propecia - the bigger picture

[jblig]

[quote="guy83How certain is it that there would be a miracle drug would come out?I think first they should stumble across some drug that would work like propecia and minoxidil but only faster. So instead of having the results in a year time, u get it in a 6 months time or 3 months time.
Something like that sounds more reasonable to be discovered in the next 8 years than a ''miracle drug''. But then again, who knows?![/quote]

when propecia first came out it was considered a miracle drug. I dont mean necessarily a drug that promises a full head of hair overnight.....

 

[Bryan]

There's not a shred of evidence to suggest that finasteride eventually loses its ability to prevent the formation of DHT.

Bryan if finasteride doesn't eventually lose it's capacity to prevent the formation of DHT then why does it stop working for people? When they adapt to the drug, the drug loses it's potence and is no longer able to do it's job which is preventing DHT. That is why people are talking about finasteride's life capacity in this thread.

I don't know for sure why finasteride "stops working" (assuming that it actually DOES "stop working"). There's a whole lot of speculation about that, ranging from theories that maybe other androgens besides DHT play a role in balding, to possibly increasing sensitivity of hair follicles to remaining DHT (BTW, one of my own pet theories is that what some people are seeing is not so much a "failure" of finasteride, as a continued thinning due to ageing).

However, one thing seems fairly certain to me: if finasteride's ability to reduce DHT really did decline over time, I think doctors and scientists would have known that LONG ago! They'd be all over that like a cheap suit! I'm sure countless DHT measurements are taken every day in labs all over the world, and Proscar has been used now for many many years. It's incomprehensible to me that nobody would have noticed by now that DHT levels start creeping back up (BTW, there have indeed been long-term studies showing that Proscar continues working for BPH for several years).

Bryan

 

[guy83]

[quote="guy83How certain is it that there would be a miracle drug would come out?I think first they should stumble across some drug that would work like propecia and minoxidil but only faster. So instead of having the results in a year time, u get it in a 6 months time or 3 months time.
Something like that sounds more reasonable to be discovered in the next 8 years than a ''miracle drug''. But then again, who knows?!

when propecia first came out it was considered a miracle drug. I dont mean necessarily a drug that promises a full head of hair overnight.....[/quote]


Awwww Homer!

 

[jblig]

huh?

 

[guy83]

huh?

Dont take it personal but my avatar is Marge from the Simpsons and yours is Homer.

If you watch The Simpsons Marge has a weird deep voice and its funny when she goes ''oh homer'', or just ''homer''.

LOL

 

[Kramer3]

However, one thing seems fairly certain to me: if finasteride's ability to reduce DHT really did decline over time, I think doctors and scientists would have known that LONG ago! They'd be all over that like a cheap suit! I'm sure countless DHT measurements are taken every day in labs all over the world, and Proscar has been used now for many many years. It's incomprehensible to me that nobody would have noticed by now that DHT levels start creeping back up (BTW, there have indeed been long-term studies showing that Proscar continues working for BPH for several years).

Bryan: What makes you certain that doctors aren't aware that the ability of proscar to reduce DHT is eventually reduced over time. Our body is able to adapt to a lot of things, particularly treatments. It's just the nature of taking drugs for an extended period of time. Proscar's orginal use which is preventing the further enlargement of BPH seems to me to be something that wouldn't require years and years of using the drug. I've personally just assumed that its general belief that proscar eventually stops working because it is no longer able to block DHT.

My questions have been answered. My cause of concern wasn't particularly proscar and its abilities but rather what other availabe options would their be if someone experienced BPH after proscar's affect had demised.

 

[Bryan]

Bryan: What makes you certain that doctors aren't aware that the ability of proscar to reduce DHT is eventually reduced over time.

Because I've NEVER seen a hint or suggestion of that in the medical literature. Have you?

Our body is able to adapt to a lot of things, particularly treatments.

Yeah, but not finasteride, to the very best of my knowledge. If you know anything to the contrary, please post the references or citations.

Proscar's orginal use which is preventing the further enlargement of BPH seems to me to be something that wouldn't require years and years of using the drug. I've personally just assumed that its general belief that proscar eventually stops working because it is no longer able to block DHT.

Again, I can show you studies that Proscar continues to work for BPH for at least 5 years. By now, there may be even longer-term studies than that.

Bryan

 

[Bob_Marley]

Let me throw my two cents in here. Not that it means as much as study savvy Bryan.

There can be something to be said for our bodies adjusting to a drug to a certain extent, but this would not explain why some claim loss of effectiveness at 2 years and other at 5 years. Our systems are'nt that different. As long as you're TAKING(1st year or at 6th year) propecia, your DHT levels will be significantly reduced versus placebo.

What I think it comes down to is obviously genetics(speed/final severity) and then what looks cosmetically bald. eg. They say you have to lose 50% density to notice thinning sometimes, so a guy that notices that he is balding has probably been losing his hair for longer period than he thinks. Also keep in mind that propecia reduces DHT by about 67%(i think) not 100%, therefore the culprit one is after is not completey eliminated.

So with that in mind, your "average" hairloss sufferer notices some recession(nw2 lets say). Now if he's destined to be a nw4-5, that hair behind his recession has probably already thinned 30%. Buddy takes propecia and 2 years later is singing it's praises nw2 still intact. But little does he know that the remaining DHT is still clinging to receptors and thinning his hair, just very slowly(in comparison to not taking propecia).
Anyways, At 2.5 years that hair get over that 50% density hump(due to continued slow loss) and all of a sudden he notices more loss.

Of course this guy says that propecia has lost it's effectiveness, but in reality doing exactly what it's always done, SLOWED DOWN HIS LOSS. IT NEVER STOPPED HIS LOSS COMPLETELY and then all of a suddens stopped working.

I know it's long but I'm sure you guys will get what I'm trying to point out.

 

[Guest]

Also keep in mind that propecia reduces DHT by about 67%(i think) not 100%, therefore the culprit one is after is not completey eliminated.
.

Do all men produce DHT? I think they do. So if all men produce DHT, wouldn't they all go bald? But not all men go bald. I think those guys that don't make as much DHT as us male pattern baldness sufferers just make the right amount of DHT to allow them to keep there hair. Perhaps they make 30% less DHT then male pattern baldness sufferers, or maybe 60%. I don't know. It is just a thought. I don't think DHT has to be fully suppressed 100% because that would cause adverse reactions. Anyone have some legit info on some of these ideas?

 

[Resultsnottypical]

loss of efficacy

Bob Marley:

Great post, I understand exactly what you are saying. Maybe it slows it down like "half-lifes" or something...but each person is rigged differently as far as the time-frame and scope of their loss. Oddly, before starting minoxidil last fall...every time I let my hair grow out from shaving it with a razor, it looked about the same (relatively bad) as it did 5 years ago.

It seemed like I lost an initial amount and then held steady (and this was more than recession, etc). minoxidil has brought back a lot of hair.

But eventually, I would figure my hair will continue to thin...to a point beyond "cosmetically acceptable" ...its just a matter of when. minoxidil and finasteride probably hold that off, and help with regrowth..which eventually slows down...

hopefully there will be a cure anyhow (in some form or another) in the next five years.

I'm waiting for artificial hair...something akin to a rug that looks decent, and lasts years once inserted or applied (however it is done).

 

[shineydome]

Do all men produce DHT? I think they do. So if all men produce DHT, wouldn't they all go bald?

Well, I'm not a doctor, but, as long as you produce testosterone, you'll produce DHT. As far as going bald, if you have those DHT receptors in your scalp follicles that are sensitive to DHT..the baldness ball will start rolling. I believe there is a race of humans on some island somewhere that are devoid of those receptors, or at least the chemical that reacts with testosterone, to create DHT... no hairloss.

 

[Bob_Marley]

Badass

Every guy of course produces DHT. YOu could have all the DHT in the world in your body, but if you do not have the genes which set in motion a process in which DHT becomes harmful, then it just does not matter. There is no such thing as a perfect level of dht in our bodies, it's as simple(or really f*cking extremely complex) as genetics.

Pseudo hemaph's of Dominican are born with no DHT and all of them keep perfect hairlines. However my buddy, will die a Norwood-1, and he probably has just as much DHT as myself(or did, until propecia came along)

dutasteride, supposedly reduces like 93% of DHT, and it got approved for BHP. It has not stopped hairloss in some.

 

[Bryan]

What I think it comes down to is obviously genetics(speed/final severity) and then what looks cosmetically bald. eg. They say you have to lose 50% density to notice thinning sometimes, so a guy that notices that he is balding has probably been losing his hair for longer period than he thinks. Also keep in mind that propecia reduces DHT by about 67%(i think) not 100%, therefore the culprit one is after is not completey eliminated.

So with that in mind, your "average" hairloss sufferer notices some recession(nw2 lets say). Now if he's destined to be a nw4-5, that hair behind his recession has probably already thinned 30%. Buddy takes propecia and 2 years later is singing it's praises nw2 still intact. But little does he know that the remaining DHT is still clinging to receptors and thinning his hair, just very slowly(in comparison to not taking propecia).
Anyways, At 2.5 years that hair get over that 50% density hump(due to continued slow loss) and all of a sudden he notices more loss.

Of course this guy says that propecia has lost it's effectiveness, but in reality doing exactly what it's always done, SLOWED DOWN HIS LOSS. IT NEVER STOPPED HIS LOSS COMPLETELY and then all of a suddens stopped working.

Bob, I agree with your point in general, as far as it goes, but you're leaving out another very puzzling phenomenon: Propecia does NOT merely slow down hairloss (I'm talking AVERAGES here)...it actually results in a certain amount of REGROWTH. So the puzzling question is: why does it cause a spurt of regrowth (again, on average) during the first year of use, which then slowly starts to decline again during subsequent years? Your theory doesn't account for that.

There have been a number of attempts to explain that which seem to be centered on the general idea of the "upregulation" of the effects of androgens (like androgens other than DHT, or perhaps androgen receptors). However, my own pet theory is that at least part of that effect is due to "normal" senescent thinning of hair as we get older, and not a continuation of the actual male pattern baldness process itself.

Bryan

 

[Bob_Marley]

Bryan,

Maybe not a puzzling question at all. I think that you would agree first, that the "average" hairloss sufferer/responder(I think the two go hand in hand) will never see significant regrowth, but most likely will see maintenance. Let's say that follicles get past a certain level of atrophy and they're gone, propecia won;t save these hairs. Now the hairs that it does save is the "regrowth", which of course is a very slow process. So after 2 years propecia has saved all the hairs it could and you eventaully see the fruits the pill. But no further regrowth beyond that because you did not get too those other hairs quick enough. Just a thought.

It's the dramatic drop in DHT that helps intially, however in the long run it will eventually catch up.

YOur natural age theory would not explain the further progression of a typical male pattern baldness pattern, rather than overall general thinning.

I read one study on pubmed that large amounts of Test act like DHT at receptors. COuld this ever play a significant role in male pattern baldness.

 

[Guest]

Pseudo hemaph's of Dominican are born with no DHT and all of them keep perfect hairlines. However my buddy, will die a Norwood-1, and he probably has just as much DHT as myself(or did, until propecia came along)

dutasteride, supposedly reduces like 93% of DHT, and it got approved for BHP. It has not stopped hairloss in some.

Well i was wondering since these domicicans are born with no DHT and keep perfect hairlines, do they also live a healthy life? Is DHT essential? Do we really need it? So if those dominican guys with no DHT live healthy lives(and healthy sex lives?), it seems Adovart really is a lot better then propecia if it blocks 97% of DHT. It would be 30% better than finasteride.

And the other average guys that do not ever suffer hairloss, if they create the same amount of DHT as male pattern baldness guys, why don't they have the other effects of DHT. eg. More body hair. I just don't know what is the point of DHT. Genetically it seems that black and asian men seem to have less body hair then other ethnicities. They also seem to have less instances of male pattern baldness. Do they make as much DHT as other ethinicities?

I don't know where i am going with the post, but these are just a few things that have been on my mind.

 

[Bryan]

Bryan,

Maybe not a puzzling question at all. I think that you would agree first, that the "average" hairloss sufferer/responder(I think the two go hand in hand) will never see significant regrowth, but most likely will see maintenance. Let's say that follicles get past a certain level of atrophy and they're gone, propecia won;t save these hairs. Now the hairs that it does save is the "regrowth", which of course is a very slow process. So after 2 years propecia has saved all the hairs it could and you eventaully see the fruits the pill. But no further regrowth beyond that because you did not get too those other hairs quick enough. Just a thought.

Yes, but you haven't answered the fundamental question: why does the growth first go UP, and then DOWN?

It's the dramatic drop in DHT that helps intially, however in the long run it will eventually catch up.

WHAT will catch up? The DHT? No, I defy anybody to find a study showing that finasteride eventually loses its ability to reduce DHT!

YOur natural age theory would not explain the further progression of a typical male pattern baldness pattern, rather than overall general thinning.

That's a very good point, but we don't really KNOW to what extent the thinning only occurred in the typical pattern, since the haircounts in the Propecia trial were taken in a fixed location each time in the vertex.

Bryan

 

[Bryan]

Well i was wondering since these domicicans are born with no DHT and keep perfect hairlines, do they also live a healthy life? Is DHT essential? Do we really need it? So if those dominican guys with no DHT live healthy lives(and healthy sex lives?), it seems Adovart really is a lot better then propecia if it blocks 97% of DHT. It would be 30% better than finasteride.

The so-called "pseudohermaphrodites" in the Dominican Republic _do_ have DHT, just not as much as normal men. They are deficient in levels of the 5a-reductase type 2 enzyme, but have normal levels of the type 1 enzyme. Not surprisingly, as a result of that, their hormonal profiles are strikingly similar to normal men who take finasteride! :wink:

Wanna see some pics of the pseudo's?? Check it out...these were published in a medical journal:

http://www.geocities.com/bryan50001/pse ... rodite.htm

And the other average guys that do not ever suffer hairloss, if they create the same amount of DHT as male pattern baldness guys, why don't they have the other effects of DHT. eg. More body hair. I just don't know what is the point of DHT. Genetically it seems that black and asian men seem to have less body hair then other ethnicities. They also seem to have less instances of male pattern baldness. Do they make as much DHT as other ethinicities?

Don't put too much emphasis on DHT! There's a lot more to genetics than just that! :shock:

Bryan

 

[Guest]

O man, i didn't catch the hermaphrodite thing until just now.

 

[Bob_Marley]

Bryan

Yes, but you haven't answered the fundamental question: why does the growth first go UP, and then DOWN?

That's what I tried to answer. Propecia saves(regrows) hairs that have not already been severly damaged. That's the regrowth UP, the down comes from the fact that certain hairs cannot be saved. IT can;t go on regrowing hair forever. It saves what it can, from lowering DHT, that's it.

WHAT will catch up? The DHT? No, I defy anybody to find a study showing that finasteride eventually loses its ability to reduce DHT!

You misunderstood what I was saying. I agree propecia does not lose it's ability to reduce DHT as far as we know. What I was saying is that we benefit initially from a big drop in DHT. Bam, all of a sudden follicles get way less exposure to DHT which allows them to rejuvenate. However the 33% left(which may be more in some guys than others) is still roaming around attacking follicles. So in the long run this 33% is still doing damage.

 

[hope is near]

From what I understand, what happens is that when Propecia or Avodart reduce DHT the immune systems stops or decreases it's attack on the hair follicles therby allowing them to grow. And thus making minoxidil more effective since the immune system is not attacking the hair follicles.

Consequently, I believe modulating the immune system response to it's sensitivity to either DHT or the hair follices will result in normal hair growth as if someone who does not have male pattern baldness.

Also vertex hair loss has been linked to "syndrome X", also known as "metabolic syndrome". Although there is no known cure for syndrome X, treating some of the symptoms and apparent causes might help in regrowth on the vertex.