Dr. P - Reflex Hyperandrogenicity
AA6214
long.....it may be that the more Finasteride, the more reflex
hyperandrogenicity.
Could you please explain a little further as I don't fully understand what
hyperandrogenicity is or what the symptoms are. Is it just increased body hair
and scalp\facial oiliness or are there other symptoms. I ask because I have
been taking Proscar 5mg for quite a few years with no problem, however, for the
past few months I have noticed increased facial oiliness, incessent scalp
itching and major recession and hair miniturization. My scalp gets so oily
that even after 3 hours of shampooing, it is greasy to the touch. I have never
had this problem in my life before. I have had no increased body hair at all.
Does hyperandrogenicity imply that too much Finasteride may have negative
effects on MPB...that is to say, advance it's progression versus arrest it?
Would you recommend that I stop taking the Proscar for a period of time, and
then begin again at a lower dosage. If so, how long should I stop it for and
what dosage do you recommend that I begin after a period of elapsed time.
The only other factor that may be a play here is that my seasonal allergies are
at their all time worst, which I know causes imflammation. My usual allergy
meds, Betamethasone seems to be having no positive effect this time around so I
wonder if reflex hyperandrogenicity may be the real underlying culprit.
Peter H. Proctor
>From: aa6...@aol.com (AA6214)
>Subject: Dr. P - Reflex Hyperandrogenicity
>Date: 22 Jul 1998 11:34:09 GMT
>A few posts ago you mentioned that you can't use potent antiandrogens for
>long.....it may be that the more Finasteride, the more reflex
>hyperandrogenicity.
Really potent antiandrogens such as Flutamide often can't be used
for long on uncastrated males because they cause a reflex increase in
androgenic activity. This seems to be a combination of increased
testosterone production plus possible increased tissue senstivity.
A moderate increase in testosterone levels occurs with
Finasteride. In fact, this may help minimize potential side-effects such
as libido decrease. Don't know about increased tissue sensitivity, but it
seems possible. All this is rather variable and at least in theory may
"overshoot" a bit in a few people, actually producing symptoms of androgen
excess. possibly without inducing hair loss so much because the specific
5-alpha reductase is blocked.
This may explain part of the puzzling flat dose response curve of
finasteride ( i.e. 0.5 mg seems to work as well a 5 mg ). Besides the
limit to what antiandrogens can do anyway, beyond a certain point reflex
increases in androgenic activity may balance any therapeutic gains.
>Could you please explain a little further as I don't fully understand what
>hyperandrogenicity is or what the symptoms are. Is it just increased body hair
>and scalp\facial oiliness or are there other symptoms. I ask because I have
>been taking Proscar 5mg for quite a few years with no problem, however, for the
>past few months I have noticed increased facial oiliness, incessent scalp
>itching and major recession and hair miniturization. My scalp gets so oily
>that even after 3 hours of shampooing, it is greasy to the touch. I have never
>had this problem in my life before. I have had no increased body hair at all.
These are all symptoms of excess androgenic activity and/or
sensitivity. But they could just be coincidental. This is one reaosn
this has been diffcult to sort out.
>Does hyperandrogenicity imply that too much Finasteride may have negative
>effects on MPB...that is to say, advance it's progression versus arrest it?
Possibly in some persons-- see above about how it may partially
explain the flat dose/response curve for finasteride. But recall that
finasteride specifically blocks the production of the main baldness-inducing
antiandrogen. So you may see hyperandrogenic effects elswhere without those
necessarily being expressed as exacerbation of balding.
>Would you recommend that I stop taking the Proscar for a period of time, and
>then begin again at a lower dosage. If so, how long should I stop it for and
>what dosage do you recommend that I begin after a period of elapsed time.
Because of the potential hyperandrogenic state, I suggest that people
taper off slowly from Finasteride if possible. You should talk to your local
doctor about this. BTW, The dose I use is one quarter proscar tablet a day
and skip every fifth day. This is purely arbitrary but 1) gives the same
integrated overall dose as Propecia. 2) Gives a "day of rest". Intermittent
dosage is a well-known way of minimizing side-effects in chronic drug
treatment.
>The only other factor that may be a play here is that my seasonal allergies are
>at their all time worst, which I know causes imflammation. My usual allergy
>meds, Betamethasone seems to be having no positive effect this time around so I
>wonder if reflex hyperandrogenicity may be the real underlying culprit.
Don't know.
Peter H. Proctor, PhD, MD
http://www.drproctor.com
Timeo25082
>Date: Wed, Jul 22, 1998 07:34 EDT
>Message-id: <199807221134...@ladder01.news.aol.com>
>
Excellent post! I have been raising this issue about Proscar for a long time.
On the two separate occasions that I tried Proscar, I had an 'enormous'
increase in forehead/scalp oiliness and felt that the drug was detrimental to
my regrowth efforts. This reaction does seem to be rare but it certainly
exists.
It would be really interesting to peruse the Merck FDA study files and look at
those 17% who did not respond to Propecia. Were any determined to have an
'accelerated' rate of loss? If so, did they have a higher occurance of
hyperandrogenic side effects compared to the responders?
--T
>A few posts ago you mentioned that you can't use potent antiandrogens for
>long.....it may be that the more Finasteride, the more reflex
>hyperandrogenicity.
>
>Could you please explain a little further as I don't fully understand what
>hyperandrogenicity is or what the symptoms are. Is it just increased body
>hair
>and scalp\facial oiliness or are there other symptoms. I ask because I have
>been taking Proscar 5mg for quite a few years with no problem, however, for
>the
>past few months I have noticed increased facial oiliness, incessent scalp
>itching and major recession and hair miniturization. My scalp gets so oily
>that even after 3 hours of shampooing, it is greasy to the touch. I have
>never
>had this problem in my life before. I have had no increased body hair at
>all.
>
>
>Does hyperandrogenicity imply that too much Finasteride may have negative
>effects on MPB...that is to say, advance it's progression versus arrest it?
>Would you recommend that I stop taking the Proscar for a period of time, and
>then begin again at a lower dosage. If so, how long should I stop it for and
>what dosage do you recommend that I begin after a period of elapsed time.
>
>The only other factor that may be a play here is that my seasonal allergies
>are
>at their all time worst, which I know causes imflammation. My usual allergy
>meds, Betamethasone seems to be having no positive effect this time around so
>I
>wonder if reflex hyperandrogenicity may be the real underlying culprit.
></PRE></HTML>
Motohead32
>at
>those 17% who did not respond to Propecia. Were any determined to have an
>'accelerated' rate of loss? If so, did they have a higher occurance of
>hyperandrogenic side effects compared to the responders?
>
I bet they dont. They were probably labeled non-responders and left at that.
Since no other negative or dangerouse effects were noted, progression of
baldness or acceleration could be discounted as " natural progression " I
think this needs a study of its own to really determine what it all means.