Could Propecia Cause Alzheimer’s?
Dr. Rassman,I have been on finasteride for a little over a year, and it has pretty much stopped my hair loss. Needless to say, I am a pretty big fan.
However, I just came across an article that seems to think that finasteride has some questionable long-term safety concerns that deal with its ability to block allopregnanolone. The article seems to hint that the lack of allopregnanolone in the body could lead to neuro-degenerative diseases like Alzheimer’s in the future. I am not a doctor, so I was hoping that you could give me your thoughts and possibly speculate on the article’s validity.
Here’s the article: Allopregnenolone (synthesized from 5AR) may prevent neurodegeneration
My thoughts are that if you do enough scouring and research on the Internet for any hint of negative effects associated with any medication you will be amply rewarded… and thus spiraling you down the path of confusion, fear, indecision, mistrust of the medical field, and eventually diverting you from your original path of enlightenment and trying to take control of your health.
I am not trying to brush off the article, but I really do not know what the clinical value is with the research (on mice) you found or what it means at hinting of a correlation. But ALL medications have risks and benefits. I personally believe finasteride 1mg is a very safe medication and I prescribe it to my patients. On a positive note, there are actual human studies on 5mg finasteride that was shown to reduce the risk of certain prostate cancer.
A lot of the questions we receive through this site have to do with finasteride (Propecia/Proscar) and its side effects or other various concerns. In the real world grand scheme of things, out of thousands of drugs that people take daily, finasteride is a very safe medication. Furthermore, I highly doubt I am answering all these question from men who ONLY take finasteride (no other drugs) and does not have any medical or psychological issues… plus doesn’t smoke, drink alcohol, or take recreational drugs (such as marijuana). All medications and herbs and even certain foods can have negative effects. My point is that anything is a possibility, but we need to look at the probability of such side effects and think of the risks and benefits of what we do. This mouse study just doesn’t cut it. I do appreciate you sending the article though.
Stepping down from my soap box now…
Notice that the doctor doesn’t explain *why* “the mouse study just doesn’t cut it.” Instead, in paragraph one, he states that there’s lots of negative info about pharmaceuticals on the Internet (irrelevant to the study’s findings), in paragraph two he assures readers he’s not brushing off the article, but then states that all drugs pose some risk, finasteride is generally safe in his opinion, and helps prevent an unrelated ailment (irrelevant to the study’s findings), and in paragraph three states that other drugs and substances can have negative health effects (irrelevant to the study’s findings). This seems to be a pattern with Dr. Rassman. Why not just address the soundness of the study’s content? Perhaps it’s because it would be embarrassing for a doctor to explain if negative long-term effects were discovered in a drug he has been recommending for several years. That’s one possible explanation. But nevertheless, it’s an odd pattern when readers submit questions about studies suggesting negative effects and the doctor/scientist downplays the findings by citing arguments based on his anecdotal practice, “other substances are bad too,” “it’s good for unrelated conditions,” and so on, and then rendering a faux-authoritative judgment that the study “doesn’t cut it.” That’s not how good empirical advice works. And disclaimers that he’s not brushing off the article are unconvincing when he discusses correlation and probability without a single reference to the study itself. I’m not saying Rassman is being intentionally misleading, but it’s curious that when he’s presented with these studies that he fails to discuss their content; e.g., statistical significance, sample size, etc., yet gives ample room to other topics that are less important to his readers’ health; e.g., cosmetic procedures, news tidbits, etc. It’s not an impossible task. If he doesn’t know whether there’s something to these studies, the responsible thing would be to simply say, “I don’t know,” or “I’m too busy to figure out whether this study’s conclusion is a serious concern.” As a respected and influential doctor, it’s his duty.
Did you read the linked article? The study doesn’t specifically link finasteride and Alzheimer’s, but the article does offer a lot of “might” and “may” without offering much beyond speculation on a study done on an unknown amount of mice. Mouse studies have value in science, but until the link is definitively made to humans in an actual study and not simply in an article that is making a very thin hypothesis, I don’t see why it’s worth sounding the alarms. If I wanted to keep this under wraps to somehow prevent embarrassment like you suggest, I’d simply not post the original email or my response.
Should someone find the time, there are plenty of other articles out there that try to link various common medications to possible health risks. If you’re looking for it, you can likely find it. One final note to remember — the medication is elective. If you don’t want to take it, then don’t take it. If you’re the type that thinks the sky is falling when someone whispers about it, by all means do what you feel is best.
Thanks for the reply. What you did in your reply to my comment (addressed the content of the study) is precisely what I was suggesting would be more valuable to your readers. Thanks again.
By the time there is a study linking finasteride and Alzheimer’s and finasteride it will be too late for thousands of users. Good doctors are supposed make good judgement calls. Does finasteride impact neurogenesis based on the mouse model? Does impaired neurogenesis increase the risk of brain issues? If yes, then finasteride should not be used for cosmetic purposes.
Come on, do not blame the doctor(s). There are so many mechanisms in our body that we have very limited knowledge of as a scientific society as a whole. A doctor can only act on what is proven relevant in clinic.
Nontheless these types of studies are important and shows the diverse effects something (perhaps perhaps etc) can have when you block a major physiological pathway such as the 5AR based on one of the several possible outcomes. In the end, it is up to you to decide if it is worth it. I wouldnt do it.