Does finasteride block dht or cause the body to produce less dht?

[chrisis]

Fair enough, yes many conditions are race specific. but my problem is you are saying an entire study is BS because there *might* be a chance it only affects certain races? what you are doing is trying to get me to prove a negative (basically evidence of absence) by asking me to rule out the possibility that it’s race specific. This is a really, really weak argument.

How is it a weak argument? Clearly the participants were all Japanese. How can the trial prove safety in men who aren't Japanese in that case? There is a high likelihood in my view that there is a genetic basis to whether someone suffers side effects, just as there is a genetic basis as to whether a man suffers from MPB at all!!

Took a while, but found it! http://www.ncbi.nlm.nih.gov/pubmed/12824459

You've cited two trials. In one all of the participants were Japanese, in the other all of the men were 55 years of age or older.

Do you SERIOUSLY not see any problem with the methodology of these trials despite the fact no men under 55 of caucasian descent were involved? I'm not sure whether you're a troll, an idiot or a Merck employee.

Okay again, how *exactly* are they “backtracking” on their warnings? Look up the definition of that word please, just so you understand it’s the complete opposite of what you are trying to explain. You might want to use the word "revising" because it makes much more sense and is completely accurate.

They changed the labeling to expand the list of sexual adverse events and suggest a possibility that they may be permanent in some men. Whether it's a "revision" or "backtracking" is mere semantics.

OK so if the FDA is as unreliable as you say then should we just ignore this new warning they released? Okay lets just do that, it will save a lot of time arguing!

I did not suggest we should ignore them, simply acknowledge they are not infallible, as demonstrated by their "revised" (happy?) stance on Propecia.

All I was trying to show is that propecia is *relatively* safe, when you compare to other common prescription medications.

"Relatively" safe just does not cut it! Who are you kidding? We have a right to know exactly how safe. This is not a prescription medicine to treat a disease, it is purely a vanity drug; men deserve to know the full risks before opting into a drug they don't necessarily need.

Okay, just a few posts back you said, and I quote “Let the men on these forums speak the truth” meaning we should stop listening to the fda and merck and studies, and start listening to the individual, anecdotal stories that people have to tell. So my experience, because it is good, should be ignored, yes? But yours and others because they are bad should be listened to? How ass backwards is that?

You miss my point. I will try to spell it out one more time. Your experience is supposed to be good - probability is supposed to be strongly in your favour; you are in the 97%. I (and many others) are in the 3%, so my experience is far more important in terms of determining the safety of Propecia. It's not a matter of bias, it's a matter of statistics.

I'm sorry but when you said the word "testosterone" I thought you might have been talking about testosterone.. not sure how I ****ed that one up, apologies.

I messed up there. I was referring to a comment I read elsewhere and "****ing up testosterone levels" is a casual and inaccurate way of describing what happens. I described the actual interactions of finasteride and DHT in my follow-up post and either way, the truth is finasteride impairs hormones in the body which can subsequently impair sexual health. That is undeniable - it's how the drug works.

Im going to call you out on this and ask for a source also, please. The Wikipedia article says nothing about DHT regulating libido, so can you show me a source that says that? You are just jumping to conclusions, unless you have a better source.

Sure took me 30 seconds!

"DHT's status as a highly active androgen hormone causes an increase in sex drive, especially in individuals using supplemental amounts of it. Its inhibition of estrogen in the body also causes the increase in sexual desire."

You might possibly be right that if there is no DHT in the body whatsoever, it could affect the libido. But finasteride only inhibits like 60% of DHT right? So it’s pretty obvious that the remaining 40% is more than enough for most men to get along great without problems.

Are you kidding me? You think it's ok that finasteride might only mess up 60% of a hormone that is crucial for good sexual health? Sure some men might get along with 40%, but the question remains how many men? How safe is this drug? Nobody knows!!!.

[the_charger]

As someone who publicly defends Propecia and is thereby charged with demonstrating that it's safe, can you rule out that side effects aren't race specific? I'm sure you know for instance that many people of Asian descent can't tolerate alcohol because of a genetic mutation that other races don't have.

Fair enough, yes many conditions are race specific. but my problem is you are saying an entire study is BS because there *might* be a chance it only affects certain races? what you are doing is trying to get me to prove a negative (basically evidence of absence) by asking me to rule out the possibility that it’s race specific. This is a really, really weak argument. It’s the type of argument people use when they don't have a leg to stand on (yes I took a debate course last semester and am quite familiar with techniques people often try to use to win an argument). Its just like if we were arguing about the color of the sky: I think its blue and you think its red. You tell me “okay smart ass, prove to me that the sky ISN’T red!”

Source the trial.

Took a while, but found it! http://www.ncbi.nlm.nih.gov/pubmed/12824459

Yes. If Merck and the FDA are backtracking on their warnings, then there's clearly something that concerns them - no doubt for legal and financial reasons. As I mentioned earlier, it wouldn't be the first time that a drug has been withdrawn because the original trials that cleared the FDA were proven to be unreliable. Reasons why that happen are numerous! It's naive to think that the FDA are infallible and that Merck aren't operating solely with regard to commercial interest.

Okay again, how *exactly* are they “backtracking” on their warnings? Look up the definition of that word please, just so you understand it’s the complete opposite of what you are trying to explain. You might want to use the word "revising" because it makes much more sense and is completely accurate.

OK so if the FDA is as unreliable as you say then should we just ignore this new warning they released? Okay lets just do that, it will save a lot of time arguing!

Where to begin with this? Literally sighing here.

LOL!! you are the one sighing? You made so many contradictory remarks in this next statement. I have a paper due tomorrow, but I just have to point out how many blatant mistakes you have made here:

For a start, you're inferring that Propecia is totally safe

So this is exactly what I said a few posts back: “finasteride isn’t perfect, I don’t even think its near perfect. but it is a very effective treatment for hair loss but you risk some very rare symptoms if you take it.”

You read that statement and then somehow take my meaning to be “Propecia is totally safe”. You are clearly pulling things out of your ass here… Try to remember that posts are saved on this thread and very easy for everyone to confirm!

All I was trying to show is that propecia is *relatively* safe, when you compare to other common prescription medications. In all honesty, no prescription medication is or ever will ever be completely safe.. But its all a matter of weighing out risk versus benefit

because of your single, anecdotal, positive experience (thus far)

Okay, just a few posts back you said, and I quote “Let the men on these forums speak the truth” meaning we should stop listening to the fda and merck and studies, and start listening to the individual, anecdotal stories that people have to tell. So my experience, because it is good, should be ignored, yes? But yours and others because they are bad should be listened to? How ass backwards is that?

Next, it's got nothing to do with testosterone levels. The issue is DHT. DHT is what causes you to bald, and the interactions of DHT is what Propecia basically blocks.

and again a few posts back you said this “Let the fact that Propecia is designed to literally **** with your testosterone levels speak for itself”

I'm sorry but when you said the word "testosterone" I thought you might have been talking about testosterone.. not sure how I ****ed that one up, apologies.

DHT is a primary sex hormone involved in regulating libido is both men and women, so if there is no DHT in the body, your libido will be effected.

Im going to call you out on this and ask for a source also, please. The Wikipedia article says nothing about DHT regulating libido, so can you show me a source that says that? You are just jumping to conclusions, unless you have a better source. the wikipedia article actually kinda supports what I thought, that DHT is really only important during development, and after puberty it doesnt do much of anything except make people bald.

You might possibly be right that if there is no DHT in the body whatsoever, it could affect the libido. But finasteride only inhibits like 60% of DHT right? So it’s pretty obvious that the remaining 40% is more than enough for most men to get along great without problems.

[chrisis]

I think people with peanut allergies have the same viewpoint about peanuts. again its really horrible that anyone has to deal with bad side effects.. I can totally understand your viewpoint here, but rare reactions to happen on all medications.

Your thinking is so flawed that I don't know where to begin, but I'll attempt to dissect your points one by one.

You simply cannot compare a hypersensitive reaction to nuts, to a drug that is prescribed to intentionally alter the biochemistry of the male hormonal system. Peanuts aren't a medication for a start, peanut allergic reactions affect between 0.4-0.6% of the population, and sufferers can avoid symptoms by simply avoiding peanuts. Let's hope that stops the peanut analogy right there!

Why does it matter that they are japanese men? if you are saying that severe side effects are race specific?

As someone who publicly defends Propecia and is thereby charged with demonstrating that it's safe, can you rule out that side effects aren't race specific? I'm sure you know for instance that many people of Asian descent can't tolerate alcohol because of a genetic mutation that other races don't have.

I saw this mentioned in the big thread with spencer and Dr.Wasserbauer, but the biggest and long term study of finasteride for like 18,000 men (half on placebo) for 7 years was done by a university and not funded by Merck. The only thing I saw that Merck funded was providing Proscar tablets for the patients to take during the study. Whats wrong with this one then?

Source the trial.

You are saying to listen to guys on forums that are basing their opinion on their own bad experience instead of these studies that involve thousands of men in a controlled environment?

Yes. If Merck and the FDA are backtracking on their warnings, then there's clearly something that concerns them - no doubt for legal and financial reasons. As I mentioned earlier, it wouldn't be the first time that a drug has been withdrawn because the original trials that cleared the FDA were proven to be unreliable. Reasons why that happen are numerous! It's naive to think that the FDA are infallible and that Merck aren't operating solely with regard to commercial interest.

How does propecia literally **** with your testosterone levels? doesnt your testosterone levels rise when you take finasteride? If my testosterone levels are so ****ed right now, how is it possible I havent had any side effects? I have made almost 20lbs in gains at the gym in the last year. How could be this possible with "****ed" testosterone levels?

Where to begin with this? Literally sighing here. For a start, you're inferring that Propecia is totally safe because of your single, anecdotal, positive experience (thus far). Are we meant to be surprised at your account that it's safe?! It should be! Probability ought to be in your favour! The real question is how many people is the drug NOT safe for? Your positive experience tells us absolutely nothing of any value!!!

Next, it's got nothing to do with testosterone levels. The issue is DHT. DHT is what causes you to bald, and the interactions of DHT is what Propecia basically blocks.

"DHT has approximately three times greater affinity for androgen receptors than testosterone and has 15-30 times greater affinity than adrenal androgens."

DHT is a primary sex hormone involved in regulating libido is both men and women, so if there is no DHT in the body, your libido will be effected.

[the_charger]

That's because for some of us it has been a horrible devil drug!

I think people with peanut allergies have the same viewpoint about peanuts. again its really horrible that anyone has to deal with bad side effects.. I can totally understand your viewpoint here, but rare reactions to happen on all medications.

And if, as you suggest, "everyone" is suggesting so, then perhaps it's time to start questioning the validity and integrity of the studies! There have actually been very few reliable trials. The biggest ones were either funded by Merck - no potential bias there then! And another was comprised entirely of Japanese men - which can at most only document how safe the drug is for Japanese men!

Why does it matter that they are japanese men? if you are saying that severe side effects are race specific?

I saw this mentioned in the big thread with spencer and Dr.Wasserbauer, but the biggest and long term study of finasteride for like 18,000 men (half on placebo) for 7 years was done by a university and not funded by Merck. The only thing I saw that Merck funded was providing Proscar tablets for the patients to take during the study. Whats wrong with this one then?

Let the men on these forums speak the truth. Let the FDA and Merck's revised positions and label-changing antics speak the truth. Let the fact that Propecia is designed to literally **** with your testosterone levels speak for itself.

It's time to face facts and for people to talk about this drug responsibly and safely.

No more "it's in your head".

No more "it only affects 2%".

I call bullshit on both of those statements.

You are saying to listen to guys on forums that are basing their opinion on their own bad experience instead of these studies that involve thousands of men in a controlled environment? How does propecia literally **** with your testosterone levels? doesnt your testosterone levels rise when you take finasteride? If my testosterone levels are so ****ed right now, how is it possible I havent had any side effects? I have made almost 20lbs in gains at the gym in the last year. How could be this possible with "****ed" testosterone levels?

you can call bullshit all you want, but you havent really provided a good argument for any of this. you are telling everyone to ignore studies (proof) and instead listen to all the guys on forums that have bad experiences, and then you say in the same post that we should talk "responsibly"?

I’m sorry dude but your reality is a little skewed.

[chrisis]

Also the very fact that the FDA and Merck are in "reverse" position on side effects should be enough to cast doubt on those initial trials that passed the FDA.

Would the drug be approved if the potential for permanent side effects was known then? Unfortunately we find ourselves in a position where there is too much money involved and there are too many reputations at stake.

[chrisis]

But since finasteride did pass the required safety protocols of those clinical trials, the onus is really now upon those who claim it is unsafe to prove their case.

Never heard of Accutane?

In 2009, Roche decided to pull Accutane off the US market after juries had awarded millions of dollars in damages to former Accutane users over inflammatory bowel disease claims. Among others, actor James Marshall sued Roche for $11 million in damages over Accutane-related disease that resulted in removal of his colon.

Accutane was cleared by the FDA, until people started killing themselves and reporting depression.

I got this from elsewhere and I can't improve on the wording so I quote:

"Don't take something as gospel just because "science" tested it and the FDA approved it. Scientists can lie just like everyone else. The FDA isn't some superhuman infallible agency. Biotechnology is INCREDIBLY competitive and a huge portion of companies are living month to month and/or barely making it on angel funding. The pressure to prove efficacy and publish good results can be incredible. I admire your faith and I do think the FDA does a good job. But blind faith will kill you."

[chrisis]

everyone seems to make propecia out to be some sort of horrible devil drug, but has anyone ever looked at antidepressants?

That's because for some of us it has been a horrible devil drug!

And if, as you suggest, "everyone" is suggesting so, then perhaps it's time to start questioning the validity and integrity of the studies! There have actually been very few reliable trials. The biggest ones were either funded by Merck - no potential bias there then! And another was comprised entirely of Japanese men - which can at most only document how safe the drug is for Japanese men!

Let the men on these forums speak the truth. Let the FDA and Merck's revised positions and label-changing antics speak the truth. Let the fact that Propecia is designed to literally **** with your testosterone levels speak for itself.

It's time to face facts and for people to talk about this drug responsibly and safely.

No more "it's in your head".

No more "it only affects 2%".

I call bullshit on both of those statements.

[gmonasco]

Also, the onus is on the drug pusher to prove its safety, not the patient or victim.

But since finasteride did pass the required safety protocols of those clinical trials, the onus is really now upon those who claim it is unsafe to prove their case.

[the_charger]

Isnt the FDA medication approval process a pretty thorough way of determining if a medication is fit for public consumption or not? even if it isnt, there have been a ton of studies done on finasteride after the fact that all show it is tolerated well and I don’t think any permanent or severe side effects resulted from those... the fact that all this talk of severe side effects is so recently compared to how long the medication has been on the market really shows how very rare this is!

of course after a drug is released and millions of people start taking it, you will start to see very rare side effects that weren’t found initially. This isn’t unique to finasteride and it happens with literally any prescription medication out there. Merck and the FDA aren’t backtracking like you are saying, if anything it shows they continue to monitor adverse side effects to watch for these rare events and updates their labels to warn of these changes. Just like how they noticed in extremely rare cases it can cause male breast cancer or prostate cancer or depression.

finasteride isn’t perfect, I don’t even think its near perfect. but it is a very effective treatment for hair loss but you risk some very rare symptoms if you take it. On the other side of the coin, there isn’t much else to treat hair loss right now, and hair loss itself can be extremely hard on some people, so anyone thinking about taking it really needs to weigh out the pro’s and con’s.

everyone seems to make propecia out to be some sort of horrible devil drug, but has anyone ever looked at antidepressants? sexual side effects from antidepressants effect somewhere around 20% of all users, and this is very well documented. Not to mention about another dozens of common side effects. Just to name a few: nausea, vomiting, headache, fatigue, dizziness, insomnia, diarrhea, weight loss, weight gain, mania, tremors, cardiovascular problems, severe withdrawal symptoms, and even sexual dysfunction that can last years after stopping the treatment. And MILLIONS of people take these treatments, usually without a second thought. Whats worse is kids are getting treated with antidepressants more and more often. I think I read that over 50 million people have taken or are currently taking antidepressants! Its weird to me that

So yeah, finasteride isn’t perfect, and it can cause very rare and severe symptoms. But when you put it into perspective and compare it to other drugs like antidepressants, which are one of the most commonly prescribed types of medications, finasteride isn’t really that bad. Unfortunately this doesn’t help the people that ended up with bad side effects.. Hopefully we can get some better studies that give us a full understanding of whats happening and how these people can be treated.

[oOKawaiiOo]

Finasteride basically sticks itself in between 5-AR and Testosterone. Finasteride has binding receptacles that 5-AR Type II binds to so it effectively prohibits a large portion of the conversion of T to DHT.

Finasteride has a half life of I believe it was 8 hours. So 1mg is .5mg after 8 hours and .5mg would be .25mg after 8 hours etc etc.

Finally some biological mechanism. I always thought fin was a competitive inhibitor to 5-AR (enzyme) that catalyzes testosterone to DHT. So by increasing the substrate levels [concentration], it would have a better chance in binding to the enzyme and preventing further increase in DHT levels.

What is an competitive inhibitor? Binds substrate that competes for the binding at the active site of the enzyme where the reaction occurs.

http://en.wikipedia.org/wiki/Competitive_inhibition

But from what your saying, it looks like an uncompetitive inhibitor which binds to the enzyme and testosterone. Meaning you slow down the production of DHT but not as effective as competitive inhibitors.

http://en.wikipedia.org/wiki/Uncompetitive_inhibitor

Most of the drugs out there are competitive inhibitors, and are more effective in preventing reactions from occuring than uncompetitive.

http://www.drugs.com/pro/propecia.html

The link above claims fin is a competitive inhibitor.....so it doesnt bind to testosterone at all. Just the 5-AR.

I also have a B.S in Biological Sciences.

[sausage]

Well apparently some people believe side effects are in peoples heads.....but to be honest I have never heard so much tosh in all my life.

[chrisis]

Finasteride has a half life of I believe it was 8 hours. So 1mg is .5mg after 8 hours and .5mg would be .25mg after 8 hours etc etc.

If that's the case, it means after 3 months I should be fine, unless something else is going on. Any ideas on what the "something else" is? Then we can figure out how to resolve it.

[NotBelievingIt]

The bodys naturally produced enzyme, 5 Alpha-Reductase, binds to Testosterone and in that binding process it "pulls" apart what it has bound and creates other hormones such as Allopregnanolone (a neurological hormone) and Dihydrotestosterone. DHT does not exist in the body, at all, unless 5AR creates it.

5-AR Type II is the primary enzyme that creates DHT, though Type I is being found to have some effect on hair loss as well (due to dustasteride being found to also help).

Finasteride basically sticks itself in between 5-AR and Testosterone. Finasteride has binding receptacles that 5-AR Type II binds to so it effectively prohibits a large portion of the conversion of T to DHT.

Dutasteride has receptacles for 5-AR Type I and Type II and thusly has a greater effect. One could almost say the use of Dut would simulate a 5-AR deficiency.

Finasteride has a half life of I believe it was 8 hours. So 1mg is .5mg after 8 hours and .5mg would be .25mg after 8 hours etc etc.


Why a reduced dosage has the potential to lessen side effect symptoms is that the body will have what amounts to a mostly clear period after 8 hours. .5 to 1mg Finasteride "blocks" approximately 70% of 5AR conversions, and it parabolically drops off below .5mg.

[JJacobs152]

The body does not produce DHT directly, really. Basically, testosterone in your bloodstream is binded to a substance that prevents it's breakdown. This allows testosterone to get to androgen receptors in a functional state. Once unbinded though (as it must be to bind to receptor sites and enzymes), substances can convert testosterone into other hormones. You're probably familiar with the fact that test converts to estrogen. It also converts to DHT though, once combined with a particular enzyme. Fin, however, is more competative in reacting with this enzyme. Thus, fin sort of uses up all of that substance by binding with it instead of test, allowing testosterone to remain as testosterone. It doesn't do anything to DHT itself.

So the answer to your question is that yes, those are different processes. Fin does the stop production one.

(A substance that "blocked" DHT would instead be more competative in binding with the receptor site. But as the site in question is the androgen receptor site, I'd imagine blocking that would be bad news bears even harder than fin is already sometimes bad news bears.)

Nicely said, and the enzyme which finasteride works on is 5alpha-reductase. Also, used for the treatment of benign prostatic hyperplasia.

[chrisis]

And for those who think side effect reports are constrained to these forums.

You're wrong