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|Dosage range:||Oral: 1mg - 5mg|
|Brand names:||Proscar, Propecia|
I'm growing pretty concerned about finasteride. It seems to increase the risk of high Gleason-score (aggressive, dangerous) prostate cancers, even though it reduces the risk of low-grade ones. In fact, it was unanimously rejected by the FDA for treatment of prostate cancer.
It's also implicated in Post-Finasteride Syndrome, which can cause:
- Lowered sex drive.
- Reduced energy.
- Brain fog / depression.
The 5α-reductase enzyme is responsible for the production and lifecycle of many crucial neurosteroids such as progesterone and allopregnanolone. Finasteride blocks this enzyme. In trans health, finasteride is used to block the metabolic conversion of testosterone to Dihydrotestosterone, which has a higher binding potency.
Unfortunately, the machine that finasteride *breaks* is how these natural, mind-helping steroids are produced and interconverted!
Why long-term side effects happen
There are only three brands *(isoforms)* of this enzyme. Each has a different structure, and plugs into different things with different adapters. Since finasteride blocks 5-AR forms 2 and 3, the cells decide to replace it with 5-AR form 1 instead. This is really bad news, because that isoform *simply wasn't designed* to work in those other gene regulatory circuits! This could be the reason behind PFS and the increased cancer risk.
Finasteride has demonstrated long-term effects well after discontinuation, so this may even be *irreversible.* Isoforms 2 and 3 don't get manufactured again once you withdraw the drug. Your cells keep churning out isoform 1!
I highly recommend everyone start pressing their doctors for answers about finasteride. Don't trust it. The doctors *simply don't know this research.*
Effects on hormone levels
- (December 2017) Negative Impact of Testosterone Deficiency and 5α-Reductase Inhibitors Therapy on Metabolic and Sexual Function in Men.
- (October 2017) Therapeutic experience with oral finasteride for androgenetic alopecia in female-to-male transgender patients.
- (July 2017) Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients.
- (March 2016) Opposite effects of dihydrotestosterone and estradiol on apoptosis in the anterior pituitary gland from male rats.
- http://ir.uiowa.edu/cgi/viewcontent.cgi?article=1053&context=fmrc | Transgender Health Primer
- Traish AM, Hassani J, Guay AT, Zitzmann M, Hansen ML. Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients. J Sex Med. 2011 Mar;8(3):872-84. https://doi.org/10.1111/j.1743-6109.2010.02157.x
- Handbook of Drug Interactions: A Clinical and Forensic Guide (2011) p. 656
- Joseph M Unger et al (2018). "Using Medicare Claims to Examine Long-term Prostate Cancer Risk of Finasteride in the Prostate Cancer Prevention Trial". JNCI: Journal of the National Cancer Institute. 110 (11): djy035. doi:10.1093/jnci/djy035. PMID 29534197. ISSN 0027-8874.
- Lynn Drake et al (1999). "The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia". Journal of the American Academy of Dermatology. 41 (4): 550–554. doi:10.1016/S0190-9622(99)80051-6. PMID 10495374. ISSN 01909622.
- "FDA Drug Safety Communication: 5-alpha reductase inhibitors (5-ARIs) may increase the risk of a more serious form of prostate cancer". Retrieved 2018-03-07. https://www.fda.gov/Drugs/DrugSafety/ucm258314.htm