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Dutasteride Dangers and Benefits

 
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LoveBuzz



Joined: 13 May 2014
Posts: 140

PostPosted: Wed Jun 17, 2015 8:59 am    Post subject: Dutasteride Dangers and Benefits Reply with quote

Hi Dr T,

I wanted to know if you could take the time to answer some questions I have regarding Dutasteride. Currently I take finasteride, however am considering making the switch.

The biggest concern I have with even trying Dutasteride is as follows:

- Blocks certain neurosteroids and is said to affect neuronal plasticity, block things in the brain which have a neuroprotective effect. On the other hand I've seen studies which show dutasteride to have a neuroprotective effect. See studies below:

hairlosshelp.com/forums/messageview.cfm?catid=10&threadid=85335&highlight_key=y&keyword1=dutasteride

hairlosshelp.com/forums/messageview.cfm?catid=10&threadid=105155

- Effect on insulin (and possible pro-ageing effect)
ncbi.nlm.nih.gov/pubmed/25460297

- I've read taking Dutasteride can cause the skin to become permanently dried out. I've not seen this mentioned in a study, however.


The BENEFITS of Dutasteride:

- ncbi.nlm.nih.gov/pubmed/26006269

- Could help acne and other skin problems

- Will further increase my Testosterone levels which would be beneficial after they were reduced from Accutane


--------

Please note that I am
NOT asking for medical advice.

I am, however, imploring you to take the time to review some of the literature and give me your personal opinion on some of the concerns I've raised, in addition to any others.

I truly would appreciate you doing this for me as it's very difficult to have this made sense of by the commonfolk on most other forums.
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drtodorov
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Joined: 10 Dec 2004
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PostPosted: Wed Jun 17, 2015 2:54 pm    Post subject: Reply with quote

What is the purpose for which you are taking finasteride? What is your gender?
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LoveBuzz



Joined: 13 May 2014
Posts: 140

PostPosted: Wed Jun 17, 2015 9:14 pm    Post subject: Reply with quote

drtodorov wrote:
What is the purpose for which you are taking finasteride? What is your gender?


Sex is male, and I'm taking finasteride as I lost a lot of hair as a result of Accutane. This is in many ways insurance against further loss now that I've discontinued.

However, one benefit of dutasteride may well be acne and improving T levels which have been affected by accutane.
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drtodorov
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PostPosted: Thu Jun 18, 2015 2:27 am    Post subject: Reply with quote

I am not a clinician and I do not know your history, so I am just making some general points:

1) Dutasteride (and to a lesser degree finasteride) affects the synthesis/balance of multiple steroid hormones, each with multiple functions in multiple organs.

2) The research in the effects of dutasteride is relatively limited and much of it either on animals/cell lines or short-term

3) There is much variability among humans, including in regard to benefits and side-effects of hormonal treatments.

4) Long-term effects of hormonal treatments are often different from short-term effects because endocrine system has many feedback loops that get activated over time.

In the light of the above, the long-term effects of dutasteride in a particular person are hard to predict, but these effects can certainly be negative. Both positive and negative effects of dutasteride are greater in men due to higher levels and greater role of testosterone and DHT.

With both finasteride and dutasteride one would generally want to use the lowest effective dose. I recall seeing a research article somewhere that for finasteride a dose as low as 0.5 mg/day may be effective for some people. But check with your doctor regarding any dose adjustments, of course.
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LoveBuzz



Joined: 13 May 2014
Posts: 140

PostPosted: Thu Jun 18, 2015 3:43 am    Post subject: Reply with quote

drtodorov wrote:
I am not a clinician and I do not know your history, so I am just making some general points:

1) Dutasteride (and to a lesser degree finasteride) affects the synthesis/balance of multiple steroid hormones, each with multiple functions in multiple organs.

2) The research in the effects of dutasteride is relatively limited and much of it either on animals/cell lines or short-term

3) There is much variability among humans, including in regard to benefits and side-effects of hormonal treatments.

4) Long-term effects of hormonal treatments are often different from short-term effects because endocrine system has many feedback loops that get activated over time.

In the light of the above, the long-term effects of dutasteride in a particular person are hard to predict, but these effects can certainly be negative. Both positive and negative effects of dutasteride are greater in men due to higher levels and greater role of testosterone and DHT.

With both finasteride and dutasteride one would generally want to use the lowest effective dose. I recall seeing a research article somewhere that for finasteride a dose as low as 0.5 mg/day may be effective for some people. But check with your doctor regarding any dose adjustments, of course.


Thank you for that.

Would you be able to postulate about the effect such inhibition could have on steroid hormones? In particular concerning the brain? That's really my biggest concern. As you say, there are multiple feedback loops and in some studies I've noted how when one hormone is inhibited in one part of the body it responds in some cases relatively quickly by producing it elsewhere. However, in the case of dual 5-ar inhibition (95% or more blocked) it seems like any steroid hormones caught up in that loop are basically done for.

A large number of people obviously take dutasteride for prostate reasons, and it has been out for a long time. Anecdotally it seems there aren't many concerns with its use even over a long period of time. However, when changes only occur subtly over time they're difficult to detect. And quite simply no studies are looking at side effects after 6-12 months.

I'm more hopeful that Setipiprant will offer some good solutions when it comes to hair loss and acne. It should be relative side-effect free too.
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drtodorov
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PostPosted: Thu Jun 18, 2015 11:42 am    Post subject: Reply with quote

Multiple complex effects on the brain certainly occur but the research data is too limited and inconclusive to predict the net long-term effect in an indivudual.

e.g.

ncbi.nlm.nih.gov/pmc/articles/PMC2726011/
ncbi.nlm.nih.gov/pmc/articles/PMC4136953/
ncbi.nlm.nih.gov/pubmed/15219653
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