All Finasteride & Dutasteride Users..... A MUST READ UPD

JohnnySeville

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Guys...

Just ran across this article and thought you should be made aware of it. All I am offering is information, what you make of it is your choice. Makes you think about the so-called "Brain Fog"?



Allopregnenolone (synthesized from 5AR) may prevent neurodegeneration
Kofi kofi at anon.un
Wed Aug 11 19:26:31 EST 2004


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The latest research in mice raises a disturbing question about the
safety of FDA approved 5AR inhibitors like finasteride
(Proscar/Propecia) and especially dutasteride (Avodart) when it comes to
managing long-term risk for neurodegenerative diseases like Alzheimer's.
This is because these drugs not only reduce levels of DHT but also wound
allopregnanolone production in the process.

To summarize the new findings on allopregnanolone (see attached below),
Niemann-Pick type C is a rare lysosomal storage disorder/childhood
neurodegenerative disease in which brain cells accumulate fat and die
due in part to severely disrupted neurosteroidogenesis. A mutant gene
for lysosomal acid sphingomyelinase disturbs cholesterol synthesis
throughout the body and results in the accumulation of sphingomyelin.
Progressive loss of neurosteroid synthesis may contribute to
neurodegeneration. Replacing lost allopregnanolone substantially
increases the survival of mice with this type of disease by mitigating
the damage and delaying the onset of symptoms. Results were best when
administered as early as possible in the animal¹s life.
Allopregnanolone may be effective with managing other neurodegenerative
disorders. Other important neurosteroids like pregnenolone are also
diminished in Niemann-Pick type C but what's interesting here is how
valuable allopregnanolone is by itself.
<http>. NPC
model mice may have amyloid-beta accumulations similar to those in
Alzheimer's [PMID 14982851, 14982829] and may represent a good model for
studying general aspects of neurodegeneration.

5 alpha reductase (5AR) is an enzyme which comes in two forms, type I
and type II. It not only converts testosterone (T) to
dihydrotestosterone (DHT, a ketone), it also converts progesterone to
allopregnanolone and deoxycorticosterone (Doctor) to tetrahydroDOC (THDOC),
both allosteric enhancers of the GABA(a) receptor (e.g., they increase
the effectiveness of inhibition signals relayed along GABA channels in
nerves). The second stage of this conversion is performed by
3alpha-hydroxysteroid oxidoreductase.

This pathway has widespread influence in the body. Progesterone is the
precursor to allopregnanolone. Monthly drops in women¹s progesterone
prior to their periods is a factor in PMS and epileptic seizure.
Progesterone lozenges ameliorate seizures. Both estrogen and
progesterone are important for TMJ remodeling [PMID 10670598]. Men with
epilepsy can benefit from aromatase inhibitors which block the
conversion of testosterone to estrogen via aromatase [PMID 15123030].
Allopregnanolone can block cocaine induced seizures [PMID 12921865].
Complete 5AR inhibition shortens inhibitory currents in GABA(A) channels
both via allopregnanolone [PMID 12559121] and
5alpha-dihydrocoticosterone (THDOC) [PMID 11978855].

SSRIs (antidepressants like Zoloft) have been shown to upregulate levels
of progesterone and allopregnanolone (THP) [PMID 12957330] as well as
neurogenesis [PMID 14872203, 15001810, 14512209]. In animal models it¹s
the hippocampal neurogenesis that accounts for the behavioral effects of
SSRIs [PMID 12907793]. Conversely, inescapable stress which reduces
hippocampal neurogenesis also causes depression [PMID 12838272].

Levels of allopregnanolone can also be regulated by 3alpha-HSDs
(3alpha-hydroxysteroid dehydrogenase) - enzymes which are identical in
function to 5AR, except they convert T back from DHT instead of the
other way around. 3alpha-HSDs are responsible for downregulating levels
of DHT in the prostate and unusual inhibition of 3alpha-HSD would
increase DHT levels, decrease allopregnanolone and incline a male toward
impaired GABA functioning, acne, baldness, BHP and prostate cancer.
Stimulating 3alpha-HSD might be more effective than 5AR inhibition for
treating androgen disorders (although elevated exposure to either
progesterone or allopregnanolone can become anxiety-provoking instead of
calming; there are gender differences to this effect [PMID 12606703]).

Certain synthetic progesterones may interfere with allopregnanolone
synthesis. Medroxyprogesterone acetate (MPA), an ingredient in some
birth control pills and hormone replacement therapies, doesn¹t convert
into allopregnanolone and causes anxiety, aggression and depressed sex
drive in mice compared to combinations of natural hormones
<http>.

This overview should drive home just how important allopregnanolone may
be to human health. Finasteride is a 5AR type II inhibitor which
reduces DHT levels by up to 70%. Dutasteride inhibits both type I and
type II 5AR achieving a reduction of up to 94% of DHT. Type I is the
only 5AR expressed in the brain. Its long term inhibition was never
studied when dutasteride was approved by the FDA. Blocking DHT
synthesis in the brain like this also blocks allopregnanolone production
there. While other tissues like bone also express 5AR, finasteride has
been specifically studied on bone growth and has had no effect. Will
this also be true for neurodegenerative disorders which take decades to
develop? Will 5AR inhibitors be safe for individuals with epilepsy,
TMJ, neuropathy, alcoholism, tinnitus, metals poisoning or other
GABAergic illnesses?

If it's true that dramatic 5AR inhibition contributes to long term
neurodegeneration then what other therapeutic agents are available for
dealing with excessive DHT?

Understanding why male hormonal disorders like BHP, prostate cancer and
baldness have become common in "advanced" economies is important to
answering this question. One contributing factor is the bad mix of fats
consumed in the American diet (high in trans-fats, hydrogenated oils,
bad omega-6 and -9's and low in omega-3). Another factor is high
glycemic index diets which contribute to insulin resistance and androgen
signaling disorders like polycystic ovarian syndrome. High levels of
insulin lower levels of sex hormone-binding globulin, a substance which
binds to testosterone and lowers the amount of "free" androgens
available to bind to the receptor (see [PMID 14527633],
<http>). These
androgen driven disorders are all complex genetic disorders which can
develop from many different angles. For instance, in a small study,
prematurely balding men could be divided into two groups: the first
group (about a third of the men) had a hormonal/insulin profile similar
to women with polycycstic ovarian syndrome (low SHBG, hyperinsulemia,
high free androgens and insulin resistance) whereas the second group had
no similarities or only lower SHBG [PMID 15209536]. How you react to
pathologically elevated levels of DHT is determined by your genetic risk
and your environment.

While dietary factors like fat and sugar consumption are important , the
major actor on DHT throughout our evolutionary history has been a
substance called equol. Equol is a derivative of the soy metabolite
daidzein produced by bifidus bacteria in the gut. It directly binds to
dihydrotestosterone and deactivates it [PMID 14681200]. Most male
mammals produce ample amounts of equol to regulate excessive DHT
production. High levels of equol in men lowers the risk for prostate
cancer [PMID 14681200, 14720329] and improves blood cholesterol [PMID
14679315].

By taking antibiotics, you usually increase your risk for chronic
inflammatory disorders. In this case, killing your gut bacteria leaves
abnormally high levels of free DHT floating around in your blood
stimulating your androgen receptors beyond what your body is used to.
Over a lifetime, this brings out your genetic risk for androgen-driven
disorders like the ones I keep mentioning. Destroying your gut bacteria
with antibiotics probably also increases the risk for allergies, asthma,
arthritis and other inflammatory disorders (see
<http>,
<http>, PMID
15120189) - not to mention it can give you a bad yeast infection like
you see in chronic sinusitis.

How can you obtain equol if you no longer make your own?

That's the problem. You can't. The only versions manufactured and sold
today are racemic - meaning both the left and right isomers of the
molecule are produced in a mixture. Only one form is naturally made and
used in the human body. The other is not well studied. Another
limiting factor is that finasteride and dutasteride are patented while
equol can't be - it's a natural product which has been around too long.
Contact manufacturers and let them know there is a market for this
therapeutic substance and that it's worth conducting clinical trials.

If 5AR inhibitors do pose long term risks and you absolutely have to
take them, it may be possible to lessen the neurological damage with
things like acetyl-l-carnitine, minocycline, l-theanine, taurine,
curcumin, green tea (EGCG), CoQ10, nicotinamide/niacinamide, creatine,
ketogenic diets, so on and so forth (each of which carries with it its
own complicating factors).
 

Harie

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Inhibiting 5ar1 could be bad in long term usage of dutasteride. The only 5ar that's in our brains is 5ar1...Which dutasteride inhibits 50% of. It said that before dutasteride was approved, it was not studied to see if there was any long term impact on the brain.

Summed up, the article said that dutasteride users could be promoting their own alzheimers conditions later in life. And it recommended supplements to combat this.

The article also talked about daziden and production of equol etc...And the use of antibiotics on the production of equol.

This article is exactly why I only take 0.5mg/week of dutasteride. I like having 5ar1 in my body.
 

docj077

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Good post, but it's a little too late. We've dealt with this on this forum months ago.
 

JohnnySeville

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docj077 said:
Good post, but it's a little too late. We've dealt with this on this forum months ago.

Obviously worth repeating, since some members are unaware of it.
 

CousinIt

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johnnyseville said:
docj077 said:
Good post, but it's a little too late. We've dealt with this on this forum months ago.

Obviously worth repeating, since some members are unaware of it.

I would have to agree, information such as this cannot be stressed enough, for every action there can be a possible reaction, no "free lunches" in this world.
 

SkylineGTR

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thats why you take rigorously it till you get the regrowth you want then cut back.

I myself have already started to cut back to M W F from previously taking it daily.
 

Lorenzo_91

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I am all for this stuff in my body. I don't have a care in the world about what happens to these rats when they take medication.
 

JohnnySeville

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Lorenzo_91 said:
I am all for this stuff in my body. I don't have a care in the world about what happens to these rats when they take medication.

That's funny, the rats said the same thing about you taking the medication!
 

Pondle

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How much 5AR do women have, relative to men? What is the prevalence of Alzheimer's in women relative to men, adjusting for their longer life expectancy?
 

JohnnySeville

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Pondle said:
How much 5AR do women have, relative to men? What is the prevalence of Alzheimer's in women relative to men, adjusting for their longer life expectancy?

Women have about half the 5AR as men do. As far as Alzhiemers, it's about a dead even, taking in account a woman's longer lifespan.
 

Pondle

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The implication of that is that inhibiting 50% of a man's type 1 5AR is no big deal in health terms.
 

JohnnySeville

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Pondle said:
The implication of that is that inhibiting 50% of a man's type 1 5AR is no big deal in health terms.

Only if men had the same needs as women in that respect, which we do not obviously.
 

Pondle

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So do you think that reducing type 1 to "female" levels exposes men to increased long term risk of Alzheimer's?
 

JohnnySeville

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Pondle said:
So do you think that reducing type 1 to "female" levels exposes men to increased long term risk of Alzheimer's?

That is the whole question, one can speculate, and it certainly is a possiblility, but to have definitive answers requires many years. In essence, those taking these drugs are conducting trials for the manufacturers, like it or not.
 

JohnnySeville

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Just ran across this info. It appears the NIMH will be running trials on Dutasteride's neurological implications. Though it does not address the issue of its contribution toward Alzheimers, the study will determine its effects on Allopregnanolone. Perhaps this will answer some questions and lead to further testing.

*************************************************************



Title: The Effects of Dutasteride on Mood, HPA Axis, and Serum Allopregnanolone Levels in Women with Menstrual-Related Mood Disorders and Controls

Number: 04-M-0139
Summary: This study will explore the effects of dutasteride on mood and the stress response across the menstrual cycle. Dutasteride blocks production of neurosteroids-hormones that help regulate the stress response systems. These systems may be disturbed in women with menstrually related mood disorders (MRMD). The effects of the drug will be compared in women with and without MRMD to determine how neurosteroids regulate mood and the stress response across the menstrual cycle. Dutasteride is approved by the Food and Drug Administration to treat benign prostatic hyperplasia (excess growth of the prostate gland) in men.

Menstruating women 30 to 45 years of age with and without MRMD may be eligible for this study. Candidates are screened with a medical and psychiatric history, physical examination, screening for symptoms of depression, and routine blood and urine tests. Participants are required to use barrier contraception (condoms or diaphragm) during the 3-month study and 6-month follow-up.

Participants undergo the following tests and procedures:

- Dutasteride or placebo treatment: Participants receive 1 month of dutasteride and 2 months of placebo. Neither the participants nor the investigators know when the subject is taking the active medication or the placebo.

- Biweekly follow-up visits: Every 2 weeks during the 3-month treatment period, patients come to the NIH Clinical Center to have blood drawn and to complete mood symptoms ratings.

- Monthly follow-up visits: Participants return to the Clinical Center once a month for 6 months after the end of the treatment period to monitor hormone levels and pregnancy status.


Sponsoring Institute:
National Institute of Mental Health (NIMH)
Recruitment Detail
Type: Participants currently recruited/enrolled
Gender: Female
Referral Letter Required: No
Population Exclusion(s): Male
Children


Eligibility Criteria:
INCLUSION CRITERIA:

healthy controls and women who meet the criteria for MRMD.


The criteria for MRMD, from Protocol 81-M-126, "The Phenomenology and Biophysiology of Menstrually Regulated Mood and Behavior Disorders," briefly are as follows:


1) History within the last two years of at least six months with menstrually-related mood or behavioral disturbances of a severity sufficient to cause at least moderate subjective distress;


2) Symptoms should have a sudden onset and offset, with symptoms most severe during the week prior to menstruation and tending to disappear abruptly on or about the first day menstruation;


3) Age 30-45 years;


4) In good physical health;


5) To qualify for study inclusion, women with MRMD will have prospectively demonstrated in at least two of three menstrual cycles a 30% worsening of mean negative mood symptoms in the premenstrual period compared to the week following menses, corrected for the range of the scales employed.


healthy controls will have no symptoms of MRMD (confirmed prospectively), be between the ages of 30 and 45, and be in good physical health.


In addition all subjects will have a normal clinical breast exam prior to study entry.


EXCLUSION CRITERIA:


Subjects will be excluded from the study for the following reasons:


1) Pregnancy or any intent to become pregnant;


2) Medical illness, in particular diabetes, cardiac or renal disease;


3) Use of psychotropic or hormonal medications within three months prior to the study;


4) Current prescription medication use;


5) History of or current alcohol or drug abuse or dependence;


6) A history of (within the past two years) or current psychiatric disorder determined by administration of the Schedule for Affective Disorders and Schizophrenia-Lifetime Version (SCID);


7) Male gender; and


8) Age less than 30 years.


In addition to the above, due to the long half life of dutasteride and its teratogenic effects on male fetuses, only women who have already decided to discontinue child-bearing and are willing to continue barrier contraception for 6 months after the study will be included in the protocol.


Special Instructions:
Currently Not Provided
Keywords:
Neurosteroids
5 Alpha-Reductase Inhibitor
Depression
Menstrual Cycle
Gonadal Steroids
Recruitment Keyword(s):
Menstrual Cycle
Depression
Menstrual Cycle Related Mood Disorder
MRMD
healthy Volunteer
Condition(s):
Premenstrual Syndrome
Investigational Drug(s):
Dutasteride
Investigational Device(s):
None
Intervention(s):
Drug: Dutasteride
Supporting Site:
National Institute of Mental Health

Contact(s):
Patient Recruitment and Public Liaison Office
Building 61
10 Cloister Court
Bethesda, Maryland 20892-4754
Toll Free: 1-800-411-1222
TTY: 301-594-9774 (local),1-866-411-1010 (toll free)
Fax: 301-480-9793
 

abcdefg

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so propecia is not really safe to use? Long term it could do some damage?
That sucks after we throw our propecia away whats left? just hairloss i guess.
 
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