Dr. Rassman’s Comments: I fully understand the clinical science that is stated below; however, this reflects a minority of patients who take this drug who report side effects. Many people have no side effects and great results from the drug finasteride. Despite this, everyone on this drug should read these comments carefully because his concerns are real and as he said, if you are the one that is impacted, it is 100% for you.
The fact that this poison is still being regularly prescribed undermines the legitimacy and perceived objectivity of the American medical system and the pharmaceutical industry. There have been plenty of publications that have come out over the decade that have shown 5 alpha reductase inhibitors to be dangerous, even to those who appear to respond well to them, which I’ll link at the end of this comment. I am glad that the FDA was objective enough to deny the approval of these drugs as chemo-preventative therapies – who knows how many lives would’ve been destroyed if they’d been approved for that – and that they decided to finally label the drugs with serious warnings, but it’s not enough.
The risk of full-blown Post Finasteride Syndrome, while apparently low, is not something to dismiss. Additionally, the odds of developing side effects increases with time. These drugs have been shown to chronically lower neurosteroid levels, the most significant of which being allopregnanalone, which is responsible for anxiolytic, anti-depressant, pro-sexual, and other important effects. And as it turns out, DHT isn’t useless after puberty like many people seem to claim. There is no way to screen for who is at risk for post-5ARI syndrome and who isn’t. Even if the odds are low, you’re playing with fire. And many men who don’t develop the condition will still eventually have milder side effects, like a loss of morning erections, weaker erections, lower libido, increased anxiety or depression, etc. all to save a few thousand hair follicles. How do physicians justify this? It’s one thing to prescribe it for a hyperplastic prostate (and even that’s questionable), it’s quite another to prescribe it for vanity. Any physician that considers prescribing this drug for hair loss, as far as I’m concerned, should never be allowed practice medicine again, and should be sued for malpractice and negligence. Clearly they’ve never considered “first do no harm”.
Many physicians’ ignorance of what they’re prescribing is astounding, and the denial of a very real condition when it happens is, at the very least, cruel and pathetic. This sort of science-denial is akin to climate change “skeptics” or evolution deniers. I don’t think I need to explain why this is a terrifying trait to see in a licensed physician. The science is in and has been for years now.