How To Avoid Nocebo From Finasteride/Dutasteride

[Hexmask]

This will be a quick and simple guide to avoid nocebo effect when taking finasteride or dutasteride.

What is nocebo? Per the dictionary: "when a patient's negative expectations about a medical treatment cause them to experience undesirable symptoms or illnesses, even though the treatment has no known physical effects." This is something very important to understand what it is and that it happens ESPECIALLY when using these drugs.

Now firstly what you must understand is that DHT is a useless hormone past puberty:
https://www.ncbi.nlm.nih.gov/books/NBK557634/
"DHT does not play a significant role in the normal physiology of adults. The most notable effects are prostate enlargement and male pattern hair loss as they age."
"This hormone finds its utility as an essential hormone in males until puberty, after which it is considered an etiology for certain diseases. "

Next, "But Hex!!! Muh muscle binding affinity 5 times as potent muh muh muh" WRONG NIGGER. DHT is rapidly metabolized 3-alpha-hydroxysteroid dehydrogenase in muscle tissue: https://pubmed.ncbi.nlm.nih.gov/182...erone (DHT),,in the pathogenesis of hirsutism.

Lastly, neuro steroids. "But hex muh neuro steroids in the type 1 enzyme, allopregnanolone, muh suppression of essential neuro steroids!!!" AGAIN WRONG NIGGER. We have no conclusive evidence that inhibiting DHT will effect these. The only testing they have done were on rats and they would drop them into water and see how long they would fight for. While at the same time giving the rats a dosage humans could not even touch(I believe it was like 1g of finasteride). I would also like to note an important part is that depression nor anxiety was never listed as a list of symptoms on finasteride nor dutasteride until the PFS community forced the manufactures to list it on the finasteride bottle.

Overall, the issue is is many people like to claim the idea of these drugs being the worst of the worst, but in actuality most people give themselves a nocebo effect. 2-3% of men experience symptoms over millions of prescriptions every year and you simply can stop the drug or switch drugs or reduce dosing. You also have to understand that if you are natural you can potentially have a rise in estrogen which can cause a host of symptoms. People need to understand that it is always reversible. There is no conclusive evidence on anything about permanent side effects. All studies on permanent things happening that have even been done are mechanistic studies. The issue with that is that it will make up a fraction of what's actually happening in the pathways. All in all, I believe PFS isn't real and you have no real concern to take these drugs and save yourself from a life long pain of balding, and horrible skin. (Especially if you're roiding).

DHT=DESTINED HAIR TRANSPLANT

 

[Hexmask]

Honorable Mentions:
@MA_ascender @NZb6Air @Bitchwhipper2 @Dyorotic @PsychoH

 

[Bitchwhipper2]

Definitely agree.

Only reason i want my dht intact though is to not halt my beard development

 

[lestoa]

.

 

[PsychoH]

This will be a quick and simple guide to avoid nocebo effect when taking finasteride or dutasteride.

What is nocebo? Per the dictionary: "when a patient's negative expectations about a medical treatment cause them to experience undesirable symptoms or illnesses, even though the treatment has no known physical effects." This is something very important to understand what it is and that it happens ESPECIALLY when using these drugs.

Now firstly what you must understand is that DHT is a useless hormone past puberty:
https://www.ncbi.nlm.nih.gov/books/NBK557634/
"DHT does not play a significant role in the normal physiology of adults. The most notable effects are prostate enlargement and male pattern hair loss as they age."
"This hormone finds its utility as an essential hormone in males until puberty, after which it is considered an etiology for certain diseases. "

Next, "But Hex!!! Muh muscle binding affinity 5 times as potent muh muh muh" WRONG NIGGER. DHT is rapidly metabolized 3-alpha-hydroxysteroid dehydrogenase in muscle tissue: https://pubmed.ncbi.nlm.nih.gov/18252781/#:~:text=Context: Dihydrotestosterone (DHT),,in the pathogenesis of hirsutism.

Lastly, neuro steroids. "But hex muh neuro steroids in the type 1 enzyme, allopregnanolone, muh suppression of essential neuro steroids!!!" AGAIN WRONG NIGGER. We have no conclusive evidence that inhibiting DHT will effect these. The only testing they have done were on rats and they would drop them into water and see how long they would fight for. While at the same time giving the rats a dosage humans could not even touch(I believe it was like 1g of finasteride). I would also like to note an important part is that depression nor anxiety was never listed as a list of symptoms on finasteride nor dutasteride until the PFS community forced the manufactures to list it on the finasteride bottle.

Overall, the issue is is many people like to claim the idea of these drugs being the worst of the worst, but in actuality most people give themselves a nocebo effect. 2-3% of men experience symptoms over millions of prescriptions every year and you simply can stop the drug or switch drugs or reduce dosing. You also have to understand that if you are natural you can potentially have a rise in estrogen which can cause a host of symptoms. People need to understand that it is always reversible. There is no conclusive evidence on anything about permanent side effects. All studies on permanent things happening that have even been done are mechanistic studies. The issue with that is that it will make up a fraction of what's actually happening in the pathways. All in all, I believe PFS isn't real and you have no real concern to take these drugs and save yourself from a life long pain of balding, and horrible skin. (Especially if you're roiding).

DHT=DESTINED HAIR TRANSPLANT

bump. awesome thread bud.

 

[BecomingHuman]

Definitely agree.

Only reason i want my dht intact though is to not halt my beard development

Fixable problem through trimax + shave

 

[Hexmask]

Definitely agree.

Only reason i want my dht intact though is to not halt my beard development

Have you considered topical minoxidil? I was able to grow great stubble even before roids with using the foam 5 percent twice a day. Haircafe suggests the same

 

[Bitchwhipper2]

Have you considered topical minoxidil? I was able to grow great stubble even before roids with using the foam 5 percent twice a day. Haircafe suggests the same

Already on topical minox for my beard for nearly 4 years now.

My plan is to use low dose topical fin with RU and perhaps topical E avoid inhibiting systemic dht as much as possible while also reducing scalp androgenicity

 

[SquareChinOrDeath]

I'm 0.5mg Duta once a week for over 3 years with zero side effects.

 

[spermium]

that inhibiting DHT will effect these.

It's not the DHT it's the enzyme that converts them. Fin doesn't mess with any of that so I would stay on that tbh.
Fin still does reduce allopregnolone somehow but it's less impactful than dut, plus you could always inject it back.

Also we don't know what dht does to our bones, mice that had no type 1 enzyme weaker limbs. You're just guessing with dut

Mental side effects from balding are gonna be way more brutal and destructive compared to whatever messing with neurosteroids does, but we're potentially picking the lesser of the two evils. We just don't know, ingenuous to claim otherwise

 

[Hexmask]

It's not the DHT it's the enzyme that converts them. Fin doesn't mess with any of that so I would stay on that tbh.
Fin still does reduce allopregnolone somehow but it's less impactful than dut, plus you could always inject it back.

Also we don't know what dht does to our bones, mice that had no type 1 enzyme weaker limbs. You're just guessing with dut

Mental side effects from balding are gonna be way more brutal and destructive compared to whatever messing with neurosteroids does, but we're potentially picking the lesser of the two evils. We just don't know, ingenuous to claim otherwise

It doesn't matter about it converting to it again we have zero conclusive studies. As for your argument on the choice of drugs, we can see the molecular weight of dutasteride is barely even comparable to the molecular weight of a molecule to be able to pass the blood-brain barrier. Essentially, it's impossible for dutasteride to have an effect or finasteride.

If lowering systemic DHT had an effect on any of these areas of topic, then dutasteride would have more side effects then finasteride and every study proves that they have an equal amount that either clear up as your body adjust to the drug or stop after discontinuation and allowing the 5ar enzyme to convert again.

 

[Hexmask]

I'm 0.5mg Duta once a week for over 3 years with zero side effects.

How much scalp reduction does that give? Im happy for you though.

 

[SquareChinOrDeath]

How much scalp reduction does that give? Im happy for you though.

A stable 90%

 

[Hexmask]

A stable 90%

Out of curiosity, do you have a link to a study talking about that? That would save me money lol. From what I read .5mg a day reduced scalp DHT to 51 percent and system to I believe around 90 percent.

 

[Hexmask]

Already on topical minox for my beard for nearly 4 years now.

My plan is to use low dose topical fin with RU and perhaps topical E avoid inhibiting systemic dht as much as possible while also reducing scalp androgenicity

I haven't watched the video, but I saw haircafe has a newer video about new studies related to beard growth and DHT. Might want to check it out.

 

[spermium]

doesn't matter about it converting to it again

Forget dht the 5ar converts other steroids too. We have no clue what inhibiting those does. I think there's a paper showing how dut and fin altered neurosteroids and dut did it more so it definitely crosses the brain barrier

 

[DR. NICKGA]

It's not the DHT it's the enzyme that converts them. Fin doesn't mess with any of that so I would stay on that tbh.
Fin still does reduce allopregnolone somehow but it's less impactful than dut, plus you could always inject it back.

Also we don't know what dht does to our bones, mice that had no type 1 enzyme weaker limbs. You're just guessing with dut

In rats yes

Look at people who are genetic deficient in dht, do have they bone issues? Or mental issues? No they dont

This issues was not reported

 

[spermium]

A stable 90%

You shouldn't worry about muh scalp dht, the scalp is full of oil glands that contain DHT but are unrelated to hairloss. Dut 0.5 crushes hair follicle DHT to 99.9%

 

[spermium]

In rats yes

Look at people who are genetic deficient in dht, do have they bone issues? Or mental issues? No they dont

This issues was not reported

Nigger humans can only have a type 2 enzyme deficiency, the type 1 is the one in bone tissue. Those anomalous faggost still had normal dht levels in their bones

 

[DR. NICKGA]

Nigger humans can only have a type 2 enzyme deficiency, the type 1 is the one in bone tissue. Those anomalous faggost still had normal dht levels in their bones

oh

 

[NZb6Air]

DHT will effect these

? 5alphareductase, not DHT

 

[NZb6Air]

Mental side effects from balding are gonna be way more brutal and destructive compared to whatever messing with neurosteroids does

 

[Bitchwhipper2]

I haven't watched the video, but I saw haircafe has a newer video about new studies related to beard growth and DHT. Might want to check it out.

I saw it.

Conclusion is that it generally doesnt cause beardloss, although it does halt the development of it.

 

[gofortheeyes]

SUP CHOOM, another proud haircafe witcher

 

[DR. NICKGA]

https://www.hs.fi/tiede/art-2000010796631.html

The largest Finnish newspaper just published an article about the ongoing fin/dut EU investigation (paywalled and in Finnish, link at the end). The title asks if the meds do more harm than good, and they interviewed couple of experts. Here's the gist of it:

• There were around 300 men with fin prescriptions for hair loss in Finland in 2021.
• The senior physician from Finnish Medicines Agency says that they get "less than 1-2" reports of psychiatric sides per year, and the rate has been the same for decades.
• There were 94 000 men on fin for prostate problems. Sadly no mention how many psychiatric sides they report or does the same 1-2/year apply here.
• Professor of urology from university of Helsinki says that the risk of suicidality was only seen with younger users taking meds for hair loss. He also adds that the studies are epidemiological and do not show clear causality. No such risk has been seen with older men using the meds for prostate problems.
• The same guy estimates that 10-20% of fin users have sides such as lowered libido, ed or ejaculation changes/problems.
• In the article it says that the British Regulatory Agency MHRA has received 281 reports regarding finasteride and depression and suicidality between now and April 1993.
• The number of reports regarding sexual sides such as lower libido and ed has been 400 within the same timeframe.
• After depression was added as a warning to fin boxes in the US, FDA received over 700 suicidality reports in a short time.

 

[DR. NICKGA]

they are scared of a fda approved medicine named finasteride

Which has multiple studies on it, for example this meta analysis of 2+ million people
Meta analysis = multiple studies

Association of 5α-Reductase Inhibitors with Depression and Suicide: A Mini Systematic Review and Meta-analysis - PubMed

5α-Reductase inhibitors (5-ARIs) are widely prescribed for treatment of benign prostatic obstruction and androgenic alopecia. Several studies with controversial findings regarding 5-ARI exposure have been published over a number of years, and concerns were recently raised about the potential...

pubmed.ncbi.nlm.nih.gov

"SUMMARY: We reviewed study data for more than two million patients taking drugs called 5α-reductase inhibitors (5-ARIs), which are widely prescribed for urinary problems caused by benign prostate enlargement and for male-pattern hair loss. In a pooled analysis we found no evidence of an association between 5-ARI use and the risk of depression or suicide
Keywords: 5α-Reductase"

No depression or suicide risks, now this is one example of two side effects
I can give 1000+ more studies


The only people i see that got side effects are reddit users or users from a weird obscure hairloss community

 

[DR. NICKGA]

I'm 0.5mg Duta once a week for over 3 years with zero side effects.

me too , 7 days a week

 

[DR. NICKGA]

Finasteride (Propecia and Proscar) for Male Pattern Baldness May Also Lower Cholesterol

Finasteride can reduce cholesterol levels and heart disease risk in men in addition to treating hair loss and enlarged prostate, new research finds.

www.everydayhealth.com

• New research suggests that the medication finasteride, already used for male pattern baldness and enlarged prostate, may reduce cholesterol and cut heart disease risk.
• Finasteride works by blocking formation of the active form of testosterone.
• Previous studies on the impact of testosterone on heart health have reached conflicting conclusions.

 

[Hexmask]

Finasteride (Propecia and Proscar) for Male Pattern Baldness May Also Lower Cholesterol

Finasteride can reduce cholesterol levels and heart disease risk in men in addition to treating hair loss and enlarged prostate, new research finds.

www.everydayhealth.com

• New research suggests that the medication finasteride, already used for male pattern baldness and enlarged prostate, may reduce cholesterol and cut heart disease risk.
• Finasteride works by blocking formation of the active form of testosterone.
• Previous studies on the impact of testosterone on heart health have reached conflicting conclusions.

Mirin all your studies, thanks for adding to this thread. So tired of all this fear mongering here in the forum yet we recommend roids to people…I literally wouldn’t roid if it wasn’t for dut

 

[Hexmask]

@noodlelover

 

[noodlelover]

@noodlelover

Thank you for the tag.

Here's the study mentioned by the emotionally dysregulated youtuber, highly emotionally invested in finasteride not being the cause of his emotional dysregulation.

Association of 5α-Reductase Inhibitors with Depression and Suicide: A Mini Systematic Review and Meta-analysis - PubMed

5α-Reductase inhibitors (5-ARIs) are widely prescribed for treatment of benign prostatic obstruction and androgenic alopecia. Several studies with controversial findings regarding 5-ARI exposure have been published over a number of years, and concerns were recently raised about the potential...

pubmed.ncbi.nlm.nih.gov

https://www.sciencedirect.com/science/article/abs/pii/S2405456924000622

It finds no statistical correlation between people using DHT inhibitors and depression or suicide. What "studies" were considered in this meta analysis? It mentions some studies were left out (possible sampling bias). Why were these left out? What was the statistical difference? We'll never know because the full text of the study is no where to be found online, not even in illegal repositories of leaked journal studies.

But...

If you develop depression or suicide after taking DHT inhibitors are you going to keep taking the drugs? Obviously not, which is why we have so many people that try it, develop symptoms and then stop taking it.

If we forced all of those people to keep taking the drug despite their symptoms the statistics would be different.

Then there's the people that don't develop diagnosable levels of depression but became clearly highly emotionally and mentally dysregulated like, most likely haircafe that continue using but aren't going to meet the statistical criteria because they haven't reached a clinically diagnosable level of depression.

I really would like to see the full text of the study, but we'll have to wait and see.

 

[DR. NICKGA]

But...

If you develop depression or suicide after taking DHT inhibitors are you going to keep taking the drugs? Obviously not, which is why we have so many people that try it, develop symptoms and then stop taking it.

If we forced all of those people to keep taking the drug despite their symptoms the statistics would be different.

?? This is such a stupid logic

Yea they are gonna stop taking the drug, and will report the side effect

Did this side effects get reported in those studies? (Beside from random reddit users)

No



"So many people"
This is again a lie , redditors or hairloaa forums dont count

 

[DR. NICKGA]

10-Year Finasteride Study: First to Investigate Long-Term Effects and Safety

2011 study by Dr. Alfredo Rossi, is the first comprehensive study on long-term safety and efficacy of Propecia. Click to read Dr. Bernstein's analysis.

www.bernsteinmedical.com

In “Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up,” the Italian research team sought to fill a gap in our understanding of the long-term effects of treating hair loss with Propecia. The study tracked hair growth in 118 men between the ages of 20 and 61, with mild to moderate hair loss, who were treated with 1mg finasteride. These patients were evaluated before treatment and then again at 1, 2, 5, and 10 years on treatment.

The result of testing found not only that Propecia works and is safe for use, but there were some other interesting findings as well. Only 14% patients experienced a worsening of hair loss, while 86% benefited from the treatment over this extended time period and efficacy of the drug was found not to reduce over time for the majority of patients.




In conclusion, the authors found that Propecia is a safe and effective hair loss medication, even when used long-term. It is effective in patients older than 40 years and it is particularly beneficial for patients over 30 and who are in early stages of hair loss. Perhaps the most important finding is that a patient’s response to finasteride after the first year of treatment can be an indicator of the patient’s success with the drug in the long-term.




100% SAFE

 

[DR. NICKGA]

http://jnci.oxfordjournals.org/content/99/13/1025.long (n=17,313) Overview of sexual side effects from the PCPT trial. "The effect of finasteride on sexual functioning is minimal for most men"

http://www.ncbi.nlm.nih.gov/pubmed/8881946 (n=14,772) Observational cohort study. "Impotence or ejaculatory failure, decreased libido and gynaecomastia in a small proportion of patients were associated with the use of finasteride. This drug is acceptably safe when used in accordance with the current prescribing information."

http://www.ncbi.nlm.nih.gov/pubmed/12477383 (n=8,820) Overview of BPH Trials. "Significantly more sexual dysfunction, impotence, ejaculation disorder and decreased libido occurred with finasteride at 12 months; the NNH for any sexual dysfunction at 12 months was 14"

http://www.ncbi.nlm.nih.gov/pubmed/20956649 (n=3,927) Review of efficacy and safety for treating hair loss. "Moderate-quality evidence suggests that daily use of oral finasteride increases hair count and improves patient and investigator assessment of hair appearance, while increasing the risk of sexual dysfunction."

http://www.ncbi.nlm.nih.gov/pubmed/9610579 (n=3,270) Long-term safety study of finasteride in use for BPH.

http://www.ncbi.nlm.nih.gov/pubmed/21980923 (n=3,177) Study on 3,177 japanese men for hair loss. "Adverse reactions occured in 0.7% (23/3,177) of men; seven men discontinued treatment based on risk-benefit considerations. No specific safety problems associated with long-term use were observed."

http://www.ncbi.nlm.nih.gov/pubmed/12639651 (n=3,040) PLESS placebo controlled safety study of finasteride for treating BPH. "Compared with placebo, men treated with finasteride experienced new drug-related sexual AEs with an increased incidence only during the first year of therapy."

http://www.ncbi.nlm.nih.gov/pubmed/10197842 (n=895) 5-year efficacy and safety study of finasteride. "Finasteride was well tolerated, with no significant increase in the prevalence of sexual adverse events over time."

http://www.ncbi.nlm.nih.gov/pubmed/12670567 (n=725) 6-year placebo controlled study on finasteride. "no increase in the prevalence of drug-related adverse events over time."

http://www.ncbi.nlm.nih.gov/pubmed/11763381 (n=472) Evaluation of sexual side effects in 1mg finasteride. "The sexual and erectile function of subjects taking finasteride does not significantly differ from that of age-matched controls. This is consistent with the experience of many dermatologists who do not see sexual or erectile dysfunction in patients taking Propecia."

http://www.ncbi.nlm.nih.gov/pubmed/12695131 (n=424) 2-year efficacy and safety of 1mg finasteride. "Treatment with finasteride 1 mg was generally well tolerated."

http://www.ncbi.nlm.nih.gov/pubmed/23067029 (n=378) Safety assessment of fin vs dut. "The incidence of erectile dysfunction, ejaculatory dysfunction and decreased libido resulting in discontinuation from therapy for finasteride was (2.1%, 1.8%, 1.4% respectively."

http://www.ncbi.nlm.nih.gov/pubmed/15262698 (n=186) Evaluation of sexual function for 1mg finasteride. "Our results support the clinical impression that sexual side effects are actually much less common than reported in clinical trials. The sexual function of all patients remained stable during treatment with 1 mg of finasteride." (This is less than 200 participants, but I included it since it was more relevant due to it being conducted on younger men)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2840927/ (n=N/A) Finasteride and it's impact on sexual function and prostate cancer. (This is a retrospective analysis, but I wanted to include it because it analyzed some of the studies I posted and also gives some great information)

 

[DR. NICKGA]

The European Medicines Agency (EMA) did their safety investigation on FINASTERIDE....

The FDA did their safety investigation on FINASTERIDE....

They found out that its safe

 

[DR. NICKGA]

Its a easy battle if finasteride is safe or not.. look


Thousand of studies with millions of participants = finasteride and dutasteride is safe

Vs

broscience (anecdote evidence from reddit or forums that finasteride ruined their life) . Bad studies with a baised opinion . Bad articles . SHITTY theorys that dont happend in real life

 

[vtribal]

at the end of the day if you don’t want to mess with DHT then be ok with losing your hair

 

[cucklek]

what can u do if ur sides are from the increase of estrogen?

take low dose AI forever?

 

[Hexmask]

what can u do if ur sides are from the increase of estrogen?

take low dose AI forever?

Clean up your diet and lose weight. Only reason I take dutasteride is because Im on gear. If I was natty I wouldn't need it. But if I was norwooding and natty I would still take it. Could also try DIM. But yeah it doesn't hurt to take low dose Ai.