anyone worried by this video?

[bostonusa2009]

I agree with Winston there is too much fear mongering on the web that is never properly back up by reputable, experienced doctors.

After you have the pill for 6 months. Ask yourself, Is sex as good as used to be? Do you desire sex as much as you used to?

Be painfully honest with yourself, Are you experiencing vision problems, slight memory loss. I'm giving you the warning signs before the really bad stuff starts.

The propeciahelp forum has 1,500 + users and there probably double that number that are reading the forum, but aren't yet members.

Don't just ignore these things. Go on that forum read a few of the stories, so you know what to look for in case you also begin experiencing the same things.

[William Reed, MD]

Finaseride Video: Long Term Side Effects

Dear Steve,

I am not providing any information other than what the 17 doctors that I have contacted have given me. I, too, am a bit shocked that there have been no long term side effects in our practices where over 30,000 patients have received finasteride; I'm especially shocked when I contrast these results to the videos on UTube.

I would imagine that the doctors you cite are familiar with issues in medicine being unclear and in there being a difference of opinion on many different medical issues. I would hope they find this informal survey of interest to help them put the situation into a perspective enriched by this large number of patients treated by their colleagues.

Since you don't know me, I won't take offense at your questioning my ethics. I know many people who could reassure you. I have no interest of any sort in promoting or berating finasteride. I just want to know how to help people manage hair loss and to understand the tools available as well as possible.

I am sorry that you are a sufferer of finasteride use. I hope that you can find this informal study reassuring that your symptoms are not as permanent as you fear. I should add that one patient in the 30,000 patients did feel that impotence resulted even after stopping finasteride but that this perception disappeared after a year. I hope that this will be the case for you and for others who suffer.

Best regards,

William Reed, MD

[EDVictim]

Mr. Reed,

Thanks for your reply. Healthy conversation regarding this condition is very important. I invite you to our website, create a username and browse through the hormone/blood section so you can get a better glimpse & understanding on this serious matter.

What will interestingly strike you on there is the amount of individuals who are still suffering after 6+ years and have not recovered. You will also see a pattern of blood test results showing unhealthy hormone levels/thyroid levels which can also lead to another serious condition: An increase risk of stroke. Poor vascular health is a contributor to this.

After reviewing this section of our website, you will see a lot of previously healthy individuals are now on TRT for life. Unfortunately, they were forced into this life long treatment because their hormonal profile never recovered naturally after stopping finasteride.

I do have a question for you Mr. Reed regarding the informal survey, are these doctors solely specializing in hairloss? Are they monitoring their patients Testosterone levels, Estrogen levels, Free Testosterone, Bioavailable testosterone, Thyroid(full thyroid, not just TSH) on an ongoing basis? Would these doctors be interested in completing a formal survey with their patients and releasing it to the public?

In summary, I can respect your willingness to bring this informal survey to the public. The validity behind it however, remains unknown. I'm not 100% understanding what your motive is still, all I know is we are in a very tough economy, and losing clients is the last thing you would want to happen. However, what is known to the public are a bunch of consistent blood tests on www.propeciahelp.com website which shows many individuals who are struggling with hypothyroidism, extreme fatigue, brain fog, and severe erection dysfunction(including an abscence of nocturnal erections).

Regards,

Steve

[Winston]

EDVictim,
If you would like Dr. Reed to take you seriously, you might want to refer to him as “Dr. Reed”, not “Mr. Reed”. I’m not sure if this was an oversight on your part or if you’re trying to be intentionally disrespectful?
I don't see how it would be in the best financial interest of a hair transplant surgeon to promote the use of Propecia when in fact he would make much more money if his patients skip the drugs and just go for repeated surgeries.

[Dr JN]

Hello,

I am Dr JN, and am both a medical doctor and sufferer of the horrific side effects of finasteride for over 9 years.

I want to add weight to the fact that Propecia is a dangerous medication to take. I am not interested in arguments or contrasting opinion but feel I have a personal and professional duty to alert all men who wish to save their hair that Propecia could potentially devastate their lives.

I took 1mg finasteride per day for 6 months as a 4th year medical student and have since suffered horrific physical, psychological and sexual symptoms, only partially alleviated with supraphysiological androgen therapy.

Common physiological parameters amongst sufferers include:

Low 3 alpha androstanediol glucuronide levels
Low Vitamin D levels

indicating permanent irreparable damage to the Type 2 5AR enzyme and/or vital steroid pathways.

I am currently working on the theory of clinical hypothyroidism, with abnormalities in reverse T3 levels; possibly a physiological, cortisol-induced response to finasteride- A 'stress' response.

If you take Propecia I wish you the best of luck and hope you are not one of the few longterm sufferers of a very debilitating condition.

As a person I feel I have a responsibilty to warn all finasteride users or potential users. As a professional, I encourage further scientific analysis of the possible mechanisms of destruction of finasteride on the human body.

For further information please visit www.propeciahelp.com

Many thanks

Dr JN, MBCHB FACEM

[John-]

Dr. Reed, regarding your comment as follows:

"A good start would be for them to publish their references that they feel support their positions.

The references were shown at the end of the video, and are also available under the video's description, which is viewable by clicking the expandable vertical >> arrows, (below the video clip, left of "number of views"): https://www.youtube.com/watch?v=SZsgCQ2-ZS8

[John-]

Further to the above, below are links to substantiate the claims of men negatively affected by Finasteride use.

According to the manufacturer's website:

"A small number of men had sexual side effects, with each occurring in less than 2% of men. These include less desire for sex, difficulty in achieving an erection, and a decrease in the amount of semen. These side effects went away in men who stopped taking PROPECIA because of them. In addition, these side effects decreased to 0.3% of men or less by the fifth year of treatment."

The manufacturer states that a small number of men had sexual side effects, including less desire for sex and difficulty in achieving an erection. The manufacturer also states that all side effects will resolve upon discontinuation of Propecia.

Unfortunately, an unknown number of men worldwide have acquired permanent hypogonadism (loss of Testosterone metabolism) from use, resulting in persistent sexual, mental and physical side effects long after quitting. Some medical professionals are now beginning to suspect these men may have acquired partial androgen resistance as a result of androgen deprivation (loss of DHT) from usage of the medication.

Below are some links which provide additional information on these topics. As was mentioned by some posters in this thread, there seems to be a perception that posting such information is simply for the purpose of "fear mongering"; however, this could not be further from the truth.

The public deserves to have access to as much information as possible about the medication they are consuming, in order to make an informed decision about usage. Beyond FDA labelling and the manufacturer's claims, anecdotal reports and real-world experiences, coupled with emerging reports from medical professionals, provide additional knowledge and potential to weigh the risks of undergoing androgen deprivation therapy by taking a 5AR2 inhibitor, to treat what is ultimately a cosmetic, vanity-related and emotional issue (hair loss).

--------

1. 2010 - Dr. Irwig @ George Washington University conducting clinical study into persistent Propecia side effects

http://www.propeciahelp.com/forum/download/file.php?id=365

2. UK - MHRA: Permanent ED a reported outcome of use

http://www.mhra.gov.uk/home/groups/par/documents/websiteresources/con054522.pdf

- Under Undesirable Side Effects, pg. 7, section 4.8:
"Persistence of erectile dysfunction after discontinuation of treatment with PROPECIA has been reported in post-marketing use."


3. UK MHRA - Male Breast Cancer now an official side effect

http://www.mhra.gov.uk/home/idcplg?IdcService=GET_FILE&dDocName=CON065504&RevisionSelectionMethod=Latest

"Cases of male breast cancer have been reported for finasteride, and the review suggested that an increased risk of male breast cancer associated with finasteride use cannot be excluded... on the basis of the review, it was recommended that a warning on the risk of breast cancer should be included in the product information for all medicines containing finasteride."


4. Swedish Medical Products Agency -- Male breast cancer now an official side effect

http://www.lakemedelsverket.se/PageFiles/17091/BUpp%20finasteride.doc

"Breast cancer has been reported in men taking finasteride 1 mg during the post-marketing period."

"In addition, the following have been reported in postmarketing use: persistence of erectile dysfunction after discontinuation of treatment with Propecia; male breast cancer (see section 4.4 Special warnings and precautions for use). has been reported in post-marketing use."

[John-]

5. Swedish Medical Products Agency

http://www.lakemedelsverket.se/SPC_PIL/Pdf/enhumspc/Propecia%20film-coated%20tablet%20ENG.doc

Under "Special Warnings and Precautions for Use ", pg. 2, section 4.4:

"Long-term data on fertility in humans are lacking, and specific studies in subfertile men have not been conducted. The male patients who were planning to father a child were initially excluded from clinical trials. Although, animal studies did not show relevant negative effects on fertility, spontaneous reports of infertility and /or poor seminal quality were received post-marketing..."

- Breast cancer has been reported in men taking finasteride 1 mg during the post-marketing period.


Under "Undesirable Side Effects", pg. 3, section 4.8:

- persistence of erectile dysfunction after discontinuation of treatment with PROPECIA
- male breast cancer "


---

6. Youtube - Swedish TV Investigation into permanent Propecia side effects

https://www.youtube.com/watch?v=2nXWVTStnHs

7. Youtube - PERMANENT ERECTILE DYSFUNCTION NOW OFFICIAL IN EUROPE

https://www.youtube.com/watch?v=QIDM2N1MuWw

8. Youtube - Dr. John Crisler speaking about permanent Finasteride side effects

https://www.youtube.com/watch?v=BEGCTMtlgoc

8. Hair loss medicine may cause permanent erection problems

http://translate.google.ca/translate?u=http%3A%2F%2Fsvt.se%2F2.22620%2F1.1649111%2Fharavfallsmedicin_kan_ge_permanenta_erektionsproblem%3Flid%3Dis_search527895%26lpos%3D1%26queryArt527895%3Dpropecia%26sortOrder527895%3D0%26doneSearch%3Dtrue%26sd%3D47225%26from%3DsiteSearch%26pageArt527895%3D0&sl=sv&tl=en&hl=en&ie=UTF-8

---

9. Dr. Alan Jacobs - A Neuroendocrine Approach To Finasteride Side Effects In Men

http://blog.alanjacobsmd.com/alan-jacobs-mds-blog/2010/04/a-neuroendocrine-approach-to-finasteride-side-effects-in-men.html

10. Dr. Alan Jacobs - The Plot Thickens, Along With The Hair, When You Mess With Dihydrotestosterone

http://blog.alanjacobsmd.com/alan-jacobs-mds-blog/2010/06/the-plot-thickens-along-with-the-hair-when-you-mess-with-dihydrotestosterone.html

11. Dr. Alan Jacobs - A Proposed Mechanism For Prolonged Sexual Side Effects From Finasteride

http://blog.alanjacobsmd.com/alan-jacobs-mds-blog/2010/06/a-proposed-mechanism-for-prolonged-sexual-side-effects-from-finasteride.html

12. Italy - Alarm for baldness drug

http://translate.google.ca/translate?hl=en&sl=it&u=http://canali.kataweb.it/salute/2010/06/21/arresta-la-calvizie-ma-causa-il-cancro-ma-il-ministro-non-risponde-al-parlamento/&ei=zaAyTIi6LsH7nAfQpty2Aw&sa=X&oi=translate&ct=result&resnum=10&ved=0CDMQ7gEwCTgK&prev=/search%3Fq%3Dirwig%2Bpropecia%26start%3D10%26hl%3Den%26safe%3Doff%26sa%3DN

[martinM]

Reported to whom?

This is a very disturbing video. Unfortunately, it makes many generalizations and accusations that are not referenced to allow examination of its claims. I would hope that the authors of this video would supply their references.

I will be posting a poll I am conducting of fellow hair transplant surgeons. I will post the final tabulation but at the moment, I have estimates totaling 20,000 patients from 12 surgeons who have been prescribing finasteride since it received approval in the late 90s. At the moment, THERE ARE NO REPORTED SIDE EFFECTS reported that persisted after the patients stopped the medication. Very strange, indeed, that these findings are at such odds with the video. I will be sure that the reporting physicians do not sell finasteride in their practices or have any other bias motivating distortion of their data.

I am a registered user at propeciahelp.com. You can find me under this same username.

Here are a few questions to ask yourselves:

1) No reported side effects to whom? I have reported long term sides multiple times to both Merck and the FDA as have other former FINASTERIDE users on propeciahelp. Merck tells me every time there is no suggested time on how long their stated side effects (ED) take to go away. They wouldn't even say within 5 years.

2) How closely are you paying attention to the state of your body? The side effects (beyond ED) for me took years to develop and worsen before they came to crises. I visited multiple doctors trying to figure out what was wrong. The standard line was "we don't know". It was only after 4+ years of worsening symptoms, when ED finally set in at age 27, that I realized how bad it had gotten. I slowly gained water weight, lost energy, lost mental acuity, and became depressed.

3) How do you track the claims of the disbelieved? I have spent thousands on doctors and blood tests trying to get someone interested in my case. Many doctors have refused to look at me because long-term side effects are not listed in the packaging of propecia.

4) Statement: Doctors don't tend to sell propecia at their practices. They write scripts for it and get kickbacks from pharma for doing so. Any doctor "saving men's hair" has a bias to prescribe propecia. Doctor's prescribing Propecia cannot be unbiased.

[mlao]

4) Statement: Doctors don't tend to sell propecia at their practices. They write scripts for it and get kickbacks from pharma for doing so. Any doctor "saving men's hair" has a bias to prescribe propecia. Doctor's prescribing Propecia cannot be unbiased.[/QUOTE]

I would like to hear from some of the doctors who regularly post on this forum. In response to this unsubstantiated allegation.
when I started using Propecia I was not pressured in any way. My doctor talked about possible sides and I made my own decision.

[martinM]

4) Statement: Doctors don't tend to sell propecia at their practices. They write scripts for it and get kickbacks from pharma for doing so. Any doctor "saving men's hair" has a bias to prescribe propecia. Doctor's prescribing Propecia cannot be unbiased.

I would like to hear from some of the doctors who regularly post on this forum. In response to this unsubstantiated allegation.
when I started using Propecia I was not pressured in any way. My doctor talked about possible sides and I made my own decision.[/QUOTE]

Good for you. Doesn't mean your doctor didn't get a kickback. Doctors are the “sales men” for these drugs -they and the drug companies are business partners. Due to the information asymmetry between doctors and patients, the patients are not in a good position to make the best decision in these kind of situations. Humans are driven by economic incentives, and doctors are no exception.

Read "Overdo$ed America" for another viewpoint about how much profit is made from the pills you're swallowing that can rob you of your functional penis.

http://www.overdosedamerica.com/

Don't forget, none of the Doctor's here are LEGALLY OBLIGATED to tell you about incentives or interaction they have with drug companies. If you prefer to let the propecia sales people (your doctors on this board who have prescribed to over 30,000 people) be your sole source of information about what you're taking be my guest. Just remember that for every dollar profited one will be spent to clean up the mess.

http://news.blogs.nytimes.com/2007/05/09/doctors-getting-paid-to-prescribe-drugs/

http://ww.scu.edu/ethics/publications/submitted/morreim/prescribing.html

http://www.thebostonchannel.com/r/21106691/detail.html

http://www.jsonline.com/features/health/37397284.html

These are the first few hits on google. Do a little research before crying "unsubstantiated claims". Furthermore, why wouldn't you ask me to substantiate? After all, I'm the one who made the claims, right?

[mlao]

The articles you provided give good insight into drug company practices. And while I'm sure they exist,
I just wanted some of the doctors who frequent this forum to voice their opinion about their relationship with Merck.
In my case I have a GP who is very hesitant to prescribe medication. She did not pressure me at all in regards to a script for Propecia.
I did not mean to show any disrespect to you or your opinions.

[martinM]

The articles you provided give good insight into drug company practices. And while I'm sure they exist,
I just wanted some of the doctors who frequent this forum to voice their opinion about their relationship with Merck.
In my case I have a GP who is very hesitant to prescribe medication. She did not pressure me at all in regards to a script for Propecia.
I did not mean to show any disrespect to you or your opinions.

No problem. But keep in mind the Doctors who post here have material interest in promoting Finasteride at their practices to save hair and are NOT LEGALLY OBLIGATED to disclose their relationships with any pharma.

[John-]

Update from Dr. Jacobs on persistent Finasteride side effects:

Another Piece of the Post-Finasteride Hypogonadism Puzzle?

http://blog.alanjacobsmd.com/alan-jacobs-mds-blog/2010/10/another-piece-of-the-post-finasteride-hypogonadism-puzzle.html

The persistence of male sexual side effects (hypogonadism) after discontinuation of finasteride is a serious problem for a significant subset of men who use the drug. I had previously written about whether the propensity of finasteride to cause lasting hypogonadism could be due to the development of partial androgen resistance and whether this relates to the number of CAG repeats in exon 1 of their androgen receptor genes.

Recently, a patient of mine brought to my attention a research paper from Csoka, et al.(J Sex Med 2008;5:227-233) titled "Persistent Sexual Dysfunction after Discontinuation of Selective Serotonin Reuptake Inhibitors". They added 3 well-characterized case reports to the half dozen or so that were already in the literature and cited studies probing underlying mechanisms for the problem. Their fourth proposed mechanism relates to a growing field that has caught my attention in a big way, the field of epigenetics. They note that antidepressants can cause complex changes in the expression of genes. They cite animal research that has linked SSRI treatment during youth to permanantly decreased sexual behavior that persits into adulthood and that has explored underlying mechanisms for this including brain epigenetic changes at the molecular level.

Epigenetics is a field that concerns the complex web of proteins that surround our DNA. These proteins include histones, which help package and unpackage our genes to either turn on or turn off their function. "Acetylation" and "methylation" are chemical reactions that alter the histone's function, which in turn alters the expression of our genes. Within this emerging field may lie a new mechanism by which a drug can cause persistent changes in gene expression that can influence sexual behavior.

This brings up the idea that there is a common epigenetic mechanism that may apply generally to medications that cause persistent sexual dysfunction. It may be the case with finasteride that a common epigenetic effect interacts with a less common variant in the androgen receptor gene CAG repeat profile to cause its syndrome of crippling persistent post-finasteride hypogonadism.

Human research in this area has yet to be done, but holds promise for new therapies to treat this troublesome side effect of finasteride and other widely used medications.

[mechephd]

I'm still a little incredulous to the propeciahelp claims--I'm sure, like any drug, there are side effects and that in a small & of the population these might be exacerbated.

However so far the only mounting evidence to substantiate the claims are anecdotal, youtube clips and blogs. The research and clinical gold standard are randomized and double (or triple) blinded clinical studies with results published in a peer reviewed journal--so far I haven't seen any publications that are indicative of the propeciahelp claims.

I'm not doubting that some men out there are indeed suffering but personally I'd attribute to those to psychosomatic or nocebo effects.