#247

Because prostate cancers only make up 6% of all cancer deaths and cancer deaths make up 18% of all deaths, so only 1% of all deaths are due to prostate cancer. Obviously women don’t die from prostate cancer but even if you quadruple the incidence to 4% of all male deaths, that would still not be easily detectable in a randomized, placebo-controlled trial.

FastStats - Leading Causes of Death
Prostate cancer cases and deaths U.S. 2024 | Statista

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#248

Precisely, prostate cancer is a slow progressing cancer - most men die from other causes before prostate cancer demise. If a man is planning to live over a hundred he is way more likely to face prostate cancer.

Technically there was a 25% reduction in prostate cancer death with 5AR but it wasn’t statistically significant due low deaths in general in study. As more men live past a 100, I imagine we would see more prostate cancer deaths and this difference can become pronounced.

With 296,842 person-years of follow-up and a median follow-up of 18.4 years, of 9423 men randomized to finasteride, there were 3048 deaths of which 42 were due to prostate cancer; of 9457 randomized to placebo, there were 2979 deaths, 56 due to prostate cancer. With the small number of deaths due to prostate cancer, the 25% lower risk of death from prostate cancer with finasteride was not statistically significant.

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#249

My supply of dutasteride arrived this week and I have to say that it is far superior to finasteride. Finasteride caused depression for me. Dutasteride is causing a little bit of euphoria (maybe placebo). However, it does not cause depression!

Finasteride caused testicular pain. Dutasteride does not!

Dutasteride is superior to finasteride IMHO.

I take Dutasteride due to my high PSA (1.71), BPH, hair loss, and a familial history of prostate cancer. I feel wonderful about taking it. There is no reason for me to ever go back to finasteride.

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#250

I take 0.5 mg/day dutasteride after a little more than 2 years on finasteride. I never had any side effects on finasteride, and have none on dutasteride either, but I’m surprised how common it is for people to report what you did: finasteride causing unpleasant side effects while the stronger dutasteride causes none. Could some of the side effects be not due to DHT suppression, but something specific to the finasteride molecule?

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#251

I have no idea what the mechanism is. I’m just happy there is a viable alternative with no side effects (so far)).

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#252

Return of the Placebo King. :wink:

I only get slightly euphoric after a night’s sleep if it’s high quality and waking up at the end of REM or a dream, just watching the trees then at dawn in the wind is dreamy bliss. No clue why that happens yet.

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#253

Me I wake up euphoric when a maniac episode is starting lol. Do you guys know Haircafe on YouTube? He talks about hair loss and 5 alpha reductase inhibitor and he’s super interesting and captivating. He made a few videos on dutasteride and explained a probable mecanism of why dut has less side effects compared to fin. I don’t remember why however

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#254

Well it’s not a lot of euphoria for me, just the dream magical feeling continuing a bit which feels nice. It dissipates relatively quickly. I can get the same feeling after exercise if I haven’t done it for awhile.

Haircafe – yes he’s good :+1:

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#255

5ar inhibition is weird. 1mg finasteride causes no side effects in me but with 2mg I get a bit depressed. 0.5mg dutasteride causes a variety of side effects in me but 2.5mg causes fewer despite far more tissue DHT suppression. People need to experiment with what 5ar inhibitor at what dosage and frequency they feel fine with.

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#256

I’ve been researching finasteride and dutasteride, and my doctor seems to favor dutasteride for treating benign prostatic hyperplasia (BPH).

One thing I find curious is that dutasteride—despite being stronger, having a longer half-life, and inhibiting both Type I & Type II 5α-reductase—has fewer reported neurosteroid-related side effects. This might be due to less research on its neurological effects rather than an actual difference in impact.

On the other hand, finasteride, which primarily inhibits 5α-reductase Type II, has been shown to directly lower allopregnanolone and tetrahydrodeoxycorticosterone (THDOC). This reduction in neurosteroids can lead to:

  • Increased anxiety, depression, or brain fog in some users.
  • Sleep disturbances, as allopregnanolone plays a role in deep sleep.
  • Possible anhedonia or emotional blunting, reducing enjoyment from activities.

Supplementing with DHEA, Pregnenolone, Magnesium, Taurine, etc. can help compensate for the neurosteroids that finasteride depletes.

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#257

It has reduced allopregnanolone in serum which is not necessarily he same as brain allopregnanolone.

Type 1 isoform is expressed in cortical, hippocampal and olfactory bulb glutamatergic neurones and in some output neurones of the amygdala and thalamus, 34 with high levels in midbrain, corpus callosum, anterior commissure, optic chiasm, pons and spinal cord, 33 , 35 , 36 and particularly in purified myelin preparations obtained from the rat brain. 35 , 37 , 38 At the cellular level, this isoform has been detected in oligodendrocytes and neurones, 39 , 40 , 41 in microglia 42 and astrocytes, 39 , 40 and in Schwann cells. 43 , 44 , 45 , 46 Type 2 isoform is widely expressed from the forebrain to the brain stem and cerebellum of the adult rat 47 and also highly expressed in the spinal cord, particularly in oligodendrocy

Allopregnanolone: An overview on its synthesis and effects - PMC

Most serum allopregnanolone reduction could be the result from inhibition of the 5ar 2 isoenzyme in the spinal cord, for example.

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#258

Good points, I should do more research. Thank you for the link.

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#259

What did you settle on? 2.5 mg dutasteride?

#260

After 3 years on finastride and Duta i always wanted to try allopregnanolone nasally to see if it makes a difference in my mood ( allopregnanolone is giving intravenously to some women after birth to treat post birth depression cases) not as if i feel something negative from fin or duta im all good and thankful for this wonderful drugs

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#261

1mg finasteride as I did not notice any additional regrowth with dutasteride over finasteride.

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#262

Damn you all ! I have used finasteride 1 mg daily.
Now you have me question if the life has been a bit lackluster for me. :rofl:
I mean I don’t feel overtly depressed or anxious, I have zero issues with impotence and libido.
But I don’t brim with enthusiasm like I used to, I just thought it was part of being 51.

Well …Cost Plus has 90 days of dutasteride 0.5 mg for $12.84

Thanks for the NOCEBO effect !

BTW, just for the record - taking rapamycin is a miserable experience- I am exhausted for 36- 48 hours from admin. This thing better have some measurable effect - like improved dental pocket numbers to gauge my perio.

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#263

It’s probably easy to forget about and let it slide, then slowly over the years and decades, different mental knots, personal circumstances, cumulative damage, start decreasing amount of positive valence (e.g happiness, joy, calm, peace), and increasing negative valence (e.g anger, sadness, depression, anxiety) that someone has on a day to day, weekly, yearly, basis.

I think personal circumstances matter a lot (what someone does and experience on a day to day basis, on average), also in the body and brain (e.g maybe inflammation and such, brain/mental patterns or habits), and of course other things.

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#264

Dr. Bart … take a breath… lol.

I’ve been on 5mg daily finasteride for about 33 years. No depression… pretty euphoric ( rapamycin probably helps there too)… got a small prostate… nice… got my hair… getting a trim in a few minutes… and no plaque or calcium… recently reported that finasteride keeps cholesterol cleared in blood.

I am staying the course on finasteride.

And yeah… I get you on rapamycin fatique… take my dose at night… feel out of sorts the next day til noon at least. Like I have been given a mickey finn.

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#265

My father gets Rapamycin fatigue as well for about 24-48 hours after dosing. It’s a thing.

The finasteride effect for me builds over 3 days of continual dosing. I can logically look at my life and say that I should be happy, but I feel like everything is sh!t. And my testicles ache continuously. So, I don’t take finasteride anymore. Dutasteride doesn’t have those side effects.

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#266

Having side effects on finasteride is not the same as PFS lol. Side effects usually resolve within 3 months of cessation while the supposed PFS condition allegedly gives people side effects for many months or years until they are miraculously solved by snake oil products.

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