Why Don’t Doctors Analyze Patient Blood Before Prescribing Propecia?
Dr. Rassman,
I have been taking propecia for a little over three months now and I have not noticed that my shedding has slowed. My doctor put me on the propecia without any kind of real analysis. I expected a more scientific approach. For example, why not take blood or hair samples to see how much DHT is in my system before starting the drug… then a few months later check again to see if the DHT level is lower? Then adjust the dosage of propecia accordingly. Does anyone do this? Or is it always this rough experiment?
If a doctor can make a diagnosis of genetic androgenic alopecia, then one of the medical treatments for men is Propecia. You do not need blood tests to confirm genetic androgenic alopecia and you do not need a blood test to start Propecia.
For example, if you have high blood pressure, or hypertension (HTN), there isn’t a blood test you need have done before starting a blood pressure lowering medication. If you have a diagnosis of HTN, the doctor will put you on a medication and your blood pressure will be monitored. If you are on Propecia for hair loss, you hair loss status will be (should be) monitored with miniaturization tests, hair bulk analysis, and even photos.
Studies were done (approved by the FDA) that show the best and most effective dose for Propecia based upon safety and this does not require blood test or monitoring. This is not an experiment and I would not know what blood tests you think are needed. Dosages of finasteride (Propecia) are fixed by the drug company’s studies. Propecia does not require monitoring or adjusting of the dosing. Measuring testosterone or DHT in your blood stream will not impact how you take the drug or how the drug will respond. There is no clear correlation.
The doctor’s response to this question is not really correct. Studies were done by Merck and were approved by the FDA, but they did not demonstrate that 1mg was necessarily the most effective or safest dose. The dose response curve proportionally decreases as the dose increases and other doctors have argued that a much smaller dose is warranted.
Merck prefers that its drug can be administered without the use of regular blood tests because patients would be much less likely to take their drugs and would lead to less revenues. For example, the FDA’s label update that requires Merck to warn of possible persistent side effects caused the sales of Propecia to drop by $500m a year.
Yes, it is a shame. The same thing has happened to things like childhood vaccines. The vaccination of children has dropped significantly in recent years due to fear of its link to autism. Study after study show that the childhood measles, mumps, rubella vaccine (MMR) does not cause autism.
But for so many, that doesn’t matter. Only the fear of this vaccine matters and childhood innoculations have droppped as a result.