Artas

[StressedToTheBald]

Dr. Cole, I agree regarding percents.. its easy to portray it as a few percent, but once a man suffers from it, suddenly it becomes very personal and it doesn't feel as minority.. and when the total number of users is taken into account, few percent easily becomes thousands of people. We call them patients, but its human beeings, just like me or You, they have lives, family, dreams and wishes.. and if their health is compromised.. then everything else fades..

I'd be very careful regarding percents. Even manufacturer's own study is not straightforward enough. If percentages of disorders overlap and they might.. the combined figure of disorders goes 5%+ for 1mg finasteride and progresses way beyond that for 5mg finasteride to 20%+. Now, we all know that 5mg finasteride is not presribed for MPB, but for BPH.. but, the fact also is that a good number of patients takes more than 1mg of finasteride.. even if its just a subtle increase to 1.25mg.. that too adds up to increased risks.

I have faith in both Boston study by Dr. Traish and Washington study by Dr. Irwig. Let's take Washington study & Dr. Irwig's conclusions for example as more detail and numbers are given. He took 71 men, from worldwide, most importantly - previously perfectly healthy guys in their prime age between 21 to 46. I know many propecia promoters tend to blame the old age, saying ED is bound to happen in old age anyway. Well, that argument stands no ground for this group of patients. The results are: 94% developed low libido, 92% developed erectile dysfunction and decreased arousal, 69% developed problems with orgasm, 66% reduction in sexual activity, plus almost all had multiple sexual function problems. I think You'd agree, its outstandingly different percentage results than with manufacturer's study. Further more, Dr. Irwig's conclusion is far from saying that all these side effects are temporary - He says this: "What is known is that unlike the vast majority of drugs, whose side effects cease when you stop taking them, Dr. Irwig explains that “finasteride is different because it can actually change the brain’s chemistry. The enzyme 5 alpha reductase is present in many areas of the brain. It is rare for a drug to have the capability to persistently change the brain's chemistry.”

You said people might loose sex drive because of the fact that they are loosing their hair as well. Sure thing, I agree completely, the major problem with that theory here is that all the patients in Washington study had perfectly good sex drive to begin with. You also said that depression could be caused not by the drug by the fact of the hair loss. True, but these guys had no depression before the propecia treatment started. If it happened, it happened during of after the treatment. If environmental toxins are impacting spermatogenesis, then this would show not only in the after results but would also reflect in a sense that a percentage of problem would show as previous, one that existed before the treatment itself.

Now when I look back I regret taking Accutane to a good extent. But as Nelson Mandela likes to say 'There is no point crying over spilled milk'. Whats done is done and I can't turn back the time. Interesting enough that You mentioned Accutane related wound healing, I know by now Accutane is long gone from my system, but what has it changed inside is that puzzles and worries me. I notice that whenever a have a wound, even a small cut, it takes enormous amounts of time to heal.. weeks, even months, and scars.. I'm never left without a very visible scar.. I take zinc and have full support for the otherwise to happen, yet when I get hurt, its slow healing and scarring is always a must.. rather frustrating to be honest.

You're very welcome, thank You for the list of Your ingredients as well.. its always good to learn more and incorporate more with hope that it will bring in more results I'm desperately aiming for.

[John P. Cole, MD]

Please correct me if I am wrong. Weren't these sexual side effect studies done in clinics devoted to sexual side effects? If so, If so, you have a confluence of symptoms in a home seeking relatives.

i'm no fan of medications in general on a personal level. Treatment is always a personal decision. People make decisions based on prior studies and safety publications. We should be careful discriminating against these individuals based on inconclusive science. They may be taking a proper and safe course. Let me be clear. If you try to confirm most medical studies that appear scientifically sound, you will more than likely be unable to confirm them. You will not be able to prove the null hypothesis in almost all instances. With scientifically unsound studies the probability that you can prove the findings is even more remote. it occurs all the time when drug companies try to confirm studies in Lancet and the like. It is more than acceptable for you to have concerns about the safety of any medication, but that does not mean it it true. I wish I or anyone could give a solid, safe recommendation one way or the other, but this is simply impossible for me or anyone else to promulgate. Keep an open mind, but conform to that which you feel most acceptable for yourself. Express concerns and give references. Let people draw their own personal conclusions. My own personal experience questions whether the benefit is worth the long term potential with finasteride. Many tell me that their hair loss seems to slow down, but i rarely see any significant hair loss reversal. Personally, i think hair loss slows down after any short term exacerbation. When you have a medication where 8 of 10 stabilize, 1 of 10 get worse and 1 of 10 get better, how can you conclusively imply that the 8 of 10 that stabilize due so as a result of medicating with finasteride? You can't? Still i think the decision should be personal simply because the long term risks seem reversible for the vast majority.

[StressedToTheBald]

Well, Dr. Irwig is Director for the University’s Center for Andrology and it also says research was published in Journal of Sexual Medicine, but I can't really say I understand the point. I mean, in what sense does this make the research any less objective ? It feels quite the opposite, with the given expertise in the very area, it can only add up to credibility and objectivity of the conclusions - regarding the subject of propecia induced sexual disorders, and if these disorders are permanent or not.

It is a personal decission. I just believe people should know the risks and know them very clearly.. way too many people are so desperate regarding hair loss, that they would do anything, even if they do not fully understand what the consequences of their choices might be. Had I fully understand those risks in my own adventure with Accutane for example, I could have chosen differently. With propecia risks beeing so serious, I believe the approach from the starts should have been very different, even including the signing of a consent form.. in that sense, people would think twice, knowing that even though the most serious of side effects might not happen, in the case that they do, how devastating they can turn out to be, and what they are signing up for.

With these 2 studies gone public, news going around, lawyers preparing for first class lawsuits and manufacturer's decission to pull down their own website, its all very strong signs the whole perspective regarding this drug is very soon about to change.. Its also a legal thing now, and bureaucracy wise these things take time, but it shouldn't be that far off to imply that propecia might end up banned or the safety & risks labels to be upgraded to highest level.

For me, the more I read both Your thoughts in the last post, and also experiences of patients, the more I doubt that propecia even remotely has the hair regrowth potential as advertised. People here on the forum who praise propecia, tend to share those before & after photos from Bernstain medical website.. but to be honest, even in that best case scenario people haven't achieved full density even after 2+ years on propecia treatment, especially if they had worse case of baldness to begin with. I've recently read here on the forum, way much worse experiences - as an example - one guy took propecia for 5 years and says that it hardly did anything in terms of regrowth, the other guy took propecia for 3,5 years and still has bald spots and Norwood scale pretty much as I have. If it doesn't grow hair in the bald spots, then whats the point to begin with, and with all the side effects.. it doesn't make it remotely attractive solution nor does it feel proven as so often portrayed. I know for many people, even the slowing down of the process might mean something, I feel completely different. For me, its not about keeping what I have - honestly Norwood 3-4 feels devastating enough as it is.. the only thing that makes sense is regrowth and regrowth in the bald spots, and for way too many people not even the gamble with propecia was able to deliever results in that area.

[Follicle Death Row]

It is certainly possible that DHT inhibition through "herbal" remedies could result in similar side effects. Quite honestly, i'm not convinced that DHT alone is the responsible party in male pattern hair loss.

I think you're right. It may only be one part of the puzzle. I think the whole caspase cascade is very complex and to be honest I would not be at all surprised to find out that their is a genetic autoimmune component to it too. We know that under microscopic examination many miniturised follicles appear slightly inflammed. Why couldn't it be like any other autoimmune condition that flairs up at a certain point in your life.

I know they did that study on the pseudohermaphrodites who do not have 5 alpha reductase and there's anecdotal stuff out there about eunuchs but I still think you'd have to wipe out DHT completely to stop the process forever. The idea of a potential autoimmune component intrigues me.

[John P. Cole, MD]

the autoimmune theory might have legs. Recently, a patient with MPB, who had a nice transplant result began to loose his transplanted hair from the traditional donor area. His physician biopsied the grafts. The diagnosis was androgenic alopecia. The biopsy was read by an experienced dermatopathologist. What it means is that grafts from the traditional donor area are not permanent. I've seen it in a very small number of my patients, but it can happen. in other words, the recipient area must have an influence on the grafts of some people, and the most likely mediator would be some sort of autoimmune process though many other possibilities exist.

[StressedToTheBald]

I believe inflamation plays a certain role.. its again back to hormones, I wish someone would make a flash presentation of how exactly DHT behaves and what it does in hair folicles.. how exactly is that DHT kills a hair - does it stop the blood flow and flow of nutrients, or by causing inflamation, or as a combination of all these things.

Some interesting quotes..

"Study conducted on 412 patients (193men and 219 women) showed the presence of a significant degree of inflammation and fibrosis in at least 37 percent of androgenetic alopecia cases.."

"The term ‘microinflammation’ was proposed by Mahe and colleagues because the process of inflammation in androgenetic alopecia adopts a slow, subtle, painless and lethargic course, in contrast to the inflammatory and destructive process that has been seen in the classical inflammatory scarring alopecias."

"Only 55 percent of male pattern androgenetic patients with microinflammation had hair re-growth in response to Minoxidil treatment."

And for us who suffered from acne, and have issues with excessive sebum production.. There might just be a connection..

"According to Mahe, the only apparent link that can be established between androgen metabolism and the complex inflammatory process proposed by him is sebum production, which is controlled by androgens. As sebum harbors a large amount of microorganisms, which use lipids as nutrients, it is possible that, at least for some individuals, androgen metabolism might make possible the colonization of the sebaceous infundibulum and sebaceous ducts by microorganisms. These microorganisms may well be involved in the first steps of pilosebaceous unit inflammation."

[StressedToTheBald]

As for the natural DHT blockers vs. DHT blocking delivered by propecia, I think the problem might be that propecia does it differently, that mechanisms are not the same, and that it does it either too much or affects something else besides just blocking DHT... therefore the side effects are completely different. Studies on beta sitosterol and saw palmetto compared side effects vs. finasteride and report than unlike finasteride these natural DHT inhibitors have NOT shown any significant or permanent side effects.

[ryan555]

As for the natural DHT blockers vs. DHT blocking delivered by propecia, I think the problem might be that propecia does it differently, that mechanisms are not the same, and that it does it either too much or affects something else besides just blocking DHT... therefore the side effects are completely different. Studies on beta sitosterol and saw palmetto compared side effects vs. finasteride and report than unlike finasteride these natural DHT inhibitors have NOT shown any significant or permanent side effects.

The issue is whether or not SP and Beta work to combat hair loss. I am going the natural route these days and am getting ready to add those two to my regimen. I wonder if there is even in value in them.

[StressedToTheBald]

The issue is whether or not SP and Beta work to combat hair loss. I am going the natural route these days and am getting ready to add those two to my regimen. I wonder if there is even in value in them.

60% success rate is reported by the study of beta sitosterol + saw palmetto. Several recommendations suggest giving it a minimum of 6-12 months for visible improvements. Some people have taken beta for more than 2 years..

I am roughly close to end of my 1st month, now combining 510mg of beta sitosterol + 300mg of saw palmetto. I have noticed a few new small hairs on the bald spots where I never remember having any hairs whatsoever. These fine small hairs are indeed small and weak in colour, so in that sense my 1st month is not spectacular, but if these fine hairs continue to appear on other places and even more importantly if their number becomes more significant in following months, that would be a small miracle and good enough as a proof that my natural regimen does work.

[ryan555]

60% success rate is reported by the study of beta sitosterol + saw palmetto. Several recommendations suggest giving it a minimum of 6-12 months for visible improvements. Some people have taken beta for more than 2 years..

I am roughly close to end of my 1st month, now combining 510mg of beta sitosterol + 300mg of saw palmetto. I have noticed a few new small hairs on the bald spots where I never remember having any hairs whatsoever. These fine small hairs are indeed small and weak in colour, so in that sense my 1st month is not spectacular, but if these fine hairs continue to appear on other places and even more importantly if their number becomes more significant in following months, that would be a small miracle and good enough as a proof that my natural regimen does work.

OK, well let's call a truce on the whole finasteride disagreement and compare notes. I have started a regimen of:

- Green tea extract
- Apple cider vinegar (taken orally)
- Pumpkin seed oil
- Biotin
- Inositol
- MSM
- Topical emu oil
- Adding in (1 at a time) - Saw Palmetto, beta sitosterol, stinging nettle, pygeum
- Thinking about resveratrol and circumin

I still wish I could just take a quarter or a half a milligram of finasteride and avoid all this but I cannot take any drugs right now. If this natural regimen works for me I'll be more than happy to stick with it.