Testosterone Replacement: Will It Cause Hair Loss If I'm On Finasteride?

[Jefff]

Today I got some blood test results and discovered that I have low Testosterone. My number was 219 and I'm 43 years old. I have no symptoms and feel fine though. :confused: Anyway, I really am terrified of taking any T replacement because I'm afraid it will cause hair loss. I've been taking 1mg/daily Finasteride for approximately 7 years now and I've had no hair loss issues all this time (and am desperate to keep it this way).

 

If I end up taking T replacement will it increase my chances of losing hair or will the Finasteride continue to keep it under control (if in fact that's what's been preventing my hair loss)? I literally feel sick over having to make this decision.

Thanks very much for any info/help.

[Postdoc]

Today I got some blood test results and discovered that I have low Testosterone. My number was 219 and I'm 43 years old. I have no symptoms and feel fine though. :confused: Anyway, I really am terrified of taking any T replacement because I'm afraid it will cause hair loss. I've been taking 1mg/daily Finasteride for approximately 7 years now and I've had no hair loss issues all this time (and am desperate to keep it this way).

 

If I end up taking T replacement will it increase my chances of losing hair or will the Finasteride continue to keep it under control (if in fact that's what's been preventing my hair loss)? I literally feel sick over having to make this decision.

Thanks very much for any info/help.

 

Hi Jeff,

 

Although it may sound counterintuitive to be on both testosterone replacement and finasteride, this shouldn't be a problem. In fact, some doctors prescribe finasteride to patients put on testosterone replacement to counter the increase in DHT levels. There's a short reference here:

 

Testosterone replacement in the setting of Finasteride therapy: a therapeutic dilemma

 

Regards

David (Postdoc)

[Bobilero]

I went for blood tests and found i had a low Free test level caused by a few years of finasteride use. I dropped the Fin over a year ago and my test levels have steadily increased since then.

 

It was 100% the fin causing it. Wont be going back on it.

[Postdoc]

I went for blood tests and found i had a low Free test level caused by a few years of finasteride use. I dropped the Fin over a year ago and my test levels have steadily increased since then.

 

It was 100% the fin causing it. Wont be going back on it.

 

Actually the evidence is that finasteride usually causes an increase in serum testosterone level. Ditto dutasteride. There is an inverse relationship between BMI and testosterone level, so weight gain is the more likely explanation for low serum testosterone.

 

Regards,

David (Postdoc)

[Bobilero]

I train 4/5 times a week and am about 10% body fat. Its wasnt weight gain.

 

That evidence you point to is a short term effect when free test level can increase as theres more floating not being utilised for DHT.

 

It was for sure the reason in this case. Ive had it tested every 3 months since coming off over a year ago and in each case its increased 2nmol.

 

There are no long term studies and as evident in the unlucky group who have had permanent side effects which wont go away. There is evidence emerging how it affects test production and DHT production receptors.

[Blake Bloxham]

Actually the evidence is that finasteride usually causes an increase in serum testosterone level. Ditto dutasteride. There is an inverse relationship between BMI and testosterone level, so weight gain is the more likely explanation for low serum testosterone.

 

Regards,

David (Postdoc)

 

Physiologically speaking, this is what I would assume would happen as well. Interesting that Bob noted the opposite.

[Postdoc]

I train 4/5 times a week and am about 10% body fat. Its wasnt weight gain.

 

That evidence you point to is a short term effect when free test level can increase as theres more floating not being utilised for DHT.

 

It was for sure the reason in this case. Ive had it tested every 3 months since coming off over a year ago and in each case its increased 2nmol.

 

There are no long term studies and as evident in the unlucky group who have had permanent side effects which wont go away. There is evidence emerging how it affects test production and DHT production receptors.

 

I've done a pretty through literature search and I can't find anything that substantiates low serum testosterone as a side effect of long-term finasteride use. Perhaps you were unlucky, but I wouldn't like to see others generalising from your experience.

 

Regards,

David (Postdoc)

[GNX1]

Today I got some blood test results and discovered that I have low Testosterone. My number was 219 and I'm 43 years old. I have no symptoms and feel fine though. :confused: Anyway, I really am terrified of taking any T replacement because I'm afraid it will cause hair loss. I've been taking 1mg/daily Finasteride for approximately 7 years now and I've had no hair loss issues all this time (and am desperate to keep it this way).

 

If I end up taking T replacement will it increase my chances of losing hair or will the Finasteride continue to keep it under control (if in fact that's what's been preventing my hair loss)? I literally feel sick over having to make this decision.

Thanks very much for any info/help.

not for nothn but you have the test of a sick 90 year old man!

 

u need to get on some test treatment. it does more help then harm. ur a man, ur made of up of test.

 

low lest can make you LOSE hair.

 

you need to find out why ur test is so low. thats far from normal. u have an underlying problem.

[Jefff]

not for nothn but you have the test of a sick 90 year old man!

 

u need to get on some test treatment. it does more help then harm. ur a man, ur made of up of test.

 

low lest can make you LOSE hair.

 

you need to find out why ur test is so low. thats far from normal. u have an underlying problem.

 

I know, from everything I've read it sounds very low and I am very concerned. Do you know what exactly the underlying problem could be?

I am having some testicle issues that I strongly wonder whether or not are causing my low Test.

In early 2008 I was diagnosed w/ a hernia: I had/have a lump on my right testicle which the Urologist said was a hernia... however when I went for a sonogram the woman performing it said it was a hydrocele so I don;t know exactly what it is.

I also have what I believe to be is a varicocele under my left testicle: It was not diagnosed by the Urologist but I don't even know whether or not to completely trust what he said to begin with.

I stupidly haven't been for a follow up since then but am planning on seeing an Endocrinologist soon. I've read that hydrocele and varicocele can cause low Test and am hoping it's nothing more serious than that.

Oh... and I should also mention that I developed Gynecomastia about 8 years ago which I still have... so something isn't hormonally right with me.

 

Should I see a Urologist or would the Endocrinologist also be able to examine my testicles?

Any insight or info you have would be greatly appreciated. Thanks a lot.

Edited December 23, 2012 by Jefff

[Postdoc]

GNX1 is being somewhat alarmist. A free testosterone level of 219 isn't that low and it's unhelpful for him to say that it's "of a sick 90 year old man". The normal range is very wide, ranging from around 240 to over 1000. It's not that unusual for testosterone levels to drop as one gets older and there are probably hundreds of thousands of men over the age of 40 who have a low testosterone level without realising it and without it causing any problem either. It's definitely essential that you see an endocrinologist and he may decide to watch and wait rather than start you on replacement therapy. If he does start you on replacement the objective would just be to bring your level within the normal range and I'd be very surprised if this had any impact on your scalp hair, particularly as you already take finasteride. You mention having gynaecomastia and it sounds as if this was before you started on finasteride. DHT blocking drugs like finasteride and dutasteride can rarely cause gynaecomastia, so this happening before you started the drug needs an opinion from then endocrinologist. Both hydrocele and varicoceles are entirely benign conditions and shouldn't affect the production of testosterone. The exception would be if the blood supply to the testis is compromised, e.g. at surgery, but the endocrinologist might want you to see a urologist just to make sure.

 

Regards,

David

[GNX1]

GNX1 is being somewhat alarmist. A free testosterone level of 219 isn't that low and it's unhelpful for him to say that it's "of a sick 90 year old man". The normal range is very wide, ranging from around 240 to over 1000. It's not that unusual for testosterone levels to drop as one gets older and there are probably hundreds of thousands of men over the age of 40 who have a low testosterone level without realising it and without it causing any problem either. It's definitely essential that you see an endocrinologist and he may decide to watch and wait rather than start you on replacement therapy. If he does start you on replacement the objective would just be to bring your level within the normal range and I'd be very surprised if this had any impact on your scalp hair, particularly as you already take finasteride. You mention having gynaecomastia and it sounds as if this was before you started on finasteride. DHT blocking drugs like finasteride and dutasteride can rarely cause gynaecomastia, so this happening before you started the drug needs an opinion from then endocrinologist. Both hydrocele and varicoceles are entirely benign conditions and shouldn't affect the production of testosterone. The exception would be if the blood supply to the testis is compromised, e.g. at surgery, but the endocrinologist might want you to see a urologist just to make sure.

 

Regards,

David

 

he stated that he was diagnosed with gynecomastia 8 years ago. low test is a common contributor to those with gyno and test treatment is often prescribed.

 

he didnt state FREE test levels. he stated test levels. at 219 his total test levels would absolutley be that of a sick 90 year old man.

 

total test levels on average for his age is around 600-650.

 

free test levels range from 50-250. total ranges from 350 and 1230 npd. so he is either VERY low total numbers or has very HIGH free levels.

[Bobilero]

I've done a pretty through literature search and I can't find anything that substantiates low serum testosterone as a side effect of long-term finasteride use. Perhaps you were unlucky, but I wouldn't like to see others generalising from your experience.

 

Regards,

David (Postdoc)

 

 

A 30 second google search will show umpteen examples of guys who suffer low free test from finasteride use despite elevated Total T levels, it seems for certain people, the more critical FREE Testosterone (2% of which is actually available to the body at any given time) can be driven down.

 

This is because Finasteride has been documented to raise estrogen levels and shift androgen/estrogen ratio in men to be in favor of estrogens, especially the longer you are on it. Increased Estrogen levels are also linked with increased SHBG / gyno.

 

Considering the lack of understanding the medical community has on this drug and its long term use . I would not like to see user's generalising from YOUR advice but rather keep an open mind on the effects this drug can cause. AND get proper baseline test data BEFORE starting the drug they can refer back too should they have these issues. Something the medical community continues to fail to advice users on leaving them in limbo when they have problems.

[Jefff]

Hey guys,

Thanks a lot for the replies. I don't know what my free T results were as they weren't tested for. It's been a long time since I first developed the gyno. but I'm almost positive it began a few years before I began the Finasteride. I'm a vegetarian and I recall questioning whether or not my soy based diet may have caused it.

I have been reading a huge amount on low T, etc, and I do recall reading that hydroceles and varicoceles could cause low T. Was that just incorrect info?

Is there any chance that I could be prescribed something other than Testosterone to counteract something such as way too high Estrogen/estradiol levels (if that's determined)?

Thanks again for the quick and helpful replies.

 

Edit: My test results do say something for T4 and T3 if this means Testosterone (?): They're T4 12.11 and T3 1.54

if these mean anything?

Edited December 25, 2012 by Jefff

[Postdoc]

A 30 second google search will show umpteen examples of guys who suffer low free test from finasteride use despite elevated Total T levels, it seems for certain people, the more critical FREE Testosterone (2% of which is actually available to the body at any given time) can be driven down.

 

This is because Finasteride has been documented to raise estrogen levels and shift androgen/estrogen ratio in men to be in favor of estrogens, especially the longer you are on it. Increased Estrogen levels are also linked with increased SHBG / gyno.

 

Considering the lack of understanding the medical community has on this drug and its long term use . I would not like to see user's generalising from YOUR advice but rather keep an open mind on the effects this drug can cause. AND get proper baseline test data BEFORE starting the drug they can refer back too should they have these issues. Something the medical community continues to fail to advice users on leaving them in limbo when they have problems.

 

A search on Google is hardly the same as a literature search of peer-reviewed articles, but I understand that this is a contentious issue and perhaps my viewpoint is too mainstream medical, so I won't be contributing any more to this thread. Happy Christmas to all, anyway.

[Jefff]

A search on Google is hardly the same as a literature search of peer-reviewed articles, but I understand that this is a contentious issue and perhaps my viewpoint is too mainstream medical, so I won't be contributing any more to this thread. Happy Christmas to all, anyway.

 

David,

I really appreciated your input and wish you'd stay/continue posting in this thread. I feel like Im trying to learn a new language in a hurry... it's so overwhelming.

[Postdoc]

Jeff,

T4 an T3 are thyroid function tests and would be part of an endocrine screen. TSH (thyroid stimulating hormone) is often included in this screen. The normal range for free T4 is 10 - 25 pmol/l and total T3 is 1.0 - 2.5 nmol/l, so your results are normal. Happy Christmas!