Confusing report about propecia

[bob13]

Br J Dermatol. 2008 May;158(5):1121-4. Epub 2008 Mar 20.
Value of hormonal levels in patients with male androgenetic alopecia treated with finasteride: better response in patients under 26 years old.
Camacho FM, García-Hernández MJ, Fernández-Crehuet JL
Department of Dermatology, Hospital Universitario Virgen Macarena, Avda. Dr Fedriani s/n. 41071 Sevilla, Spain.

Background Finasteride is a 5alpha-reductase inhibitor that has proved to be an effective treatment for men with androgenetic alopecia. Objectives To investigate the hormonal influence of finasteride 1 mg daily on hormonal levels and hair growth in men of different ages and with different degrees of alopecia according to the Hamilton-Norwood scale. Methods Two hundred and seventy men aged 14-58 years with male androgenetic alopecia III-VI Hamilton-Norwood score (II-III Ebling score) were treated with finasteride 1 mg daily. Steroid hormone (free testosterone, 5alpha-dihydrotestosterone, dehydroepiandrosterone-sulphate, delta4-androstenedione, 17-hydroxyprogesterone), prostate-specific antigen (PSA) and sebum levels, and trichogram changes were determined at baseline, and at 6 and 12 months of treatment. Results According to significant hormonal statistical analysis, the patients were divided by age (up to or over 26 years). In the group of patients younger than or 26 years old, higher levels of 5alpha-dihydrotestosterone were found at the beginning of the treatment, but there was a 50% decrease between the onset of treatment and month 12, particularly noticeable at 6 months (P < 0.05) of treatment, running parallel to an improvement of the alopecia and an increase of anagen hairs in the trichogram. At 1 year, PSA levels decreased 20%, particularly in patients younger than 26 years old. No variations in sebum levels were observed. Conclusions High levels of 5alpha-dihydrotestosterone in patients younger than or 26 years old at the beginning of treatment are a predictive factor of good response to treatment with finasteride 1 mg daily.


Editor’s Note

As we’ve been saying for years, DHT becomes less and less of a factor in Androgenetic Alopecia the older one gets. Although DHT remains a factor, it is a relatively minor factor in older men. Other variables, notably inflammation, estrogen dominance, and senescent thinning of hair (a seemingly universal age related diffuse hair loss, principally caused by atherosclerosis and the diminishment of peripheral microcapillary circulation) become more prominent.

A real challege in hair loss treatment is simultaneously dealing with senescent thinning juxtaposed on thinning caused by Angrogenetic variables. Our treatment recommendations, which are continually updated, takes into account these age related variables, not solely hormonal variables, such as DHT, Androstenedione, and Prolactin.


Im 65 I may as well quit. Except it helps the prostate

[mpb47]

Originally Posted by bob13

Br J Dermatol. 2008 May;158(5):1121-4. Epub 2008 Mar 20.
Value of hormonal levels in patients with male androgenetic alopecia treated with finasteride: better response in patients under 26 years old.
Camacho FM, García-Hernández MJ, Fernández-Crehuet JL
Department of Dermatology, Hospital Universitario Virgen Macarena, Avda. Dr Fedriani s/n. 41071 Sevilla, Spain.

Background Finasteride is a 5alpha-reductase inhibitor that has proved to be an effective treatment for men with androgenetic alopecia. Objectives To investigate the hormonal influence of finasteride 1 mg daily on hormonal levels and hair growth in men of different ages and with different degrees of alopecia according to the Hamilton-Norwood scale. Methods Two hundred and seventy men aged 14-58 years with male androgenetic alopecia III-VI Hamilton-Norwood score (II-III Ebling score) were treated with finasteride 1 mg daily. Steroid hormone (free testosterone, 5alpha-dihydrotestosterone, dehydroepiandrosterone-sulphate, delta4-androstenedione, 17-hydroxyprogesterone), prostate-specific antigen (PSA) and sebum levels, and trichogram changes were determined at baseline, and at 6 and 12 months of treatment. Results According to significant hormonal statistical analysis, the patients were divided by age (up to or over 26 years). In the group of patients younger than or 26 years old, higher levels of 5alpha-dihydrotestosterone were found at the beginning of the treatment, but there was a 50% decrease between the onset of treatment and month 12, particularly noticeable at 6 months (P < 0.05) of treatment, running parallel to an improvement of the alopecia and an increase of anagen hairs in the trichogram. At 1 year, PSA levels decreased 20%, particularly in patients younger than 26 years old. No variations in sebum levels were observed. Conclusions High levels of 5alpha-dihydrotestosterone in patients younger than or 26 years old at the beginning of treatment are a predictive factor of good response to treatment with finasteride 1 mg daily.


Editor’s Note

As we’ve been saying for years, DHT becomes less and less of a factor in Androgenetic Alopecia the older one gets. Although DHT remains a factor, it is a relatively minor factor in older men. Other variables, notably inflammation, estrogen dominance, and senescent thinning of hair (a seemingly universal age related diffuse hair loss, principally caused by atherosclerosis and the diminishment of peripheral microcapillary circulation) become more prominent.

A real challege in hair loss treatment is simultaneously dealing with senescent thinning juxtaposed on thinning caused by Angrogenetic variables. Our treatment recommendations, which are continually updated, takes into account these age related variables, not solely hormonal variables, such as DHT, Androstenedione, and Prolactin.


Im 65 I may as well quit. Except it helps the prostate

I have always read that T and DHT decline as you get older. But I don't understand why mpb becomes more and more common with age? I downloaded an article from pubmed recently that said at age 80 mpb is still increasing and it would probably reach 100% if men lived long enough.
So wonder what makes these older guys start balding at 70-80+?

[25 going on 65]

bob, correct me if I'm wrong but didn't finasteride have a positive effect for your hair?

[Horseshoe]

Originally Posted by mpb47

I have always read that T and DHT decline as you get older. But I don't understand why mpb becomes more and more common with age? I downloaded an article from pubmed recently that said at age 80 mpb is still increasing and it would probably reach 100% if men lived long enough.
So wonder what makes these older guys start balding at 70-80+?

Who cares about loosing hair at 70 or 80, you would just be happy to be alive. In fact you have won if you lasted that long without hairloss. It's when you loose your hair in your teens (myself), 20's or even early 30's that has the biggest impact on your life because that is when you are marketing yourself for both your future spouse and your future career and we all know the psychological impact hairloss can have on both of these most important aspects of life...

Sorry just venting....

[mpb47]

Originally Posted by Horseshoe

Who cares about loosing hair at 70 or 80, you would just be happy to be alive. In fact you have won if you lasted that long without hairloss. It's when you loose your hair in your teens (myself), 20's or even early 30's that has the biggest impact on your life because that is when you are marketing yourself for both your future spouse and your future career and we all know the psychological impact hairloss can have on both of these most important aspects of life...

Sorry just venting....

Please not this old argument again!
The point is if hormones decline with age, why does mpb become more frequent?

[bob13]

Originally Posted by 25 going on 65

bob, correct me if I'm wrong but didn't finasteride have a positive effect for your hair?

I believe it has helped maintain, still thinning though.
So this report may be partly true.

[bob13]

Originally Posted by Horseshoe

Who cares about loosing hair at 70 or 80, you would just be happy to be alive. In fact you have won if you lasted that long without hairloss. It's when you loose your hair in your teens (myself), 20's or even early 30's that has the biggest impact on your life because that is when you are marketing yourself for both your future spouse and your future career and we all know the psychological impact hairloss can have on both of these most important aspects of life...

Sorry just venting....

That's ok but keep in mind people are living longer these days and men want to look the best they can at any age.

The part that surprises me is that DHT has less effect towards hair loss in men over 6o
according to this report.

[NotBelievingIt]

Originally Posted by mpb47

Please not this old argument again!
The point is if hormones decline with age, why does mpb become more frequent?

While we "know" MPB starts at younger ages because of "DHT strangulation" , as I like to call it, ultimately "DHT strangulation" simply means nutrient flow is being diminished and cut off.

As we age we historically take in less food and less overall nutrients, and thus the tiny amount our hair needs in relation to our organs becomes even smaller to the point the hair just cannot be sustained anymore.

A study of the older population and nutritional intake and hair quality/count would pretty much "prove" or "disprove" this I think. Might be tough to do given the number of meds many older folk take that might screw with things also.

[mpb47]

Originally Posted by NotBelievingIt

While we "know" MPB starts at younger ages because of "DHT strangulation" , as I like to call it, ultimately "DHT strangulation" simply means nutrient flow is being diminished and cut off.

As we age we historically take in less food and less overall nutrients, and thus the tiny amount our hair needs in relation to our organs becomes even smaller to the point the hair just cannot be sustained anymore.

A study of the older population and nutritional intake and hair quality/count would pretty much "prove" or "disprove" this I think. Might be tough to do given the number of meds many older folk take that might screw with things also.

That might explain some of it but it sure seems like it is still genetic mpb because it is so common. They have 100+ year old birthdays on the Today show in the morning. I don't think I have ever seen a man without mpb on that segment. There must be another factor besides hormones that make sure the older guys join the club as well. I have read hair docs talking about a time clock component of mpb so I am guessing this is part of it.

[WashedOut]

Originally Posted by mpb47

That might explain some of it but it sure seems like it is still genetic mpb because it is so common. They have 100+ year old birthdays on the Today show in the morning. I don't think I have ever seen a man without mpb on that segment. There must be another factor besides hormones that make sure the older guys join the club as well. I have read hair docs talking about a time clock component of mpb so I am guessing this is part of it.

Maybe it's just a matter of hair follicles no longer being able to survive? I wouldn't be surprised if people that age also have less hair than they did on their eyebrows, legs, arms, etc.