TRT will it always cause hair loss?

[baronf1974]

First post. I am 50 years old and was recently put on testosterone replacement therapy.

Background:

Minoxidil foam and 1.25mg finasteride since November 2011. First hair transplant December 2011 , second transplant December 2013. Very happy with the results. Wife and family say my hair looks great and can't even tell I had the transplant, in a good way.

Diagnosed with low T in October of this year and started treatment right away.Current treatment is 150ml Testosterone Cypionate weekly.

Approximately 3 weeks after starting treatment I noticed hair shedding when I applied the minoxidil foam. I notice 15-25 hairs on my hand after vigorously applying the foam. I honestly do not know if this was happening 3 months ago as I never bothered to check. After noticing the hair loss I upped the finasteride to 2.5mg daily.

I had a blood test run and my Total Testosterone was 1323 ng/dl ref range 250-1100. DHT was 29ng/dl ref range 16-79 ng/dl. DHT seems low mid range.

Is it normal to see hair on your hands after applying foam?

Should I expect hair loss on TRT, even when using Finasteride and minoxidil foam?

Thanks in advance

[Blake Bloxham]

Baron,

 

A few things:

 

First, the transplanted follicles should not be affected by the hormone replacement therapy (HRT). These follicles are highly resistant to DHT and should not shed with reasonable testosterone increases.

 

Second, follicles susceptible to hormones could potentially shed more with increased testosterone levels. Note I said "could" shed more; not "will" shed more. You're on a few agents that should protect against this shedding, and increases in testosterone won't necessarily cause increased hair loss.

 

Third, the increased finasteride could be responsible as well. Finasteride usage is frequently accompanied by an initial "shedding" phase that lasts 3-4 months. Increasing the dose would, in theory, cause a similar effect.

 

So, can HRT theoretically increase loss of hormone-susceptible follicles? Yes. This isn't certain, but it's not out of the question. Can this be explained by the increase in finasteride? Yes. So, a bit difficult to tell at this point. Most experts would probably recommend continuing the minoxidil and finasteride and seeing if the increasing shedding resolves in the next 4-5 months - or so.

 

Hope this helps!

[CJD]

Since DHT comes from Testosterone (actually a very small percentage of testosterone is converted to DHT), an increase in testosterone will always result in an increase in DHT levels :mad:. For those who suffer from MPB due to the fact that they are more susceptible to DHT than those who do not suffer from MPB, this can be a problem. Many doctors who prescribe HRT for men prescribe Avodart .5mg up to once a day to protect your prostate as you age from the possible risks of HRT and to also prevent further hair loss. Although hair loss prevention is currently an "off label" use for Avodart, studies have shown it to be more effective than Propecia since it blocks two enzymes in the conversion process to DHT instead of only one. Since you appear to be monitoring your Testosterone and DHT levels, I would recommend that you discuss with your doctor continuing to do that and using either of the therapies at whatever dose maintains your DHT levels at the low end of the normal range. By doing this, you should minimize (if not totally erase) the possibility of you having any significant or noticeable hair loss as a result of whatever dose of testosterone you use.

[JoeTillman]

In my experience it is wise to increase your fin intake while on T replacement therapy. It acts as a common sense buffer. The use of Avodart however, in my opinion, is questionable. After having experience with Avodart I feel it should only be used as a last resort and should be used only for prostate health if one's doctor specifically says it is necessary above and beyond 5mg finasteride. By suppressing 5a-R1 there are potential risks that I feel are not worth it's use.

[CJD]

My response was an answer to the OP's question. I did not recommend Avodart nor Propecia anywhere in it. To debate which should be used for hair loss is a personal choice. I merely stated that it should work better due to its mechanism of action. To bring up a risk of using Avodart without mentioning first the risk of testosterone therapy is inappropriate. There are risks to testosterone therapy that make it wise to use Avodart. Side effects of either Avodart or Propecia are very rare and can be easily avoided. Avodart was studied in thousands of subjects in placebo controlled double -blind clinical trials. The most common side effect was impotence that was reported by 4.7 % of those thousands of people after using it every day for 6 months. That decreased to 0.5 % of the population studied after using it every day for 1.5 -2 years. After two years of using Avodart every day, the placebo group reported a higher percentage of impotence !!!! Other sexual side effects were reported even less. The age group of the men in the study was from 47-94 years old with an average age of 66. One could easily point out that those can be typical symptoms for people in that age range and therefor further minimize the contribution of Avodart to them. People report that Propecia also causes these issues , and one cannot deny there can be a mental aspect to sexual dysfunction. The second most common side effect from that study in addition to the sexual ones mentioned was gynecomastia /breast tenderness which occurred in 0.6 % of the thousands of people studied after using it every day for 1.5 - 2 years. When considering the fact that gynecomastia occurs in the normal male population when hormones are changing , it is a very small number of people. Testosterone can cause gynecomastia and it is wise to take one of various medications available to prevent it if you are on testosterone therapy. Finally, when you consider 50 % of men have BPH by the time they reach the age of 50 , Avodart can be a very wise medication to use especially when you are on testosterone therapy.

[CJD]

My response was an answer to the original question. I did not recommend Avodart nor Propecia anywhere in it. To debate which should be used for hair loss is a personal choice. I merely stated that it should work better due to its mechanism of action. To bring up a risk of using Avodart without mentioning first the risk of testosterone therapy is inappropriate. There are risks to testosterone therapy that make it wise to use Avodart. Side effects of either Avodart or Propecia are very rare and can be easily avoided. Avodart was studied in thousands of subjects in placebo controlled double -blind clinical trials. The most common side effect was impotence that was reported by 4.7 % of those thousands of people after using it every day for 6 months. That decreased to 0.5 % of the population studied after using it every day for 1.5 -2 years. After two years of using Avodart every day, the placebo group reported a higher percentage of impotence !!!! Other sexual side effects were reported even less. The age group of the men in the study was from 47-94 years old with an average age of 66. One could easily point out that those can be typical symptoms for people in that age range and therefor further minimize the contribution of Avodart to them. People report that Propecia also causes these issues , and one cannot deny there can be a mental aspect to sexual dysfunction. The second most common side effect from that study in addition to the sexual ones mentioned was gynecomastia /breast tenderness which occurred in 0.6 % of the thousands of people studied after using it every day for 1.5 - 2 years. When considering the fact that gynecomastia occurs in the normal male population when hormones are changing , it is a very small number of people. Testosterone can cause gynecomastia and it is wise to take one of various medications available to prevent it if you are on testosterone therapy. Finally, when you consider 50 % of men have BPH by the time they reach the age of 50 , Avodart can be a very wise medication to use especially when you are on testosterone therapy.

[JoeTillman]

To bring up a risk of using Avodart without mentioning first the risk of testosterone therapy is inappropriate.

 

The OP is already on TRT so the issue of whether it is appropriate or not to discuss the potential side effects of TRT is moot.

 

And there is no debate about one or the other. I simply gave my opinion. But what do I know? I've only been dealing with the issue for twelve years with thousands of patients and have used both medications myself in varying doses for over a decade.

[Spanker]

The OP is already on TRT so the issue of whether it is appropriate or not to discuss the potential side effects of TRT is moot.

 

And there is no debate about one or the other. I simply gave my opinion. But what do I know? I've only been dealing with the issue for twelve years with thousands of patients and have used both medications myself in varying doses for over a decade.

Can you elaborate on your thoughts on dut for hair loss? What are the issues that make it not worth its use, in terms of hair and side effects.

[JoeTillman]

Hi Spanker,

 

My personal experience with Avodart was not pretty. After probably six years of taking Proscar, 1/4 tablet EOD, I switched to Avodart after I saw some of the results of other patients. I took it for about two years and while on it I had a change in my appearance that you could call "puffy". My face and body lost definition, not that I was ripped to begin with, but I had a swollen and rounder appearance. I wasn't working out on a regular basis back then like I am now but I have no question that my appearance was due to Avodart. You can see what I mean in some of my old videos. That is the only side effect I had. I've had nothing to speak of with regards to side effects on finasteride.

 

I know that Avodart acts differently in other people too. One fella I know of took Proscar for years but it was not working well for him. He then switched to Avodart and through a series of events that I won't reveal he discovered his sperm count was unusually low. Six months after he stopped Avodart his sperm count was still unusually low and I don't know if it ever rebounded. Was this from the use of Avodart or was it a pre-existing condition? He doesn't know. There is also evidence that the suppression of 5A-R1 can reduce bone mass and muscle density not to mention 5A-R1 is thought to have a role in cognitive function. For these reasons I just think finasteride is a better medication.

[Spanker]

Thanks for sharing.

[BaldingBogger]

Personally I think anyone who who alters their hormonal in doctrine structure for hair is nuts but that's just my opinion.

 

However I have seen and read cases where propecia had actually caused low free test so this may be a vicious circle.

 

Would have been good if the op could have quit propecia first to see if his test levels rebounded naturally

[CJD]

The OP is already on TRT so the issue of whether it is appropriate or not to discuss the potential side effects of TRT is moot.

 

And there is no debate about one or the other. I simply gave my opinion. But what do I know? I've only been dealing with the issue for twelve years with thousands of patients and have used both medications myself in varying doses for over a decade.

 

 

The original post was not about risks. Maybe you should read it again. After all, the title of the post is asking if TRT will cause hair loss . That is what my original post answered. I also gave truthful information about what many current doctors do with patients on testosterone therapy. I did not recommend any medication. In fact, I recommended that the OP discuss with his doctors using EITHER of the therapies to keep his DHT levels in a certain range.You brought the post "off topic" by talking of risks involved with using Avodart, so let's do that with facts in a way that the layman can understand and benefit from. I simply responded to your post by providing the actual clinical trial statistics that are the gold standard in medicine and show the known "risks" you refer to are not as you portray them to be. Since you changed the topic and brought up risks regarding one discussed medication, it is important to note there are risks in taking testosterone too. Most importantly, there are no good results of long term studies to establish what the actual risks and outcomes of it are. Also, many patients who do not actually need it are being prescribed it. As with testosterone, one must decide if the risks are worth the benefits. The same could be said for any hair loss medication and that should really be the question . Beyond that, studies do not show Avodart to be risky compared to Finasteride.

It seems you took my post personally for some reason. This is evident by you having to mention your "patients" and experience to me with a sarcastic question as if no one can possibly be an equal. If you are a doctor or have patients in some regard, you should be aware of the facts contained in my original post regarding Avodart having a mechanism of action that can make it a more effective drug at preventing hair loss with its current "off label" use. It's half life also allows a patient using it for hair loss to take it once every 3-5 days as opposed to Propecia which must be taken every day due to it's extremely short half life. This is rarely pointed out , and this benefit allows for therapeutic levels while further minimizing the already minimal chance of any side effects possibly making it SAFER than taking it every day. Additionally, you should know that the dose of testosterone the OP stated he is taking would override the miniscule chance of sexual side effects by increasing his libido/sex drive. To be a medical professional and magnify the miniscule risks from Avodart and say the risk from testosterone "is a moot point" is silly. There are minimal risks currently associated with Avodart and none that have currently been established with it that are not also associated with Finasteride. There are known risks with testosterone, so someone like the OP who has decided to use it despite those would likely not worry about the reported Avodart risks. You came forward and said the use of Avodart is not worth its "risks" and is "questionable" because of reasons like what "some fella" told you ? Are you serious ? And you can establish that Avodart caused "your face and body to lose definition" at your age for a period of two years years during a time when you were not really working out at your previous level.... how ??? from a you tube video ? LOL Even if it were true for argument's sake, the fact that it happened to you but no other people in a controlled study of thousands makes it statistically insignificant and not considered a true risk. Also, is there no one that has a low sperm count for any other reason than being on Avodart for a short time ? Seriously ? In that case, Avodart might have caused me to forget a few things that happened to me 20 years ago on a night when I was drinking heavily.

Medicine and pharmacology use science . The gold standard scientific methods are used in the study I referenced and in all good studies. They are the basis for every medical journal. The mechanism of action of Avodart and other drugs does not change based on your "opinion" or what you found out from "some fella". Everyone is entitled to their respected opinion , but in medicine it must be supported by facts to be valid and to be used to give sound advice to others. You also are aware that the law requires that all symptoms reported by patients in a clinical trial must be listed as side effects for the medicine being studied whether actually caused by it or not. This is why many medications have so many side effects listed that are not actually true. For anyone to scare others away from any drug or steer them towards one based on their "opinion" about risks that are not supported by any hard facts and only what "some fella" experienced is ridiculous. Let's present truthful information so everyone can see it and make decisions based on it. I can elaborate about what blocking the multiple enzymes involved in the conversion to DHT does to various hormone levels and how those levels can also be affected by an individual's DNA makeup and even mutations passed down from relatives. We can go on and on forever drawing possible conclusions that result in potential risks in every imaginable direction , but they will all still be speculation because they are not factually known.

I would not describe a medicine as "risky" when the information stated by the actual patients in the study show the chance of occurrence after using the medication for two years to be less than 1% ! There is also more than one study involving close to 10,000 men on a daily dose of Avodart that resulted in their risk for prostate cancer being reduced by around 25%. That COULD make it very beneficial to take for more than one reason. There are still unanswered questions about BOTH Avodart and Propecia because in another large study, it was previously determined that BOTH Avodart(Dudasteride) and Finasteride MAY also increase the chance of high grade prostate cancer at the same time. If that is true, Avodart and Propecia would be equally as "risky" there.

 

FDA Drug Safety Communication: 5-alpha reductase inhibitors (5-ARIs) may increase the risk of a more serious form of prostate cancer

 

The results of two studies related to prostate cancer prevention showed a small increase of just over 1% of the population studied concerning high grade prostate cancer when compared to the control group. However small, it is required to be mentioned and is believed to POSSIBLY affect those that are predisposed to those cancers. There are no definitive studies that show Avodart is more risky than Finasteride. The best studies to date have shown it is not. Your reference to bone density and muscle mass being negatively affected has also not panned out (you referred to bone MASS and muscle DENSITY for some reason ? ) . I have seen at least one study in the New England Journal of Medicine that concluded Avodart had no effect on either of them when compared to the control group. Sometimes things turn out to be different than originally thought for many medicines . A drug may later be shown to be safer than previously believed. Other times a drug may turn out to be more dangerous than previously believed. It is also very hard to ever prove anything which is why scientists do not use that word. You cannot say Avodart is any more risky than Finasteride based on current studies . Where did you get your information, from a bodybuilding forum ? I have no gain whether someone chooses to use Avodart, Propecia, or any other medicine, but everyone gains from us being honest about the facts as they are currently. They may change and show Dudasteride and Finasteride are both dangerous in the future for all we can speculate.

This is not supposed to be a fight. Since you posed the question "but what do I know ?" directly to me , I will answer. You obviously don't know much if you don't agree with those scientific principles since they are what governs medicine whether we like it or not. A good doctor would not base decisions about treating people with medicine on what "some fella" told them, what they heard, or on one occurrence in an uncontrolled setting with too many variables to even recognize. Since you want to mention your expertise, I graduated from a respected medical school as well and also have a master's degree in pharmacology from there. I have worked with patients like you say you have and also worked with pharmaceutical companies and scientists in the lab when designing and developing drugs.

Be careful when you wave your stick around in a presumptive manner at someone as there is always someone with a bigger stick. I don't advertise to be an expert nor care to be thought of as one, but I responded in detail about risks since you "beat your chest" about what you know to me in a sarcastic way. The way you reached your conclusions is comical.

 

I wish everyone the best with their hair loss medication !

[JoeTillman]

The original post was not about risks. Maybe you should read it again.

 

I know what it was about. You were the first to mention anything about risks in your initial post.

 

You seem to be intent on winning some sort of argument that in my opinion doesn't exist. I wasn't taking anything personally mainly because you are new and anonymous, have (at the time of this writing) only four posts to your name and you said nothing personal toward me or anything that I would consider to be insulting. You were the first to bring up the issue of Avodart and in a few short sentences I said that I think finasteride is a better alternative than dutasteride. I was not speaking to you in my first post but I was giving an alternative opinion. My comment about "what do I know" was a tongue in cheek response that you appear to have taken out of context, or personally, or both.

 

What I find somewhat disconcerting at this point is that I am the one that usually is talking up the benefits of either medication, usually Proscar rather than Avodart, and the "side effect" crowd comes after me to challenge my position and say that I downplay the side effects. What an odd position to be in. Regardless, the problem is that unlike you I have never been one to try and discredit someone that has stated they had side effects and quite frankly I think it is short sighted of anyone to do so, as you have with me. I have been of the opinion that many of the people that experience some of the side effects associated with either medication are in fact suffering from a psychosomatic effect rather than a side effect from the medication. I have heard of some very unusual side effects and while I may not entirely believe the side effect is real I have never told someone that their personal experience is "comical". It is demeaning and to one with a more fragile degree of confidence, potentially damaging. I try to keep an open mind and accept that regardless of how small the possibility is, the side effect may be real.

 

And you can establish that Avodart caused "your face and body to lose definition" at your age for a period of two years years during a time when you were not really working out at your previous level.... how ??? from a you tube video ? LOL Even if it were true for argument's sake, the fact that it happened to you but no other people in a controlled study of thousands makes it statistically insignificant and not considered a true risk.

 

I told another poster that it is easy to see in a Youtube video I was in several years back, I did not say I recognized the issue because of seeing myself in earlier videos. I determined it was the Avodart because while I was not working out on a regular basis I wasn't overweight either. I did not change my diet and I did not change my routine, at all. I did not say I lost definition in the context of muscular definition, I said I got "puffy" in that it was similar to an allergic reaction kind of puffy. I recognized this and stopped taking Avodart, restarted Proscar at a higher dosage and it was a few months later that I started to return to a more normal appearance, again, with no change to my routine or diet. I don't need a study to tell me that this happened to me and you saying it is statistically insignificant and "not a true risk" does not take away the fact that it happened nor does it diminish the extreme probability that is was due to Avodart usage. I'm not going to go through this ordeal five hundred times in a controlled study to determine this either. If I'm wrong, I'm wrong, but it's not up to you, nor is it your right, to say otherwise.

 

Regarding the "fella" comment, if you read what I said I did not say " I heard ". I said " I know" and I know because I was involved in the reporting of his problem. I won't go any further than that but this was not a hearsay conclusion.

 

I won't go into the specifics of the data you reference for two reasons.

 

1. While you may think it a point of contention I actually know about these studies and I've never tried to debunk the data. How could I? In fact, I've referenced much of the same data many times when discussing these medications with patients, sometimes on this forum.

 

2. But most importantly, the studies don't tell the whole story. There is a saying, "the numbers don't lie", which is true but the numbers do not dictate the questions and they certainly do not represent every scenario. Being in pharma I'm sure you understand this and I hope that you don't try to debunk any side effect based on whether or not it is listed in a study as being possible.

 

Since you have say you have your master's degree in pharmacology, I would like to know your opinion on generic finasteride vs. finasteride manufactured by Merck in either Proscar or Propecia.

[hairweare]

CJD, thanks for that comprehensive review however I disagree with your statement that due to finasterides short half life it must be taken daily in order to be efficacious. Considering that the drug's inhibition of 5aRll is irreversible, Unless the inhibited enzyme is replaced at rate that returns levels to baseline within 48 hours, taking it every other day would still from a pharmokinetic standpoint provide net inhibition of the enzyme and decrease circulating DHT.

[CJD]

CJD, thanks for that comprehensive review however I disagree with your statement that due to finasterides short half life it must be taken daily in order to be efficacious. Considering that the drug's inhibition of 5aRll is irreversible, Unless the inhibited enzyme is replaced at rate that returns levels to baseline within 48 hours, taking it every other day would still from a pharmokinetic standpoint provide net inhibition of the enzyme and decrease circulating DHT.

 

 

Thanks for the statement . I did use the word "must " when trying to be quick and concise and shorten my long post. It was not the right word to use. I did not want to go off on a tangent on every point that could have been elaborated on. It could be taken as you say with a slight risk of a loss of degree of efficacy in some people. I really don't want to go on forever with every hypothetical situation about dosing with both drugs. Surely it has been discussed before somewhere on this forum ? The recommended dose of Finasteride is every day, and that dose is the one I see most used and recommended in patients that tolerate it and want maximum efficacy . That is why I referenced it. Can you use it every other day ? Sure. There is even a very old study that showed it capable of suppressing DHT to some extent for 7 days, but I would not take it like that if I wanted to keep the most amount of hair on my head that is possible. Drugs USUALLY have recommended doses for a good reason and are also used in patients based on individual variables. A doctor needs to know the drug and the patient. For example, younger people will metabolize the drug faster than older people. One patient may have no side effects nor concern about them. Another may have minimal hair loss and want some protection but not feel they need the maximum. A third may want to keep every possible hair he can and feel they need the maximum protection at all times , etc.. My post did not recommend drugs nor doses. I just outlined known information for those to investigate who are concerned about the currently known potential side effects. The main point of the statement you referenced is that there is a drastic difference in half life between the two drugs. No matter how far you want to stretch the dosing schedule of either drug to try to reach a point when the risks of side effects are minimized and efficacy is still there (even if it could be slightly minimized), Avodart would not need to be taken as often in that capacity and could thereby possibly reduce potential side effects. If we were to discuss the entire pharmacodynamics and pharmacokinetiics of the two drugs and elaborate on every avenue and hypothetical situation possible, it would require another thread and would probably bore most people on here.

[CJD]

Hi Joe, I will respond to your points. Please don't take these as being argumentative or wanting the last word. I just wanted to try to point out why I said some things.

 

You were the first to mention anything about risks in your initial post.

 

I clearly mentioned the word "risks" in passing only related to his HRT as a reason many doctors prescribe Avodart today. There is no discussion of risks of Avodart nor any recommendation for Avodart nor any medication. I clearly used the words "either therapies" in my advice to the OP.

 

You seem to be intent on winning some sort of argument that in my opinion doesn't exist.

I also clearly stated that "this is not supposed to be a fight". I am responding to what you said when calling Avodart therapy "questionable". I did not call it anything.

 

You were the first to bring up the issue of Avodart and in a few short sentences I said that I think finasteride is a better alternative than dutasteride. I was not speaking to you in my first post but I was giving an alternative opinion. My comment about "what do I know" was a tongue in cheek response that you appear to have taken out of context, or personally, or both.

 

Again... I stated "everyone is entitled to their RESPECTED opinion" Your sarcastic question followed by your stated experience certainly appeared aimed at me. You are addressing what I said when you stated it.

 

 

What I find somewhat disconcerting at this point is that I am the one that usually is talking up the benefits of either medication, usually Proscar rather than Avodart, and the "side effect" crowd comes after me to challenge my position and say that I downplay the side effects. What an odd position to be in. Regardless, the problem is that unlike you I have never been one to try and discredit someone that has stated they had side effects and quite frankly I think it is short sighted of anyone to do so, as you have with me.

 

Posting in the forum does not require me to know the past positions or current opinions someone holds. Your beliefs might make this ironic. I did not try to discredit you . You made a recommendation to someone while calling the use of a medication "questionable" without any established reason other than what you discussed regarding uncontrolled, ISOLATED events you attributed to Avodart. I even stated that if you assume they are a result of Avodart, they would simply be statistically insignificant to consider the drug's use questionable .

 

 

I have been of the opinion that many of the people that experience some of the side effects associated with either medication are in fact suffering from a psychosomatic effect rather than a side effect from the medication. I have heard of some very unusual side effects and while I may not entirely believe the side effect is real I have never told someone that their personal experience is "comical". It is demeaning and to one with a more fragile degree of confidence, potentially damaging. I try to keep an open mind and accept that regardless of how small the possibility is, the side effect may be real.

 

Based on the percentage of patients in the studies that have experienced mentioned side effects, it appears a large cause of them at this point in time could be psychosomatic . I see so many people here on the forums posting worries about sexual side effects that are not even on the medication. They are worrying about things for which there is an extremely remote chance they would even experience and are not even on the medication yet. I applaud you for considering all possibilities. A closed minded physician is useless. My quote said, "The way you reached your conclusions is comical." I did not say your experience was comical. I don't take any negative experience of another creature lightly or as humorous. Thee are a couple of references that show you took the comments differently as they were stated.

 

I determined it was the Avodart because while I was not working out on a regular basis I wasn't overweight either. I did not change my diet and I did not change my routine, at all. I did not say I lost definition in the context of muscular definition, I said I got "puffy" in that it was similar to an allergic reaction kind of puffy. I recognized this and stopped taking Avodart, restarted Proscar at a higher dosage and it was a few months later that I started to return to a more normal appearance, again, with no change to my routine or diet.

 

If you are a believer in the scientific data as you say you are, you can't realistically deny that your claim has too many potential extraneous variables in addition to your workout routine and diet. Your use of the word"ripped" as a reference point and discussion of losing definition in your body and face is not a way to describe an allergic reaction that I have ever heard. After all, why mention working out and "ripped" if you are talking about the possibility of puffiness, or swelling ?

 

 

I don't need a study to tell me that this happened to me and you saying it is statistically insignificant and "not a true risk" does not take away the fact that it happened nor does it diminish the extreme probability that is was due to Avodart usage. I'm not going to go through this ordeal five hundred times in a controlled study to determine this either. If I'm wrong, I'm wrong, but it's not up to you, nor is it your right, to say otherwise.

 

I certainly never denied it happened to you , but to claim that it is a significant "risk" of using Avodart when it is not mentioned in a scientific study of thousands of men does actually make it an insignificant risk at this time. It would make the percentage of those experiencing the side effect close enough to zero to be actually be considered zero. It is certainly not something that occurs enough to call using the drug "questionable"

 

Regarding the "fella" comment, if you read what I said I did not say " I heard ". I said " I know" and I know because I was involved in the reporting of his problem.

 

Again..... Notice I quoted the "fella" part from you and did not quote the part about hearing it. Therefore, I was speaking in general terms.

 

 

But most importantly, the studies don't tell the whole story. There is a saying, "the numbers don't lie", which is true but the numbers do not dictate the questions and they certainly do not represent every scenario. Being in pharma I'm sure you understand this and I hope that you don't try to debunk any side effect based on whether or not it is listed in a study as being possible.

 

Numbers and statistics are often misleading in medicine and can have very negative impacts on the quality of health care as a result. I can tell you many stories about that. I am definitely on your side with that issue, especially with reporting illness. The numbers from what is known SO FAR makes this a little bit different at THIS point in time. If there were established numbers to back up the side efects you mentioned that make Avodart a "questionable" drug, it would be more widely known and could be considered questionable at that point.

 

 

The whole point of my post was in response to you calling the use of Avodart "questionable" in your response. It is certainly your right to make a recommendation or preference about any drug and no one should deny anyone that right in our free country, but you called the use of Avodart "questionable" in general. You then proceeded to list not one of it's most frequently occurring possible side effects that I was sure you would have done. Moreover, you used the supposed side side effects as an answer to another member's question when they asked you what are the issues that make Avodart not worth it's use ?One was something that could be unique to you. Another was regarding sperm count which you even said yourself could be unattributable to Avodart . The other two you referred to having "evidence" of have actually been shown to be false in at least one scientific study that I am aware of and mentioned.

 

My reference to your arrival at the conclusions you mentioned as"comical" was because they made me laugh. Any science driven person would laugh at reading that. Maybe it was just the way it was written and how casual it was. Surely you can see that ? After all, you did not even mention one of the top known side effects. Had you mentioned those , I probably would not have even followed up.

 

I do sincerely apologize to you if I sounded overly aggressive towards you and was rude to you in what you referred to as"debunking". I was simply pointing out the known side effects and the percentage of people that reported them in those studies for concerned people to use to be informed. Your reply to my post and sarcastic question followed by the answer did read as a rhetorical question insinuating that you would know more than all others. Had it not been written that way and in response to my comments, I would not have been that way. My response was not to imply that I know more than others. I just relayed the current facts. Would you really want to steer someone away from something possibly good because someone you know had a low sperm count or you said your face was puffy if it was an unrelated or unique issue ?

 

Since you have say you have your master's degree in pharmacology, I would like to know your opinion on generic finasteride vs. finasteride manufactured by Merck in either Proscar or Propecia.

 

This may not be the answer you want, but due to my lack of time right now, it is just my general opinion about many generic drugs. It does NOT mean that all generic drugs are bad. I learned from some old school pharmacologists that subscribed to the belief that all generics were inferior to the trade name drugs, period. Without going into it too much, you get what you pay for. It is a pretty common belief among them. You could make arguments either way, but no time for that now. It is just like every other product unfortunately. i have yet to find a product better than the original that was less expensive and cheaply made with lower tolerances. As you know, generics might have the same active ingredients but have cheaper fillers, binders, colors, etc. in them . With many medications it is a non issue. Drastic differences have surfaced in cases of extended release medications where rates of release tend to differ greatly from the brand name drug. Additionally, the fillers, binders, colors,and other components can be changed from time to time. Ingredients can be brought in from who knows where just like with any product. The pharmacological properties and risks of side effects of generic drugs can change for these reasons. The bad thing about it is there is not really oversight to do too much about it. With bad things having been exposed at times in well known US pharmaceutical companies, it is unreasonable to think that bad or even worse things don't exist in places abroad that the FDA does not inspect or at least not often. I always get brand name drugs for medications that are very important to me regarding issues I care about and also regarding more serious medical issues. I recommend to others that they should get brand name drugs in the same instances when economically feasible. Of course, that is not possible at times. Medicine is changing and has changed so much over the past 10 years . I can remember when I went to the pharmacy and it was a rarity to get generic drugs. Now, it is all most of them carry. With a more managed health care system every year, it will only get worse. Oh no...this is opening up a whole different conversation !:eek: LOL

Have to go now....my apologies again for coming off too strong .