EVERYONE Will Get Finasteride Side-Effects Eventually
- Thread starter hemingway_the_mercenary
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Pijohn favorite internet persunality
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That's why I am on a lowcarb diet btw carbs are trouble
Nailed it to a T. Been on fina for 12 years since I was 32, plus topical minoxidil 2/day. Now I'm doing minoxidil 3/day because of WFH for the last year, and I noticed a HUGE difference in regrowth. I dislike having to take drugs for this, but I know I'd feel worse if I was going bald. I'm 44 now and most of the time wake up with morning wood and have daily sex with my wife. My beard is full, I'm fit and work out every day. Are there side effects? Maybe, but they're obviously so mild that I don't notice them unless I read anti-finas threads and start getting mental anxiety about it. When I don't research this sh*t, my life is great.
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New study showing finasteride affects gene expression:
Differential Gene Expression in Post-Finasteride Syndrome Patients - PubMed
This study is the first to consider and demonstrate gene expression differences in patients with PFS as a potential etiology of sexual dysfunction. Howell S, Song W, Pastuszak A, et al. Differential Gene Expression in Post-Finasteride Syndrome Patients. J Sex Med 2021;18:1479-1490.pubmed.ncbi.nlm.nih.gov
Differential Gene Expression in Post-Finasteride Syndrome Patients
An organic etiology underpinning post-finasteride syndrome, a constellation of persistent sexual, neuropsychiatric, and somatic symptoms reported by m…www.sciencedirect.com
Clinical implications: In this study we present evidence of gene expression correlating with observed biologic differences in patients with post-finasteride syndrome; providers who prescribe 5ARIs should be aware and advise their patients accordingly.
Strengths & limitations: Strengths of this study include the evaluation of multiple proposed etiologies for post-finasteride syndrome. The study is also strengthened by the fact that not all data matched the initial hypotheses, qualifying the argument for the existence of PFS. Limitations include potential selection bias arising from more severe phenotypes seeking care; lack of gene expression data prior to 5ARI exposure; lack of non-penile tissue samples supposedly involved; and a lack of mechanistic data to imply causality.
Conclusion: This study is the first to consider and demonstrate gene expression differences in patients with PFS as a potential etiology of sexual dysfunction.
Looks alarming but this doesn't mean it's not reversible:
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Where's Hemingway when we need him. Stupid Canuck.
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tbh more copium is needed for bald guys who cannot pull of the bald look (more then 90%) and have to resort to f*****g their hands or hookers
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sadly guys who get mental breakdowns after taking 1 pill of finasterie are also usually the same people who are too afraid to wear hairpieces because they fear social judgment
and how many deep romantic relationships are really possible with that thing. one night stands and a casual relationship? sure
longtime relationships and marriage? surely not (at least you must tell your partner at that point and then you are indeed a bald guy)
however i dont think its a bad thing but obviously its far from perfect
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Well I guess I have to let my hair thin out. What you've wrote above is scary. Kinda annoyed because I'm only 20, and my mental state will go horrible, but you've proven the drug will basically ruin my life in a way. Diebietes, Ed, gyno, mood and blood changes.Lol'd at "no evidence", on the contrary, more and more studies are showing how dangerous fina is and less and less doctors want to prescribe it. Also, there are no long term finasteride trials, that's the problem. Show me a legit fina trial with young men who take it for 5 years. We also know the official studies by Merck are bullshit. "The judge sealed evidence – uncovered by Reuters – suggesting the maker downplayed the side effects." https://www.reuters.com/investigates/special-report/usa-courts-secrecy-propecia/ Btw, it's also not the first time Merck tampers with their trials: "Merck Manipulated the Science about the Drug Vioxx" https://www.newscientist.com/article/dn13685-drug-giant-merck-accused-of-deaths-cover-up/ , "Merck Agrees to Settle Vioxx Suits for $4.85 Billion"
The truth on DHT: what the research shows
The truth on DHT: what the research shows » TESTONATION
DHT is an essential male hormone, not just for libido, or feeling manly, but for general health as well. DHT is synthesized from: Testosterone through the enzyme 5 alpha reductase (5AR) 17-hydroxypregnenolone and 17-hydroxyprogesterone in what is termed the “backdoor” pathway 5α-androstane-3α...men-elite.com
DHT is an essential male hormone, not just for libido, or feeling manly, but for general health as well.
DHT is synthesized from:
- Testosterone through the enzyme 5 alpha reductase (5AR)
- 17-hydroxypregnenolone and 17-hydroxyprogesterone in what is termed the “backdoor” pathway
- 5α-androstane-3α, 17-β-diol (dihydroandrosterone/3α-diol) via the intracrine reverse synthesis pathway (3α-hydroxysteroid dehydrogenase (3α-HSD))
DHT is 2.5-10 times more potent than testosterone and here’s why:
- DHT has a 4 time higher affinity to AR (androgen receptor) than testosterone.
- Binding of DHT to the AR transforms the AR to its DNA-binding state.
- DHT upregulates AR synthesis and reduces AR turnover.
- The dissociation rate of testosterone from receptors is 3-5 fold faster than DHT (meaning DHT exerts a much more powerful effect on AR than testosterone)
However, circulating DHT is usually only about 10% or less that of testosterone and high concentrations of intracellular T can shift androgen receptor binding away from DHT by mass action (R).
Furthermore, in the blood, SHBG binds with 5 times higher affinity and for more than 3 times longer to DHT compared to testosterone.
To maximize the androgenic benefits of DHT, we want to maximize 5-AR and inhibit the binding of DHT to SHBG. You can download my guide/PDF on how to do that below.
This article is to show you what happens when men have high DHT or when they are dosed with supra-physiological amounts.
DHT is essential for libido and sexual function
It’s probably well known that DHT is very important when it comes to libido and sexual function.
According to this study, serum DHT concentration was the only independent hormonal predictor of the frequency of orgasms. An increase in concentration of 1.36 nmol/l corresponded to an average increase of one orgasm a week (R). This shows that DHT directly opposes the anti-libido effects of prolactin.
Inhibiting DHT synthesis impairs corpus cavernosum growth and trabecular smooth muscle relaxation, endothelial function and increases connective tissue deposition. This all contributes to erectile dysfunction, even in the presence of physiological levels of total testosterone (R).
DHT is also critical for activating gene expression of neuronal and endothelial nitric oxide synthases, which are critical physiological mediators of penile erection (R).
Furthermore, DHT is essential for spermatogenesis and thus fertility (R).
Estrogen is thought to be essential for sexual function in men, however, administrating high doses of DHT lowers estrogen dramatically and doesn’t reduce sexual function.
DHT isn’t just neutral towards sexual function as shown above, but is essential for it.
And also:
The effects waned after 3-4 weeks, so taking 1-2 weeks off every 4 weeks from DHT (if you’re using it) might enable you to maintain those benefits.
DHT doesn’t cause prostate cancer
There was a period of time (a few decades) where DHT was thought to promote prostate cancer, however, that thinking is luckily starting to change. It’s about time, since there has been research for over 2 decades showing that DHT doesn’t promote prostate cancer.
There isn’t a correlation between circulating DHT and intraprostatic DHT. The prostate regulates it’s own DHT levels, which is about 10 times higher than circulation.
Giving testosterone might cause issues, since it can convert to estrogen, but giving DHT directly can actually help to shrink the prostate as it can lower estrogen. It’s actually estrogen and prolactin that drives prostate cancer.
Quite a few studies found that high (supraphysiological) serum DHT levels, DHT gel treatment did not significantly increase total, central, or peripheral prostate volumes, as measured by ultrasonography, nor was serum prostate-specific antigen (PSA) elevated. Additionally, International Prostate Symptom Scores (IPSS) remained unchanged in men treated with DHT gel for 6-24 months (R, R, R).
This 1.8 years survey of 37 men aged 55-70 years treated with daily percutaneous DHT treatment suggested that high plasma levels of DHT (> 8.5 nmol/l) effectively inducing clinical benefits while slightly but significantly reducing prostate size (R).
DHT isn’t the bad guy when it comes to hair loss
Hair loss, together prostate cancer, are two of the main reasons why people want to lower DHT.
We all know that DHT is needed for beard growth (R), but it’s thought that DHT promote scalp hair loss.
The above claim is supported by the fact that men who are exposed to exceptionally high levels of DHT in response to the daily application of DHT for a long period of time didn’t experience acne, male androgenic alopecia or other androgen-associated skin pathology (R).
Furthermore, the differences in mean values of DHT were not significant according to the types of alopecia and the control group. And increased serum concentrations of DHT is not correlated with the advance of alopecia (R). This study speculates that hair loss severity is affected by other factors other than DHT, such as the duration of alopecia or the sensitivity of hair follicle cells to androgens (R).
Some people with hair loss have high DHT and others don’t, and some with high DHT have normal hair whereas others don’t (R).
So what’s going on with hairloss, if it’s not DHT?
You also might be wondering: “If DHT is not involved, why does 5-AR inhibitors work?“
This study found that although 5α-reductase inhibitors are effective in treating male androgenic alopecia, DHT does not appear to play a primary role in the pathogenesis of male androgenic alopecia or acne (R).
A few reasons for hair loss include:
- Androgen receptor polymorphisms and differences in androgen receptor concentrations and steroid-converting enzymes as the principal contributors to male androgenic alopecia (R).
- Derangement of the internal cellular environment is primarily caused by the accumulation of free radicals, the reactive oxygen species (ROS) along with poor repair and restoration of the damaged cells due to essential nutrient deficiencies.
- “An initial experimental study by Eun[40] discovered that DHT does not directly cause inhibition of hair growth but it induces the release of transforming growth factor beta 1 (TGFß1) which results in the miniaturization and hair loss. Shin et al.[41] followed this research further with cultured androgen sensitive dermal papilla cells and the addition of DHT to this androgen sensitive cell caused an accumulation of free radicles ROS within the cultured cells, which in turn induced the release of TGFß1.” So a better approach than lowering DHT is to:
- Positively modulate the skin microbiome (think sunlight, micronutrients, clean environment, etc.)
- Inhibit excess ROS production
- Prevent excess activation of TGFß1
- Reduce stress
There are many more reasons for hair loss, but I won’t be diving into that in this article.
DHT for metabolic syndrome
Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke and diabetes. Metabolic syndrome includes high blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels. The syndrome increases a person’s risk of heart attack and stroke.
Insulin sensitivity
This randomized, controlled, double-blind trial provides evidence that DHT specifically (and to a much lesser extent, testosterone), improves insulin sensitivity and decreases plasma leptin level without notable side effects (R). Testosterone treatment caused prostatic nodular hyperplasia, benign at biopsy, whereas DHT didn’t.
Androgens, especially DHT, upregulate insulin receptor expression and activity and increase glycogen synthesis and cholesterol uptake in the liver (R).
Low DHT or lowering DHT with a 5-AR inhibitor, such as finasteride or dutasteride, is associated with an increase in blood glucose and glycosylated hemoglobin A as well as the risk of type 2 diabetes (R, R, R).
5-AR is necessary to inactivate cortisol, so blocking 5-AR increases cortisol, which promotes insulin resistance and liver disorders, such as NAFLD, steatosis, etc. (R, R).
Heart, liver and kidney function
DHT therapy in men with coronary artery disease (CAD) decreased myocardial ischemia and improved left ventricular diastolic function (R).
This in vitro study found:
The findings above could explain some of the previously described clinical observations of the relationship between low T and DHT and peripheral vascular disease and the anti-ischemic effects of acute infusion of testosterone in men with CAD and similar effects by DHT gel treatment (R).
A few more facts:
- 5-AR inhibition may result in the development of kidney dysfunction (R).
- Dutasteride, a 5-AR inhibitor, treatment increased activities of liver alanine aminotransferase and aspartate aminotransferase, suggesting dysregulation of liver metabolism (R).
- DHT is a biomarker for reduced risk of stroke, which means that DHT is inversely correlated with stroke (R).
- Higher DHT was associated with lower ischemic heart disease mortality in older men (R).
I saw light for a minute, was happy about trying finasteride in a month... Now a long mental road ahead and letting my hair fall out. No way, I can toughen up.. It is horrible especially before 30. finasteride literally was my only option. Not sure what to do
sh*t man..maybe try low dose oral minoxidil and Zix (to have at least a bit DHT reduction in the scalp)Well I guess I have to let my hair thin out. What you've wrote above is scary. Kinda annoyed because I'm only 20, and my mental state will go horrible, but you've proven the drug will basically ruin my life in a way. Diebietes, Ed, gyno, mood and blood changes.
I saw light for a minute, was happy about trying finasteride in a month... Now a long mental road ahead and letting my hair fall out. No way, I can toughen up.. It is horrible especially before 30. finasteride literally was my only option. Not sure what to do
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What about topical minoxidil and microneedle. Will just that maintain 10 years? I'm only 20, so hair is very important for my young age, especially for dating and mental health. It's not like I'm 45 and past the dating age
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This is what is so horrible about this curse. Taking young people's lives. If I was 45 I'd just buzz it too. At 45 bald isn't as stigmatized because a lot of men in your age group are losing hair. But in 20s and even 30s during dating years it's a death sentence.
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Will derma rolling and topical minoxidil mantain you think? I don't shed but hair is in early stages of thinning, I'd say getting to medium. Worst part is my hairline is juvenile, but the top is thinning apparently.
finasteride is not on my list anymore. F that.
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i think its an acceptable for solution for young people with only casual relationships
if you look for something serious then its clear the women also have to like you when you are bald so it makes no sense to wear an hairpiece at all in that regard.
thats my perspective though
corkmeister
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Well I guess I have to let my hair thin out. What you've wrote above is scary. Kinda annoyed because I'm only 20, and my mental state will go horrible, but you've proven the drug will basically ruin my life in a way. Diebietes, Ed, gyno, mood and blood changes.
I saw light for a minute, was happy about trying finasteride in a month... Now a long mental road ahead and letting my hair fall out. No way, I can toughen up.. It is horrible especially before 30. finasteride literally was my only option. Not sure what to do
I'm not going to try and convince you one way or the other but you shouldn't base your decision exclusively on what forum members like Pigeon are telling you. He has an agenda. And I don't mean that in a bad way; we all do. Going bald essentially means you have a choice to make, you either take finasteride (or dutasteride) and have a good chance of treating it effectively (but take the risk of side-effects), or you don't take it and go bald. There's other stuff you can try/do but in the end, 5ar-inhibitors are the best thing we've got. It's a shitty choice either way, and once you make that choice you have to justify it for yourself to keep your sanity. Campaigning for/against the drug can be part of that. It's human nature and I'm guilty of it myself. In Pidgeon's case, he suffered significant damage from finasteride, so the choice has essentially been made for him, but what I'm saying still applies.
Now, I'm not saying he's completely wrong either. These drugs definitely carry risks. At the same time, the potential benefit is significant. You have to weigh the balance and make up your own mind. Is finasteride as safe as Merck claims it to be? I personally don't think so. Is it literal poison that amounts to chemical castration? I don't think so either. He cites some interesting studies but the truth is that this doesn't paint the full picture. He's proven very little. The fact of the matter is that plenty of men are on the drug without suffering debilitating side effects. In the end you'll have to weigh the risks against the benefits and make up your own mind. Just realize that anyone that's presenting you with black and white viewpoints (finasteride is totally safe/finasteride is poison) probably has an agenda of their own.
@Pigeon, I know you'll be reading this and I hope you won't take offense because it's not my intent. But I felt compelled to give my own view.
up up up ^^^ this
I started at 31.Well I guess I have to let my hair thin out. What you've wrote above is scary. Kinda annoyed because I'm only 20, and my mental state will go horrible, but you've proven the drug will basically ruin my life in a way. Diebietes, Ed, gyno, mood and blood changes.
I saw light for a minute, was happy about trying finasteride in a month... Now a long mental road ahead and letting my hair fall out. No way, I can toughen up.. It is horrible especially before 30. finasteride literally was my only option. Not sure what to do
I am not that bad, and sure, I could be f*****g up my system for future.
But *shrugs*.
I do get quarterly bloodwork done.
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Unfortunately finasteride is your best bet to save your hair. I understand where @Pigeon is coming from, hell I spent months avoiding finasteride because of the fear of side effects. But the thing was my hair loss bothered me so much that I was lying in bed depressed and struggling with work. I'm more worried about losing my job and the hair loss depression is killing me. At least with this drug I have a chance. Ever since I started taking it I have calmed down more with occasional fear of the drug not working. I think once you hit that breaking point where you don't care about side effects you end up trying it. Could finasteride be killing me? Sure. But I'm willing to take the risk.
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For me it's not as extreme as your case, but a very similar situation.
Like was stated above, if you're balding in your 20s you only have two options, finasteride/dutasteride or go bald (to some extent). In my situation, I'm a Norwood 3 at 27, which isn't as aggressive as some of the members on here. Regardless, the problem isn't necessarily where you are on the Norwood scale, it's where you're destined to end up based upon your genetics. Assuming no pharmacological intervention, I could hit a Norwood 4 in my mid 30s, get a hair transplant, and then potentially be fine with the possibility of touch up surgeries in the future. In contrast, I could hit a Norwood 5, run out of donor area with a first transplant, and then be done in with a harvested donor area and lacking full coverage.
Then you have to add in other considerations like the incidence of ED with age. Finasteride is obviously not your friend when it comes to ED, but a lot of men even as early as their 20s experience it. If you decide not to take finasteride, you could easily hit NW5/6/7 and then get nailed with ED in your 30s anyways. Then you're bald and you're stuck on something like tadalafil... what a great combination!
I actually agree with @Pigeon that the incidence of side effects are under-reported when it comes to finasteride. I think the studies out there that aren't funded by pharmaceutical companies are much less biased, and they tend to hit around the 5-6% mark as opposed to some of the numbers people throw around like 1-2%.
At the end of the day it's a gamble, and given the odds of experiencing side effects, let alone persistent side effects, it's a good gamble for most people. Obviously people who have been on the raw end of that dice roll don't see it that way. I don't blame them. A part of me wishes that I could be like some of the people I know and "just shave it", then move on with life. Unfortunately I'm not in that camp.
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^^^