Day: January 1, 2023

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Protein Shakes and Hair Loss

With all of the questions being asked about protein shakes, are there any that you would recommend? Is there any kind of “regular” whey out there. I try to take protein shakes everyday, but I don’t want them is they have steroids in them. I don’t want them if they are similar to steroids. Regular protein is supposed to by good for the hair not hell on the hair.

While I don’t endorse any particular protein shake, I don’t know that they’ve been proven to make hair fall out. Your genetic predisposition makes your hair fall out. Protein shakes are not anabolic steroids.

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Protein identified for controlling hair death

Researchers at the University of California Riverside (UC Riverside) have identified a single protein that seems to control when hair follicles die. Armed with this new information, it might eventually be possible to reverse the process and stimulate hair regrowth.

The protein in question is known as TGF-beta, a signaling protein that regulates the division, growth and death of cells. As such, it plays major roles in important jobs like wound healing, and seems to be hijacked by cancer cells to allow uncontrolled growth. In this case, the team found that TGF-beta extends its work to the cells inside hair follicles.

Read more here: https://newatlas.com/biology/hair-loss-baldness-regulator-protein/

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Protecting Against Shock Hair Loss

I have researched that after the hair transplant surgery, there are some patients who are experiencing a common side effects which is Shock Loss. I would like to know if this is the fault of the surgeon during the incission? Is there a way to prevent the further trauma to avoid more hair loss after the transplant? I am thinking of having this procedure done, but very much concern of loosing more hairs after the hair transplant. Please educate me. Propecia is commonly prescribed to patients before the surgery, but do you have to take this drug for the entire life or the remaining hairs will soon fall out

Shock loss is a hair loss process that accelerates immediately after getting a hair transplant. It usually occurs in the first 4 months after the surgery. Generally, Propecia will protect against most post-surgical hair loss from shock and it should be taken for a period to discuss with your doctor. The longer you take it, the better, but as hair loss is a progressive process it will kick in again when you stop the drug.

I generally recommend for patients to stay on Propecia for 9 months minimum just to deal with the threat of the shock loss, but that is not a hard rule. Everything depends upon your examination and the relationship you build with your doctor. I generally think that if you are serious about preventing any loss, men with genetic loss are best treated long term (lifetime is long term) with Propecia (finasteride).


2010-01-12 15:00:35Protecting Against Shock Hair Loss

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Prostate Pain Same Day I Took My First Propecia Pill

Hi Doc,

I’ve been reading your blog on a fairly regular basis and have found it very informative. I’m almost 19 and my hairline has been creeping back since around my seventeenth birthday. At the moment I’m probably an nw2. My brother who is 21 would be considered nw4 if it wasn’t for a very fine scruff of hair in front.

Concerned that I was following suit with him, I decided to fill a prescription of propecia. The possible side effect were pretty unnerving but I figured it was my only real chance at keeping my hair.

I’ve read on your blog that the 1 mg dose does not affect the prostate but it definitely did in my case. The day I took the first pill, my prostate had sudden pains throughout the day. My semen also became water-like. I know this isn’t supposed to be a big issue, but it concerns me that it started happening right away and seems to me like another sign that it was affecting my prostate.

My question is where do I go from here? Have any of your patients had a similar experience? I recently started using a minox product but am unsure what to do as far as meds. Should I try a lower dosage of propecia? Would saw palmetto be worth trying?

Also, have any of your patients experienced results in the hairline from minoxidil alone?

Thanks for your work

First, how do you know what prostate pain feels like? I don’t imagine most men would be able to pinpoint which internal organ is hurting so quickly… particularly the prostate. Prostate pain generally ranges anywhere from lower back problems to urinary issues. Is that what you felt? Second, you had sudden pains after one dose? That strikes me as extremely odd. It’s worth noting that there are some rare reports of testicle issues after taking finasteride, but I haven’t heard of any case where this occurred on the same day that you took your first dose ever. I’d think it’s more likely that you psyched yourself up for side effects, as you said you were pretty unnerved about the medication before you even took it. You were expecting some negative reaction and you got it — this would also be known as the power of suggestion.

You need to get a good, solid diagnosis with the tests I have suggested (miniaturization mapping, hair bulk measurement) before you make the decision on taking finasteride for life. I hope your prescribing doctor gave your scalp a thorough examination before suggesting you take this medication. Now that you’re noting problems though, you should talk to your doctor about this. I’d get off the medication to see if the pain goes away. Remember, a good Master Plan is needed for every young man facing an uncertain future for hair loss.

As for minoxidil, that is an over the counter treatment and so long as you don’t become worried over potential side effects from that drug, it might be worth a try. It would be rare to see regrowth in the hairline from minoxidil or finasteride.


2011-02-18 14:11:01Prostate Pain Same Day I Took My First Propecia Pill

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Prostate Cancer Treatment Associated with Higher Risk of Heart Failure

Men with early-stage prostate cancer who receive androgen deprivation therapy are at significantly higher risk for heart failure, according to a study published in the British Journal of Cancer. After following a cohort of 7,637 men diagnosed with localized prostate cancer between 1998 and 2008, researchers found androgen deprivation therapy was associated with an 81 percent increased risk of heart failure in men without pre-existing cardiovascular disease (CVD).

SOURCE: https://www.cardiovascularbusiness.com/topics/heart-failure/prostate-cancer-treatment-associated-higher-risk-heart-failure?utm_source=CVNW&utm_medium=6c47c50623&utm_content=article&utm_campaign=newsletter_referral

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Prostate Cancer Risks and Male Pattern Balding

Is my risk of prostate cancer higher because I am balding?

Men with Male Pattern Balding (MPB) have a consistently higher incidence of prostate cancer compared with those without MPB.

In summary, we found a significantly increased risk for prostate cancer among men with MPB, independent of established risk factors including aging and race. Although remote from the prostate, MPB may represent an early, clinically obvious marker of susceptibility and may provide clues to the pathogenesis of prostate cancer.

(source: Male Pattern Baldness and Clinical Prostate Cancer in the Epidemiologic Follow-Up of the First National Health and Nutrition Examination Survey)

When finasteride is used, “cancer prevention should be recognized as an additional benefit of treatment“. When compared with alternative treatments, “chemoprevention may also provide an excellent strategy for diminishing treatment-related costs and adverse effects such as erectile and urinary dysfunction“.

(source: Should finasteride be used to prevent prostate cancer?)

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Prostate Cancer Prevention Trial (PCPT) and Finasteride

Hi Dr Rassman, have you seen the latest findings on the prostate cancer prevention trials? The current info seems like good new for finasteride users.

see link — Finasteride Reduces the Risk of Low-Grade Prostate Cancer in Men 55 and Older

Yes, this is a consistent finding by the government sponsored studies.

Here’s the summary:

“Long-term follow-up results from a phase III trial called the Prostate Cancer Prevention Trial (PCPT) continue to show that regular use of finasteride (Proscar®) for up to 7 years decreased the risk of low-grade prostate cancer in men age 55 and older compared with that in men who received a placebo. Although high-grade cancers were more common in the finasteride group, the finasteride and placebo groups had similar 15-year overall survival rates.”

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Prostate Cancer Prevention

A recent article, titled “An update on chemoprevention strategies in prostate cancer for 2006”, published in the May 2006, Volume 16, Issue 3 issue of the Current Opinion in Urology medical journal discusses the ability to reduce prostate cancer with a variety of herbs, vitamins and drugs including the roles of: finasteride, selenium, lycopene, soy, green tea, anti-inflammatories and statins. It warns of the increased risks associated with excessive vitamin E and cyclooxygenase-2 inhibitor. We are learning much about prevention of Prostate cancer. Below is a review of the article:

PURPOSE OF REVIEW: An increasing volume of research has been directed at the prevention of prostate cancer. This review proposes to summarize the large trials, novel approaches and molecular mechanisms of effect published in 2004 and 2005.

RECENT FINDINGS: The impact of the Prostate Cancer Prevention Trial continues and subsequent articles have addressed the increase of high-grade prostate cancers detected in the finasteride arm of the trial, as well as the potential costs and benefits of extrapolating the findings to a public health campaign. Studies of risk have been published warning of excessive vitamin E and cyclooxygenase-2 inhibitor use in chemoprevention. Growing evidence supports the concept of chemopreventative agent combinations and further data on the roles of selenium, lycopene, soy, green tea, anti-inflammatories and statins in prostate-cancer prevention are presented.

SUMMARY: Level one evidence exists for the preventative effects of finasteride in prostate cancer. The evidence for other agents is less conclusive but a number of large-scale, appropriately designed trials will hopefully address some of the relevant issues in prostate-cancer prevention over the next decade.

Source: Curr Opin Urol. 2006 May;16(3):132-7, An update on chemoprevention strategies in prostate cancer for 2006, Neill MG, Fleshner NE. Division of UroOncology, University Health Network, Toronto, Canada.

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Proscar Warning Label and Possible Birth Defects

Dr. Rassman,

Thank you for continually answering questions on this forum. I am amazed how I routinely learn about hairloss by just reading the answers you post in response to other readers.

My question is about proscar. I’ve decided to switch to proscar over propecia because quite frankly, it is much more affordable to buy and split proscar into fours. I read in the past on this forum how you stated that Merck removed the warning about possibly passing Finasteride to a female through semen. My information leavelet that came with the Proscar had the following on it (women should not) “be exposed to the drug through sexual contact with a man taking Proscar”. It suggests that you should use a latex condom during sex. Does this mean that you should not try to have children while taking Proscar/Propecia? Does the fact that the dosage in split Proscar/Propecia is significantly lower than that of regular Proscar eliminate or reduce the risk for “birth defects” in a baby’s sex organs?

Also what you heard or know about a product advertised on TV by the name of Procede? They claim it is once every three months treatment.

Thank You

What is known about finasteride is that if a baby in the womb is exposed to this drug (dosage is not understood) that the development of their sex organs and possibly the way their brain is wired (female vs male) may be influenced. Genital abnormalities can be created by the influence of this drug in the first trimester of pregnancy. These abnormalities, when associated with finasteride, had been observed when the natural form of finasteride was ingested in very, very large doses (based on the research of a mountain village in the Dominican Republic).

The warning by the drug company reflects that knowledge and that a risk may be present. These are clearly warnings that are meant to protect the drug company, but to my knowledge, even with the widespread use of Propecia in young men (over a million men) there are no reports that I know of that show that there is a link between women who got pregnant with their men on Propecia and the creation of genital abnormalities in any of their children. I have one of my sons on Propecia and when he is ready for a family, I will not recommend that he change his usage of this medication. He likes the hair that is now strong in the frontal area and was thinning before he started to use it.

A little bit of history (though having little to do with your exact question) — One of the untold stories in medicine are about the hermaphrodite whose sex is misdiagnosed at birth. The absence of a penis may cause a baby to be classified as female or the presence of a large clitoris, may cause the baby to be classified as male. These children are then raised according to the original sex designations from the birthing room. These situations lead to great tragedy. For those of you wanting to learn more about hermaphrodites, I suggest that you Google the term hermaphrodite. Also, I have recently read a best selling novel titled Middlesex by Jeffrey Eugenides (a Pulitizer Prize winning epic that follows many generations in a family that had a hermaphrodite inheritance pattern in the family line). It puts a face on this tragedy and is a recommended read.

With regard to Procede, please see past responses here.


2013-06-18 11:56:30Proscar Warning Label and Possible Birth Defects