We propose that the Dermatologist Society remove from their guidelines the utilization of finasteride for male pattern hair loss., Sexual and Nonsexual Problems after Finasteride Used for Hair Loss in Young Men: American Society for Mens Health, 2014. Cheers. Theoretically, you are going to block the production of hormones that serve very important behavioral purposes. Androsterone worked wonders for me. Int J Trichology. I have tried a few of the a above already alone with no improvement however I think a holistic combination may be the answer. I have had retraction of penis and man boobs. Conducting RNA microarray analysis, 1,446 genes were . HTX Urology website, December 2019. PFS isnt fun. What do you think of TRT is PCT to recover from PFS? Over 60 years ago PEA was found in egg yolks and . Post-finasteride syndrome is an ill defined and controversial syndrome associated with a constellation of sexual, physical, and psychological symptoms that develop during or after finasteride exposure and persist after discontinuation (box 1). I think [Propecia] is a potentially dangerous drug. Im in PFS from February 2018. I am doing a High sensativity blood panel soon, would you be able to also look at my blood work to see what could be the problem with everything i am experiencing?Thanks. Reaction to French medical journal Prescrires annual update of drugs to avoid, March 18, 2021. I do not prescribe finasteride or dutasteride for sexually active patients. This is the first analysis, to our knowledge, of suicidality and psychological adverse events in association with finasteride in VigiBase, an international pharmacovigilance databaseThese findings could raise concern that younger men with alopecia may be especially at risk for suicidality compared with the general populationClinicians should pay greater attention to the psychological adverse effects of finasteride when prescribing them, especially in the younger population using the drug for hair loss. Post finasteride syndrome is so real! While you still dont hear much about it PFS as we call it is something we should at least call attention to [I]ts really important that men are informed about PFS so that they can decide whether or not they actually take finasteride. Epub 2020 Jun 26. With proper testing you know where to focus on. Some people get results, but often only 1 steroid isnt enough. (2009) of 2017. Post-Finasteride Syndrome: Current Views and Where do We Stand? Just wanna ask advice from a casual weed smoker as in vaping on weekends what would be a good supplement/nutritional addition to counter any negative effects? What do you think about proviron and other DHT derived steroids? Clipboard, Search History, and several other advanced features are temporarily unavailable. Yuck. Post-finasteride syndrome is characterized by persistent sexual, physical, and mental health side effects that continue even after stopping the medication. Response (via Twitter) to Rachel S. Rubin, MD, vis-a-vis the clinical study titled Post-finasteride syndrome: An emerging clinical problem, January 2, 2020. Prolonged use of finasteride-induced gonadal sex steroids alterations, DNA damage and menstrual bleeding in women: Bioscience Reports, February 2020. Finasteride blocks the metabolism of testosterone. Ruksiriwanich W, Linsaenkart P, Khantham C, Muangsanguan A, Sringarm K, Jantrawut P, Prom-U-Thai C, Jamjod S, Yamuangmorn S, Arjin C, Rachtanapun P, Jantanasakulwong K, Phimolsiripol Y, Barba FJ, Sommano SR, Chutoprapat R, Boonpisuttinant K. Plants (Basel). Dont let any man you know take that poison! Muscle pain Careers. Statement, via Twitter: December 4, 2022. I have blood and hormones test results if u want. I train a lot, heavy resistance, HIIT, play sport, drink very little. BPH? I will never prescribe finasteride. In 2021, an international group of doctors and researchers published diagnostic criteria for post-finasteride syndrome. cold penis Exploring the neural mechanisms of finasteride: a proteomic analysis in the nucleus accumbens, Psychoneuroendocrinology, October 2016. These constellations of symptoms constitute the basis for PFS in individuals predisposed to epigenetic susceptibility. Considering the thousands of sufferers who already have PFS, the scientific world immediately needs to conduct more research to determine how to effectively treat this horrible symptom complex. I suffered PFS till 4 years with many problems: HCG and erectile dysfunction: can it cause or help ED? What Was the Cause? 2021 Nov;7(6):524-526. doi: 10.1159/000514365. Propeciadiminishes dihydrotestosterone levels and suppresses libido in about 10 percent of men but is much more profound in younger guys Try stopping and using minoxidil instead for hair preservation. In the last decade, concerns have emerged around finasteride, a drug used for treating male-pattern baldness and prostate gland enlargement. As I read websites like yours and CDsNuts. Its awful when a patient doesnt know whats happening, and takes a medication for a specific purpose, but then develops side effects that may be more damaging than its positive effects. The Top 20 Hair Loss Studies of 2020: Donovan Medical (YouTube), December 11, 2020. Only individuals who are born with intersex characteristics (hermaphrodites) have low levels of this hormone. Men reporting Post-Finasteride Syndrome experience side effects that persist after stopping finasteride or other 5-alpha reductase inhibitors. Updated Review of the Hair Loss and Prostate Drug Finasteride: Worst Pills, Best Pills, January 2020. Can take a year to improve. To date there are no predictive factors for the risk of development of post-finasteride syndrome and no known treatment for the disorder. Yes, in general its safer with less sides, but some people have reported similar side effects as fin. THC has been shown to increase brain pregnenolone, but this study shows that cannabis users have higher pregnanolone (a 5-metabolite) and lower allopregnanolone (a 5-metabolite) (, Get lots of sunlight, especially in the morning. It is frequently marketed as androgen deprivation therapy for treatment for male pattern baldness. Hi Gary, Winston-Salem, NC, Ross J. Baldessarini, MD, Professor of Psychiatry, Quoc-Dien Trinh, MD, Associate Professor of Surgery, Wexner Medical Center, Ohio State University, Govinda Healthcare Medicentre, New Delhi, India, Associate Professor of Urology University of Arizona, University of Miami Miller School of Medicine, Omer Onur Cakir, MD, Department of Urology, Bagcilar Training and Research Hospital, Istanbul, Turkey, Pelita Harapan University Faculty of Medicine, Tangerang, Indonesia, Shelly Gray, PharmD, Shirley & Herb Bridge Endowed Professor, University of Washington School of Pharmacy, YOU & WEE Urologic Surgery & Wellness, Sarasota, FL, Faysal A. Yafi, MD, Associate Professor of Urology, University of California, Irvine Medical Center, Naeem Bhojani, MD, Associate Professor of Urology, Andrology Fellow, Northwestern University, Wedad Saeed Al-Qahtani, Assistant Professor, Naif Arab University for Security Sciences, Riyadh, Saudi Arabia, Abdulmaged M. Traish, PhD, Professor of Biochemistry and Urology, Mark A. Moyad, MD, Director of Preventive & Alternative Medicine, University of Michigan Department of Urology, Abdulilah Al Malik, Regulatory Affairs Director, Saudi Arabia, The Psychiatric Institute, University of Illinois at Chicago, Douglas G. Adler, MD, Professor of Medicine, Medical Director, Sperling Prostate Center, Serrate & Ribal Institute of Urology, Barcelona, Roberto Melcangi, PhD, Head of Neuroendocrinology, Department of Pharmacological and Biomolecular Sciences, Silvia Diviccaro, PhD, Post-Doctoral Fellow, Department of Pharmacological and Biomolecular Sciences, Irwin Goldstein, MD, Clinical Professor of Surgery, University of California at San Diego, Editor-in-Chief, The Journal of Sexual Medicine, Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, Krohnstiegcenter Dermatology Center, Hamburg, Germany, Glickman Urological and Kidney Institute, Cleveland Clinic, Hospitalist, UAB Medicine, Birmingham, AL, Andrea Militello, MD, Urologist/Andrologist, Department of Urological, Biomedical and Translational Sciences, Federiciana University, Michael Zitzmann, MD, Andrology Professor, Michael Carmone, MD, Director, Health Research Group, Dietrich von Herrath, MD, Chief Physician, Steven M. Belknap, MD, Research Assistant Professor of Dermatology and Medicine, Northwestern University Feinberg School of Medicine, Marcel Waldinger (1955-2019), MD, PhD, Professor, Department of Pharmacology, Shalendar Bhasin, MD, Professor of Medicine, Alex Tatem, MD, Fellow in Andrology, Male Fertility and Microsurgery, Department of Urology, NYU Grossman School of Medicine, Franois Desgrandchamps, MD, PhD, Chief of Urology, Bernard Bgaud, MD, Professor of Pharmacology, Carla Di Loreto, PhD, Experimental and Clinical Medical Sciences, Nelson Novick, MD, Clinical Professor of Dermatology, Charles J. Ryan, MD, Distinguished Professor of Clinical Medicine and Urology, Jan Tytgat, PhD, Professor of Toxicology and Pharmacology, Erika Cecchin, PhD, Researcher in Clinical and Experimental Pharmacology, Donatella Caruso, PhD, Professor of Pharmacology and Biology, Ralph M Treb, MD, Proefssor of Dermatology, Center for Dermatology and Hair Diseases, Zrich, Sabina Cauci, PhD, Medical and Biological Sciences, Christine A Ganzer, PhD, Assistant Professor, Silvia Giatti, PhD, Pharmacological and Biomolecular Sciences, Bruhin & Associates Psychotherapists, San Diego, California, Professor of Urology, Feinberg School of Medicine, Carlo Trombetta, MD, Head of Department of Urology, Dirk Michielsen, MD, Professor of Urology. 200 mg of pregnenalone per day. Before An observational retrospective evaluation of 79 young men with long-term adverse effects after use of finasteride against androgenetic alopecia. If youve already done blood tests and want to learn how to interpret them, check out these articles: If DHT is high, then you dont have to focus on boosting DHT, but maybe rather allopregnanolone through increasing 5-AR type 1. Epub 2016 Jan 13. Well, SSRI drugs almost never only inhibit the reuptake of serotonin, but they often also increase allopregnanolone, decrease serotonin receptor sensitivity, block certain serotonin receptors, release dopamine and histamine, etc. [T]here has been a Red Hand Letter for this drug since 2018. I have patients who come in to see me for sexual problems. By reducing DHT so drastically, effects can occur in the genital tissues and in the brain. Delusional disorder of the somatic type; Dutasteride; Finasteride; Histrionic personality disorder; Post-finasteride syndrome. The proportion of men taking 5ARIs and experiencing erectile dysfunction is likely around 5 percent. Statement via Twitter, February 10, 2022. Also do you recommend an androsterone supplement, I havent heard of that option so far. Essentially, the cells get too much DHT, it puts them in overdrive and it burns them out. This study reinforces the importance of considering the long-term effects of finasteride use on DED as part of the systemic sequelae of androgen depletion and provides anticipatory guidance for patients and ophthalmologists. Any other advice that would help is greatly appreciated. OK to keep taking: 17.5% Usually its ED. But unfortunately, in some men, the damage is hardwired. Sure I can do that for you. So lets discuss what the drug, finasteride, does in the first place. To date, there are no evidence-based effective treatments for PFS. If a patient treated with 1 mg finasteride develops psychiatric symptoms, treatment should be stopped. no libido : June 21, 2022. Unable to load your collection due to an error, Unable to load your delegates due to an error. wow very helpful articular and explains my symptoms exactly. Sure man. Epub 2018 Oct 6. Finasteride and Suicide: A Postmarketing Case Series: Dermatology, January 14, 2020. Patients and doctors remain largely unaware of the long-term consequences of this drug on the nervous system and mental health. Unauthorized use of these marks is strictly prohibited. In some patients the treatment is associated with adverse side effects that could become persistent after therapy discontinuation, resulting in the so-called post-finasteride syndrome (PFS). Decreasing the dosage strength is unlikely to reduce the risk of PFS. Here are a few good ways to increase dopamine: For more a comprehensive guide on boosting dopamine, check out this article: If dopamine is low, then prolactin will most likely be high. Response (via Twitter) to query by Harrison Kalodimos, MD: What are some atypical medication side effects that you have seen in practice and look out for now on a regular basis? April 1, 2021. Men exposed to finasteride or dutasteride are also at risk of developing post-finasteride syndrome, which is characterized by a constellation of symptoms, including some that are sexual (reduced . Le Figaro, March 3, 2019. Taking Propecia or Proscar to Prevent Hair Loss is Associated with Depression, Anxiety, and Sexual Problems: National Center for Health Research website, 2021. Acufene A low estimated prevalence of PFS cannot be an excuse for nonvigilance since the drug is used by millions of relatively young and healthy individuals.". All healthcare providers should learn about these conditions as finasteride/SSRIs are commonly prescribed. Maybe you think Im exaggerating. I have personally seen in my practice otherwise completely healthy young men who come in for ED and the only medication they had taken was finasteride for hair loss. [O]ur results showed that [finasteride] treatment affected the expression of a number of accumbal proteins involved in key functional processes, such as regulation of GABAergic neurotransmission, as well as steroid and pyrimidine metabolism. Swiss TV network SRF, May 7, 2018. At the same time, a recent study demonstrated changes in the levels of certain steroids in cerebrospinal fluid of men taking finasteride for hair loss. Agreed. Li X, Guo Y, Lu Y, Li H, Yan S, Li H, Li Y. Transl Androl Urol. Transdermal substitution of dihydrotestosterone led to an improvement in sexual symptoms in two placebo-controlled studies. Before It is important to note that many clinical studies suffer from incomplete or inadequate assessment of adverse events and often limited or inaccurate data reporting regarding harm. Episode 18. Post-Finasteride Syndrome Exists!! Finasteride-induced Infertility (English translation): Der Arzneimittelbrief (The Drug Letter), November 2013. Sex Med. My hypothesis is that finasteride can cause brain damage which needs to be reversed. . Reggie told me that sometimes he got confused for no reason and he felt tired all the time. Punk?. Ive made a 80% recovery so far and I keep improving however your hypothesis is quite scary. HHS Vulnerability Disclosure, Help Lets say your DHT is low, here are the top 7 supplements you can use to increase it: If you want additional methods on increasing DHT apart from supplements, check out my comprehensive article on boosting DHT: If DHT is normal and you still feel off, mainly anxious, not confidence, shy, nervous, experiencing brain fog, etc., you might be low in allopregnanolone. HCG will increase progesterone or will decrease it? Zhang JJ, Shi X, Wu T, Zhang MD, Tang J, Yin GM, Long Z, He LY, Qi L, Wang L. Asian J Androl. These drugs are poison. The concept of PFS has emerged from reports of non-dermatologists, neuroendocrinological research and reflections, and uncontrolled studies of low quality and with a strong bias selection, while a significant nocebo effect among patients informed about possible side effects of finasteride is recognized. really have been feeling like an empty husk like described lately, almost like a part of me was ripped out, but maybe one day i can find it again. Seems that almost half of urologists instruct their patients to stop finasteride! I have patients ask about [finasteride] all the time and I always discuss the risks of sexual dysfunction at length but its amazing how many guys seem not to care. An official website of the United States government. Finasteride is a 5-alpha reductase inhibitor and this blocks the conversion of testosterone to DHT. This is how the National Institutes of Health refers to Post-Finasteride Syndrome, and there is a specific reaction type in FAERS which can be selected. What Was the Cause? Propecia was approved in 1997 as a solution to slow male pattern baldness. So thankful to have found this article. We probably dont have the precise data wed need to answer that. What is post-fin syndrome anyway? We are certainly very cautious, because we see the side effects [of finasteride]. sharing sensitive information, make sure youre on a federal Some have petitioned the FDA to include post-finasteride syndrome as a boxed warning. This is the most serious warning given about a medication. There is no cure or treatment . And I have to use huge amounts of testosterone to overcome this drug. The effects in the brain of finasteridehave been poorly explored. They have flat emotions. Even if you take just a little finasteride, it can actually drop your DHT so low that men become impotent. Thanks for helping people with this truly debilitating syndrome, in my case I was an othewise healthy active 66 year old that was prescribed Dudasteride for an enlarged prostate 3 months ago , after 7 weeks I stopped taking the drug and within several days I came down with a host of symptoms. Biomolecules. Increasing carbon dioxide production. [A]pproximately 30 million young men, worldwide, would be prescribed finasteride or dutasteride to treat male pattern hair loss. And thats huge. Do Anti-Baldness Remedies Make You Impotent? MeSH DHEA potently increases androsterone levels, and that is how its thought to lower anxiety. The https:// ensures that you are connecting to the They barely help LUTS, cause bad sexual side effects, cause false reassurance in those with an elevated/rising PSA, and now this. Reaction (via Twitter) to publication of the study Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride, in JAMA Dermatology, January 19, 2021. Until the actual pathophysiology of PFS is determined and effective therapies are discovered, we all have to think twice before prescribing a 5ARIs for our patients with either BPH and/or AGA. My biggest issue is low/no libido. Keep me posted if you like. Do tests to see pregnenolone, progesterone, testosterone, DHT, thyroid (TSH, total and free T4 and T3, rT3), estradiol, estrone-sulfate and cortisol (both blood and 24h saliva). Healthcare Professionals should carefully monitor patients during treatment with finasteride for psychiatric symptoms (including anxiety, depression and suicidal ideation). Find support. Do you have any digestive issues? The authors declare no conflicts of interest. Post-finasteride syndrome (PFS) is still controversial in the medical world. In December 2018, I treated scar (not his real name), a 28-year-old man who was distressed by a number of symptoms associated with finasteride, a drug he had been taking for 12 months for alopecia, as prescribed by his dermatologist. [Propecia] is a scary drug and we have no idea who might be affected worse by it. You dont have to be a genius to realize that, when youre taking away the most potent form of testosterone, and youre affecting, for example, ejaculate volume, clearly something is changing around the prostate area. What is Post-Finasteride Syndrome? Good hypothesis! HCG will most likely increase progesterone, but hopefully, it can stimulate 5AR which will increase allopregnanolone. Chronic insomnia , I am now taking Trazodone which helps me get to sleep, I also have myoclonic twitches and brain zaps while trying to fall asleep and my auditory system is super sensitive any small noise at night makes my me jump even when wearing ear plugs. Although, they would like you to believe testosterone replacement is the only solution to make a full recovery. The most frequent non-sexual symptoms were reduced feeling of life pleasure or emotions (75.9%), lack of mental concentration (72.2%) and loss of muscle tone/mass (51.9%)Further studies are necessary to investigate the pathophysiological and biochemical pathways leading to the post-finasteride syndrome. Then, when people are coming back and saying they have libido issues, those are relevant. ). These observations encouraged the present systematic review of the research literature pertaining to changes in mood and possible increases in suicidal ideation and behavior in association with or following treatment with finasteride This systematic review of reports concerning adverse psychiatric effects of finasteride treatment supports the conclusion that such treatment is significantly associated with risk of clinical depression, as well as high rates of sexual dysfunction and evidence of increased risk of suicidal ideation and perhaps of suicidal behavior. But that warning isnt prominently featured. For those who argue that there is no data to support thisAs the saying goes, the absence of evidence is not the evidence of absence. When prescribing antidepressants, the advantages and disadvantages must be carefully weighed, as some antidepressants may improve the symptoms of depression but have an unfavorable effect on sexual function. It shows a much higher signal in comparison with other drugs used for alopecia or suspected to affect mood Im surprised the FDA has not done these simple comparisons to explore safety signals for finasteride. 8600 Rockville Pike The use of Finasteride (Proscar) for the prevention of cancer is limited since it only prevents the harmless type of prostate cancer (the SKY Stage.) BPH? 2019 Apr;7(2):277-282. doi: 10.1016/j.sxmr.2018.07.003. I have seen some cases of post-finasteride-syndrome that do not revert to anything. In 2017, the European Medical Agency recommended adding warnings of potential risk of suicidal ideation to product information for finasteride. Use of 5ARIs for treatment of AGA may lead to persistent sexual, genitourinary, physical, psycho-cognitive, and anti-androgenic sequelae even after cessation of 5ARI therapy Two subjects (8%) committed suicide during or after the study. MeSH I found some recovery stories with these compounds. Seen this far too often to doubt that its real. Hi, no I dont have insomnia. How do you explain that? There are serious side effects that need to be considered! Post-finasteride syndrome is leaving behind a slew of victims in its trail. If you stop with fin, then DHT should be back to normal in about 1-2 weeks (tissue binding lasts 4-5 days). Pharmacological treatments, including finasteride and oral contraceptives, that inhibit 5-RI, which results in a blood and brain allopregnanolone decrease also affect subunit expression of GABAA receptor and are associated with mood symptoms and suicide and are part of post-finasteride syndrome. Sex Med Rev. Some say it's all in the mind, a made-up mythbut those who suffer from it surely know they're not just a hypochondriac. Do you generally feel overstimulated and suffer from insomnia? Maybe not atypical, but anxiety/panic due to finasteride. Are you sensitive to dietary fats and have greasy stool with fat floating on the surface of the water after pitching a loaf? Any idea why that may be? Aim: To determine whether (CAG)n-rs4045402 and (GGN)n-rs3138869 polymorphisms in the androgen receptor (AR) gene are implicated in PFS. Optimize thyroid. Is This Hair-loss Drug Dangerous? I got Post Accutane Syndrom, which is related to PFS, there is a down regulation of 5 alpha reductase 1. For the first time, we demonstrate a tissue-specific methylation pattern of SRD5A2 promoter in PFS patients [which] could represent an important mechanism of neuroactive steroid levels and behavioral disturbances previously described in PFS The SRD5A2 promoter was more frequently methylated in the CSF of PFS patients compared to controls (56.3 versus 7.7%). Importantly, adverse effects associated with finasteride can persist even after discontinuing its use, leading to what has been termed post-finasteride syndrome, including sexual, physical, and psychiatric symptoms, including depression, anxiety, cognitive impairment, and suicidal ideation. [T]his represents the largest demographic study over 15 years of [dry eye disease] patients on finasteride, demonstrating an association with finasteride usage and [meibomian gland dysfunction], conjunctival, and corneal abnormalities. [T]here is no known treatment for lifelong PFS. Neurosteroids such as 5-DHP and allopregnanolone stimulate neurogenesis, neuronal survival, neuronal differentiation, synaptogenesis, glial differentiation, myelin formation, synaptic function, and synaptic plasticity (, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to share on Reddit (Opens in new window), Click to share on Tumblr (Opens in new window), Click to share on WhatsApp (Opens in new window), The complete guide to maximizing testosterone production to, Improve liver function for a faster metabolism, higher, Why Omega 3 should be avoided and what to use/do instead, How to Optimize Sleep for better Life Performance, 60 Best ways to lower Serotonin (2020 update), Maximize dopamine and live life on cloud nine with laser, How to interpret your testosterone blood results, How to interpret your cortisol test results, How to interpret your thyroid test results, Top 12 must-eat foods to increase testosterone, https://www.amazon.com/product-reviews/B004PVLWW0/ref=acr_dp_hist_2?ie=UTF8&filterByStar=two_star&reviewerType=all_reviews#reviews-filter-bar, From frail and hypogonadal, to gaining 60lbs of muscle, boosting testosterone over 1,000ng/dl and becoming a successful entrepreneur, Apigenin dosage for testosterone: tea is not enough, Bee pollen for erectile dysfunction: the natural sexual booster. The longer they take it, the greater the risk of experiencing persistent side effects, including after theyve stopped. Accordingly, Health Canada and the UAE Ministry of Health recommend that companies that produce products containing [finasteride] add the above-mentioned warning to the internal leaflet of their products. New Information about Post Finasteride Syndrome (PFS) October 2, 2016 At this year's ISHRS meeting in Las Vegas, Dr. Alan Jacobs a neuroendocrinologist at Duke University School of Medicine spoke on the topic of Post Finasteride Syndrome (PFS).
