Coming off Propecia

   
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jkenn

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March 23, 2011, 09:35 PM

Ok, the front page article has convinced me that I need to get off the stuff.  I’ve tried in the past, but the hairline recession and overall thinning was just horrible. 

Has anyone come off propecia and avoided that?

Will the IH regimen/Zix combat it?

I’m looking for any and all advice here, so don’t be shy!

 

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mj

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# 1 ]

March 24, 2011, 04:40 PM

I would suggest you go off of the drug gradually instead of cold turkey.  If you’re taking it daily now, I would switch to every other day for a little while, and then every three or four days over the next couple months. At the same time I would rev up the rest of your regimen to counter the declining presence of propecia in your system.  What are you using now besides propeica?

As for avoiding any thinning…..most likely you probably will lose some ground over the next four or five months.  But as your new treatment kicks in there’s a chance you would recover what you lost or at the very least hold your ground.

It’s a tough call to make because there is no guarantee anything else you try will be as effective as propecia.  But you have to go with what you believe is the healthiest and safest course of action.  At the end of the day, it is only hair.

There are a lot of people on this site that swear by a drug free approach and can offer a lot better advice than I can.  I still go back and forth between fin and natural.  I haven’t been sold entirely on either one.  But I would definitely say that lasers is a good addition to either one.


Tried a lot of things, never stuck with anything. Don’t do that

 

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OverMachoGrande

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# 2 ]

March 24, 2011, 05:00 PM

You know, I have most of the text written for an article about how the 1mg dosage of Propecia is probably too high to begin with, and Merk’s own studies show that .20mg (that’s 1/5th of a PROPECIA TAB -no, I didn’t mean Proscar) is almost as effective as 1mg.

On top of that, I’ve also seen reports that show that while Propecia’s life is only about 20-something hours in your system, the 5-AR binding lasts up to 72 hours.  So, there is evidence that supports that you can take it every two or three days and ALMOST get the same benefit.

Now, the one thing I don’t know… can you do BOTH?  Can you take 1/5th a Propecia tab every third day??  I don’t know, but maybe.

Also, I don’t know if taking less of the drug is going to mean less side effects because I don’t know if the side effects occur because of TOO MUCH finasteride or because it’s binding to the 5-AR.

The bad news?  I’ve spoken to hundreds of people that have dropped Propecia -ranging from cold turkey to weening themselves off, and it’s the same everytime.  You’re gonna shed at some point (and it’s often WAY LATER than you think it’s going to be).  So, hey… that’s some bad news, but that’s what alcohol is for!  This is why I’m a “cold turkey” man… I just haven’t seen anyone escape hell -and please correct me if I’m wrong!

-O.M.G.[./b]


Build your own Laser Helmet | Laser Brush | Laser Device at OverMachoGrande.com!  The internet’s first, best, and biggest consumer advocate site on laser therapy for hair loss!  It’s time to educate yourself about one of the greatest treatments in FORUM HISTORY…

 

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# 3 ]

March 24, 2011, 05:17 PM

Here, I tell you what… I’ll put up all of this, and you can guys can root though it.

This is data obtained from the Freedom of Information Act in reference to the approval by the FDA for the use of PROPECIA, and provided I posted the right thing here, your jaw should be dropping a little bit like mine did -especially since THIS IS INFORMATION FROM 1998!!!!

This should be common knowledge, but ladies and gentlemen… I give you a decade of deceit and coverup from those other hair loss forums!


Study of the FDA Files on PROPECIA
Sherman Frankel, April 6, 1998

Recently, the Food and Drug Administration (FDA) approved the use of the drug PROSCAR, under a new name, PROPECIA, for treatment of male pattern baldness. The medical term for the drug is finasteride but it is marketed under these two different names. The PROSCAR pill is 5 milligrams while the PROPECIA pill is 1 milligram (mg). PROSCAR is intended for older men suffering from benign prostatic hyperplasia, (BPH). It is not surprising that PROSCAR would affect hair growth since it inhibits the normal conversion of testosterone to dihydrotestosterone. It is well known that hair growth and impotence are connected to levels of dihydrotestosterone.

In the last few years it has been claimed that PROSCAR is ineffective in the treatment of BPH, both from studies of the medical literature (1), and in a more recent double blind study.(2). However there is a claim that for men with very large prostates, the incidence of choice of surgery is smaller and there is improvement in urinary retention.(3)

The double blind studies of PROPECIA do not extend beyond a few years, yet the predominant users are expected to be males in their thirties. The drug must be continued indefinitely if the new hair growth is to continue over one’s lifetime.

With the announcement of the new use of PROSCAR, we recently used the Freedom of Information Act to obtain the documentation leading to the approval by the Food and Drug Administration for the use of PROPECIA.

We have examined the material and come to the conclusions that occupy the remainder of this note. The questions we address relate to dosages, side effects, and other conclusions to be drawn from the double-blind studies presented by Merck to the FDA.

A key question that needs resolution is the size of the dose of the main ingredient, finasteride, that should be used. In the PROSCAR studies it was found that, in measurements of prostate shrinkage, a 1 mg dose could not be distinguished from a 5mg dose. Yet the dosage recommended by Merck for PROSCAR was 5 mg and the effect of dosages lower than 1 mg were not studied. In the PROPECIA studies, the effects of a range of dosages were reported to the FDA. These studies examined how the drug inhibited the conversion of testosterone to dihydrotestosterone which is the significant feature affecting hair growth. This inhibition was observed to be 60-70 % in the (NDA 20-788) Merck study.

A significant result deals with the depletion of dihydrotestosterone (THD)and enhancement of testosterone (T), as measured in the scalp skin as a function of dosage.


Figure:

As seen in Fig. 1, reproduced from the FDA material, the percent change of DHT for placebo and .01 mg finasteride were identical and essentially zero within a reasonable statistical estimate. The change dropped by 60 % for a .05 mg dose and stayed that way for all dosages up to 5 mg. Thus a 20 times smaller dose than PROPECIA had the same effect on the DHT.

 

Figure:

 


A similar dose dependence was seen for the serum DHT (Fig. 2) where the effect was independent of dose above 0.2 milligrams.


Figure:

 


The dose dependence appears also in the accompanying rise in T, one-onehundredth the 5 mg dose being identical in its effect on the scalp skin testosterone. See Fig. 3.

Typically, the price of 5 mg PROSCAR is $76 for 30 pills, a months supply. For 1 mg PROPECIA it is $54. Therefore a PROPECIA user would pay only $15 if he were to cut up the 5 mg pills. However the above depletion studies suggest that a dosage of 0.2 mgs would be as effective as the 1 mg dose, bringing the price down to $3. For the user willing to dissolve the PROSCAR pill, (it is soluble in ethanol), or divide it up by other means, the monthly cost would be seventy-six cents.

The data supplied to the FDA on ``efficacy parameters’‘, (NDA 20-788, table 8.1.2.4.2) compared .2 and 1.0 mg dosages in hair count, investigator assessment, and global photographic assessment but did not present data for other dosages above .02 mg. However the sample of participants (100) was small and the differences between the .2 and 1.0 dosages in the first two cases were not apparent and, in the photographic assessment, which showed a larger mean improvement for 1 mg, the values overlapped statistically at the 95% confidence level.

We now turn to the question of side effects. One set of such effects is sometimes called ``sexual adverse events’‘. Three of these are impotence, libido decrease, and ejaculation disorder. We have examined the results of Trials 1-5 (047,081,087,089,092), submitted by Merck to the FDA. These are studies carried out over about a year. What the data show is that about 2% of such users show these adverse events, with about 1% resulting in impotence and about 1/2 percent each showing libido decrease or ejaculation disorder. Breast enlargement and sensitivity are also occasionally reported. Merck has presented no data answering the question of whether the several effects are correlated, i.e., if one suffers impotence is one also likely to have the other side effects as well. Yet a potential user might want an answer to this question before committing to the drug.

More seriously missing are data that trace the growth, if any, in these side effects over long periods. These side effects seem to disappear after discontinuance of the drug after a short period of usage but there are no data on longtime usage.

The reduction in the ejaculate volume, more important to young users than the elderly users suffering from BPH, clearly affects the fertility of users with already low ejaculate volume, possibly dropping the quantity below the needed fertility level. While average reductions in volume are reported there are no reported data on the liklihood of large reductions.

From the earlier studies on PROSCAR, it was observed that the prostate size was decreased, falling off and appearing to level out near year’s end. But the accuracy was too low to predict whether or not, over a longer period like a decade, the prostate continues to shrink. However an extension of the study for two more years showed a further decrease in prostate size with a 5 mg dose, again with no definite plateauing effect. It is not known whether this decrease will continue over time or whether it will present a problem.

Another effect is related to the PSA score which is often used as a possible test for the onset of prostate cancer. PROPECIA produces a decrease in the PSA score. Merck states that the average observed decease is 50%. Publishing average decreases is not sufficient without presenting some indication of the spread of such decreases. Such a decrease could mask the increase in score for a patient showing signs of cancer and might inhibit the request for a biopsy. It is feared that dermatologists might not transfer PROPECIA usage information to the patient’s urologist and because of fluctuations, “doubling the PSA level”, the recommended guideline, would be misleading.

Conclusions:

The FDA has approved a drug for which there are no long term studies that relate to sexually adverse effects, and their correlations, a drug that must be taken for a lifetime by young men who wish to retain their hair. (Of course, the knowledgable user can decide for himself whether he wishes to take the negative risks, but there are no warnings in the drug insert that only longer term tests can predict the probabilities and severity of the various adverse side effects and that the potential user should take this into consideration.)

The data on the dosage dependence of the depression of conversion to DHT, reproduced in this report from the material obtained under the FOIA, does not appear in the medical literature or in the drug insert. Thus the fact that the dosage has been set by the manufacturer at a level far larger than the level measured as necessary for the main function, has not been reported publicly. Yet, the vastly lower dosages, reported in the data submitted to the FDA, would be expected to reduce the chance of side effects.

Unfortunately, nothing is found in the FDA reviews of the request for approval of PROPECIA, commenting on the renarkable dosage data reproduced in this note.

propeciafda2 printed December 21, 1998

 

Thirteen year old information right there that only ten people know about! lol…  Now YOU know, too!

-O.M.G.

 


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mj

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# 4 ]

March 24, 2011, 09:36 PM

thanks dude….interesting read.


Tried a lot of things, never stuck with anything. Don’t do that

 

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J87

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# 5 ]

March 24, 2011, 10:06 PM

You may also want to look into using finasteride topically instead, there were a few studies on this I think.
Also ASC-J9 looks promising, kouting is selling it $500 for 1 gram, at .05 concentration it would last a while.

 

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jkenn

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March 24, 2011, 11:57 PM

MJ- I’m using lasers.  My hair growth is supercharged with propecia and lasers.  I noticed that I feel the anxiety, lethargy and brain fog from propecia much worse when my diet is heavier in processed foods and carbs.  When I stick to fruits, vegetables, lean protein and eat healthy, I don’t really have the sides and my hair growth is at its best.  This is why I’m inquiring about the IH regimen.  It seems like I may be a good responder to that.

 

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jkenn

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# 7 ]

March 25, 2011, 12:00 AM

OMG- Thanks for the info.  I don’t think I’ll fall into the permanent side effects category, but I just don’t want to fool around with this junk anymore.  I’d hate to find out I’m on my way to Parkinsons or Alzheimers in 10 yrs.

 

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March 25, 2011, 11:21 AM

Hi Jkenn. I would just like to add something to the discussion if I may. Anyone who takes propecia for any length of time gets a touch of rebound hypoandrogenicity (I think I have that term right….I haven’t used it in awhile). Anyway what this means is that in response to having less DHT (while on propecia) your body compensates to a degree by making more receptor sites for DHT. In a sense it becomes better and more efficient at using what little DHT it has available.

Oddly it is this “compensation” that actually reduces the incidence and degree of side effects. The people that propecia works the very best for tend to not compensate well and this tends to make them more likely to experience side effects.

Anyway….when you quit propecia I don’t want you to freak out. Some of the hair you lost in the first 6-12 months will come back. Your body will need some time to reduce these DHT receptor sites so for awhile your follicles will be getting more DHT than they did before you started taking the drug.

In the long run however I don’t think it’s a good idea to take propecia. My god…..it’s only hair.

 

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mj

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# 9 ]

March 26, 2011, 08:52 AM

That’s interesting zix, so you’re saying that the people who experience side effects are actually getting the most benefit to combating hair loss?  I’ve never heard that before.  I never really had any sides, but I felt that propecia was working for me when I was on it.

So with hypoandrogenicity in place, wouldn’t it be better to off the drug gradually to ease the impact of this condition as the body gradually returns back to its original state?


Tried a lot of things, never stuck with anything. Don’t do that

 

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# 10 ]

March 26, 2011, 09:15 AM

Hi MJ.

Don’t know for sure but as a general rule in medicine it is usually wise to make changes slowly. I’m just worried that you will freak out at your hair loss and go back on the drug based on a temporary situation. My theory of “better benefit for those suffering the most side effects” is just that…. a theoretical example. Individuals will vary in their experience. But if you’re not experiencing side effects then in theory you may see a fair amount of hair loss after you get off of it. But your body will reduce DHT receptor sites over time and things will normalize for the most part.

How long have you been on propecia?

When I quit the drug I went off it cold turkey but I quit because of side effects. The side effects were so bad that no matter how much hair I lost, I wasn’t ever going to take that drug again. I also think that altering the hormones of the body for a cosmetic reason is a bad idea for people in the long run. Cosmetic issues seem important until you have a real health problem. Then they seem like a trivial issue. I was on the drug for about 6 months and I don’t think things normalized for about a year. To some extent I don’t think I ever fully recovered from that drug but it’s hard to tell sometimes. It’s hard to tell what was the long term damage and what was normal aging? I don’t know. That’s why drug companies don’t worry too much about these things….they can be difficult if not impossible to prove in a court of law.

 

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mj

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# 11 ]

March 26, 2011, 01:04 PM

I’ve stopped and started fin many times over the years, same with dut.  For a long time they were the only course of action that worked for me.  I agree with the long term issue, which is why I’ve never stayed on them.  But I never had any sides.

In my case, my hair loss was always preceded by a painful scalp.  Wherever the pain was isolated I would begin to shed hair after a few days.  Fin and dut both stopped that cycle and took the pain away.  Lasers have as well, which is why I stopped the drugs.  But I’m still looking for something to kick start some regrowth.


Tried a lot of things, never stuck with anything. Don’t do that

 

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# 12 ]

March 26, 2011, 01:15 PM

Well if you’ve been on and off it before you know what you’re in for. That was my only concern here.

 

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