Norwood 6/7 Do You Take Finasteride?

[Melvin- Admin]

Regardless, if you’re a bald Norwood 6/7 why on earth would you take all these risks? Early onset dementia, potential aggressive prostate cancer, just to maintain higher sides or a smaller crown, end of the day you’re still bald. The general public don’t see a difference between Norwood 5 to 7 they just see bald. 

[Curious25]

7 minutes ago, Melvin-Moderator said:

Senile alopecia/involutional alopecia is caused by dying cells, not DHT. Also, I bet he stop because of side effects, except he prescribes the stuff, so it would probably reflect poorly on saying the truth.

It does intrigue me as to what hair loss surgeons true beliefs are regarding dht inhibitors. 

If you base your judgement from the available research journals and studies that have been conducted, then statistically, negative side effects are clearly in the minority, therefore it would be fair to advocate the medication from a scientific standpoint.   
 

I am extremely conscious however of the following two factors;

-The largest ever study has been conducted by the manufacturer of the drug
-The hair retention effects actively compliment the work and goals of hair surgeons 

For me, probably more in relation to the first point, as opposed the to the second - there is clear incentive to downplay negativity. 

For as much respect and gratitude I have for hair loss doctors, and the understanding that they have completed basic medical degrees etc. it ultimately isn't their field of medicine - this was the main reason I actively searched for, and paid a lot of money to run bloods and speak with a top urological consultant, in the same sense that if I were to be told by my GP I had high blood pressure - I wouldn't be phoning up Dr Konior to help me out with that one. 

My levels of intrigue are in relation to the fact that the hair restoration surgeons and doctors are bound to have friends and peers in urological fields across the globe, so I would love to know what their views would be in regards to taking the medication themselves.   


 

[Cristero]

24 minutes ago, LonelyGraft said:

Not sure where you got your info from but finasteride helped prevent prostate cancer in over 25% of men over 55 who were in it over 7 years. That’s significant.

 

the doctor provides a very good explanation in terms of why higher grade prostate cancer was detected. It likely wasn’t finasteride that caused it directly. Take a read:

 

https://www.cancer.gov/news-events/cancer-currents-blog/2019/prostate-cancer-prevention-finasteride-parnes

You are using just one source.

This metanalisys contradict your source:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358277/#:~:text=The role of 5α-reductase,risk in high-grade disease.

 

Ypu may want to read the biggest metanalisys of studies on DHT I'm aware of, that shed light on the role of DHT in prostate cancer, which is dubious by now:

https://academic.oup.com/edrv/article/38/3/220/3788611

Edited September 1, 2020 by Cristero

[LonelyGraft]

11 minutes ago, Melvin-Moderator said:

I just copied and pasted directly from the same site you posted lol and it says specifically: 

However, the trial results also raised the possibility that finasteride might increase the risk of high-grade (potentially more aggressive) prostate cancer. This finding led the Food and Drug Administration (FDA) to place a black box warning on the drug’s label about the potential risk of high-grade prostate cancer.

I’m posting this again....if you want to overlook it for the second time then I give up:

 

So how do you explain the increased risk of high-grade disease reported in 2003?

There are two mechanisms by which we believe finasteride enhances the detection of high-grade cancer on prostate biopsy.

First, finasteride is known to decrease the size of the prostate gland by about 25%. When you biopsy a smaller gland, you are more likely to sample an area of cancer—or high-grade cancer—with your biopsy needle, compared to doing the same biopsy in a larger gland.

Second, as we showed in another analysis of the PCPT, finasteride improves the sensitivity of the PSA test for the detection of overall and high-grade prostate cancer. Because the decision to perform prostate biopsies during the study was based on PSA levels, this may have contributed to increased detection of prostate cancer, in general, and high-grade prostate cancer, in particular, among men receiving finasteride.

Due to the effects of this drug on gland size and PSA performance, it seems quite likely that the PCPT not only overestimated the harm of finasteride in terms of the observed increase in high-grade cancer, but mayhave underestimated the benefit of finasteride in terms of the amount of reduction in prostate cancer risk.

[LonelyGraft]

5 minutes ago, Cristero said:

You are using just one source.

This metanalisys contradict your source:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358277/#:~:text=The role of 5α-reductase,risk in high-grade disease.

 

Ypu may want to read the biggest metanalisys of studies on DHT I'm aware of, that shed light on the role of DHT in prostate cancer, which is dubious by now:

https://academic.oup.com/edrv/article/38/3/220/3788611

So a randomized study with 19000 patients over 7 years is something we should overlook? Ok 👍🏼 

[LonelyGraft]

12 minutes ago, Cristero said:

You are using just one source.

This metanalisys contradict your source:

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6358277/#:~:text=The role of 5α-reductase,risk in high-grade disease.

 

Ypu may want to read the biggest metanalisys of studies on DHT I'm aware of, that shed light on the role of DHT in prostate cancer, which is dubious by now:

https://academic.oup.com/edrv/article/38/3/220/3788611

Directly from your first link which go in line with the study I linked as well as the urologists comments:

 

However, the published data contradict this argument and suggest that 5-ARIs are safe in terms of prostate cancer risk and mortality, and the new research findings from Unger and colleagues⁵ and Wallerstadt and co-workers⁶suggest there might be true long-term benefits of 5-ARIs in preventing prostate cancer. What remains to be addressed is whether the safety warning should be removed from 5-ARI labels, as the benefits of 5-ARI therapy might far out-weigh any potential risks related to prostate cancer incidence.

[Cristero]

2 minutes ago, LonelyGraft said:

So a randomized study with 19000 patients over 7 years is something we should overlook? Ok 👍🏼 

You clearly have a bias and failing to understand how the research and studies works.

Just for your information, a metanalisys is a collection of several studies and it's considered superior to a single study, as it collects data from several sources throughout the years.

The source you cited is still doing a connection between DHT and prostate cancer, which has been found to be obsolete in the second metanalisys I've sent you. I guess you didn't even open it. That doesn't invalidte all it says there, but clearly shows the doctor you quoted is failing to keep himself updated.

In any case, there's no point on keeping discussing it. It's the usual self-defensive attitude of finasteride users. They don't want to hear the fact that they are possibly jeopardizing their health for the sake of a band aid that won't prevent them to eventually get bald anyway.

[Cristero]

3 minutes ago, LonelyGraft said:

Directly from your first link which go in line with the study I linked as well as the urologists comments:

 

However, the published data contradict this argument and suggest that 5-ARIs are safe in terms of prostate cancer risk and mortality, and the new research findings from Unger and colleagues⁵ and Wallerstadt and co-workers⁶suggest there might be true long-term benefits of 5-ARIs in preventing prostate cancer. What remains to be addressed is whether the safety warning should be removed from 5-ARI labels, as the benefits of 5-ARI therapy might far out-weigh any potential risks related to prostate cancer incidence.

That's what we have been saying. The actual studies didn't figure it out yet and, as you can see, the conclusion is still to be found. I see a lot of "might". The jury is out there regarding the impact of 5-ar inhibitors in terms of prostate cancer, while you are clearly taking a side.

[LonelyGraft]

13 minutes ago, Cristero said:

You clearly have a bias and failing to understand how the research and studies works.

Just for your information, a metanalisys is a collection of several studies and it's considered superior to a single study, as it collects data from several sources throughout the years.

The source you cited is still doing a connection between DHT and prostate cancer, which has been found to be obsolete in the second metanalisys I've sent you. I guess you didn't even open it. That doesn't invalidte all it says there, but clearly shows the doctor you quoted is failing to keep himself updated.

In any case, there's no point on keeping discussing it. It's the usual self-defensive attitude of finasteride users. They don't want to hear the fact that they are possibly jeopardizing their health for the sake of a band aid that won't prevent them to eventually get bald anyway.

Sorry, I think you need some schooling Bc YOU clearly have a bias and don’t know how interpret what’s In front of u

 

all I was stating is that a well controlled study with 19k participants is nothing to look over. Your meta analysis does not only look at prostate disease, rather dht inhibition as a whole

 

your second link simply states that SERUM Androgen levels likely have no effect on prostate cancer development. (Duhhh we all know 5ar is located in specific sites including but not limited to: the liver, hair follicle pilosebaceous unit, sebaceous gland, prostate, etc) serum levels tell us nothing otherwise we should all be getting blood work to see how finasteride is working for our hair. It’s all about the local activity of 5ar.
 

Keep ignoring key points 🙃

[Cristero]

1 minute ago, LonelyGraft said:

Sorry, I think you need some schooling Bc YOU clearly have a bias and don’t know how interpret what’s In front of u

 

all I was stating is that a well controlled study with 19k participants is nothing to look over. Your meta analysis does not only look at prostate disease, rather dht inhibition as a whole

 

your second link simply states that SERUM Androgen levels likely have no effect on prostate cancer development. (Duhhh we all know 5ar is located in specific sites including but not limited to: the liver, hair follicle pilosebaceous unit, sebaceous gland, prostate, etc) serum levels tell us nothing otherwise we should all be getting blood work to see how finasteride is working for our hair. It’s all about the local activity of 5ar.
 

Keep ignoring key points 🙃

You are getting all heated up for no reason and acting like a child.

I didn't say your study is something to look over. I've actually been the first onn to say that new studies debunked the high prostate cancer link to 5-ar inhibitors, but I wans't too convinced of them yet. And the reason, once again, is that things are still up in the air, with a lot of may or might.

What you are saying on the second link is something I've been talking about since a while with people obsessed about DHt serum levels and something Italians dermatologists know since a while. Some of them request a serum 3a- androstanediol value to understand enzymatic activity in tissues and even that is not giving you the whole picture. You would need a scalp DHT biopsy to understand what's going on.

In any case, even if the latest studies didn't completely shed light, how can you categorically exclude it, when some doctors are still reluctant to prescribe 5-ar inhibitors?

And most of all, what's your contribution to the topic? This is not a post about finasteride side-effects, rather a thread regerding the alleged usefulness of finasteride on the donor.

[Melvin- Admin]

The point of the thread is to weigh the pros and cons for using finasteride as a Norwood 6/7. So far I’ve seen reports saying it helps the donor, maintains the sides high, reduces the size of the crown. But when you look at all of the possible things that can occur with long-term use, especially cognitive decline and function. It’s not worth it to me.

Now, I’m saying this particularly for Norwood 6/7s. Obviously, if you’re a Norwood 2, it is definitely worth trying, as it can help you maintain your hair for a long time. A Norwood 2 still has a full head of hair, but a Norwood 6, you should’ve tried it years ago, too little too late in my opinion. 

[harry_potter1]

My dermatologist laughed at me when I asked if I should take it. Not sure why but I decided to comply lol

I suspect because of the side effect. I mean it is 5% or cases right?

That is 1 in every 20 patients, so for a clinic who probably has 100's per month, they will have at least one or two angry case per week. Not worth it for them 

[Mike_2020]

18 hours ago, Melvin-Moderator said:

But when you look at all of the possible things that can occur with long-term use, especially cognitive decline and function. It’s not worth it to me.

if you’re a Norwood 2, it is definitely worth trying, as it can help you maintain your hair for a long time. 

If cognitive function decline is on the menu then even Norwood 2s should consider what they are doing. 

[asterix0]

If I was a Norwood 2 or 3 I would never take this drug. The fact that I was clearly going towards Norwood 6 in my early twenties, and still am, but finasteride effectively stopped this process for years and now at 28, it has retained a lot of my native, but still diffusely thinning, hair on top.

I could have lived with a receding hairline, or even a thinning crown, but the fact I was on pace to lose everything in my mid to late twenties was just too psychologically crushing for me.

So, I take the risks of this drug versus the certainty of depression (for me) of being bald.

I thought well, what about just letting it all go and getting a transplant. But I was straight out of college, had student debt, and realized it would take years of savings to get a transplant with the doctors I wanted. Going to Turkey and taking a discount deal risk was not an option for me, the potential of losing precious donor and being botched with no hope left would be absolutely devastating.

So I begrudgingly took minoxidil and finasteride and I have been lucky to not have side effects (to my knowledge at least).

Edited September 2, 2020 by asterix0

[Seniormido]

On 8/31/2020 at 9:52 PM, Zoomster said:

I just wanted to show how finasteride has helped my very lower horseshoe (coronet ) which wasn’t transplanted into ..I’d almost argue my donor is more robust now post 5600 scalp grafts than pre op...hairs are darker and visibly thicker 

what’s more ..Dr Sethi needs to now be mentioned in the same breath as Konior and Wong for crowns ...very very few Doctors In my humble opinion could have achieved what he has managed to do with regard to my extreme one pass case .

Z

It’s difficult to compare because of the difference in light and in hair length between the 2 photos. As you all know both light and hair length make a big difference.

[quantumhair]

@Melvin- ModeratorInteresting topic. Are you taking fin after your recent hair transplant? Any new perspective on this topic after since you posted this thread?

[Yabala]

On 9/1/2020 at 8:08 PM, Melvin- Moderator said:

Regardless, if you’re a bald Norwood 6/7 why on earth would you take all these risks? Early onset dementia, potential aggressive prostate cancer, just to maintain higher sides or a smaller crown, end of the day you’re still bald. The general public don’t see a difference between Norwood 5 to 7 they just see bald. 

So what you wrote is that starting finasteride for advanced Norwoods(5,6 and 7) is too late? Even if it is to keep the crown high and dense at the back and keep the lateral humps high ? 

[Sunset Dune]

On 9/1/2020 at 1:08 PM, Melvin- Moderator said:

Regardless, if you’re a bald Norwood 6/7 why on earth would you take all these risks? Early onset dementia, potential aggressive prostate cancer, just to maintain higher sides or a smaller crown, end of the day you’re still bald. The general public don’t see a difference between Norwood 5 to 7 they just see bald. 

This. It’s not my opinion it’s a general consensus there’s absolutely no point in taking hair loss meds at that stage in baldness. You’ve already lost your hair, why risk losing more? (The traits that make you a man) 

[Gatsby]

I'm taking topical finasteride 0.25%. I'm doing so in the hope of protecting my parietal humps from dropping and to give what protection I can to my hair in general. I also take 5mg a day of oral minoxidil and to be fair I feel that the minoxidil is probably doing more to help. As to senile dementia, I wood Like 2 ad that sumtimes mi tiping skeelsappee2lining()FDHSJTJHsagjgoihaeeoirgeigiegioahjeg9ijhaeigjaeigjhiejg[oiajg[oiajg[oiarjgoiajg[oiajgiojgiejagija[ierjgigjedejgvaeigje8tj034utq=0tj3q4j834jg8 🤪

[Grouse]

On 9/1/2020 at 10:03 AM, Melvin- Moderator said:

My main concern isn’t necessarily the sexual effects, because that can be nocebo effects. But there is a correlation between inhibiting DHT and early onset dementia or Alzheimers. The risk is worth it if you still have hair to save, but if your bald, I just cannot justify taking that risk. 
 

https://www.jns-journal.com/article/S0022-510X(17)30372-6/abstract

Melvin, curious how your views have changed since this thread given you’re starting topical DUT.
 

I assume the thinking is it doesn’t go systemic and thus shouldn’t be a worry?

[Melvin- Admin]

11 hours ago, Grouse said:

Melvin, curious how your views have changed since this thread given you’re starting topical DUT.
 

I assume the thinking is it doesn’t go systemic and thus shouldn’t be a worry?

I’m not worried because it’s not going as systemic.