Guys, I don't want to get entangled into a heated argument about Bicalutamide, but I'd like to share my views.
hemingway_the_mercenary, though is very rude and impolite when he comments on our level of maturity and wisdom, he is very right about the information about Bicalutamide.
Bicalutamide binds itself to the androgen receptors and it goes inside the cell, but unlike androgens that have coactivator transcription, it has corepressor transcription, and it can have a huge benefit when treating hair loss. When it comes to mutant prostate cancer cells, they somehow manage to get coactivator transcription through anything that brings the receptors inside. Thus, certain prostate cancer cells become bicalutamide resistant.
Enzalutamide and Darolutamide are different. They don't translocate the AR at all. Therefore, there is no transcription and the bicalutamide resistant prostate cancer cells are not resistant to Enzalutamide and Darolutamide.
But hair follicle cells are different. They don't mutate. So, taking the advantage is corepressors is not a bad idea.
As for MTF HRT, Bicalutamide is not common because:
- Spironolactone is cheaper.
- Estrogen given for HRT makes it unnecessary for MTF to take a very strong anti androgen.
- Bicalutamide is mostly prescribed by oncologists.
- A lot of endocrinologists have no clue that Bicalutamide exists.
- Hyperkalemia is unexpected, because most MTF eventually get surgical castration and they either drop anti-androgens or switch to finasteride.
Though bicalutamide is used as experimental HRT for MTF transgenders with estrogen and non-binary people with Raloxifene.