Category: Drugs

Dr. I’ve been on propecia for almost 3 years I am 24 years old…so far its been working. I’ve just learned about Biotin. Will it be ok to take Biotin and Propecia at the same time? If you do recommend taking both at the same time what dose of Biotin should I take and for how long? My girlfriend takes 10000mcg for 4 months and her hair looks great.

Thanks

There is no problem taking biotin with Propecia (finasteride 1mg). The U.S. Recommended Dietary Allowance (RDA) for biotin is 300 micrograms daily. For more about Vitamin H (biotin), see this article at Medline Plus.

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Dear Dr Rassman,

Thank you for providing a top quality website and forum for hair loss information. I have personally gained a lot of insight from your websites.

I have a question that I can’t seem to find a definitive answer even from our family doctor. My elder brother has been diagnosed with BPH and is also a hair loss sufferer. He has been the prescribed 5mg Proscar which he has been taking for the past 1 year. However, he is also very eager in treating his hairloss. The Merck’s website suggested 1 mg to be the optimal for hair loss. Optimal would be translated in my sense to be ‘the best’ dose for hairloss. But because of his BPH condition, he has to take the 5mg dose. Would this mean he is treating his hair loss in a not ‘optimal’ dose but ideal dose for his BPH?

Is there a need to balance the dose in this scenario? I have not seen a validated testimonial of higher hair count using higher dose in the web (although some independent minor reports here and there claimed so). But according to papers, 5 mg does indeed have slightly higher haircount than 1 mg, just not by a lot. So would that mean 5 mg is also as good to treat the hair loss for my brother?

Thanks a million for your time Dr.

5mg of finasteride is as good as 1mg for the treatment of hair loss. So, yes… if he is taking 5mg for his BPH, that will be enough to treat his balding.

Doc, Thanks for all the great advice it has been a real “hair saver”. My doctor has changed me over from propecia to proscar (to save some money) and he was unsure about how long it is ok to store a quartered tablet for. I was just double checking to make sure an exposed tablet doesnt react with air/sunlight to reduce its effectiveness.

Cheers

The best practice is to only cut one pill at a time, then take each piece over the next 4 days. Do not cut all the pills at once as you will expose the pill to damage, such a moisture, etc.

Hi doc, much thanks in advance for taking your time to answer this question.

I’m a 22 yrs old healthy male. I’ve been taking Proscar daily (cut into quarter pieces) since January 2006. I wasn’t exactly losing hair when I started taking it. I initially shedded hair for the first 3 months and then the hair that I lost grew back thicker. Since then I’ve lost hair rapidly and while the medication helped me maintain hair , I’m beginning to believe it has stopped working. My hair had thinned overall and the crown area of my head constantly feels sore. I’ve recently noticed that the hairs that fall out from my crown area are much thinner than anywhere else.

Is it possible that after years of dht suppression, my body has grown immune to the medication and/or started producing more dht to compensate and this overproduction of dht is the reason why I’m losing hair? Since I don’t believe I was losing hair when I started the medication, should I discontinue using proscar to return my dht production level back to normal? If not, since proscar most definitely isn’t as effective on me as it once was, should I switch to Avodart? Thank you.

I don’t want to make this a lecture, so I’ll just say this: finasteride is a prescription drug for a reason. I can’t tell you to start or stop a medication because I’m not your doctor and I didn’t prescribe it to you in the first place. I do not believe that people get immune to finasteride, just that the genetic hair loss goes into a higher gear, of sorts. If you were to stop the drug, you will probably see considerable hair loss indicating that it is still working, although I would not recommend that as a way to find out if it is still working.

You need to get your hair mapped out for miniaturization and find out first if you have male pattern baldness — and second, the impact of the drug over time.

Dr Rassman, if you would do a little more digging, you’d realize that besides inhibiting 5AR2 reduction of Testosterone to DHT, Finasteride also operates as a NEUROSTEROID inhibitor of Allopregnanolone and THDOC synthesis, neurosterois which can then no longer act properly on GABA-A receptors in the brain.

See page 3 for diagram: PDF file at CNS Drug Reviews

Also, from Journal of Neuroscience
“This may have implications on the clinical use of neurosteroid synthesis inhibitors such as finasteride (Propecia), because certain neurological disorders related to steroid hormone changes may be worsened by finasteride treatment (Herzog and Frye, 2003).”

From Journal of Andrology
Notably, preliminary studies indicate that, as in the rodent, finasteride may increase depression in men as a result of the loss of allopregnanolone (eg, Altomare et al, 2002; Rahimi-Ardabili et al, 2006).

This raises the possibility that lowered levels of the neurosteroid contribute to the reduced sexual desire reported for some patients.”

Clearly the dermatology community loves to downplay the true sexual, physical and mental health risks of this drug — to admit the truth would be financial suicide. The fact is, neurosteroid inhibition via Finasteride can effect one’s mental health, if one is susceptible to such inhibition.

Perhaps you should try the medication yourself for 2 years Dr Rassman, and see how less mentally sharp you become… in addition to the possibility of altering the androgen/estrogen ratio in favor of estrogens, developing gynecomastia, penile fibrosis due to depleted DHT levels, loss of morning and spontaneus erections, and prostatic involution — just for starters.

If you were to experience these issues as many other men have thanks to this drug, I doubt you’d be so dismissive of the effects of androgen deprivation therapy via 5AR inhibition.

I’ve been on Propecia for well over 2 years and I still have the mental capacity to run multiple businesses, develop new tools and techniques, perform surgery, and even write a daily hair loss blog. Not only have I not seen any negative side effects from the medication, but the great majority of my patients that take the medication haven’t reported these side effects to me either. Before I started this site, it was very, very rare that I had read/heard any reports like that. The Internet provides a very big megaphone for those that have problems, real or perceived.

I have posted your opinions and your references. I appreciate the time you took in collecting the sources and quotes. Clearly the readers need to draw their own conclusions.

I have read a few posts about this issue and it concerns me as it should be listed as a side effect for the use of Propecia if it happening even in a small % of people.

I am 32 years old, I started taking Propecia about 7 weeks ago. For the past few weeks I have noticed mild pain when I ejaculate. Also, very noticeable is the consistancy of my ejaculate. Some of it appears normal but there are small jelly-like ‘clumps’ in my ejaculate. It seems to be getting worse and I am concerned it will affect my ability to reproduce which I plan on in the near future.

If you could offer any advice I would really appreciate it.

Urologists are capable of examining your ejaculate and your sperm for motility. Considering your observations, you may want to go that route if you continue to be concerned.

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