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Free Testosterone Declines with Propecia Use?

Dear Dr. Rassman,

I am a 31 year old male who has been on Propecia for 5 years. After getting bloodwork done, it was discovered that while my Total Testosterone was high, the percentage of Free Testosterone was proportionately low.

Then, I discovered an article from an Egyptian medical journal entitled “Effect of Oral Finasteride on Serum Androgen Levels and Androgenic Alopecia in Adult men”, which found that all men in the experimental group experienced a decline in free testosterone after taking Propecia relative to no change for those taking a placebo. Were you aware of this? Does this not add to the growing body of literature showing how dangerous Propecia really is?

The main point of why Propecia (finasteride 1mg) works is because it changes DHT hormone levels. DHT is the result of testosterone catabolism (it is a byproduct of testosterone metabolism). So to say Propecia affects testosterone in some way is valid, but I cannot say what this really means. The study you refer to included only 30 men and it does not go on to state what the implication is or what the significance is of the findings.

For those interested, the study can be found here (PDF file).

These are the type of articles that can cause confusion and add fuel to the never-ending debate on Propecia depending on how you parse the information presented. Anyone can quote articles and infer what they want, but the real meaning or significance is unclear. At least this is interesting reading. Let the debates begin… or rather, continue!

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Fraternal twins, one lost crown hair 40% by HAIRCHECK the other did not, can you explain this?

I just turned 20 and recently started taking propecia as my doctor told me I have lost about 40 percent of my crown hair using haircheck (None of this is visible). Even I was surprised to learn that I was actually balding. There is baldness in my genes but it’s not really aggressive or noticeable until older age (40+). Additionally, my fraternal twin hasn’t gotten his hair check but I am assuming he has not lost any hair yet. I am currently on finasteride and planning to take it as long as possible if the side effects aren’t severe. Do you think it’s possible for me to keep a full head of hair (or the appearance of one) through at least my 30s? Thanks

The difference between frarternal twins may be related to stress but the genetics of one does not impact the genetics of the other. Did you have more stress in your life than your twin brother. Did you go on any radical weight loss diet?. These can be causes of bringing out the genetic in you and not your brother but maybe your brother did not inherit the balding. Taking finasteride might work for years, if you are one of the lucky ones.
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FOX Procedure Pricing?

I am really interested in the Fox technique, do you think it will go down in price over time?

The FOX Procedure (follicular unit extraction) is heavily labor dependent and takes much more time to harvest grafts than a traditional strip procedure. Without a new breakthrough, I doubt it will go down in price much, as there are not many doctors who are doing the procedure completely.

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Forza-T and Hair Loss

I’m 23, male… Normally I have healthy hair as does everyone in my family, but about 6 months ago I took Forza-T that I think caused my hair to thin out. Forza-T boosts testosterone, so I figured my DHT level got too high. So I took DHT blockers just recently and that made it worse! My hair is noticeably thinner/weaker, and overall I just feel unhealthy compared to how I was before. I’m positive the DHT blockers caused it because I noticed a significant difference in my hair and skin within minutes of taking them. Anyway, is this permanent or is there something I can do to fix the problem… in a natural way. i’m scared to take anything now that’s not completely natural. Thank you!

Forza-T claims an increase in free testosterone from the use of this product. There is, of course, no proof, but if you take that claim at face value, it will almost certainly increase hair loss.

You sound like you are playing with fire. DHT blockers (I am assuming that you are talking about finasteride as that is the only FDA-approved medication for treating hair loss that blocks DHT on the market today) will NEVER give you an instant change. Please note that hair above the skin is dead, not alive, so it could not possibly change in minutes. Are you possibly body dysmorphic?


2007-05-21 13:32:49Forza-T and Hair Loss

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Forskolin and Testosterone Levels

Dear Dr. Rassman,

Thank you in advance for reading this question. I am a 19-year old male with MPB, NW II. I am currently on propecia to combat this.

I have recently started taking a nutritional supplement called forskolin, at half the daily recommended dose, as I am worried about the possible effects on testosterone levels. A study was done and can be found here: Body Composition and Hormonal Adaptations Associated with Forskolin Consumption in Overweight and Obese Men.

My question is, if this product does legitimately increase serum free testosterone levels significantly, is this a cause for concern?

Thank you in advance

I looked at the abstract of the study that you referenced. It seems that it does increase your serum testesterone levels, although not significantly. Time frame wise, the study only looked at the effects of this supplement at 3 months. It is possible that at 6 months or a year both the placebo and the Forskolin group may have no difference in serum testosterone levels. Who knows? With an increase in testosterone levels in the blood stream you always run the risk of having more testosterone converted to DHT, and thereby having increased hair loss.


2008-03-31 17:22:45Forskolin and Testosterone Levels

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Former Pakistan Prime Minister Nawaz Sharif Had a Hair Transplant?

Nawaz Sharif had a hair transplant? As the news channels are showing him every hour after the unfortunate killing of Ms Bhutto, I noticed how drastically un-bald he is compared to just a year ago!

Here’s him a couple of years ago – ForumPakistan

Here’s this month’s photo – ABC Australia

Digging around a bit, I found media has already gotten the clue. Pakistan’s top newspaper Dawn reports
“They share one inexplicable self-indulgence; both have had hair transplants that make them look younger in the eyes of every beholder except their electorate.”

I know ex Prime Minister of Italy Berlusconi had had a transplant. Does that make Mr Sharif the second state leader? Seeing Berlusconi lose the election so badly and Mr Sharif’s general
lack of mass support, HT may not yet be that “effective” for our leaders 🙂

Thanks

Interesting comments and photo research. Thanks for sending this in. To answer your question, I really don’t keep track of which state leaders have had hair transplant procedures, but if any readers have examples, feel free to leave a comment. It would certainly seem that Nawaz Sharif had some form of hair restoration. I do not know for sure though, until he publicly acknowledges it. The photos speak for themselves, however.

I’ve put the photos you sent side by side for easier comparison below:

Nawaz Sharif
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Forelocks and Widow’s Peaks (with Photos)

I am 21 years old and I think that I’m thinning. I have a prominent widow’s peak. My father (his white haired front view is shown here) and my grandfather both have balding (like the picture you showed of Dave Letterman on February 2nd, but the ‘pancake’ size area in the middle remains strong on both of them). I expect that I will keep my ‘pancake’ just like my father and my grandfather, but if I lost it, could it all be transplanted (including mywidow’s peak)? Can you tell me from my picture if I am losing my hair? I took a picture of it for you to see.

A widow’s peak can be created with a hair transplant. Many people (including me) think that it is a sexy look for people with narrow faces, and it works in a transplant when the surgeon is artistic. Some people have a widow’s peak with the hair direction pointing to the side instead of pointing front. This ‘cow lick’ in a widow’s peak is a bit more difficult to reproduce, but it can be done if the widow’s peak is eroding even with a ‘lick’. For an example of what I mean, see the photo below — click to enlarge.

 

The unusually good picture sent by this man (below) shows thinning behind the forelock and I took the liberty to create a zoomed version of the photo to show the difference in densities under magnification (click to enlarge).

 
His father’s hairline shows that the forelock is strong and I suspect the widow’s peak is a family trait (see photo below — click to enlarge).

 
Referring back to the son’s photo, I think that you can see this young man has reduced density and miniaturization when comparing the central part of the scalp (just behind his forelock) to the forelock. It looks like this young man will bald behind his forelock, possibly more balding than I think that his father shows now, but the strong forelock and widow’s peak may hold even if the hair around it falls out.

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Forelock Width?

I was just wonder something about the frontal area when it comes to the mature hairline. You give two measurements of where the corners and the front part of the hairline should be, but what about the size of the frontal area? I think you call it the forelock? How wide can it be or does it matter?

The central portion of the frontal hairline often has a forelock of hair that can be genetically independent of the surrounding hair. David Letterman has a strong forelock that lasted longer than much of his hairline, due to this genetic independence of the frontal hairline around it. It is just one of many unique traits in our appearance.

These forelocks tend to run in families and it can be quite small or even fairly large, depending upon the genetics of the individual. Also, these forelocks often are found low on the central hairline.

We posted on a similar question about forelocks and widow’s peaks a few years back: Forelocks and Widow’s Peaks

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Forehead Lift and Hair Loss in Female with Frontal Fibrosing Alpecia

I’m so fearful that I made a bad decision about having a forehead lift because I, too, am losing lots of hair from the top and sides of my head. I am 7 weeks out and panic struck because I am starting took bald around the incision. It looks like I have cradle a cap that is starting to come off and the surface is raw underneath. I’m using Silvadene on it. My surgeon keeps saying that it’s all fine, but I look horrible. The suture line has not healed yet. I do have a condition called Frontal Fibrotic Alopecia. Oddly enough, the hair transplants in the area are growing!

You are fortunate that the hair is growing since this disease can impact much of the frontal hair. Hair loss is not uncommon after any facial surgery in women.


2018-06-22 09:42:38Forehead Lift and Hair Loss in Female with Frontal Fibrosing Alpecia