Propecia and my Liver tests -- any red flag?

[bayareaht]

All,

 

I have been on Propecia (or the generic equivalent of it made by Cipla, India) since June, 2003.

 

However, something had me worried recently. Please take a look at the following data -

 

Date Propecia Started - 6/2003

 

Date of Test - 1/8/2004 ALT - 53 (Propecia Daily)

 

Date of Test - 1/6/2006 ALT - 56 AST - 33 (4 times a week)

 

Date of Test - 3/8/2006 ALT - 47 AST - 29 (4 times a week, none before 2 days of test)

 

Date of Test - 5/21/2006 - CT-Scan - Fatty infiltration of Liver

 

What I gather from my Doctor is elevated ALT / AST and fatty liver is somewhat common. Though it makes me think Propecia has something to do with it.

 

At the same time, after making significant investment after two HT surgeries -- and obtaining wonderful results - I'll be sad to see my hair go! But if it comes between liver (or any other organ) and hair -- I know what I will choose!

 

I do not smoke, drink very occassionally and always moderate about it (was a heavy drinker in my 20s but!), has a healthy lifestyle (workout 3-4 times a week, no significant stress etc).

 

Can you shed some light on (long-term) impact of Propecia on Liver?

 

I read about the "3-page report" Merck has on Propecia's effect on Liver.

 

http://www.baldingblog.com/2005/05/03/propecia-and-liver-disease-follow-up/

 

It says -

 

"A liver adverse effect has not been listed in the clinical trials of the drug for hair loss treatment. The drug itself is broken down by the liver, so decreased liver function will directly impact the rate at which the drug is metabolized by the liver and will keep serum levels higher in people known to have decreased liver function. In other words, the ability of the liver to clear this drug from the body may cause the serum levels to be higher than on someone without liver disease. There has been no study performed on the effects of hepatic insufficiency for Finasteride pharmacokinetics. Also, a search of the medical literature did show a rise in liver enzymes in one of 14 subjects studied in healthy volunteers (Shimazaki and Nose). One case of hepatitis induced by Finasteride was reported in a patient with many organ problems including a high alcohol intake. The inability to find another cause for the hepatitis on this patient led the doctors to believe that this drug may have been the cause for the liver disease on this one patient. When the drug Finasteride has been used with Flutamide, there was some impact possibly inducing liver disease."

 

All my research indicates that there's nothing to be seriously worried about either fatty liver or elevated ALT -- but I'm worried how this will impact my health in the long term (say, 10 years from now).

 

I'm giving it a serious thought to either reduce the dosage (2-3 times a week) or totally stop it.

 

I recently experienced some (right-sided) abdominal pain (possibly from Epididymitis / spasm caused by heavy lifting) that also radiated to my testicles and lower back. I got tested for blood, testicles, urine etc. several times - but there was nothing else wrong. So the Doctor ordered CT-SCAN and all they found was fatty liver. As you can see, I have a high level of ALT from Jan 2004 -- and never experienced something similar; so the pain might be from weight lifting as the doctor(s) have suggested.

 

I will be interested to hear your opinion.

 

 

Any other Propecia user got AST / ALT or Liver Panel tested? How does the result look?

 

Thanks,

 

B

[bayareaht]

All,

 

I have been on Propecia (or the generic equivalent of it made by Cipla, India) since June, 2003.

 

However, something had me worried recently. Please take a look at the following data -

 

Date Propecia Started - 6/2003

 

Date of Test - 1/8/2004 ALT - 53 (Propecia Daily)

 

Date of Test - 1/6/2006 ALT - 56 AST - 33 (4 times a week)

 

Date of Test - 3/8/2006 ALT - 47 AST - 29 (4 times a week, none before 2 days of test)

 

Date of Test - 5/21/2006 - CT-Scan - Fatty infiltration of Liver

 

What I gather from my Doctor is elevated ALT / AST and fatty liver is somewhat common. Though it makes me think Propecia has something to do with it.

 

At the same time, after making significant investment after two HT surgeries -- and obtaining wonderful results - I'll be sad to see my hair go! But if it comes between liver (or any other organ) and hair -- I know what I will choose!

 

I do not smoke, drink very occassionally and always moderate about it (was a heavy drinker in my 20s but!), has a healthy lifestyle (workout 3-4 times a week, no significant stress etc).

 

Can you shed some light on (long-term) impact of Propecia on Liver?

 

I read about the "3-page report" Merck has on Propecia's effect on Liver.

 

http://www.baldingblog.com/2005/05/03/propecia-and-liver-disease-follow-up/

 

It says -

 

"A liver adverse effect has not been listed in the clinical trials of the drug for hair loss treatment. The drug itself is broken down by the liver, so decreased liver function will directly impact the rate at which the drug is metabolized by the liver and will keep serum levels higher in people known to have decreased liver function. In other words, the ability of the liver to clear this drug from the body may cause the serum levels to be higher than on someone without liver disease. There has been no study performed on the effects of hepatic insufficiency for Finasteride pharmacokinetics. Also, a search of the medical literature did show a rise in liver enzymes in one of 14 subjects studied in healthy volunteers (Shimazaki and Nose). One case of hepatitis induced by Finasteride was reported in a patient with many organ problems including a high alcohol intake. The inability to find another cause for the hepatitis on this patient led the doctors to believe that this drug may have been the cause for the liver disease on this one patient. When the drug Finasteride has been used with Flutamide, there was some impact possibly inducing liver disease."

 

All my research indicates that there's nothing to be seriously worried about either fatty liver or elevated ALT -- but I'm worried how this will impact my health in the long term (say, 10 years from now).

 

I'm giving it a serious thought to either reduce the dosage (2-3 times a week) or totally stop it.

 

I recently experienced some (right-sided) abdominal pain (possibly from Epididymitis / spasm caused by heavy lifting) that also radiated to my testicles and lower back. I got tested for blood, testicles, urine etc. several times - but there was nothing else wrong. So the Doctor ordered CT-SCAN and all they found was fatty liver. As you can see, I have a high level of ALT from Jan 2004 -- and never experienced something similar; so the pain might be from weight lifting as the doctor(s) have suggested.

 

I will be interested to hear your opinion.

 

 

Any other Propecia user got AST / ALT or Liver Panel tested? How does the result look?

 

Thanks,

 

B

[bayareaht]

Just bumping this up. Any advice?

 

Another question -

 

Anybody taking Prozac and Propecia together?

[Guest]

Isn't the transplanted hair not directly affected by DHT?

 

 

Ever experience mood swings as a result of finastride?

[bayareaht]

Well, I stopped Propecia for last 5-6 weeks, and have experienced anxiety, mood swings and depression. I started 0.5 mg Propecia from y'day. Let's see how it goes. While on Propecia for last 3 years-- never had mood swings. I was rather upbeat, confident and much less worrying person all the while!

[thinkingaboutit]

besides stopping propecia during this time frame, did you begin taking or stop taking other medications?

 

Were there any extenuating circumstances in your life that might have induced extra stress?

 

Have you spoken directly with your doctor about this issue and have you considered cutting back your propecia intake to every other day?

 

I would also be curious about your diet. Do you consume a lot of high-fat or sodium foods?How much fresh fruit and juices do you consume daily?

 

Are you carrying a little extra weight in the abdominal area?

 

Things to consider.

[tkerr22]

One thing I read about on some other sites that people had complained about while taking propecia was anxiety and mood swings. I have taken propecia for about 5 years and never had any of this till last year. Over the last year have had stress about work and where I live and have had mood swings come and go and have had a decent amount of anxiety. Not sure what is up but am looking to cut back to propecia every other day to see if that helps some. I skipped a night of taking it the other night and the next day my anxiety was way down. So am not sure what to do, I know I will ask Dr. Alexander about this next week when I have my HT but does any one else have experience with this? Any suggestions on maybe what time of day is best to take propecia? I have always taken it before bed....so throw out the opinions and experiences please. Thanks!!

[bayareaht]

Thanks for the replies. Here's the timeline that should answer the questions raised-

 

(1) June 2003 - Propecia starts. 1mg a day.

 

(2) July 2003 - 1st HT done. Tremendous boost in

self-esteem and confidence.

 

(3) Nov 2004 - 2nd HT done. Mentally stable. Never stressed or under anxiety. All the time under serious physical exercise (3-4 times a week weight training) and healthy high-protein diet.

 

(4) Nov 2005 - Propecia cut down to 4 days a week. Physically and mentally healthy. Physical check-up turns out perfect except elevated ALT (Liver enzyme!)

 

(5) May 2006 - Propecia 3-4 times a week. Develop right abdominal pain that radiates to testicles and lower back. Frightened, stops propecia.

 

(5) May 2006 - CT-scan and other tests suggest everything is fine, except a bit of fatty liver.

Still the abdominal pain is on and off. Was put into anti-biotics for 2 wks just in case it were some infection.

 

(6) June 2006 - Still off propecia. Worrying about the pain and health continues. Off any physical activity for 6 wks.

 

1st panick attack ensues. Had several followed.

 

After string of tests, heart etc was found to be fine. Dr. advises Prozac.

 

Conditions slightly improved. But still experiencing a lot of anxiety et al.

 

I somehow think stopping Propecia had some effect on the whole thing.

 

Or, being a very health conscious person I just was overly-stressed and worried about my abdominal pain (which could be a muscle pull or coming from stress itself!). -and invited anxiety disorder!

 

Anyways, aside from seeing whole bunch of specialists (urologist, PCP, ER) -- I am going to see Dr. Rassman next week.

 

Thanks,

 

B

[bayareaht]

BTW, I've told doctor that I stopped Propecia. She doesn't think much about Propecia being involved in any of the issues!

 

Still I am thinking to start 0.5 mg a day - just to see if conditions improve.