Unsure Whether To Start Dutasteride Treatment. Considering Topical And Microdosing.

[22&Balding]

Your logic is understandable, but insufficiently justified. Note again: dutasteride will raise your T, which is very important.

Yeah, it may raise T a bit, but it lowers DHT dramatically, which is much more potent than T.

DHT is not of much use when you're adult - to put it simply. Logic like yours is widespread when patients fear taking a drug that lowers/inhibits smith, assuming that 'smth' is actually needed.

Are you sure? What about the studies I mentioned above? I mean, chances are it won't have a huge impact on my health, I get it but the risks are there. Are you confident you won't get cognitive impairment when you are older because of this drug? Personally I am not, at all.

What is Smith/smth?

This logic is also widespread among those who deny statins - these drugs lower your cholesterol and CRP. They also argue that cholesterol is produced for a purpose and prefer to die of a heart attack or stroke. Human body is more complex that that. Do your research about sides in the long term - the data (types of events, frequency of adverse events etc) are abundant.

People who take statins have high cholesterol levels, while most people who take finasteride or dutasteride have normal DHT levels, and these drugs often lower the already normal DHT levels by 90+%. Do statins lower cholesterol levels 90% below NORMAL levels?

Long-term consequences of dutasteride have been well studied.

When I say long term I mean at least a decade or two. Has dutasteride been proven to be safe over that period of time? Do Benign prostate hyperplasia patients take it their whole lives?

A serious concern is erectile disfunction - this is rare and difficult to distinguish from a normal ageing process over e.g. a decade.

In this case I guess you would have to compare the rates of ED in dutasteride users with those of the normal population of the same age.

Another concern is cancer: earlier accounts raised concerns about a slight increase in the incidence of prostate cancer. However, in 2020 it's quite established that long-term dutasteride use decreases the risk of prostate cancer.

Yeah, it may have some benefits, I guess.
Though in the information leaflet it says the opposite, and that must based in a study as well. Same thing for heart failure.

 

[22&Balding]

Cognitive impairment on finasteride has nothing to do with DHT, it's because finasteride inhibits neurosteroids.

Ok, but this is the drug I have been prescribed, so it isn't really relevant what the cause is.

This side effect is not certain A,but it's real.

What do you mean?

As far as diabetes goes there is a possible increase of diabetes and finasteride use in men who have bph. This finding hasn't been confirmed, and no one knows by what pathway this potential risk is mediated.

According to the study I mentioned before:
"Low concentrations of DHT were strongly associated with higher insulin resistance and higher risk of diabetes, and this negative association remained even after adjusting for covariates known to contribute to diabetes risk and modifiers such as binding proteins (SHBG). These finding are consistent with those of Mather et al."

I would definitely say it looks bad.

Anatoly has already answered your other concerns. To add to what he said, when a person's cholesterol is elevated they may reject the use of statins out of fear, but then when they have a heart attack they will take anything to avoid having another. They don't realize the seriousness of the situation until it's too late. Similarly people refuse finasteride in the early stages of hair loss, but when they become a Norwood 4 all that concern goes out the window and they start taking drugs far more dangerous than finasteride.

He said the same thing, basically. Thus I will give the same response: people who take statins have high cholesterol levels, while most people who take finasteride or dutasteride have normal DHT levels, and these drugs often lower the already normal DHT levels by 90+%. Do statins lower cholesterol levels 90% below NORMAL levels?

Not to mention that a heart attack is generally a much more serious problem than hair loss (unless you become seriously depressed or suicidal as a result).

What are those drugs that you mention that are more dangerous than finasteride/dutasteride? Do you mean that some people end up using them because they are afraid of taking finasteride/dutasteride and are unaware of the dangers of those drugs?

 

[22&Balding]

Just remember to slather a generous helping of the topical variety on your balls and good to go

Lol

 

[Anatoly]

Yeah, it may raise T a bit, but it lowers DHT dramatically, which is much more potent than T.

-------- It's true, but not that simple. One may have high DHT and zero hair loss and low DHT and pattern hair loss. AR sensitivity is genetically determined as well. Some males have better genetics than others who are more challenged - they need treatment. Pattern hair loss esp. if starts early has strong correlation with cardiovascular and cancer risks and chronic inflammation - all things being equal. Do not stick to T and DHT levels in blood tests, there are many more factors to affect interpretation.


Are you sure? What about the studies I mentioned above? I mean, chances are it won't have a huge impact on my health, I get it but the risks are there. Are you confident you won't get cognitive impairment when you are older because of this drug? Personally I am not, at all.

------- I'm aware of the sides you mentioned. This is why we need statistics with good p-values to understand the probability of these effects in certain cohorts of patients in comparison with placebo. Yes, I won't get it) because of dutasteride. Imagine: on DHT inhibitor 2 out of 100 subjects get some cognitive decline (assessed on some subjective scale which is methodologically challenged) and on placebo 1 out of 100 gets this effect - does this mean you chances of this side are increased twice on this drug?


People who take statins have high cholesterol levels, while most people who take finasteride or dutasteride have normal DHT levels, and these drugs often lower the already normal DHT levels by 90+%. Do statins lower cholesterol levels 90% below NORMAL levels?

------ More complex than that. Consult Steve Nissen from Cleveland Clinic. One may have lower that 'normal' LDL and rapidly progressing atherosclerosis. Statins are not indicated simply to lower cholesterol, LDL is just a laboratory indicator to control their effectiveness in case you have signs of atherosclerosis. Statins cannot lower LDL 90%, but in combination with Repatha (evolocumab) they can do this - e.g. a relative of mine of senior age has LDL of 8 mg/dl which is far below the lowest recommended guideline 70 mg/dl and allowed to reverse atherosclerosis. In 2020 it's well known that the lower level of LDL 'normal range' is zero. The lower LDL the lower the risk of MACE.
'Normal' is a dangerous and quite misleading word esp with respect to 'normal ranges' of some biological substances in your body.

DHT levels is just a laboratory indicator, nothing more. Dozens of other factors affecting assessment...


When I say long term I mean at least a decade or two. Has dutasteride been proven to be safe over that period of time? Do Benign prostate hyperplasia patients take it their whole lives?
-- Yes, at least the data are persuasive to me. Moreover, it has benefits other than treating hair loss.


Though in the information leaflet it says the opposite, and that must based in a study as well.
------- Information leaflet is not exactly a medical scientific document, it is a result of FDA voting, level of accumulated data by the time this document was approved, pressures from insurances companies.... opportunities for lawsuits, many things. To include a new indication into prescription info is extremely expensive (the company needs a new trial to meet FDA criteria). What you find and find not in this leaflet is also a result of money saving, widespread with many other drugs when insurance companies benefit from not allowing patents to get some drug off-label.

Same thing for heart failure
--- come on))) it's listed among side effects .... confidence intervals and p-values devaluate this concern + correlation and causation are different things, ask some FDA expert about the process of how a certain side effect may appear on the leaflet - this may change a lot your attitude