Propecia decreases bioavailable testosterone!

Ende

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Some months ago, I read a study which showed that finasteride decreased the level of free testosterone in all the subjects! I've used a couple of hours now, trying to find it again - but without any result. However, I did come across another study, and it shows exactly the same thing! Take a look at page 6!

DHT has greater affinity for SHBG, and finasteride decreases the level of DHT by 60 - 70%. The hormone which is next in line is testosterone, and that's probably the reason.
 

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Ende

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It wouldn't affect the level of free testosterone, if SHBG is the reason. At least I believe so. It's a different game when DHT is heavily suppressed.
 

Ende

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Say if vitamin D increases the testosterone production, the estrogen level will increase as well, maybe drastically when you're using a reductase inhibitor. Excessive estrogen is linked to increased SHBG level, so actually it could make it a lot worse.
 

Ende

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I would like to have some discussion on this topic, but no one seems to be interested. This is something which concerns all Propecia users!!

FYI, a reduction in the free testosterone level is a lot worse than a reduction in the total testosterone level. If a doctor reveals a low, borderline testosterone level, it's the free testosterone level which decides whether you get treatment or not!

MERCK has failed to inform you about this!
 

Ende

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What's new, is that this is something which concerns all men and women who take Propecia, not just those with side effects and PFS. Besides, this is different. This is a study which shows that Propecia decreases free testosterone - in all cases!
 

Wuffer

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Crap, i'm surprised i've never seen this.. Thats actually a little troubling. I have bloods from pre-finasteride, so i'm going to schedule another test to check for bioavailable T.

Thanks for posting this, I think it's yet another reason for people to take before/after bloods.

I didn't read the entire study, but do these levels return to normal after discontinuing? At least in these subjects?
 

Ende

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Wuffer said:
I didn't read the entire study, but do these levels return to normal after discontinuing? At least in these subjects?
I don't know. If the DHT level does, the free testosterone level should return to baseline value as well. Merck claims that all hormone values returns to normal within 2 weeks after quitting Propecia. However, it's clear that they never did any research on bioavailable testosterone...
 

StoptheMadness

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Enden said:
Wuffer said:
I didn't read the entire study, but do these levels return to normal after discontinuing? At least in these subjects?
I don't know. If the DHT level does, the free testosterone level should return to baseline value as well. Merck claims that all hormone values returns to normal within 2 weeks after quitting Propecia. However, it's clear that they never did any research on bioavailable testosterone...
Enden, you should read my last post
http://www.hairlosstalk.com/interact/viewtopic.php?f=46&t=64933&start=40
 

Ende

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StoptheMadness said:
had a follow up visit with my Endo today to discuss if I should take another blood test to see if SHBG levels would go down. She advised against another test because she's seen too many ppl get into this loop of testing and re testing, especially now that there is no difficulty now with ED. However she changed her tune immediately when I presented her my April 5th T and free T levels (for some reason I didn't have these with me on my first visit to her on May 6th and I forgot to mention to her that I had them back at home). Well, when I showed her that my free T was low, she immediately said that is usually one sign of hypogonadism. She then went to re-examine the T and free T results from my May 6th blood test and realized (!) the free T was relatively low compared to the total T (the latter shooting way up from my April 5th blood test). Again, a sign of hypogonadism. I could actually see the light bulb go on in her brain, making a connection :)

Herewith are her notes from today:
"The patient is interested in learning whether he has experienced an adverse drug effect from prior use of Propecia. He probably is not will to rechallenge himself with Propecia, but might interpret an improvement of hormone levels as suggestive of a drug effect. A lingering effect after drug interruption would be likely to occur, if hormonal effects upon SHBG are observed, so that normalization might require some weeks. A reasonable hypothesis might be that high estrogen levels in the past could have driven the elevation of SHBG, such that, for a given testosterone level, the free testosterone would be low. However, areas of silence or uncertainty in the medical literature exist, such that we do not have evidence from controlled trials to support this interpretation as an expected consequence of treatment with Propecia. At the request of the patient, and to be assured as to whether he does or does not have abnormal endogenous estrogen production (which would require a search for cause), now that he has been off of Propecia since April 7, 2011, we are ordering: FSH, LH, estradiol, estrone, testosterone, fee testosterone, and SHBG. Endogenous estrogen overproduction could signify a medical illness or tumor. Therefore, the tests are medically indicated."
It's very interesting, but concerning. I'm certain that administering a small dose of Andractim over a short period of time, would normalize the SHBG- and free testosterone level. However, you would have to be careful, so you don't suppress the testosterone production. See how this pans out, and keep us updated!

Just to clarify; do you feel normal?
 

Bryan

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Enden said:
Some months ago, I read a study which showed that finasteride decreased the level of free testosterone in all the subjects! I've used a couple of hours now, trying to find it again - but without any result. However, I did come across another study, and it shows exactly the same thing! Take a look at page 6!

DHT has greater affinity for SHBG, and finasteride decreases the level of DHT by 60 - 70%. The hormone which is next in line is testosterone, and that's probably the reason.

I don't fully trust that posted study, because they also make the claim in the Discussion section at the end (although in rather muddled English -- I hope I'm understanding them correctly) that there was no change in LH and FSH levels in the finasteride users. That disagrees with what the PDR (Physician's Desk Reference) says: testosterone, LH, and FSH levels are all increased by about 10% with finasteride usage. I think I trust the PDR more than I do that one Egyptian study.
 

Ende

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I trust independent studies more then Merck. There is also at least one study, which shows that finasteride affects androstenedione. My level was twice as high as normal when I used Propecia. Another member on this site reported the same. I saw a study recently, which suggested that this was because androstenedione uses the 5AR enzyme as well.

Here it is; http://www.ncbi.nlm.nih.gov/pubmed/7982796

The prescribing information leaflet doesn't contain any information about this either. Regarding LH and FSH, Merck claims that no significant changes to those hormone levels were observed.
 

Bryan

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Enden said:
I trust independent studies more then Merck.

Okay, but where do you suppose that information about LH and FSH in the PDR came from? Are you absolutely sure it came from Merck alone? :)

Enden said:
The prescribing information leaflet doesn't contain any information about this either. Regarding LH and FSH, Merck claims that no significant changes to those hormone levels were observed.

Maybe they (and the FDA) just don't consider a 10% increase to be "significant". This kinda reminds me of the blanket statement in finasteride studies that "there was no effect on estrogen levels" in finasteride trials.
 

Ende

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It doesn't matter to me. All I know is that Propecia is a dangerous drug, and that it's a lot more to it than the prescribing information leaflet states. Merck refuses to take any responsibility, and the FDA is corrupt. Studies like this are necessary, and I trust them more than Merck and the American authorities.

Personally, I don't understand why you would doubt it, when certain hormone levels were monitored, and the free testosterone level decreased in ALL the subjects!!! Every single one of them, and it's at least one other study, which shows exactly the same thing - and it all makes sense to me, because DHT has greater affinity for SHBG, and it's reduced by 60 - 70%. Theoretically, a reduction in the free testosterone level, is a natural consequence - the way I see it.
 

StoptheMadness

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to clarify I am fine physically (knock on wood)......

A fews after stopping finasteride, my free T level was 8.3 (8.7 -25.1 pg/mL) from a 4/8/2011 blood test*. Then on a retest* on 5/6/2011 the free T was 34.98 (15.5 - 102).

My endo realized the oddity when she saw the 4/8 and 5/6 blood tests sides by side. The low free T and the disparity between the free and total T levels was concerning to her.

She then hypothesized that these abnormal levels or ratios could have been a result of the finasteride (obviously to us, but there is no literature to prove this - according to her). So she wants to see me take another blood test to see if the free T and total T normalize. If they do I think she wants to write a case study on this.


*Total T:
4/8 - 489 (249 - 835 ng/dL)
5/6 - 738 (208.00 - 800.00 ng/dL)
 

Ende

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StoptheMadness said:
to clarify I am fine physically (knock on wood)......

A fews after stopping finasteride, my free T level was 8.3 (8.7 -25.1 pg/mL) from a 4/8/2011 blood test*. Then on a retest* on 5/6/2011 the free T was 34.98 (15.5 - 102).

*Total T:
4/8 - 489 (249 - 835 ng/dL)
5/6 - 738 (208.00 - 800.00 ng/dL)
It was a wise decision to quit treatment...
 
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