinc and Curcumin as well because I was already taking those (did not get the impression that this brand of curcumin helped but zinc helps a bit).

[Muon]

SAM-e AND ITS THERAPEUTIC PRINCIPLES
It is from 2013 though.

Recent testing by ConsumerLab.com of over-the-counter brands of SAMe in the United States found, on average, that for 6 of the 13 brands tested, less than half the amount of SAMe stated on the label was actually present.

Does anyone have a membership on this website?:
https://www.consumerlab.com/reviews/sam-e-review-comparisons/same/

[Warrior]

SAM-e AND ITS THERAPEUTIC PRINCIPLES
It is from 2013 though.

Recent testing by ConsumerLab.com of over-the-counter brands of SAMe in the United States found, on average, that for 6 of the 13 brands tested, less than half the amount of SAMe stated on the label was actually present.

Does anyone have a membership on this website?:
https://www.consumerlab.com/reviews/sam-e-review-comparisons/same/

In response to your DM, these would probably be my top brands for SAMe: Jarrows, Doctor's Best, LifeExtension & NutraLife.

I personally have tried both Jarrows and NutraLife. Both work very potently.

Always choose from reliable brands and make sure the SAM-e is enterically coated. Ideally take on empty stomach.

Not sure what country you're in, but iHerb stock all of these big name brands. The general advice within the supplement community is not to trust Amazon.

[Muon]

Temperature has a major effect on me. Also when I hit a local area on my body with cold water it can relieve some kind of local tension/fibro-like sensation in that area. But above all my overal muscle strength increases when exposed to low(er) ambient temperatures and less autonomic instability. Demo his thread got me thinking. Dumping some links here, will look at it later.

https://www.neurology.org/doi/abs/10.1212/wnl.23.11.1182
https://onlinelibrary.wiley.com/doi/abs/10.1111/ina.12525
https://onlinelibrary.wiley.com/doi/abs/10.1002/mus.880150606
https://onlinelibrary.wiley.com/doi/abs/10.1002/mus.10490

[Muon]

https://www.reddit.com/user/esauseasaw/

"The muscle loss, flu-like symptoms, being skinny, and diarrhea all sound like POIS. When I first got POIS, one of the things I was most worried about was my "metabolism being too fast". I was constantly hungry and never gained any weight. It was like food just went right through me without my body absorbing any nutrients. This was in addition to spasms in my face, brain fog, and speech impairment. You may not have these latter symptoms, but I don't anymore either. But that's only because I've learned to manage my POIS to a certain extent."

Highlighted text: This is where symptoms started to escalate in my case exactly 20 years ago (just turned 39 this week), in terms of intensity of existing symptoms and quantity (new symptoms).

Dose of SAM-E used in literature for a variety of issues is more than 800 mg when I do a quick scan of studies.

[Muon]

The mechanosensitive Piezo1 channel is required for bone formation
https://elifesciences.org/articles/47454

Furthermore, osteoporosis patients show reduced expression of Piezo1, which is closely correlated with osteoblast dysfunction.

My mother got osteoporosis. Just taking a note here.

[Muon]

It's difficult to observe effects of therapies in general when the weather becomes hotter (It feels like it amplifies systemic low grade chronic inflammation).

I have never adressed elevated liver enzymes. Things that might help:
Bile salts (because of low cholesterol)
Silymarin >140mg
Sam-E (dose?)
I've read about Niacin, need to double check that one.

I'm thinking about moving dexamethasone, cryotherapy and ketodiet more towards the top of my things to try list. I also wonder whether the body needs to be loaded at all times with anti-oxidants.

[Muon]

I suspect that in my case brainstem function needs to be measured upon physical exertion and/or (post) sexual arousal/orgasm.

[Muon]

Which specialist deals with the type of investigations in the picture below?
Brainstem Abnormalities in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Scoping Review and Evaluation of Magnetic Resonance Imaging Findings (2021)

[Muon]

Central 5-HTergic hyperactivity induces myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)-like pathophysiology

Can this be a reason why I had a hard time tolerating low dose citalopram which acted on middle of my head?

[Muon]

I wonder if plasmalogens will help. The prices are insane though: https://prodrome.com/