Anyone else have Primary AND secondary POIS? Unique sequelae

[exobat]

I first developed POIS symptoms around age 15, and it only occured when I masturbated. When I became sexually active with girls, it didnt bother me at all. Even if I used my own hand, then placed hers on it when I ejaculated, I had no symptoms. For a while I was also able to avoid symptoms by masturbating then dry humping my bed to completion, and this lasted several years, then symptoms started again. I would find various toys that worked for some time, but after some time, every self pleasure gave me symptoms. One day at age 37 I had sex with my wife and noticed the same symptoms, and since then, I have POIS with any ejaculation. My symptoms are: tender/puffy left nipple, mood swings, sensitivity to touch, can get itchy but only when I exercise, mainly high levels of irritability and transient depression, after 2 days it self resolves.

For the life of me I can't figure out why some specific acts caused symptoms, others didnt, and progressively developed until every ejaculation became symptomatic. I tried all the supplement stacks (niacin, vitamins, antihistamines, no change). Anyone have anything like this happen to them??

[Mr Raba]

Hi,

Very interesting…
I had mine spontaneously developed after 4 grams of Slo-Niacin for months for high cholesterol.

Happened with any ejaculation after that. Also developed CFS    Same night all started .

[Progecitor]

Hi,

Very interesting…
I had mine spontaneously developed after 4 grams of Slo-Niacin for months for high cholesterol.

Happened with any ejaculation after that. Also developed CFS    Same night all started .

If it is so, then uremic toxins may have been involved in the development of your POIS and CFS. I am entirely convinced that another uremic toxin, 4-HNE, is a major culprit in my ailment and I also have POIS/CFS.

A terminal metabolite of niacin promotes vascular inflammation and contributes to cardiovascular disease risk
Serum levels of the terminal metabolites of excess niacin, N1-methyl-2-pyridone-5-carboxamide (2PY) and N1-methyl-4-pyridone-3-carboxamide (4PY), were associated with increased 3-year major adverse cardiovascular events (MACE) risk in two validation cohorts.
https://pubmed.ncbi.nlm.nih.gov/38374343/

Nicotinamide metabolites have recently been implicated in increased risk of major cardiovascular events (MACE). Supportive data about clinical risk of MACE for nicotinamide users is lacking.
Conclusions and relevance: In this retrospective cohort study of 6039 adults from two different patient populations, we found no increased risk of MACE in patients with nicotinamide exposure.
https://pubmed.ncbi.nlm.nih.gov/39371179/

This means that taking niacin in a normal amount should not be a problem, however the risk probably comes from consuming it in excess.

Additional information on uremic toxins:

Three classes of uremic toxins have been postulated, based on molecular weight and interactions: small, water-soluble uremic toxins (e.g., urea, creatinine), protein-bound uremic toxins (e.g., indoxyl sulfate, p-cresyl sulfate), and middle molecules (e.g., beta2-microglobulin, parathyroid hormone [PTH], interleukin-6 [IL-6], immunoglobulin light chains). Other mediators of uremic toxicity not mentioned in this classification include lipopolysaccharides (or endotoxin) and AGEs.
https://www.sciencedirect.com/topics/medicine-and-dentistry/uremic-toxin

4-Hydroxynonenal is a uremic toxin. 4-Hydroxynonenal (HNE), one of the major end products of lipid peroxidation, has been shown to be involved in signal transduction and available evidence suggests that it can affect cell cycle events in a concentration-dependent manner. Increased levels of uremic toxins can stimulate the production of reactive oxygen species. This seems to be mediated by the direct binding or inhibition by uremic toxins of the enzyme NADPH oxidase (especially NOX4 which is abundant in the kidneys and heart).
http://www.t3db.ca/toxins/T3D4180

What are the symptoms of uremia?
- Unexplained weight loss.
- Problems with thinking and remembering (cognitive dysfunction).
- Feeling very tired (fatigue).
- Shortness of breath (dyspnea).
- Metallic taste in your mouth.
- Muscle cramps.
- Itching.
(source: Google)