Author: Dr. William Rassman

“People who divorce face a higher risk of acute myocardial infarction (AMI) than those who remain married” said an article published online in Circulation some time ago as shown in a website for the Journal of the American Heart Association. The overall risk of death from a heart attack is eight percent but it is not as simple a statistic as it appears to be.

“Among women, those who were divorced once were one-quarter more likely” to have a heart attack than men who are at a lower risk. The risk rises significantly for men who were divorced multiple times, as high as 77 percent. Men on their second divorce had a 30 percent increase of heart attack. “Once men remarried, that increase disappeared,” said the article.

Married men and women have less heart attacks when compared to divorced pairs. It does seem that marriage may decrease stress and stress may be the important factor in the risk of having a heart attack.

How does finasteride/dutasteride affect your predictions of the hair loss pattern in an 18 year old? Does it change the pattern or do patients follow the same pattern but slower?

These drugs slow the advancement of these advanced patterns provided that the genetics are not very aggressive as with the young men who inherit a Class 7 pattern that starts appearing at 18-19 years of age. In these young men, we just don’t know if their hair loss pattern can be stopped in its tracks, but there is never a harm in trying.

DHT is a byproduct of testosterone metabolism and is a critical hormone for establishing male characteristics. No diet can’t change your DHT levels

I’ve been told by several doctors that Fin isn’t a good idea because I have IBS (Irritable Bowel Syndrome).

Finasteride should not impact Irritable Bowl Syndrome. It might be worth a try. There is a balance between benefits and risks which only you can assess.

Yes. Many people with DUPA present with hairline recession or crown loss often with a typical Norwood Pattern of hair loss.

Yes this can be done. We do this all of the time. You must be over 25 and have a HAIRCHECK test to be sure that you know what your potential balding pattern will be so that when it is fixed, it will be part of your Master Plan for future balding if that is what is going to happen to you. The HAIRCHECK test at 25 will give you are a reasonable assessment of this possibility and allow you to go about this reconstruction with the power of knowledge.

Merck states that “Contact with the semen from a man being treated with PROPECIA is not a risk to the unborn child of a pregnant woman“. My question is: can the same rule be applied to those taking DUTASTERIDE, considering this is a higher potent DHT inhibitor? I take 0.5mg daily for the treatment of hair loss.

Probably not, but we don’t know. Dutasteride can also have fertility issues in the men who take this drug, but the proof is not available at this time. This is probably one of the many reasons that dutasteride is not approved for the treatment of hair loss by the FDA.

The answer to this question is NO. From the attached article here (Still No Giraffe) and a recent article in the Scientific American (June 2017), it is clear that our metabolic rate is relatively stable regardless of how much we exercise. The attached article has a scientist who followed a ‘primative bushman’ from Africa as he burned calories after he shot a giraffe with a poison dart and followed the giraffe for a few days on almost a constant run 12+ hours/day. He collected the bushman’s urine for the days he followed the giraffe. The bushman was fed a special type of water which was excreted in his urine indicating the calories he burned. He found out that the number of calories burned by this bushman was only about 10% above the calories burned by someone who sat at his desk all day. Our brains use the most calories we consume, following by our heart, our kidneys, out liver and our intestine. Our muscles are only responsible for about 10% of the calories we burn so if an average man burns 2680 calories per day and doubles his calorie burn from skeletal muscles (not really practical to do this), then he would bun only another 268 calories. That turned out to be a surprise for the researcher and the author who ran along side the bushman for a few days as he chased the giraffe. In the Scientific American this month (June 2017), another article focused on the number of calories burned by men or women and were shown to be relatively constant, regardless of the exercise program undertaken by either of them.

So you might ask, why exercise if you can’t lose weight? Why not just sit and watch TV all day and night? The answer is that exercise makes you healthier, lets you live longer and develop less diseases such as cancer, heart disease, stroke, diabetes and other diseases. The conclusion of both articles is that if you want to reduce weight, you must reduce your caloric intake. Sitting on a couch by the TV all day will just take all of what you eat (for example, eating just two small cookies per day can translate to a weight gain of one to three kilograms per year) all of which gets turned into fat. Of course, that is the problem in America today as 1/3rd of the population is obese (expected to be half of the US population by 2030) and about another 1/3rd may be overweight. Just like a car cruising at 50 miles per hour, if you overfeed it gasoline, it will overflow the tank (your body’s fat reserves here reflect that tank). There is no substitute for good eating and controlling your obsessive need to stuff foods into your mouth every-time you see a good ice cream cone or some extra BBQ ribs or a third hamburger with french fries until you feel stuffed. This type of obsessive eating increases your risk to dying with cancer, heart disease and stroke, especially if you don’t exercise. Add to that, Alzheimer’s disease, dementia and almost every disease we humans develop by being alive, and overeating leads us to an early grave.

Dutasteride is like Finasteride. They are both DHT blockers. The results from Dutasteride should parallel Finasteride.

Dutasteride is not FDA approved for safety in use for hair loss. There are known reports that Dutasteride has caused sterility in some men, maybe rare, but we don’t really know how common it is.

Can “end stage” miniaturized hairs be salvaged with medication such as Finasteride/Dutasteride/Minoxidil. Or are those a lost cause once they reach that stage?

We tend to look at these hairs as lost causes; however, microneedling may have changed that perspective. We don’t really know as proper research has not been done. I have seen finasteride reverse miniaturization on a limited basis, possibly when it is early.