Does this Article Link Finasteride to Mental Side Effects?

Hi doctor, what do you think of this article? https://www.reuters.com/investigates/special-report/usa-courts-secrecy-propecia/

TLDR: The article indicates that Merck appears to have lied about side mental effects of this drug.

I have read the article previously. There is nothing to link finasteride to the change in behavior with absolute certainty. This type of change can happen in mental illness as well. This man should have stopped taking the drug with these side effects. His doctors should have been involved in his management. Many possible things could have happened that may have altered this person’s course.

UPDATE: There are two more studies that are concerning about post-finasteride syndrome and the mental side effects can be found here:

  • https://www.ncbi.nlm.nih.gov/pubmed/32033719: The article states: “Also, increased depression, anxiety and suicidal ideation in a subset of men treated with these drugs were commonly reported in a number of studies”
  • https://www.ncbi.nlm.nih.gov/pubmed/31935720: CONCLUSION: Men under the age of 40 who use finasteride for alopecia are at risk for suicide if they develop persistent sexual adverse effects and insomnia. Further research is needed to establish whether finasteride has a causal relationship to suicide.


2020-02-19 08:33:11Does this Article Link Finasteride to Mental Side Effects?

I Am 26 Now and for the Last 3 Years My Hairline Is Receding.

Hi, I am 26 year old male and for the last 3 years, my hairline is receding. I am eating healthy, exercising and not smoking, but it doesn’t help much. Could it be my testosterone?

You’re history suggests that you are in the early stages of male pattern balding with a Class 3 pattern of hair loss that is emerging. See a doctor who specializes in hair loss and can offer a diagnosis, then set up a Master Plan with the doctor to cover your future hair loss.

HGH Doesn’t List Hair Loss As a Side Effect

Here’s a link about Human Growth Hormone from the MayoClinic, a trustworthy source. It does not list baldness as any of its side effects. Although when you go to testosterone under the MayoClinic, it does list baldness as a side effect.

MayoClinic.com – Human growth hormone (HGH): Does it slow aging process?

I do believe that human growth hormone (HGH) can precipitate genetic male pattern balding, as it has some androgenic properties. I can’t explain why Mayo Clinic doesn’t list this side effect; perhaps they overlooked it or connection between the androgens and the HGH? Aside from a few patients over the years taking HGH (none that were taking anabolic steroids, which many bodybuilders use concurrently HGH), I don’t have a ton of patient references for real-world examples — but those that were taking HGH did experience increased hair loss since starting their HGH regimen.

There have also been reports on the Internet that HGH can actually help hair growth, but I’ve yet to see that at all. Unfortunately, this is not one of the areas of my particular expertise.

What insight do you gain when you see a frontal pic with the eyebrows lifted high so that the creases show?

The frontalis muscle is responsible for the folds on your forehead and it gives me anatomic location for where the juvenile hairline belongs, as it usually hugs the highest crease and is concave. The mature hairline is one finger breadth above the highest crease in the midline and then establishes a gentle V- Shape so I can tell if the changes are maturing or recession and how much recession.


2021-01-10 07:31:29What insight do you gain when you see a frontal pic with the eyebrows lifted high so that the creases show?

Herbs, Vitamins, Potions, Fava Beans, & Hair Loss

After going through this web site and reading your blog comments, I have come to believe that you are closed minded and inflexible when it comes to using homeopathic, natural herbs and other natural remidies for treating hair loss. Are you just unwilling to show flexibility and open mindedness?

Natural supplements and homeopathic medicine may be a great alternative means to treat a condition or an ailment. Unfortunately, these supplements are not well regulated by the FDA, so claims that are made can not be often substantiated, except by rumor mills and word of mouth communications that tend to praise the remedies more than criticize them. You can’t truly know what chemicals are included in the supplements that may have been used to process the product that you are buying. What the FDA calls Good Manufacturing Processes (GMP) may not be adhered to with food, naturopathic herbs, or potions and lotions sold over the counter in natural food stores. Furthermore, these products may not be covered in the regulatory process that confirms the dosages and the purity of such product, including the safety and efficacy of them. The research and studies that show efficacy are often funded by the manufacturers of the supplements which may bias the reported results. Finally the proper dosage for such products seem arbitrary. Just because the friendly neighborhood natural food outlet, their sales rep, or a salesman in a white lab coat can attest to its efficacy, does not mean that these are safe and/or effective.

For example, Vitamin A is one of the few vitamins that when taken in high doses, can cause hair loss. I have read that this vitamin is recommended for hair loss, so many people think that if a little is good, more may be better. In the case of Vitamin A, excess doses (overdoses) can cause death, so who cares about hair loss when you overdosed on this vitamin? Vitamin C, when taken in low doses is an antioxidant that theoretically prevents heart disease, but when taken in high doses (according to a UCLA published study) it accelerates coronary atherosclerosis (heart disease). Saw Palmetto, which is believed to be a DHT blocker for the treatment of hair loss, may compete with Propecia for the enzyme block that stops DHT production, making it less effective. What is not commonly known, however, is that Saw Palmetto was used by the military in WWII as a sex drive reducer for our troops. It was added to our soldier’s food supply. In studies performed by an independent agency, the dose of Saw Palmetto varied widely by the manufacturers. As such, some people get poor response from the drug as a DHT blocker (it is a weak blocker) while others get sexual side effects, reducing a man’s sex drive as the dose is possibly too high.

Kava is a widely used herb root in Polynesia that can be used to treat anxiety. There are case reports that this herbal supplement has caused liver failure that eventually led to a liver transplant as a life saving procedure, when used on someone who could not tolerate it. Did she lose hair? Possibly so. As part of our medical education, doctors learn that fava beans are harmless, yet they can cause death in very small quantities in those people who carry a rare genetic defect . People who carry a defect in the enzyme glucose-6-phosphate dehydrogenase, can not process the fava bean toxin. This toxin then poisons the red blood cells of the body. This is a genetic defect passed from mother to child. In the Mediterranean, where fava beans long have been a dietary staple and where the genetic mutation is more common than in the U.S., physicians frequently test children for the enzyme deficiency. The fava bean’s effect on hair loss is not as well known but on a positive side, look at the statement made by Hannibal Lecter in the movie “Silence of the Lambs” who recommended it by saying: “A census taker once tried to test me. I ate his liver with some fava beans and a nice Chianti.” I guess that Hannibal Lecter did not have the enzyme defect I just discussed and it made his meal memorable.

The question I am posing here in answer to your somewhat caustic challenge to me, is that I tend to protect my patients from the unknown. When I do not know something as a fact, I might ask myself: “How many undocumented side effects or enzyme defects float around that are either caused by natural herbs that could threaten a person’s health or life that are not researched or understood?” Arsenic is a natural substance used historically to treat syphilis, but as I have said before, I would not recommend arsenic as an alternative to penicillin, which is safe and well tested (also FDA regulated through GMP standards) and accepted world-wide.

The answer to this blog entry was partly written by Jae Pak, M.D., an emergency room physician with great interests in hair loss and hair surgery. He has worked with me for almost 9 years.

Herbal Shampoo and Rogaine for Women

my mother takes rogaine. i have found a herbal shampoo system that is supposed to enhance hair growth.

the ingredients are: cetearyl alcohol, dimethicone PEG-8, meadowfoamate, cocamidopropyl, pg-dimethiconol, lecithin, borago officinalis seed oil, caprylic/capric triglyceride, retinyl palmitate, tocopheryl acetate, ascorbyl palmitate, phosphatidyl choline, panthenol, glycerin, phopholipids, niacin, sodium riboflavin phosphate, calcium pantothenate, pyridoxine hcl, carbomer, papain, hydrolyzed algae extract, biotin, salvia officinalis(sage) leaf extract, ezuisetum hiemale extract, juniperus communis fruit extract, hypercium perforatum extract, arctium lappa root extract, symphytum officinale extract, m humulus lupulus(hops) extract, uirtica dioica(nettle) extract, thymus vulgaris extract, serenoa serrulata fruit extract, yucca schidigera extract, glycyrrhiz glabra extract, rosmarinus officinalis leag extract hydrolytzed wheat protein, benzyl nicotinate, guar hydroxypropytrimonium chloride, citric acid, hydroxyethylcellulose, safflower, sessssssssame seed oil, stearamidopropyl dimethylamine, quaternium-80, methylchloroisothiazolinone, methylisothiazolinone, butylene glycol, menthol, mentha piperita.

can she use this with the rogaine?

Yes, I don’t see why not.


2007-10-01 08:33:57Herbal Shampoo and Rogaine for Women

Herbal H

Hi Doctor,

Was wondering if you have heard anything whatsoever about this product called “Herbal H” for hair loss, I came across it a few days ago. I am attaching a link to their website; herbal-h.com

They have minoxidil listed as an ingredient which is obviously FDA approved. But I wanted to know if you have any information regarding the other listed ingredients or the product itself, for hair loss.

Thanks you.

This seems to basically be just 3% minoxidil with supplements in it (iron, saw palmetto, zinc, copper, angelica, and other things I’m not familiar with). There are a variety of products out there that contain minoxidil with other supplements, and I don’t know that one is any better than the other.

So the only thing I can really say is that topical minoxidil does grow hair, but the strength of minoxidil that is recommended for men is usually 5%.


2012-09-25 10:44:56Herbal H

Hepatitis B Vaccine and Hair Loss?

I just started the Hep B vaccine and am experiencing hair loss at 54. Will it grow back?? I’m very concerned because of my age.

All health care workers receive hepatitis B vaccine, yet health care workers are not at any increased risk for hair loss. What you may be experiencing may be coincidental or very rare.

I did find this quote from the National Foundation for Infectious Diseases: “There have been rare reports of hair loss after hepatitis B vaccination, with the majority of individuals regrowing their hair (Wise, 1997). Studies are in progress to better quantify the possible slight risk of hair loss.


2012-02-01 12:14:46Hepatitis B Vaccine and Hair Loss?

Help with Craniotomy Scar?

Hi there,

I’m hoping I can get some guidance on craniotomy scar issue I am having. I am a 27 year old male, and about 6 months ago I had a craniotomy for the removal of a benign tumor which was discovered shortly before the procedure. The surgery went well and all is good now health wise. However, I now have a 6″ long scar that is about 5/16″ wide in the back of my head.

I would now like to address how I can improve the aesthetics of the scar, as I prefer to keep my hair short. The good news is with longer hair (shown in the photo), I am able to cover the scar, but I’d really like to wear my hair shorter. I have visited 2 cranial plastic surgeons and one hair doc in the Bay Area, California. Here is summary of their recommendations on how to improve the scar:

– UCSF plastic suregon: Scar Revision and change scar to a zig zag shape.
– Stanford plastic surgeon: Standard Scar Revision. Advised against doing a zig zag as it would change hair growth directions and “make it look weird”.
– Hair Doc: Standard Scar revision and possibly hair transplant on scar if scar needs additional improvement.

Is it true that changing the scar to a zig zag shape would change the hair directional growth? If that is the case, why would the UCSF surgeon recommend that? Do any of you have any recommendations on the best way to improve aesthetics of the scar? My end goal is to not get rid of the scar completely, but to at least improve the aesthetics of it. I’d appreciate some feedback!

I really cannot give you good, personal medical advice via the internet, so I’d suggest if you’re interested you can see us at our office in San Jose or Los Angeles (the consultation is free). We have transplanted hair into craniotomy scars with very good success. Many of these patients have had scar revisions that failed to resolve the cosmetic issues. You may need more than one transplant depending on the case, the size of the scar, and the location of the scar. Dr. Pak recently performed a FUE/FOX transplant into a craniotomy scar where a zig zag attempt was made. Sometimes a zig zag revision can make the scar worse.

Ask your surgeons for examples with before and after photos. Maybe it will help disguise the scar, but it’s still a scar nevertheless. Hair transplants to the scar does not mean the scar will be removed, but at least there is hair growing “ON” the scar and if there is enough hair in the proper direction, the scar will not easily be seen.