For those on or considering starting finasteride therapy

[zenmunk]

I've been on propecia for 13 years. That's finasteride 1mg/day. I've rarely missed a day. I've experienced no observable sides (except a slight reduction in semen viscosity) - libido has not decreased and no ED. Also, I've maintained virtually all of the hair I had when I first started the meds.

 

Recently, I went to my urologist to undergo a series of medical tests to see if I'm doing OK in areas where finasteride use may adversely affect my body in less observable ways. Although everyone is different, I thought you might find it interesting to view the results of a long-term finasteride user:

 

- GU exam (Male Genitourinary exam): normal phallus and testes.

 

- Ultrasound of testes: normal

 

- Ultrasound of bladder: normal

 

- Ultrasound of kidneys: normal

 

- Urinalysis: negative for infection, flow normal

 

Bloods:

 

Liver function tests (LFTs): all within normal range

Testosterone, serum: within normal range

Testosterone, free: within normal range

Thyroid profile: within normal range

Estradiol, serum: within normal range

Follicle-Stimulating Hormone (FSH): within normal range

Prolactin: within normal range

Lutenizing Hormone (LH): within normal range

Sex hormone-binding globulin (SHBG): within normal range

PSA: within normal range

DHEA: slightly below normal range

 

Semen Analysis: all normal

 

 

So, DHEA is the only area of concern. Cortisol (stress hormone) and DHEA are like two ends of a see-saw - when one has long-term stress or anxiety, Cortisol spikes and DHEA levels fall. For the past 2+ years I've been under the greatest psycho-emotional stress of my life which may explain the decreased DHEA levels.

 

I've started a program to reduce stress/anxiety - increased exercise, daily meditation, reducing caffiene intake significantly and a low-glycemic diet balanced in protein, healthy fats, and complex carbohydrates like vegetables, eaten as smaller meals more frequently (5-6 small meals/day). I plan to re-test for DHEA in 3 months. If it's still abnormally low, then I will test for Pregnenolone (blood), Progesterone (saliva) & 4x per day Cortisol (saliva).

 

I've read claims online that there is a connection between finasteride use and low DHEA, but I have no idea how scientifically accurate that is. I will ask my urologist if he's familiar with such a connection, but perhaps an endocrinologist would be a better doctor to ask. Of course, if anyone on the forum has valid scientific evidence regarding this connection, then I welcome your input.

 

I'll keep the community posted with my progress.

Edited November 15, 2011 by zenmunk

[TakingThePlunge]

zenmunk,

 

That's great news and I'm sure it will be a value to many members. Thank you for sharing your results.

[Sean]

Zenmunk, I saw your post on the other thread in response to my concerns about finasteride use. You wrote, "Sean,

 

I've been taking propecia for 13 years. The following post may interest you:

 

For those on or considering starting finasteride therapy

 

The only change is, instead of saliva, my doctor recommended blood tests for Progesterone & Cortisol (am & pm). If/when I get the tests done for Pregnenolone, Progesterone & Cortisol, I will update the above post."

 

As always you have highly informative posts and I want to thank you for sharing such awesome information. I never had concerns before but that thread and those youtube videos had me thinking since I haven't used propecia long term. You have used it for many years and everything seems to be normal. I am going to continue taking it as I don't see any serious sides from it. Your information has been very helpful and has reassured me. I just went through GU exam/ultrasound and blood tests a week ago. Everything seems normal and within range too.

 

If it has worked so well for you for 13+ years and the tests show nothing serious at all after such a long time, then I guess it is safe to say that there could be other underlying causes that may cause issues in those people that speak of serious side effects from propecia. I have yet to meet a person that had serious side effects other then the 2-3 or so members that wrote against its use. I know some friends and family members that are taking finasteride and they too did not complain of any side effects.

 

This is a valuable post and I can't wait to read your updates.

[zenmunk]

Sean,

 

I'm glad you've found my post reassuring. All I can say is everyone is different. What works for one person may not work for another. It all comes down to the willingness to experiment. It involves risk. How much risk will vary from person-to-person. I think that there is sufficient evidence that finasteride is a relatively safe drug for the majority of people. However, there may always be a smaller group of people who will suffer from having tried it. And, of course, it's possible some ex-fin users are mistakenly attributing symptoms from unrelated illnesses to finasteride use.

 

I'm not completely out of the woods yet since my DHEA levels are a little low. It may or may not be related to finasteride. Given my stress levels over the past couple years I'd say odds are pretty good it's not finastride-related. I'm re-testing DHEA in 3 months and, if necessary, testing Pregnenolone, Progesterone & Cortisol levels. I'm being extra thorough. I'm not advocating that others follow suit. It's just what works for me to have some peace of mind while on the meds. Also, all this testing is HT-related. In the less-than-likely event that finasteride is causing me problems on a hormonal level, then I will discontinue use and not get a HT. For me, it's not worth getting a HT w/o meds.

 

I'll definitely keep the community posted since there probably aren't that many members who have consistently been on the meds as long as I have, and it may be of use. All the best to you.

 

Z

Edited January 16, 2012 by zenmunk

[gasto]

Thanks for sharing, definitely informative.

[zenmunk]

As promised, I'm giving an update on my finasteride-related bloodwork:

 

1) I re-tested DHEA. I did the more comprehensive kind of DHEA test that requires fasting and a one week wait before results are in. I'm happy to report that the levels are now well within the normal range. I cannot say what accounts for the change. Perhaps my efforts to de-stress and change my lifestyle, as illustrated in an earlier post in this thread, have done the trick. Regardless, it's pretty clear that finasteride was not the culprit.

 

2) In an effort to be thorough, I also had the following blood tests done:

 

- Progesterone: within normal range

- Cortisol (am & pm): within normal range

- Pregnenolone: within normal range

 

So, combining the most recent blood test results with all of the tests I already had done, I think it's pretty safe to say that 13+ years of daily finasteride use hasn't caused adverse side effects (at least as measured by all of the above tests and my general sense of well-being).

 

I didn't want to commit to a HT without committing to continued use of finasteride for as long as it keeps working for me. I couldn't do that unless I put myself through these tests to be as sure as I know how to be that finasteride wasn't hurting me on levels not easily observable. Even after this, there are no guarantees, but then again there are no guarantees in life, period. At least, I'm a lot more confident about the matter.

 

On a side note, you may be interested to know that I had a full body scan (from neck to pelvis) done about 2 years ago, and the results were fine. I had it done for reasons unrelated to finasteride use. I mention this, because I know some people are concerned about the possible cancer risks associated with finasteride. At that time I had been on finasteride for about 11 years straight, so take it for what it's worth to you.

 

I know all of this testing is subjective. I wasn't part of some controlled scientific study involving numerous people. It's only my personal attempt to see where I'm at. Also, I don't have bloods from my pre-propecia days with which to compare. Bottom line: results may vary, so take finasteride at your own risk. However, I hope the results of this experiment are somewhat encouraging to those of you who are on or considering finasteride therapy.

 

Peace,

 

Z

[Sean]

Z, this is great great information. Everything is in within normal range and you taking it for such a long time still had normal levels. I am comforted by this information. I am still taking it but didn't know if it altered anything. Most I heard were the cancer and sexual side effects but never witnessed any of those.

 

But you had some extensive blood tests and it came out good. All of my bloodwork also came out normal and within range. I have been on the stuff for about or under 2 years.

 

Well this is great news though and I am very happy for you. You can tolerate the medication and it doesn't seem to be doing anything in terms of side effects even after so many years of use.

 

On your last test DHEA could have been altered by stress, it's possible:

Levels Of Certain Hormones May Be Increased By Stress

 

 

This is a very informative and helpful thread. Thanks for sharing Z.

[mattj]

Thanks for this. I hope that Finasteride users, and people wary of taking it, find this reassuring.

[trapps99]

SOunds good...i persopnally had my sex drive plummet while on the meds....For those whom it does not effect thank the lucky stars you can function normal...Ive heard a lawsuit has been launched, and i dont think a med that would grow hair with no side effects that would happen to. Guys would be way to happy picking up chicks in their new convertables to have time..

That being said one persons experience doesnt hold a ton of water......some people have smoked until 80 and not gotten cancer,,,,

[zenmunk]

trapps99,

 

Your point is well-taken. Everyone is different. One must take finasteride at one's own risk. However, the reason for this post is to show that one can take finasteride daily for a very long time and be OK.

 

Also, it's worth considering the possibility that some ex-fin users are mistakenly attributing symptoms from unrelated illnesses to finasteride use.

 

Or, perhaps there is a synergistic effect between finasteride and some other health problems whereby finasteride is compounding the problems.

 

Of course, psychosomatic illnesses are possible, too. A psychosomatic illness may be emotional or mental in origin but have physical symptoms. Psychosomatic illnesses are not imaginary. They are physical disorders in which both emotions and thought patterns are believed to play a central role, and usually develop when a person's disease-fighting ability is weakened due to stress.

 

I'm not suggesting that finasteride use hasn't hurt a relatively small number of users. It may very well have. However, it's possible that some of those people are suffering from illnesses with other causative factors.

 

zen

Edited April 3, 2012 by zenmunk

[bonkerstonker]

Very interesting pal I think it's probably just problems in your life causing that small problem and I'm sure you'll be fine soon.

[zenmunk]

Thanks, bonkerstonker. Actually, that DHEA problem did clear up, thankfully. I think you (and Sean) are right - stress was probably the culprit.

[blueboy08]

Having started on finistride in Jan 2012 I noticed a sharp decline in sex drive, first time ever, but will keep on taking it but may cut down to every other day. I have just undergone my first HT this week so want to make the most of the of it so don't want to give up on them just yet. I will also start on minoxidil in a few weeeks when the op has settled down and see what happens.

[zenmunk]

blueboy08,

 

Your HT is a big investment. I'd recommend staying the course a bit longer (with whatever adjustments to dosage you deem necessary). See if your libido improves. If it doesn't, then you have to decide what's more important to you. I've been pretty lucky so far, but I can honestly say that if I experienced remotely serious sides, I'd be off the meds lickety-split. Nothing is more important than one's health.

 

Z

[blueboy08]

Thanks for your reply, I will carry on with taking it for at least a year as having had the HT I want the best results, but from what I can see so far I will probably need another but will wait and see.

[bonkerstonker]

I've been on finasteride for over ten years and if I look at a photo of my self now at 32 and when I was 22 I look exactly the same and people are always shocked how old I am, have you noticed anything like that? I swear it stops me ageing.

[zenmunk]

bonkerstonker,

 

I kind of have a baby face, so it's hard to tell whether the meds have contributed to a more youthful appearance. I think some people have good genes regarding the appearance of aging. Maybe you're one of them. I can say, like you, that luckily I've maintained the vast majority of my hair since starting Propecia, and that makes a huge difference in itself.

 

Z

[zenmunk]

No problem, Spex. I encourage you to get the tests done for peace of mind especially if you were planning on it anyway.

 

Z

[Bobilero]

Very useful and helpful post. But may i had add one thing for people to bear in mind.

 

I had to come off Fin last year after 3 and a half years due to sudden sexual sides. Massive Loss of libido etc. First time ever in my life anything like that.

 

I got all the above said blood work done in April this year and the Dr informed me everything was within normal range.

 

Now the key criteria in all these tests is not if its in within normal range. Its if its within normal range for your AGE. This is something that these tests dont bother factoring or mentioning to you most of the time.!

 

My below result for example was the same

 

Testosterone, free: within normal range .

 

However the normal range is 9-27 i believe as the Dr explained. Now my reading was 12. For someone, 32 , in pretty good shape working out 4 or 5 times a week this is ridiculous.

 

This is a reading for someone potentially twice my age.!

 

I will say after nearly 8 months off Fin it is only this month i am feeling truely back to normal or 'pre fin' state with everything recovered. The last month or 2 i have felt a big rebound in everything so feel thankful.

 

I am getting more tests done soon so i will share the results. Hopefully there is a noticeable difference in my levels in line in how i have felt of late.

[zenmunk]

Bobilero,

 

Thanks for your post. I think you raise an interesting point regarding age. I agree that levels will vary according to one's age, and that should be kept in mind while interpreting results.

 

I'm happy to hear you're feeling back to normal. I'm curious to know if your test results change. Please feel free to post them in this thread when you get them.

 

z

[BaldEagle1892]

I've been on propecia for 13 years. That's finasteride 1mg/day. I've rarely missed a day. I've experienced no observable sides (except a slight reduction in semen viscosity) - libido has not decreased and no ED. Also, I've maintained virtually all of the hair I had when I first started the meds.

 

Recently, I went to my urologist to undergo a series of medical tests to see if I'm doing OK in areas where finasteride use may adversely affect my body in less observable ways. Although everyone is different, I thought you might find it interesting to view the results of a long-term finasteride user:

 

- GU exam (Male Genitourinary exam): normal phallus and testes.

 

- Ultrasound of testes: normal

 

- Ultrasound of bladder: normal

 

- Ultrasound of kidneys: normal

 

- Urinalysis: negative for infection, flow normal

 

Bloods:

 

Liver function tests (LFTs): all within normal range

Testosterone, serum: within normal range

Testosterone, free: within normal range

Thyroid profile: within normal range

Estradiol, serum: within normal range

Follicle-Stimulating Hormone (FSH): within normal range

Prolactin: within normal range

Lutenizing Hormone (LH): within normal range

Sex hormone-binding globulin (SHBG): within normal range

PSA: within normal range

DHEA: slightly below normal range

 

Semen Analysis: all normal

 

 

So, DHEA is the only area of concern. Cortisol (stress hormone) and DHEA are like two ends of a see-saw - when one has long-term stress or anxiety, Cortisol spikes and DHEA levels fall. For the past 2+ years I've been under the greatest psycho-emotional stress of my life which may explain the decreased DHEA levels.

 

I've started a program to reduce stress/anxiety - increased exercise, daily meditation, reducing caffiene intake significantly and a low-glycemic diet balanced in protein, healthy fats, and complex carbohydrates like vegetables, eaten as smaller meals more frequently (5-6 small meals/day). I plan to re-test for DHEA in 3 months. If it's still abnormally low, then I will test for Pregnenolone (blood), Progesterone (saliva) & 4x per day Cortisol (saliva).

 

I've read claims online that there is a connection between finasteride use and low DHEA, but I have no idea how scientifically accurate that is. I will ask my urologist if he's familiar with such a connection, but perhaps an endocrinologist would be a better doctor to ask. Of course, if anyone on the forum has valid scientific evidence regarding this connection, then I welcome your input.

 

I'll keep the community posted with my progress.

 

 

Hey Z,

 

I would like to start and say thanks for taking the time to write such an informative article. It really helps newcomers like me in finding the right path for what I should consider next.

 

 

I'm very new in regards to finding the solution to my own MPB but I've been researching a lot since I've started and I've came across a lot people commenting on problems with Propecia which to be frank scares the s*** out of me. This hasn't stopped me from buying it and I'm more than willing to give it a go but I would like some reassurances from some regular hormone tests whilst taking the drug in the early stages. I'm just not sure where to go to get them done? Can I just drop into my local GP?

 

 

Cheers

 

Cheers

[zenmunk]

BaldEagle1892,

 

I took care of all of the testing through my GP. As long as you have a good relationship with him/her, then s/he will very likely understand your concerns and accommodate you.

 

I think it's very important to establish a baseline for your levels BEFORE you begin with finasteride. That way you have something to compare it to with periodic testing. You'll be able to see how finasteride affects those levels (if at all). Unfortunately, I had no idea to do this way back when I started with Propecia.

 

Keep one thing in mind. You will become a slave to this medication. Once you start you can't stop it if you want to keep whatever hair the meds are preserving. When you're in panic mode and just want to stop or slow MPB, you don't give that much thought. But you may find later on that it really starts bothering you for multiple reasons.

 

No matter how much testing we do, my feeling is we can never know exactly how this medication is affecting us. So, even if all your results come back normal, there may be something bad happening that is not detected. Or, maybe not. It's pretty much a gamble, but with all the testing you can rest a little easier.

 

In the end you have to pay attention to your body. Aside from establishing baseline levels, it may not be a bad idea to keep a finasteride journal for at least the first 6 months of use. This is not about your hair, but your health. How do you feel on it over time? Do you notice any negative changes? You may start detecting symptom patterns which will make you question whether remaining on the meds is a good idea. Or, you may not notice anything which would mean you tolerate the meds well. You can discuss your findings (if any) with your GP or Urologist.

 

Hope this helps and good luck,

 

z

[BaldEagle1892]

Thanks mate.

 

I will definitely get the base line tests done before taking the drugs for sure. I will also post my progress and pics when this all rolls into action.

 

I know that you could be torn between having side effects and keeping your hair, but in the long run I think my health is first and foremost and I would try something else if the side effects were a problem for me. I did read there was another drug out there that brought down DHT levels but it wasn't as efficient as PRO/FIN. It was called KERATENE® alphactive Retard. It sounds like a plan B for me but am sure if you tested this drug over a million males with MPB you would find some with side effects to!

 

Catch 22 I suppose...

 

It would be really unfair to get side from both of these

 

Hopefully things will go smoothly the first time round

 

 

Eagle

[jonke]

I've been on finasteride for over ten years and if I look at a photo of my self now at 32 and when I was 22 I look exactly the same and people are always shocked how old I am, have you noticed anything like that? I swear it stops me ageing.

 

 

well i think lowering dht can lower the masculine effects on the body maybe giving a more youthful look?

[N-6]

What concerns me about propecia is that it may artificially lower your psa score, meaning someone may receive a low psa score when it can actually be double that score. Its fake reassurance. Psa is one test used to try and diagnose prostate cancer. Your urologist needs to be aware of propecia use and aware of its impact on psa.