Long term depletion of DHT in the body and LOW SEMEN COUNT

[ggyy3366]

I am a finasteride user for years and recently like many of you wanted to be on the dutasteride band wagon to aggressive combat my receding hairline. The finasteride and Monoxidil just isn't really do it it for me any more. I am now just about at the boarder line of my baseline and hated every moment of it. I wanted something stronger. I had placed an order of Dutas from inhouse and now I am in the third day of my dutas regime. I had also wanted to order the Xandrox15 and spironolactone 5% from Dr. Richard Lee. Through the required patient consultation before ordering I had asked him about being on dutastride. His answers were the following and I quote:

Question to Dr. Lee: Should I use Dutasteride?

Absolutely not. Glaxo has abandoned any plans for Phase III trials for dutasteride as a treatment for male pattern baldness, and I don't advocate the use of dutasteride (Avodart 0.5 mg dutasteride soft gel) for the treatment of male pattern baldness. We have no data in regards to its efficacy and safety for treating hair loss.

When you consider that treatment for male pattern baldness may last for decades and that we have no knowledge what DHT deprivation does to the body over a lifetime, there is no way we can endorse its use. Of significant concern is the potential duration of side effects. The long half life of dutasteride exceeds 240 hours vs. the rather short 6 to 8 hours for finasteride. There have been some cases where the DHT levels had only returned to 25% of their original levels nearly a YEAR after having discontinued dutasteride. As a result, any dangers or side effects that may be seen from Avodart, whether directly related or as a hypersensitive or allergic reaction may take literally months to resolve.

Most of the panel members at the International Society of Hair Restoration Surgery October 18-22, 2006, which I attended in San Diego, did not approve of the use of dutasteride for treating male pattern baldness. They sited an additional finding that the sperm count in patients taking dutasteride were low (as low as 10%) and that the sperm count remained low even 6 months after discontinuing dutasteride. There are a number of drugs that are more effective than finasteride at reducing serum DHT. At issue with most of them is their safety.

If you access http://www.rxlist.com/cgi/generic4/avodart_ad.htm, you will read that “The effects of dutasteride 0.5 mg/day on semen characteristics were evaluated in normal volunteers aged 18 to 52 (n = 27 dutasteride, n = 23 placebo) throughout 52 weeks of treatment and 24 weeks of post-treatment follow-up. At 52 weeks, the mean percent reduction from baseline in total sperm count, semen volume, and sperm motility were 23%, 26%, and 18%, respectively, in the dutasteride group when adjusted for changes from baseline in the placebo group.

The anecdotal reports I have received from patients who have obtained dutasteride from other sources and have tried it are mostly unenthusiastic, and mostly about the side effects of decreased libido/erectile dysfunction.

End of quote.
Believe it or not folks his answers got me a little worried. No long term
studies on the prolong depletion of DHT in the body, any complication of side effects will be hard to treat because of it. Also the low sperm count doesn't sound good as well. I really need advice from you guys... I believe Dutasteride will indeed be very effective in treating male pattern baldness and in my case I have exausted all efforts in all the other stuff. I really wanted to give it a shot. Aren't you guys just even a bit worry about this side effect
coming from a medical doctor. Please give me hope and the strength to continue. I want to celebrate the Dutas victory at the end with all of you
loyal Dutasteride fans any hope I have.

P

 

[WorldofWarcraft]

Thanks for the post. It was an interesting read.

However..... You can't go around asking companies for medical advice. I mean, they could easily be sued if they give you the wrong awnser. Their response will always be the most saftest route so that they can avoid a lawsuit.

Even if they don't get sued, if they give out bad advice it could ruin the rep of their brand name.

If dutasteride was so powerful that it cut down DHT levels for good, then why aren't people who tried it for 6 months and quit coming back reporting that their hairloss has stoped for good? I mean, if dutasteride kicked that much DHT ***, one could take a 6 month dose and cure themselves of male pattern baldness.

Their whole response seemed biased. It was a blitz against dutas. I would have appreciated more neutrality in their tone.

p.s. the whole thing about low DHT a year later is ended with the question of if the patient was hypersenitive or allergic. This implies this patient was a freak, out of the norm. The patient's reactions were abnormal.

 

[Sean68]

if im reading this right...

26% reduced semen count? i can cope with that if it keeps my hair.

reduced libido for a few months after? i can handle that too.

 

[Sean68]

any time i worry about that sort of thing i just go and look at my hair in the mirror.

 

[SkylineGTR]

eh ..

Lose a few million soldiers and grow hair back.

I'll take the hair...

Reduced libido? where? Mine's fine.

I get it up and get it on 3x a week with my g/f just fine.
(the decreased load makes cleanup easier also lol)

 

[powersam]

i'd like more detail about this line though :

"There are a number of drugs that are more effective than finasteride at reducing serum DHT. At issue with most of them is their safety. "

which drugs other than avodart? i suppose he might mean spironolactone but that isnt more effective than finasteride for serum dht is it?

as to avodart i dont think i'd recommend the usual 0.5mg once a day, i feel happier on 2 a week or thereabouts. this is just personal preference though, due to it only lowering type1 5ar by 15% or so which would be well within the realms of normal variation.

plus a 23% drop in motility isnt the end of the world. if you were normal to begin with you'd still be fertile.

 

[Bryan]

Re: Long term depletion of DHT in the body and LOW SEMEN COU

(Quoting Dr. Lee) There have been some cases where the DHT levels had only returned to 25% of their original levels nearly a YEAR after having discontinued dutasteride.

I suspect that that claim is apocryphal. I've never seen any medical journal article or study on dutasteride which found that DHT levels had only recovered to 25% of their baseline value a year after stopping the drug. That just doesn't make any sense.

 

[Bryan]

which drugs other than avodart? i suppose he might mean spironolactone but that isnt more effective than finasteride for serum dht is it?

Why would anyone think that spironolactone would reduce serum DHT at all?

Interestingly, I've seen conflicting information as to whether or not spironolactone is a 5a-reductase inhibitor: one study says it is, another study says it isn't.

 

[Pondle]

I think Lee is being somewhat alarmist. I'm not bothered about long-term DHT inhibition, after all women have about 50 times less than men. It's funny how Lee thinks that dutasteride is so dangerous, unless you have BPH in which case it's fine. :roll: And he's keen to emphasise the negatives in the information he cites.

The effects of dutasteride 0.5mg/day on semen characteristics were evaluated in healthy volunteers aged 18 to 52 (n=27 dutasteride, n=23 placebo) throughout 52 weeks of treatment and 24 weeks of post-treatment follow-up. At 52 weeks, the mean percent reduction from baseline in total sperm count, semen volume and sperm motility were 23%, 26% and 18%, respectively, in the dutasteride group when adjusted for changes from baseline in the placebo group. Sperm concentration and sperm morphology were unaffected. After 24 weeks of follow-up, the mean percent change in total sperm count in the dutasteride group remained 23% lower than baseline. While mean values for all parameters at all time points remained within the normal ranges and did not meet the predefined criteria for a clinically significant change (30%), two subjects in the dutasteride group had decreases in sperm count of greater than 90% from baseline at 52 weeks, with partial recovery at the 24 week follow-up. The possibility of reduced male fertility cannot be excluded.

 

[ggyy3366]

Thanks guys, I think I should stick with the regiment. I think hair is more important than a lot of other stuff in my life, I might as well deal with the long term effects as we get there.

 

[ggyy3366]

Do really have to be on dutasteride for a while before I see results? How long does it usually take? Also, does the 6 month shed happens to most. I am so afraid of that. I cannot imagine me being on a hard shed, I will be at norwood 26 after that. Any ways to prevent that? :freaked:

 

[Bryan]

Thanks guys, I think I should stick with the regiment.

You're in the Army? No, you don't want to go AWOL.

 

[hair today gone tomorrow]

Thanks guys, I think I should stick with the regiment.

You're in the Army? No, you don't want to go AWOL.

LMAO!...I also hate it when people call their regimen's regiments.

 

[Bryan]

Yeah, there are regimens, and then there are regiments. Why is so difficult to keep track of the difference between those two words? And do I even need to mention lose and loose?

 

[techprof]

After being on dutasteride (0.5mg/day) I have switched to 5mg finasteride per day from March 2007.
I haven't seen any significant loss yet.
In fact, I am getting some of the lost hairs in my front growing again.
This could be mainly because of restarting xandrox 15 after stopping it for 6 months).
I stopped dutasteride for two reasons - 1. My concerns with dht 1 inhibition 2. And mainly we are planning on another kid in a year or two. I wanted to make sure dutasteride didn't decrease our chances.

 

[powersam]

which drugs other than avodart? i suppose he might mean spironolactone but that isnt more effective than finasteride for serum dht is it?

Why would anyone think that spironolactone would reduce serum DHT at all?

Interestingly, I've seen conflicting information as to whether or not spironolactone is a 5a-reductase inhibitor: one study says it is, another study says it isn't.

well i dont know if it does, i've read from some sources that it lowers 5ar but not all sources agree. i was more wondering what he could be referring to when he talks about drugs which work better than dutasteride against serum dht...

so can something lower 5ar but not serum dht bryan? i figured if some people say it lowers 5ar then they are also saying that it would lower serum dht.

 

[ohdearno]

Re: Long term depletion of DHT in the body and LOW SEMEN COU

Glaxo has abandoned any plans for Phase III trials for dutasteride as a treatment for male pattern baldness

That says it all? If it was safe and working there would be phase 3 trials.. right?

 

[Pondle]

No it is in Phase III trials at the moment - http://clinicaltrials.gov/ct/show/NCT00441116?order=8

There are commercial reasons why GSK might never release dutasteride for male pattern baldness. Merck has first mover advantage with Propecia, and dutasteride's ability to regrow hair might not be sufficiently better to generate high sales, especially if it is sold at a higher price point. Even if dutasteride sides are only slightlyworse than finasteride it may put off potential customers, especially as the prime market is men in their 30s who are more than likely to be very concerned about sexual performance.

 

[Bryan]

which drugs other than avodart? i suppose he might mean spironolactone but that isnt more effective than finasteride for serum dht is it?

Why would anyone think that spironolactone would reduce serum DHT at all?

Interestingly, I've seen conflicting information as to whether or not spironolactone is a 5a-reductase inhibitor: one study says it is, another study says it isn't.

well i dont know if it does, i've read from some sources that it lowers 5ar but not all sources agree.

What do you mean by "lowers 5ar"? Do you mean literally lower the cellular production of the enzyme 5a-reductase, or do you mean INHIBIT 5a-reductase? To avoid confusion like that, we need to speak as precisely as possible whever discussing such technical issues.

I suppose it's possible that really large doses of oral spironolactone that were sufficient to inhibit the production of testosterone would indirectly lower levels of DHT in the body by reducing the available substrate for 5a-reductase, without actually inhibiting the enzyme itself. But I believe that would require much larger doses than anybody here would be willing to take.

i was more wondering what he could be referring to when he talks about drugs which work better than dutasteride against serum dht...

Yeah, I was wondering about that, too.

so can something lower 5ar but not serum dht bryan? i figured if some people say it lowers 5ar then they are also saying that it would lower serum dht.

I'm going to assume that you're referring to inhibiting 5a-reductase. No, I don't see how inhibitng it significantly wouldn't result in lowering serum DHT.

 

[powersam]

bryan - my apologies, i'll try be more precise in future. however despite my lack of precision you did manage to answer all my questions, thanks.

ggyy3366 - could you email him again and ask him exactly what drugs he was referring to when he said "There are a number of drugs that are more effective than finasteride at reducing serum DHT. At issue with most of them is their safety."