Propecia decreases bioavailable testosterone!

[blakes33]

I didn't want to play the 'I have medical training card' but I do.

LOL!! Cleaning bedpans, changing dirty sheets, checking vitals every few hours and administering little pills in a cup to patients doesn't even come CLOSE to 'medical training' as it pertains to this topic.

I just hope I never end up at the hospital you work at, Nurse Boy

Lol very funny! Not quite, I'm an anesthetist.

Ha!! Exactly what I said...your'e a NURSE!! Nurses don't receive any training in Endocrinology.... maybe you overheard the Doctors discussing the subject on their lunch-break in the cafeteria....... :jackit:

 

[eclipsegum]

I didn't want to play the 'I have medical training card' but I do.

LOL!! Cleaning bedpans, changing dirty sheets, checking vitals every few hours and administering little pills in a cup to patients doesn't even come CLOSE to 'medical training' as it pertains to this topic.

I just hope I never end up at the hospital you work at, Nurse Boy

Ha!! Exactly what I said...your'e a NURSE!! Nurses don't receive any training in Endocrinology.... maybe you overheard the Doctors discussing the subject on their lunch-break in the cafeteria....... :jackit:

Wow what ignorance. Let me tell you something I learned from one year with my ex-GF MD, MDs are just people and there are LOTS of bad ones. Many of them are not especially smart and do not understand the body especially well, they are just extremely good at memorizing things. The good ones understand physiology/biology/chemistry and don't have to rely on memorization.

Even the good ones, which my ex is, don't get much of an education on endocrinology; the scope of what they learn is so vast.

And you know what nearly all of them suffer from? -- overconfidence bias, in fact more so than any ever profession -- interestingly meteorology has the least overconfidence, they recognize they are incorrect. MDs never want to say "I don't know."

There are plenty of nurses that are smarter and know more than MDs. Not all nurses "clean bedpans, checking vitals every few hours and administering little pills in a cup to patients".

Sure some states on require an associate's degree and won't have much medical training, but there are programs for nursing all the way up to the PhD level, some of which have residencies. Comparing an associate degree nurse cleaning bedpans to a anesthetist is like comparing the knowledge of a family practitioner DO to a endocrinologist.

Btw I broke up with my ex to be with my current GF who is in her nursing school residency. She has a better understanding of medicine than many doctors, though her education is more intense and a longer program than here in the U.S. -- in her country they have nurse assistants that clean the bed pans.

 

[antman]

the article

'An Open, Randomized, Comparative Study of Oral Finasteride and 5% Topical Minoxidil in Male Androgenetic Alopecia’

did a before and after blood test of free testosterone on 40 healthy males using 1mg finasteride. The results were 18 to 14 avg (Free Testosterone normal = 8.7–54.7 ng/ml)

this is finasteride vs min for hair regrowth

 

[antman]

if anyone has access to this and can post the results, i would be very grateful.

Tenover J. S., Zeitner M. E. and Plymate S. R.: Effects Of 24-week administration of a 5ct-reductase inhibitor (MK-906) on serum levels of testosterone (T), free T, and gonadotropins in men. 7lst Annual Meeting of The Endocrine Society, Seattle, Washington (1989). Abstr. 583

 

[mlb]

I'm surprised this discussion has faded. Seems to me that the reduction in free testosterone could explain a few of the "propecia mysteries"...1) impact on libido, 2) why older men are more severely affected, 3) potentially some of the cognitive effects.

How is the FDA able to approve a drug that changes your hormone profile without measuring something as fundamental as Free T? My hunch is that Merck knew the impact on Free T and did everything they could to steer the focus towards Total T. Scary really.

Anyone dig up that study mentioned in the prior post?

 

[kehcorpz]

I'm surprised this discussion has faded. Seems to me that the reduction in free testosterone could explain a few of the "propecia mysteries"...1) impact on libido, 2) why older men are more severely affected, 3) potentially some of the cognitive effects.

How is the FDA able to approve a drug that changes your hormone profile without measuring something as fundamental as Free T? My hunch is that Merck knew the impact on Free T and did everything they could to steer the focus towards Total T. Scary really.

Anyone dig up that study mentioned in the prior post?

Merck did measure these and circulating free testosterone was increased by 15% as was estrogen which is understandable since the excess free testosterone will be converted by aromatase as 5-ar has a higher affinity and keeps aromatase from binding to test. This is also why some libido problems occur, the increase in estrogen for some people is too great.

In healthy volunteers, treatment with finasteride did not alter the
response of LH and FSH to gonadotropin-releasing hormone, indicating that the hypothalamic-pituitary-testicular axis
was not affected. Mean circulating levels of testosterone and estradiol were increased by approximately 15% as
compared to baseline, but these remained within the physiologic range.

You can find the full study on the fda website.

The point is, it's like with any drug, some people will react differently as their biology is completely different. That's why studies are done to measure the amount of people that are affected by bad effects and based off statistical significance it gets approved.

There is a lot to consider here. It could be that finasteride increased sex globulin binding hormone in some people and therefore the free testosterone is bound. It is also a higher possibility that some peoples bodies increase production of aromatase in order to compensate for the increase in free testosterone which gets converted to estrogen. The point is this is not the majority of people. I have blood work done regularly and my free testosterone has gone up considerably, especially after I switched from 1mg to 1.25mg. In fact that small 0.25mg boost had a big impact on lowering my dht levels as well. It could be that this was the sweet spot for me. I'm different just like everyone else and I experimented on my needs.

 

[kehcorpz]

Here's some sales data on propecia over the years. Remember you guys experiencing problems are a minority and I feel bad for you but that's life unfortunately.

http://en.wikipedia.org/wiki/Annual_pha ... drug_sales

for finasteride in MILLIONS:
2004: $270.2
2005: $291.9
2006: $351.8
2007: $405.4
2008: $429.1


The pattern is pretty clear. There's no conspiracy, the money speaks for itself. Finasteride is this big bad drug and it ruins your sex drive and causes aliens to come down and abduct you at night because you are irradiating chemicals.

Give me a break, everyone I know who takes finasteride is perfectly fine. You are the minority.

 

[Hairforever]

Spoken like a true Merk salesman. How much is your commision? Sales prove nothing sunshine. They just show how desperate men are to keep their hair at any cost. The 2 % side-effects figure is conjured up out of thin air. Who knows what the real figure is and what it is when time scales are factored in? But the argument used on this website that it's only a small number of men who suffer from side-effects and all of those go on websites like this one to complain thereby creating an impression there are lot more is a lame one. There are bound to be many men out there who are experiencing or have experienced side-effects who don't post on websites and suffer in silence, perhaps too embarrassed to admit they were vain and foolish enough to try this Russian roulette drug. If doctors don't know the short, medium and long term implications of taking the drug, you sure don't.

I've lost count of posters on this site who dismiss watery semen as nothing, brain fog as nothing but a spot of tiredness, softer erections as an unhealthy diet or insufficient exercise or reaching the grand old age of 40. Anything but stop taking this little pill that could save some of their hair. It's called denial and there is plenty of it around. I can understand it because it's natural for men to want to keep their hair. But if you read enough medical studies posted on this site there is growing evidence to make anyone taking this drug feel uneasy. DHT is in our bodies because we need it to be healthy males. It's our genetics that are the problem.

Take out the DHT and you are screwing with nature. It's not just physical side-effects, there are psychological and cognitive ones too, such as early onset of dementia ('Hey I'm 55 and still have some hair. What's my name again?)The damage may not manifest itself short or even medium term but there are no studies by Merk or anyone to give users peace of mind about long term use.

 

[kehcorpz]

I stand corrected. I remembered it wrong.

7/9/2011 blood test (3 months post finasteride)
LH 4.1
FSH 1.6
testosterone 856 (249-836 ng/dL)
free t, direct 13.0 (8.7-25.1 pg/mL)
SHBG 77.5 (14.5-48.4 nmol/L)
estradiol 37.0 (7.6-42.6 pg/mL)
estrone 45 (12-72 pg/mL)

letter from my endo dated july 2011
It would probably be worth having liver function tests done to be sure the high SHBG is not one manifestation of a more general problem with hyperglobulinemia due to hepatitis or chronic liver disease, but that explanation for the high SHBG seems highly unlikely. My previous speculation, that high estrogens might have explained the elevation of SHBG, was not supported by the current studies. There may be a relatively long timeframe for changes to be seen in the levels of circulation globulins, after revision of any influence that had been formerly exerting an effect upon their levels. A possibility is that we still could be seeing lingering effects from estrogen elevations of the past; the present estradiol level is in the high end of the normal range. However, given that estrogen elevation is not a recognized complication of treatment with Propecia, I now think the likeliest explanation might be that SHBG levels could be affected by the ratio of dihydrotestosterone to estrogen, such that a low ratio induces SHBG levels to be elevated. Once SHBG is elevated, the total testosterone is elevated, but not the free testosterone. With the passage of time, if there has been a temporary effect of this type, the effect should regress. Although I have tried to research these questions, I'm not finding clearcut answers. If I hear from you with your permission, I might like to share the de-identified data with an expert in the field of andrology or sex steroid metabolism. If you should learn anything further from your contacts who have similar concern, I would be interested to hear of your findings. (she means the hairloss community).

viewtopic.php?f=46&t=64933&st=0&sk=t&sd=a&start=40

Wow that's a revelation....

See when you measure testosterone you measure Total testosterone and you measure circulating testosterone which is considered unbound. Propecias studies saw an increase in unbound circulating testosterone.

Furthermore the study in your signature seems fabricated as it only exists on some home made websites and nowhere in the scholarly text. I skimmed through it and it is a poorly written study. You will notice in mercks studies that there were over 2000 random men of no particular race. In that study there were 30 males CHOSEN. It could have been done to elicit a particular response if this study is even real. I can write a pdf document and post it on none scholarly websites as well. Next you will notice that in the Merck studies (there were multiple) measurements of all hormones were done to account for any irregularities and explain any changes that may occur. This includes estrogen among other hormones. You poor poor man. Accept that finasteride didn't work for you and you may have been a minority and move on. Stop preaching.

 

[kehcorpz]

Spoken like a true Merk salesman. How much is your commision? Sales prove nothing sunshine. They just show how desperate men are to keep their hair at any cost. The 2 % side-effects figure is conjured up out of thin air. Who knows what the real figure is and what it is when time scales are factored in? But the argument used on this website that it's only a small number of men who suffer from side-effects and all of those go on websites like this one to complain thereby creating an impression there are lot more is a lame one. There are bound to be many men out there who are experiencing or have experienced side-effects who don't post on websites and suffer in silence, perhaps too embarrassed to admit they were vain and foolish enough to try this Russian roulette drug. If doctors don't know the short, medium and long term implications of taking the drug, you sure don't.

I've lost count of posters on this site who dismiss watery semen as nothing, brain fog as nothing but a spot of tiredness, softer erections as an unhealthy diet or insufficient exercise or reaching the grand old age of 40. Anything but stop taking this little pill that could save some of their hair. It's called denial and there is plenty of it around. I can understand it because it's natural for men to want to keep their hair. But if you read enough medical studies posted on this site there is growing evidence to make anyone taking this drug feel uneasy. DHT is in our bodies because we need it to be healthy males. It's our genetics that are the problem.

Take out the DHT and you are screwing with nature. It's not just physical side-effects, there are psychological and cognitive ones too, such as early onset of dementia ('Hey I'm 55 and still have some hair. What's my name again?)The damage may not manifest itself short or even medium term but there are no studies by Merk or anyone to give users peace of mind about long term use.

You don't even understand the pharmaceutical world. There are no merck salesmen going on websites trying to convince people to buy their product. Merck sales men have conferences where they invite doctors and provide them with data in order to promote their product. You are so butt-hurt that it didn't work for you but worked for others. I don't care what you believe, it works great for me. My friend has been using it for 11 years and it works great for him. I know others who have been on it from 2-8 years as well and they are all happy and have normal sex lives and have had kids.

Now do the math, say 6000000 people took finasteride. At 2% side effect rate 120,000 people would be very vocal about their problems. While 120,000 seems like a lot, it is not when looking at the larger picture. There are antidepressants who people swear are horrible and give nothing but side effects and that's all I see on the internet but yet they help millions of people, including myself.

Furthermore, your argument about DHT being there because it's natural and healthy is illogical. The world of medicine exists because not everyone has perfect genetics, there are abnormalities which require intervention. Cancer forms naturally, without medicine and letting yourself go natural you won't last long. There are people who have excess long protein serotonin transporters and end up depressed because of it, but hey they are there naturally.

Medicine doesn't know everything about our bodies and new information comes up quite often. But fact remains that there are no studies showing any ill effects even after long term use and we are talking about the majority.

Think about it this way. It's like high school all over again and you're the guy that's being left out of the majority and you're angry because of it.

 

[mlb]

I'm pretty sure Merck tested Total T, not Free (or bioavailable) T.

 

[kehcorpz]

K well I don't have the full text on me but I do have the summary which other parameters imply that bioavailable testosterone was increased.

First an understand that only free testosterone can bind to intraprostatic tissue. You can read the scientific text here that at least describes it:

Only testosterone that is not bound to SHBG (i.e. FT and albumin-bound
testosterone) can enter target tissue cells by passive diffusion.

http://journals.cambridge.org/productio ... tid=634364


Now in the finasteride study summary I see the following:

When PROSCAR® was given for 7–10 days to patients scheduled for prostatectomy, the drug
caused a decrease in intraprostatic DHT of approximately 80%. Intraprostatic concentrations of
testosterone were increased up to 10 times over pre-treatment levels.

Bound testosterone cannot increase intraprostatic concentrations. I do have the full study somewhere on an external drive kicking around I believe. I'll try and find it when I get home.

 

[kehcorpz]

No luck. Ahh well. No point in arguing really, my blood tests show increase so I'm not worried. Get your own blood tests done and that will solve this argument as you are your own unique individual.

 

[Wuffer]

I enjoy your posts kehcorpz! I'm not sure if you already posted this, but what are your hormone levels from before and after finasteride?

The study that was posted here showed that all men experienced quite a significant decrease in FT levels. Does anybody else have any studies that show the same thing? Preferably with a larger sample of men? I am interested to know how accurate these results are in a larger sample, or some further explanation of why free T levels would drop in ALL men.

I don't know all that much about hormones, but nobody really knows why finasteride causes sides. If all men in this study experienced quite a significant drop in free T, yet none experienced side effects, I would guess that this isn't the cause. Another explanation is the raise in estrogen, but E can also be quite significantly lowered in men by taking supplements such as DIM.

It could possibly just be explained by a genetic intolerance to any changes in hormonal levels.. Who knows. But I've been on finasteride for 1.5 years with no sides. I am able to put on muscle mass seemingly easier than ever, so I don't think there are any problems with my T or free T levels... But I might get them checked because this thread has made me quite curious.

 

[antman]

i've read many studies on muscle and bone density of men on dutasteride/finasteride and it doesn't affect anything. in one of the studies the men on dutasteride had an average of 3% increase in muscle mass.

my testosterone and free testosterone is at the very bottom of the spectrum when i'm on finasteride. but i recover quickly from exercise and put on muscle easily just like everyone else my age. and after googling around i find - there are lots of very muscular men out there with low T (but within the spectrum).

if finasteride or dutasteride affected muscle mass or bone density all the thousands of weight lifters and body builders would be crying about it on forums. it would have been noticed by now.

@ Wuffer
what if you go to the doctor like me and find out that your T and free T is low? then what? it doesn't change anything or mean anything to anyone.

 

[kehcorpz]

I enjoy your posts kehcorpz! I'm not sure if you already posted this, but what are your hormone levels from before and after finasteride?

The study that was posted here showed that all men experienced quite a significant decrease in FT levels. Does anybody else have any studies that show the same thing? Preferably with a larger sample of men? I am interested to know how accurate these results are in a larger sample, or some further explanation of why free T levels would drop in ALL men.

I don't know all that much about hormones, but nobody really knows why finasteride causes sides. If all men in this study experienced quite a significant drop in free T, yet none experienced side effects, I would guess that this isn't the cause. Another explanation is the raise in estrogen, but E can also be quite significantly lowered in men by taking supplements such as DIM.

It could possibly just be explained by a genetic intolerance to any changes in hormonal levels.. Who knows. But I've been on finasteride for 1.5 years with no sides. I am able to put on muscle mass seemingly easier than ever, so I don't think there are any problems with my T or free T levels... But I might get them checked because this thread has made me quite curious.

Thanks. I don't deny that this could happen. I'm just saying that people on forums blow results out of proportion. There's not that many studies that show these tests done and maybe 1 was done but it was too limited and not enough sample sizes and users were chosen specifically it seems. The latest Phase 2 results of dutasteride/fina even show increased testosterone in the scalp tissue which means it could not have been bound.

Scalp Testosterone rose 24% for Finasteride, 46% for 0.05mg Dutasteride, 44% for 0.1mg Dutasteride, 104% for 0.5mg Dutasteride, and 154% for 2.5mg Dutasteride.

While serum levels may still not show up as being high it's because bioavailable testosterone will target tissues and bind and this tissue bound testosterone will not show up in a test unless specifically testing for it.

My bioavailable testosterone was in the 122ng/dl range prior to fina and subsequent tests have shown it in the ranges of 240-370ng/dl. Now I had lower than optimal before fina and still sometimes it is lower than optimal. I would say anything over 350 is good. But it is always higher than before that's for sure.

And yes, you make a good point it's different for everyone. So instead of going nuts over what some people on the internet are saying, try it yourself and have your doctor monitor, and if you get the same problem, go off it.