Post Finasteride Syndrome (Theory)
I'm a new user on this site, though I've visited the site an watched the show. I've recently started on dutasteride, so I've started to read up on it. Naturally I've come across repeated references to post finasteride syndrome and arguments about whether it's real or not. Most stories suggest that it occurs after discontinuing the drug. The interesting thing is that most discussion on it revolves around whether or not the medication causes the symptoms and not whether the discontinuation does.
That's not to say "Stay on the drug forever," but whether these people abruptly stopped the medication and whether that could have caused the crash in their endocrine system or other related symptoms. Hearing about this syndrome made me think of osmotic demyelination syndrome (which I've had experience with before; not personally, but someone close to me). To summarize very briefly, ODS is caused when someone with hyponatremia (low blood sodium) has his/her sodium level corrected too rapidly. The brain tries to deal with this abrupt increase, but if it can't, there can be severe damage to the myelin sheaths of nerve cells in the brain stem, causing permanent brain damage.
Finasteride/Dutasteride are 5a-reductase inhibitors that effect the conversion of Testosterone to DHT. They have been shown to lower DHT levels by something like 70%-90% (I don't have the numbers in front of me, but something like that). I imagine the body would have to attempt to compensate for this drop, which is why people experience side effects when taking it. Could the abrupt stoppage of the medication (especially after a period of use) be the cause of what people are experiencing in Post Finasteride Syndrome? It seems that from the stories I've read most people who experience PFS were experiencing side effects and abruptly stopped the drug. They then experienced a positive reversal of side effects (increased energy, mood, sexual potency, etc.) after stopping, but some time afterwards experience a sharp and permanent return of symptoms, usually stronger than earlier experienced. Maybe the positive effects could be the immediate return of DHT levels in their systems and the later symptoms could be permanent damage to the nervous system caused by that abrupt change? It could explain why some people, whose brains may be able to compensate the change better, don't experience this effect while others do.
I actually created an account, especially on this site, to throw this theory out there because I found it strange that I haven't seen anyone suggesting or discussing it (if this has been mentioned or discuss, I apologize for missing it.) Could people avoid permanent damage by simply titrating off of the medication slowly?
I chose this site because it seems to be big in the hair loss community and if there is any merit to this theory (and it hasn't been discussed) I hope it spreads so people can avoid future issues.