Stress and the side effects of finasteride (5mg Proscar)

[EricD]

So I first posted this topic on ************ and Immortalhair forums. However, both of those forums set off my bullshit detectors when I learned that those sites sell hair loss solutions as well as offer information. That immediately sets off my cynicism, so here I am, hoping for more information.

So I started noticing some thinning on one side of my hair line (just the right side of my head for some reason), so I went and asked my doctor about it. He prescribed 5mg Proscar to me, with instructions to use a pill splitter to cut it into four pieces and then take one quarter per day. I did so. However, a few weeks ago I began to notice some of the side effects, which my doctor had told me specifically not to worry about due to the small dosage of finasteride I was taking. These included:

-Depression
-Mild difficulty maintaining erection (I could get it up, but it went away quicker and easier than before)
-Lessened ejaculatory volume
-Increased shedding (Before I started taking Proscar, I would run my hand through my hair in the shower and two to five hairs would come out. Now I run a hand through my hair in the shower and seven to ten hairs will come out)

So I went online and did some research. I read some of the horror stories about people experiencing these side effects permanently, so I stopped taking the pills this last weekend and the side effects seemed to subside somewhat, though the shedding is continuing. I also went to my barber and asked him about my hair loss, and he took a look at the one thinned out area of my scalp and said it was stress based in nature. I'm only 19, so that would make sense. I want to ask my doctor about it, but he'll be out of town for the next month or so, so I came on here to ask a bit about it.

Do the side effects of finasteride show up when first starting taking the drug and then gradually go away as your body becomes more used to the medication or something like that?

Are the stories about permanent side effects just typical internet hype or are have they shown up in peer-reviewed scientific studies?

Would a reduced dosage of finasteride per day still have the intended effect with lessened side effects?

If my hair loss is just stress-based, what would the effects of finasteride be?

If you stop taking finasteride as a shed is occuring, do you lose the shed hairs permanently or will they still regrow?


Any help would be greatly appreciated!

To help you guys understand my situation, I've attached two pictures of my hairline. "Hairline" is the thinned area, "Hairline2" is the other side of my head, where the hair loss isn't so bad, for purposes of comparison. Ignore the dark spot in the thinned area, that's just a scab from banging my head at work recently.

[EricD]

Well because I was cutting my 5mg pills into quarters and taking a quarter every day, I was taking dosages of about 1.25mg. I haven't taken any since last Thursday, so I think I'll give it another week, then I'll have been off it for three weeks and I'll start taking it again in a reduced dosage (.5mg or less) every other day. I'll try to keep in mind what I've been reading about the side effects to prevent the placebo effect from giving me side effects unrelated to the finasteride. If side effects redevelop, I'll ride it out for a few weeks to see if they improve. If they don't, I'm going to stop taking it and seek another solution.

I'd still appreciate answers to my questions though...

[clandestine]

You might have some success taking a reduced dosage, then again you might not. From what I understand, the percentage of plasma DHT reduced by taking finasteride doesn't vary much whether you're taking 0.04mg or 1.5mg (after 7 days). [http://www.propeciahelp.com/forum/viewtopic.php?t=1170]

Try a reduced dosage for a while if you're willing, watch for sides but understand placebo. You're on the right track. Keep us updated.

[25 going on 65]

First of all, let me say that your barber doesn't necessarily know. The surest way to get an accurate diagnosis is to consult a hair loss specialist and try to rule out other causes. (I should tell you that the vast majority of male hair loss in adults is due to male-pattern balding, though.)

Do the side effects of finasteride show up when first starting taking the drug and then gradually go away as your body becomes more used to the medication or something like that?

Everybody is different, but quite a few people do seem to go through a temporary adjustment period when starting finasteride. Your body may need some time to adjust to the change in hormone levels.
Most people who experience these early side effects see them disappear, but definitely not everyone.

Are the stories about permanent side effects just typical internet hype or are have they shown up in peer-reviewed scientific studies?

Permanent side effects haven't been proven in peer-reviewed literature, but there was a study on Proscar (5 mg finasteride) in which a small % of men experienced side effects that didn't resolve after six months (which was the last time researchers followed up with them). I don't interpret this as proof of permanent side effects because some drugs, including hormonal ones, take longer than half a year to fully recover from for some people. However, we also don't know if those men ever did get rid of all their sides.
There was also a series of 70-80 case studies done by a Dr. Irwig in which he interviewed people who felt they had long-term side effects from finasteride.
I have a feeling more studies will be coming out on this subject in the next few years.

Would a reduced dosage of finasteride per day still have the intended effect with lessened side effects?

It might not be as effective but it could possibly resolve your side effects. There are people on this forum using as little as .25 every 1-2 days, if I'm not mistaken.

If my hair loss is just stress-based, what would the effects of finasteride be?

If you don't have male-pattern hair loss, finasteride won't do much of anything. At that point it's just a prostate drug that you don't need.

If you stop taking finasteride as a shed is occuring, do you lose the shed hairs permanently or will they still regrow?

Assuming you have MPB... it probably depends on how weak the hairs were that fell out. If they were already highly miniaturized, the chance of them coming back is reduced. But those hairs would have fallen out anyway without finasteride, it just probably would have taken x number of months longer.

[EricD]

Well I've been taking finasteride again at a reduced dosage (1/8th of a 5mg Proscar tablet rather than 1/4th) for a week or two now. It seems to be having an effect as I am going through a shed of my hair. Side effects are definitely reduced, the only one I'm noticing is that erections seem to go away easier without stimulation, no loss of libido or depression or anything. I take 1/8th (0.625mg) of a Proscar tablet every other day, and if the side effect does not resolve itself in another week or two, I think I'm going to move down to 1/16th (0.5mg) every three days.

[EricD]

I've also started taking a 50mg zinc supplement daily, which is supposed to help with energy and libido, and I hear that should help counteract sides I think. We'll see what happens!