Finasteride Reassurance Please

[nyny12]

ED increases with age because testosterone levels drop as you get older.

another stupid question, if T levels decrease with age then shouldn't dht decrease as well since T is converted to DHT, so shouldn't we have thicker hair as we get older??

It seems to me as I have been looking on every forums on how to treat my loss that for every negative propecia post there is a positive one. All I know is that millions of men take it and have taken for years. Of course online there is going to be more negative posts...I agree that maybe more people get sides than merck says but even so I do not think it is more than 10%... anyways its been 6 months and I still have no clue what to do....but everyday I get closer to getting on finasteride

 

[Hiker]

I've had side effects from Propecia but they've gone away.

You raise a good question about testosterone levels and dht, I don't know the answer to it. Generally speaking though, t levels drop with age and then some men experience circulatory problems, so ED becomes a problem and then you have people like the Boston Medical Group trying to take advantage of it.

 

[barcafan]

Ok lets have a little poll......

If you have experianced side effects from Finasteride post a :sobbing:

If you have not experianced side effcts from finasteride post a

If mew can stop even 10 guys in total from going through these problems, im sure its a huge accomplishment.

He presented SCIENTIFIC evidence that you guys cant dispute, so either put up or shut up.

Why did you stop minoxidil? ITS FDA APPROVED, there cant be anything wrong with it, you're crazy if you say you have sides. I didnt get any sides, Neither did most other people, therefore nobody should care about you.


Then again your name is 'finasteride fighter' so as ive said, you're just a shill anyway so your opinion doesn't mean sh*t.




I think most people here are just pulling the wool over their own eyes because their fragile mind can't cope with the fact that the drug that GIVES THEM THEIR HAIR BACK ( Ergo Confidence, Self esteem, happiness ) can possibly cause them huge problems. It's a very conflicting thought. It's easier to stay in the dark, right?

another stupid question, if T levels decrease with age then shouldn't dht decrease as well since T is converted to DHT, so shouldn't we have thicker hair as we get older??

Androgen receptor sensitivity increases with age, probably much 'more' in relation to the decrease of androgens themselves.

 

[Nuli]

Mew, what's up with the scare mongering?

I respect what you're doing, and that you help people and offer a forum, but it's kind of annoying the way you come here trying to scare people when even you admit the basic fact that only a VERY VERY small percentage of people experience these "life ruining" sides.

FACT: I've been on finasteride 2 years, the only side I've experienced is thicker hair.

Scare mongering? Mew is presenting scientific data for the OP questions/concerns, if the facts are scary then maybe well there is a need for concern. He's not even giving advice on either to take finasteride or not, unlike many of you who are blinded by ignorance and tell others to start the medication based on YOUR experiences/opinions.

 

[JDS 17]

Thanks again for the info and testimonials everyone.

Does anyone think they can provide a counter argument to Mew's post, a challenge for Bryan perhaps?

 

[zephyr31]

finasteride has totally destroyed my liver. Its also made my penis exhausted


My social life is GREAT as my confidence is alot higher with good hair, which leads to drinking ALOT more beer.


Having a great social life means im meeting alot more chicks and having ALOT more sex.

Darn you finasteride, get out of my life.

if i see any problems ill stop, untill then ill take my chances thank you.

 

[Matw]

Given what I've read about finasteride I'm extremely hesitant to take it, too. But I did have a couple of questions for Mew or maybe another member of the board who is knowledgeable in this area.

If you're taking finasteride and experience ED, can you take v**** to get it up or does that just not work once the damage has been done? Sorry for such a crude question. uke:

Just one more question... If you exercise on a regular basis (say weightlifting 3-times a week) and take creatine supplements or something similar, can this potentially off-set the muscle loss and weakness that finasteride can apparently lead to?

What I'm thinking is... If I do decide to take finasteride, I should start exercising regularly to keep my muscular strength... I'd keep a v**** pill close by if I ever needed it... and enjoy the confidence of having a full head of hair? :hump:

Am I being extremely ignorant or is that actually a plausible solution?

 

[somone uk]

like mew pointed out the necessity of DHT but didn't tell you that finesteride inhibits about 70% of 5ar type 2 and about 0.5% type 1, it doesn't deplete your body DHT and i wouldn't say it's sensible to do that

the man on youtube criticising propecia in the video also suggested topical spironolactone for hair loss. Topical spironolactone was concocted by dr lee, looking at his website his scientific practice is pathetic and he should lose his medical licence if he really had one in the first place

lastly on the penile "damage" the study was carried out on RATS, now i think that i can surely say that my anatomy is very different to a rat
it annoys me when people use rat/mice study and then use the resultant data to "prove" human effect
so i will say yes it will damage your penis provided you're 3 inches tall with a tail, whiskers and a massive warfarin allergy

also 15% of men who are NOT on propecia get erectile dysfunction, people who have "permanent effects" could just be someone who got ED for a completely different reason, i mean ED has more causes than hairloss, as such you can't prove that propecia caused it without a DIAGNOSIS, i bet a lot of people don't diagnose their ED

people who have taken propecia have smoked, drank and ate themselves into a large fatty but blamed propecia if they get ED because neither cigs, alcohol nor fatty foods carry the warning label "may cause erectile dysfunction"
there is also a placebo effect, taking a drug then getting told over and over "PERMANENT SIDE EFFECTS" could cause it to come true, seriously
also the chances of you having ED increases exponentially as you get older so you can't jump to the conclusion it's propecia if someone took the drug for 10 years without side effects

it's a scapegoat imho

 

[Bryan]

like mew pointed out the necessity of DHT but didn't tell you that finesteride inhibits about 70% of 5ar type 2 and about 0.5% type 1

FYI: At the doses that are typically used, finasteride inhibits around 85% - 90% of 5ar type 2.

Topical spironolactone was concocted by dr lee...

???

I hope you're not hinting or suggesting that Dr. Lee was the FIRST person to produce and sell topical spironolactone. The idea of using spironolactone topically as an antiandrogen is an old one, and Dr. Lee is just one of the people who decided to stick it in a bottle, sell it, and make some $$$ off it.

 

[JDS 17]

Bryan I would really appreciate it if you could give your opinion on finasteride side effects and address Mew's post as you seem like one of the most knowledgable posters on here. I'm sure interpreting the information correctly would help a lot of people on here thinking about taking finasteride.

 

[zephyr31]

i made a joke in a earlier post, but in all honesty not being bald is a massive thing in my life, yes shallow i know but its a very shallow world.

i just look so much younger now, i feel more confident, it just makes u feel so much better.

could finasteride be dangerous to my long term health?, possibly. Any more so than my partying every weekend? or my love for steaks and burgers?, my love for 1 night stands?. my love for fast motorbikes?.

If i dont look good i tend to not feel good. Id love to just go bald and not even think about it, but i cant.

You could spend the rest of your life reading up on the risks just to find yourself back at "undecided". I say roll with it and take a chance.

Id say the majority of finasteride bashers out there are people its not worked for and are prob a little hacked off about nothing working. the guys that have had good results will think its the best drug ever made.

 

[JDS 17]

Bryan could you please give us your opinion on finasteride side effects and in particular Mew's post?

 

[somone uk]

like mew pointed out the necessity of DHT but didn't tell you that finesteride inhibits about 70% of 5ar type 2 and about 0.5% type 1

FYI: At the doses that are typically used, finasteride inhibits around 85% - 90% of 5ar type 2.

"typically used doesage"?
is that 1mg, 1.25 or 5mg?
obviously 5mg will inhibit more than 1mg but i also know it won't be a linear comparisemant
so how does the 5ar inhabitation compare in 1mg compared to 5mg

Topical spironolactone was concocted by dr lee...

???

I hope you're not hinting or suggesting that Dr. Lee was the FIRST person to produce and sell topical spironolactone. The idea of using spironolactone topically as an antiandrogen is an old one, and Dr. Lee is just one of the people who decided to stick it in a bottle, sell it, and make some $$$ off it.

i assumed he was because he is the only guy i know of selling topical spironolactone
well ok but i still stick to the point that i have never seen any real clinical evidance that spironolactone works so i can't take the opinion of a doctor that essentially says "finesteride is bad, use this treatment i am selling that hasn't really been proven to work instead " as impartial

 

[Mew]

so how does the 5ar inhabitation compare in 1mg compared to 5mg

Read for discussion about near-flat dose response:
http://www.physics.upenn.edu/facultyinf ... peciafda2/

Same graphs from official FDA Propecia Clinical Trials files, pg. 20 & 22:
http://www.accessdata.fda.gov/drugsatfd ... PHARMR.PDF

 

[Bryan]

FYI: At the doses that are typically used, finasteride inhibits around 85% - 90% of 5ar type 2.

"typically used doesage"?
is that 1mg, 1.25 or 5mg?
obviously 5mg will inhibit more than 1mg but i also know it won't be a linear comparisemant so how does the 5ar inhabitation compare in 1mg compared to 5mg

A dose of 5 mg/day inhibits the type 2 enzyme by around 90%, according to the Gisleskog et al studies. They didn't say anything about a 1 mg dose, but I've always "guesstimated" that 1 mg/day probably inhibits it somewhere between 85% and 90%.

I hope you're not hinting or suggesting that Dr. Lee was the FIRST person to produce and sell topical spironolactone. The idea of using spironolactone topically as an antiandrogen is an old one, and Dr. Lee is just one of the people who decided to stick it in a bottle, sell it, and make some $$$ off it.

i assumed he was because he is the only guy i know of selling topical spironolactone

Dr. Proctor has been selling topical spironolactone (as part of Proxiphen, of course) for more than 25 years. There's also one other fairly well-known doctor in the hair loss field (besides Lee and Proctor) who sells it, too, but his name escapes me at the moment.

well ok but i still stick to the point that i have never seen any real clinical evidance that spironolactone works so i can't take the opinion of a doctor that essentially says "finesteride is bad, use this treatment i am selling that hasn't really been proven to work instead " as impartial

You haven't seen any clinical evidence?? HUH?! I've been talking about the published spironolactone studies for YEARS on hairloss sites!

Besides that small trial by the Greek doctors with four individuals that tested oral spironolactone (200 mg/day) for hairloss, there's also the Italian study that tested topical spironolactone successfully for male pattern baldness. I've only been posting that study for YEARS! Where have you been all this time?? Here's a scan of the full study:

http://www.geocities.com/bryan50001/spiro2.htm

Besides that one, there's also another one with topical spironolactone for balding in women, but I don't have a copy of that whole thing. I've only read the abstract.

And there's also that study that Dr. Proctor reports having seen being circulated around a medical conference he attended many years ago. One of the other doctors had used topical spironolactone for balding in his own patients, and reported haircount increases that were similar to what you get with Propecia.

 

[Pondle]

I agree with somone uk - you can't necessarily extrapolate results in rats to humans. First, finasteride inhibits *both* types of 5AR, I and II, in rats. In humans it's basically selective for type II. Mew actually addresses this on propeciahelp:

http://www.propeciahelp.com/forum/viewtopic.php?t=1402

Second, the rats in the Lu et al study Mew links to were only 5 weeks old - I don't know anything about the rat lifecycle, but are they physically mature at that age? It would be misleading to draw conclusions about penile tissue changes in adult humans from effects seen in immature rats. Besides, if this effect is genuine in humans too, why are there no published studies? So far, we only have anecdotes on internet forums.

On the incidence of side effects, it's true that some finasteride studies have reported higher levels than Merck's Propecia trials. But it's not reasonable to quote the Proscar studies in this context because they were conducted on a population of much older men. That's like comparing apples and oranges.

We also have to bear in mind the relative sizes and statistical power of different research studies. Generally a bigger study is preferable - and the Propecia trials enrolled thousands of men. So unless there was outright deception (is there any evidence of that?) I would prefer the results of these bigger studies.

http://www.medicine.ox.ac.uk/bandolier/ ... atpow.html

On the final question of the 'other functions' of 5AR/DHT, I'm reassured by the fact that men with a natural 5AR deficiency seem to get along fine apart from their lack of genital development (which occurs, or doesn't if you get my drift, in childhood / adolescence).

http://emedicine.medscape.com/article/924291-overview

 

[Mew]

you can't necessarily extrapolate results in rats to humans. First, finasteride inhibits *both* types of 5AR, I and II, in rats. In humans it's basically selective for type II.

Yes, Finasteride inhibits both isozymes equally in rat -- however, 5AR2 is specifically found in genital tissues in both human AND rodent models, thus making extrapolations is possible when it comes to the drug's effects on inhibition within those tissues. Leading researchers have already confirmed this exact point, using data from animal models as the basis for explaining negative effects of the drug in humans, such as ED:


The Effect of 5 -Reductase Inhibitors on Erectile Function
http://www.andrologyjournal.org/cgi/con ... l/29/5/514

Further evaluation of the role of DHT in the penis has been done at the penile morphologic level. Shen et al (2000) investigated the ultrastructural changes of the penile corpus cavernosum and tunica albuginea in rats representing 3 groups: sham control, castrated, and treated with finasteride. Four weeks later, blood samples were obtained for the determination of serum T and DHT levels, and penile tissues were taken for scanning electron microscopy. The T and DHT levels in castrated rats and the DHT level in finasteride-treated groups were significantly lower than those in the control group. In the castrated animals, there was a high degree of fibrosis in the corpus cavernosum with irregularly arranged collagenous fibers and a marked decrease in smooth muscle fibers, while in the DHT-inhibited group (finasteride-treated), the corpus cavernosum comprised a substantial amount of thick and irregularly arranged collagenous fibers, but the degree of fibrosis was less than that of the castration group (Shen et al, 2000). This work suggests that because finasteride inhibits the action of DHT but not T on the corporal cavernosal tissue, the degree of fibrosis was less in the DHT-inhibited group than in the castration group. In the castration group, the thickness of tunica albuginea decreased significantly and the elastic fibers were mostly supplanted by collagenous fibers, and in the DHT-inhibited group, the elastic fibers were replaced by disorganized and thick collagenous fibers. Since the tunica albuginea plays a major role in the erectile mechanism of the penis, the latter results offer an explanation for the presentation of ED in patients treated with 5ARIs.

On the final question of the 'other functions' of 5AR/DHT, I'm reassured by the fact that men with a natural 5AR deficiency seem to get along fine apart from their lack of genital development

Being born as a pseudohermaphrodite is completely different compared to taking a fully functional man with a working 5AR2 enzyme, and then transforming his hormonal profile to match that of a genetically deficient 5AR2 mutant via Finasteride. They (5AR2 deficient pseudohermaphrodites) are freaks of nature -- an exception, NOT the rule -- especially considering 99.9% of the world's population has a functional 5AR2 enzyme.

This enzyme was put in our bodies for a number of reasons to support numerous critical functions, as has been alluded to in previous posts in this thread... and its not simply to make you "go bald". Additionally, 5AR2 pseudohermaphrodites may have other biological adaptations which have allowed them to appear to function "normally" without a 5AR2 enzyme (Bryan of course will disagree).

As for wether they are "healthy" or not, or lead full lifespans without succumbing to disorders as a result of being born without functional 5AR2 -- not sure if they've been followed for their entire lifespan, as I haven't come across any specific studies on this. Perhaps other posters have studies and can provide links.

For example, have any studies been done on anxiety and depression (unlisted side effects linked to inhibition of 5AR activity, ie decreased Allopregnanolone and THDOC, neurosteroids which can no longer act on GABA-A receptors in the brain) in such pseudohermaphrodites? Not to my knowledge... and just because these conditions haven't been studied in this target group, doesn't mean this is not a potential outcome of being 5AR2 deficient.

Then again, since they never had a functional 5AR2 enzyme in the first place, its possible their biological pathways/functioning, particularly in the spinal cord, is different vs men with functional 5AR2. In fact, there was a lengthy discussion from the poster "Alex Miller" about the potential implications of inhibiting 5AR2 when it comes to neurological damage, and how normal men are NOT the same as genetically deficient 5AR2 pseudohermaphrodites. Read it here: http://www.hairlosshelp.com/forums/mess ... erthread=y

People are free to make up their own minds, of course. But the information presented is certainly worth considering. Also, I find it interesting that Bryan, who is one of the most knowlegeable posters on these sites, refuses to take Finasteride himself, for whatever reason. Interesting to note.

 

[Pondle]

Being born as a pseudohermaphrodite is completely different compared to taking a fully functional man with a working 5AR2 enzyme, and then transforming his hormonal profile to match that of a genetically deficient 5AR2 mutant. They may have other biological adaptations which have allowed them to appear to function "normally" without a 5AR2 enzyme (Bryan of course will disagree). As for wether they are "healthy" or not, or lead full lifespans without succumbing to disorders as a result of being born without a functional 5AR2 enzyme -- not sure if they've been followed for their entire lifespan, as I haven't come across any specific studies on this. Perhaps other posters have and can provide links?

This is the absolute crux of the matter as far as the wider implications of taking finasteride are concerned. I haven't read extensively about the men with 5AR deficiency and I'm not a doctor, but what I have seen online typically says something like "males with genetic deficiency of 5-alpha-Reductase were born with ambiguous genitalia which virilizes at puberty. As adults, these men have a grossly underdeveloped prostate but are otherwise healthy with normal male libido and bone and muscle mass and sparse facial and body hair."

As you say, I'd be very interested if someone can point to:
* any differences, aside from the 5AR deficiency, which distinguish these 5AR-deficient men from 'normal' males; or
* any information on whether they also suffer from additional complications as a result of their condition, especially neurological.

If Bryan or whoever else has any expertise on the literature about these guys could comment, I'd be very grateful!

 

[Bryan]

As you say, I'd be very interested if someone can point to:
* any differences, aside from the 5AR deficiency, which distinguish these 5AR-deficient men from 'normal' males;

More specifically:

* any differences, aside from the 5AR deficiency, which distinguish these 5AR-deficient men from 'normal' males who take finasteride;

or
* any information on whether they also suffer from additional complications as a result of their condition, especially neurological.

If you read that cautionary thread on HLH about the alleged problems associated with finasteride usage, you saw that question I posed to Dr. John Crisler near the end about Alex Miller's wild theory about "demyelination" of nerves caused by finasteride. Dr. Crisler had never heard or considered such an oddball theory, and seemed to be skeptical of it.

 

[mezzanine]

I was lurking this thread and decided to join the board to comment. I'm not someone with a specific agenda, and although I personally question the value of anecdotal evidence, I felt it was worth including my experience.

Reading Mew's posts regarding the effect of finasteride on the penile structure of rats reminded me of a conversation I had with a (somewhat) famous urologist that I was visiting for an assessment of my peyronie's disease.

Peyronie's results from the formation of scar tissue on (I believe) the tunica of the penis. The result is a bend in the penis and other deformations. I asked this urologist whether there was a possibility that my Peyronie's had developed from finasteride use. I started using finasteride in my very early twenties and developed Peyronie's about a year after. The doctor said that it was not possible, which surprised me a little, given the rat study and the fact that he is a Peyronie's specialist.

After experiencing a painful and major bend, the symptoms of Peyronie's began to stabilize. Fast forward five years and I've lost approximately 30% of my 'size'- both thickness and length- due to restricted blood flow. I never experienced ED. I feel somewhat fortunate that I was on the larger end of the spectrum before Peyronie's, but 1/3 is 1/3 and believe me when I say it sucks.

Peyronie's is very uncommon in men as young as I was when I contracted it. The urologist was surprised to see someone as young as myself with as bad a case of it. It's hard not to personally speculate about a causal relationship between my finasteride use and the development of the disease.

Considering the evidence from the rat studies, I don't see any obvious reason why there wouldn't be possible an analogous response in human males. It's possible I'm lacking in the scientific knowledge to make such a claim.

It really sucks because I'm still tempted to try finasteride as I didn't experience obvious side effects and now that I've 'got' Peyronie's, I figure, what could happen that could be worse?

:shakehead: