Hey everyone, I just wanted to share my Accutane regimen and how I'm trying to minimize any potential negative side effects. I used to have no acne, and topical tretinoin worked fine until I got into pre-med, and my cortisol was out of control from all the stress, and I was blessed with horrible acne as a result. Dermatologist put me on 80mg ED, and although it was my last result, I'm done coping.
I personally think Accutane is really dangerous, depending on individual response and dose, so I made this regimen. There are a few main concerns that I had.
Accutane concerns:
Hepatoxicity
Liver toxicity was a concern, it's a health marker that will directly show cosmetically if affected a lot. First of all, I don't drink, so that was never a concern, but definitely avoid anything hepatotoxic like alcohol and oral AAS while taking Accutane is important.
NAC: So the next course of action is taking NAC, a very powerful antioxidant that supports liver function and damage, even used in American healthcare for Tylenol overdose. My dose is 1,200mg ED. After 2 months, my liver panel came back healthier while ON accutane, so I decided this was enough. Although I started cutting recently, so my diet has been dialed health-wise wise so this may have contributed.
5-alpha-reductase inhibition
Now, this may be a little controversial, but I believe DHT is an important hormone for our health and longevity, even though it causes androgenic alopecia. My opinion may be a little biased since no one in my family has ever been bald and has extremely thick hair. The biggest concern regarding DHT, though, is that it affects your Androgen receptors' sensitivity by upregulating receptor density and enhancing binding. In my opinion, a risk I am not willing to take is having lower AR sensitivity, and my testosterone being "worth" less in my own body.
L-carnitine: Since I am not taking DHT exogenously, I have decided to stick to L-carnitine. The dose is 2500mg Oral and 600mg Subq with carbs to shuttle it into skeletal muscle tissue. Studies show it increases AR sensitivity, so I hope that can help if any DHT suppression causes AR desensitization.
Testosterone/Fertility
So yeah, I started having low test symptoms, no morning wood, no sexual attraction, no drive to do things. Got my test levels checked and went from a 650ng/dL to a 300ng/dL total testosterone. There are multiple mechanisms Accutane reduces testosterone, which we need to pinpoint:
Enclo+HCG: I want to treat the suppressed LH and FSH, so I started taking 20mg Enclo EOD to start my HPTA back up and give a conservative test boost, and then 10mg ED MK677 to prevent HGH and IGF-1 suppression from both Accutane and Enclo. I also did HCG 2500iu for 2 weeks to jumpstart the Testes, and HOLY MOLY did that work instantly, next day I had morning wood that wouldn't go away. After 2 weeks, I got my test checked, and it was 980ng/dL but after stopping HCG the Enclo kept me at a good 700ng/dL, which is my natural range where I want it(I prefer to work for my gym gains "naturally" for those who wonder why I dont abuse PED's).
NAC & CoQ10: lastly, preventing any Leydig cell toxicity, the last thing we want is our testes slowly dying and not making any sperm or testosterone. NAC & CoQ10 are the antioxidants I am taking to prevent that, with micronutrient supplementation as stated before.
Balding
Kind of simple, I need my hair, and I'm not prone to androgenic alopecia, so it was a side effect of a dry scalp and hairs being pushed into a telogen phase (shedding). You know the basics: hydrate scalp with rosemary oil, don't overly shampoo, and use topical minoxidil. It worked like a charm, stopping the shedding from my scalp, eyebrows, and eyelashes.
Neurosteroid production
Accutane lowers key neurosteroids like allopregnanolone, which help regulate mood and calm the brain. This drop can trigger depression, anxiety, and brain fog. To counter this, I take 10–20 mg pregnenolone, phosphatidylserine at night to lower cortisol, plus fish oil and magnesium for extra brain support. This combo helped bring my mood and focus back. I also took Aderall, which helps a lot, giving a boost in dopamine and focus, but I am trying to manage ADHD without it, so I am taking Gorilla Mind Smooth as a more natural nootropic, which also helps support cognitive function on Accutane. Accutane depression is a real thing that me and others have experienced, so it's important that you actually go outside and find hobbies to support your mental health.
I personally think Accutane is really dangerous, depending on individual response and dose, so I made this regimen. There are a few main concerns that I had.
Accutane concerns:
- Hepatoxicity (Affects important health marker that can affect outward appearance cosmetically)
- 5-alpha-reductase inhibition (Lower DHT=Lower AR sensitivity)
- Balding
- Testosterone/Fertility
- Neurosteroid production (depression)
Hepatoxicity
Liver toxicity was a concern, it's a health marker that will directly show cosmetically if affected a lot. First of all, I don't drink, so that was never a concern, but definitely avoid anything hepatotoxic like alcohol and oral AAS while taking Accutane is important.
NAC: So the next course of action is taking NAC, a very powerful antioxidant that supports liver function and damage, even used in American healthcare for Tylenol overdose. My dose is 1,200mg ED. After 2 months, my liver panel came back healthier while ON accutane, so I decided this was enough. Although I started cutting recently, so my diet has been dialed health-wise wise so this may have contributed.
5-alpha-reductase inhibition
Now, this may be a little controversial, but I believe DHT is an important hormone for our health and longevity, even though it causes androgenic alopecia. My opinion may be a little biased since no one in my family has ever been bald and has extremely thick hair. The biggest concern regarding DHT, though, is that it affects your Androgen receptors' sensitivity by upregulating receptor density and enhancing binding. In my opinion, a risk I am not willing to take is having lower AR sensitivity, and my testosterone being "worth" less in my own body.
L-carnitine: Since I am not taking DHT exogenously, I have decided to stick to L-carnitine. The dose is 2500mg Oral and 600mg Subq with carbs to shuttle it into skeletal muscle tissue. Studies show it increases AR sensitivity, so I hope that can help if any DHT suppression causes AR desensitization.
Testosterone/Fertility
So yeah, I started having low test symptoms, no morning wood, no sexual attraction, no drive to do things. Got my test levels checked and went from a 650ng/dL to a 300ng/dL total testosterone. There are multiple mechanisms Accutane reduces testosterone, which we need to pinpoint:
- Hypothalamic-pituitary disruption (Suppressed LH&FSH)
- Oxidative stress in Leydig cells
- Reduced steroidogenesis
Enclo+HCG: I want to treat the suppressed LH and FSH, so I started taking 20mg Enclo EOD to start my HPTA back up and give a conservative test boost, and then 10mg ED MK677 to prevent HGH and IGF-1 suppression from both Accutane and Enclo. I also did HCG 2500iu for 2 weeks to jumpstart the Testes, and HOLY MOLY did that work instantly, next day I had morning wood that wouldn't go away. After 2 weeks, I got my test checked, and it was 980ng/dL but after stopping HCG the Enclo kept me at a good 700ng/dL, which is my natural range where I want it(I prefer to work for my gym gains "naturally" for those who wonder why I dont abuse PED's).
NAC & CoQ10: lastly, preventing any Leydig cell toxicity, the last thing we want is our testes slowly dying and not making any sperm or testosterone. NAC & CoQ10 are the antioxidants I am taking to prevent that, with micronutrient supplementation as stated before.
Balding
Kind of simple, I need my hair, and I'm not prone to androgenic alopecia, so it was a side effect of a dry scalp and hairs being pushed into a telogen phase (shedding). You know the basics: hydrate scalp with rosemary oil, don't overly shampoo, and use topical minoxidil. It worked like a charm, stopping the shedding from my scalp, eyebrows, and eyelashes.
Neurosteroid production
Accutane lowers key neurosteroids like allopregnanolone, which help regulate mood and calm the brain. This drop can trigger depression, anxiety, and brain fog. To counter this, I take 10–20 mg pregnenolone, phosphatidylserine at night to lower cortisol, plus fish oil and magnesium for extra brain support. This combo helped bring my mood and focus back. I also took Aderall, which helps a lot, giving a boost in dopamine and focus, but I am trying to manage ADHD without it, so I am taking Gorilla Mind Smooth as a more natural nootropic, which also helps support cognitive function on Accutane. Accutane depression is a real thing that me and others have experienced, so it's important that you actually go outside and find hobbies to support your mental health.
TLDR
- No alcohol or liver stressors
- NAC + CoQ10 for liver & testicular protection
- L-carnitine to keep AR sensitivity sharp
- Enclomiphene, MK-677, HCG (if needed) for testosterone recovery
- Scalp hydration + minoxidil for hair health
- Pregnenolone, phosphatidylserine, fish oil, magnesium for mood & neurosteroids
- Healthy lifestyle: manage stress, exercise, and socialize
