Finasteride Losing Effect Over Time And Androgen Receptor Upregulation

[Samson123]

No one is denying the fact that the body has the ability create more androgen receptors when it needs to. How could hair follicles not upregulate AR in response to artificially low levels of DHT? Our hair follicles in male pattern baldness areas are programmed to stop producing hair and the best way to counter this process so far is to deprive the hair follicle of the most 'damaging' androgen, DHT. As far as our genetics are concerned, DHT isn't causing any damage, it's doing exactly what it is supposed to and will try to compensate for low levels in other ways, basically AR upregulation. I don't even understand why this is even still being debated.

My hair is way worse off being on finasteride for almost two years now, including the donor areas which were prior to finasteride very thick. I've lost a lot of density but what confounds me is that my hair became very fine all over. What is that all about. I'm definitely not the only one who has experienced this. Anyone have any insights into that? I'm thinking massive AR upregulation and/or my hair follicles are uptaking other androgens that cause hair to grow in finer.

I agree with the OP that new users should start at a much lower dose than 1 or 1.25 mg. There seems to be enough anecdotal evidence that once your hair follicles upregulate AR in response to finasteride that they don't necessarily downregulate at a lower dose or upon cessation of finasteride, though I have read accounts of people's hair getting both better and worse after stopping the drug.

 

[abcdefg]

Is finasteride up regulating androgen receptors really a fact? As you age the androgen receptors grow more and more sensitive to androgens regardless so that might happen regardless of propecia. Just one of those things we can only guess at. ARs sensitivity to androgens though doesnt stay constant over time. maybe propecia makes it worse I dont know
Does the body compensate for the lower androgens in everybody equally? I dont know if that is a fact or not.
You cant discount the fact that finasteride never really worked for you, and hair loss always progresses so it just got worse naturally while you used finasteride. Could be a lot of things really, and no one knows most of the answers.
Lets say AR upregulation does happen. What then? You cant practically do anything about that anyways.

 

[abcdefg]

Do we really know this is true though? Why do so many older women have almost perfect hair even at crazy ages like 50 or 60+. A lot of women dont lose much if any hair with age even density. It seems its a way way larger percentage of older men which still leads back to hormones as the major difference.

"
2. Androgenetic Alopecia, maybe partly, maybe as a whole is a form of "stress". As you get older cells are weaker, worn out and thus m(think ROS, oxidative stress), inflammation etc. Therefore when one gets older they might succumb to these forms of stress as their threshold is weakened.

3. It is hypothesized that later in life senescence alopecia can set in which can start from age 30 or 40 which is characterized by diffuse hair loss all over the scalp. This might be completely unrelated to Androgenetic Alopecia itself. Meaning that you could suffer from both."

 

[abcdefg]

True, but the sample size was 118 in this. A tad small when you consider the millions of people on it in the wild.

"Prostate AR does not = scalp AR. The 10 year+ finasteride studies kinda fly in the face of any notion of AR upregulation in the majority of users."

 

[WangMQ]

What about this?

http://ehrs.org/conferenceabstracts/2000marburg/guestlectures/s04-sawaya.htm

 

[abcdefg]

What about this?

http://ehrs.org/conferenceabstracts/2000marburg/guestlectures/s04-sawaya.htm

Its funny on every debate about upregulation on ARs someone always cites studies from Marty E. Sawaya. She seems to be one of the only people that ever even looked into ARs which is odd given how critically important they are in male pattern baldness you would think researchers would look at that first.
Anyhow she was a fraud so I dont know how much of her work is true or not. She is being debarred by the FDA for getting a felony related to her field.

https://www.federalregister.gov/art...ary-e-sawaya-aka-marty-sawaya-debarment-order

"This offense was committed when Dr. Sawaya created a medical license by obtaining a copy of a colleague's Florida medical license, altered that license using a photocopy machine to reflect that the license was issued in her name, and submitted the false and fraudulent Florida medical license to the sponsor of a clinical trial, for which she was a clinical investigator. "

 

[Armando Jose]

3. It is hypothesized that later in life senescence alopecia can set in which can start from age 30 or 40 which is characterized by diffuse hair loss all over the scalp. This might be completely unrelated to Androgenetic Alopecia itself. Meaning that you could suffer from both.

Also this is my idea, senescent alopecia is unrelated to common hair loss

 

[frenchy]

Its funny on every debate about upregulation on ARs someone always cites studies from Marty E. Sawaya. She seems to be one of the only people that ever even looked into ARs which is odd given how critically important they are in male pattern baldness you would think researchers would look at that first.
Anyhow she was a fraud so I dont know how much of her work is true or not. She is being debarred by the FDA for getting a felony related to her field.

https://www.federalregister.gov/art...ary-e-sawaya-aka-marty-sawaya-debarment-order

"This offense was committed when Dr. Sawaya created a medical license by obtaining a copy of a colleague's Florida medical license, altered that license using a photocopy machine to reflect that the license was issued in her name, and submitted the false and fraudulent Florida medical license to the sponsor of a clinical trial, for which she was a clinical investigator. "

lol good catch

 

[Afro_Vacancy]

True, but the sample size was 118 in this. A tad small when you consider the millions of people on it in the wild.

"Prostate AR does not = scalp AR. The 10 year+ finasteride studies kinda fly in the face of any notion of AR upregulation in the majority of users."

118 is a perfectly reasonable sample size in science if you're measuring a large effect.

WangMQ's post completely disagrees with the 10+ year finasteride study. I'm guessing that there are biases in that study, maybe survival bias, I don't know.

 

[Dench57]

Dench, have you come any closer to understanding the biological mechanism of what happened to you after taking finasteride?

No idea. The symptoms (burning, itching, scalp pain, accelerated miniaturisation, increased sebum, increased libido, increased acne) all point to either a) increased AR sensitivity or b) increased 5AR2 activity. Doesn't make any sense how finasteride could cause this but its too much of a coincidence that this all started within 3 weeks of starting finasteride when I'd been balding for 2+ years without any sign of these symptoms.

Whatever my reaction was obviously does not apply to the vast majority of finasteride users, as we can see from the long term studies. These studies suggest AR upregulation is not a "given" with finasteride treatment as some people seem to think. I'm actually getting a scalp biopsy on Friday to see if there is something else going on but I'm sure its just Androgenetic Alopecia inflammation.

 

[Pray The Bald Away]

No idea. The symptoms (burning, itching, scalp pain, accelerated miniaturisation, increased sebum, increased libido, increased acne) all point to either a) increased AR sensitivity or b) increased 5AR2 activity. Doesn't make any sense how finasteride could cause this but its too much of a coincidence that this all started within 3 weeks of starting finasteride when I'd been balding for 2+ years without any sign of these symptoms.

Whatever my reaction was obviously does not apply to the vast majority of finasteride users, as we can see from the long term studies. These studies suggest AR upregulation is not a "given" with finasteride treatment as some people seem to think. I'm actually getting a scalp biopsy on Friday to see if there is something else going on but I'm sure its just Androgenetic Alopecia inflammation.

Thanks for the reply! Keep us updated on the biopsy.

 

[GoldenMane]

I really hope you're wrong about AR upregulation, but if that is the case, I'm sure a two pronged approach as suggested with an AE antagonist could help. I've read that Retin A and EGCG from green tea, selenium can downregulate androgen receptor activity.

Also found an article on androgen receptors being downregulated due to Androgen deprivation, though that was in prostate cancer cells. There are quite a few studies on androgen receptor downregulation as a means of treating prostate cancer, many of the treatments result in cell death in cancerous cells though I'm not sure what affect they may have on healthy prostate,or more importantly hair follicle cells.

 

[GoldenMane]

Another question I have, is why would reducing DHT and increasing testosterone via 5a reductase inhibitors result in androgen receptor upregulation? Testosterone is still a potent androgen, and it will still bind with the androgen receptors. It's not like androgen receptors are being deprived of androgens, they're just getting less DHT and more testosterone and testosterone is still an androgen... Do androgen receptors increase solely due to a lack of DHT even when other potent andogens are still present?

 

[DontWant2BeBald]

You are so wrong. Decreasing the presence of androgens decreases the number of androgen receptors. A possible reason why people lose later in life is that androgen sensitivity increases

 

[GoldenMane]

You are so wrong. Decreasing the presence of androgens decreases the number of androgen receptors. A possible reason why people lose later in life is that androgen sensitivity increases

I said that was one study on prostate cancer cells. The more important question was in my second post, androgen presence ISN'T being decreased. DHT is. Testosterone (still an androgen) is actually increased using finasteride or dutasteride.

 

[Bigbone]

You are so wrong. Decreasing the presence of androgens decreases the number of androgen receptors. A possible reason why people lose later in life is that androgen sensitivity increases

Where have you read that it decreases androgen receptors?

 

[Johnmpb]

You are so wrong. Decreasing the presence of androgens decreases the number of androgen receptors. A possible reason why people lose later in life is that androgen sensitivity increases

derp

 

[Kagaho]

If upregulation of receptors is such an issue in male pattern baldness, castrates and pseudos would lose their hair too.

The problem with long term users of finasteride is, especially the younger ones, that androgen levels arent lowered enough to mantain all their hair.

I think in those cases testosterone plays a role and continues the process initatied by DHT

 

[abcdefg]

Yes combination of having plenty of T, some DHT left, and as you age your hair does continue to get more sensitive to androgens as hamilton had proven. Maybe more sensitivity is result from oxidative stress from aging as swoop would mention who really knows. male pattern baldness is still almost an entirely hormonal issue and the shoe fits when you realize most women dont grow beards and back mats of hair or go bald. Hormones make perfect sense its just the huge mess down stream where things get really confusing.
One thing for sure keep taking your propecia/RU and whatever AAs you can manage because AAs arent going anywhere for a long long time.

 

[GoldenMane]

Oxidative stress is just one of the genetic causes of aging along with telomere genetic erosion. Nothing to do with male pattern baldness really but yeah it can also damage hair follicles, along with everything else in your body. Only way to fight that is healthy lifestyle, no cigarettes, no junk food, eat lots of blueberries/acai/goji berries and drink lots of green tea.