I know some worship DHT blockers like a new religion.
If something works, why would I not love it?
But it’s not so simple. Neither finasteride nor dutasteride actually prevents prostate cancer
They do, although it isn’t enough to affect acm.
In the updated analysis, men taking finasteride had a 30 percent decrease in the relative risk of developing prostate cancer compared with men who took a placebo: 10.5 percent of men in the finasteride group were diagnosed with prostate cancer versus 14.9 percent of men in the placebo group. This reduction in risk was explained solely by the prevention of low-grade cancers—those with a Gleason score of 6 or less—which present little health risk but, nonetheless, are often treated with radical surgery or radiation. The risk of such cancers was 43 percent lower in the finasteride group than the placebo group.
The men who took finasteride were more likely to be diagnosed with high-grade cancer compared with the men who took a placebo: 3.5 percent of all men in the finasteride group versus 3.0 percent of all men in the placebo group, a relative increase of about 17 percent.
The survival rates at 15 years were very similar between the two groups: 78.0 percent in the finasteride group versus 78.2 percent in the placebo group. When the researchers looked specifically at men who had been diagnosed with prostate cancer, the survival rates for individuals diagnosed with prostate cancer were also very similar between the two groups.
Finasteride for Prostate Cancer Prevention - NCI
But keeping hair and virility can be attained with far less possibly consequential methods.
Without using a 5ari, hair cannot be maintained in balding men. Unless you are 80+ and losing hair from senescent alopecia in which case minoxidil alone may suffice.
Optimal androgen levels are a biomarker for survival because older men with midrange levels of T and DHT had the lowest death rates from any cause, whereas those with higher DHT had lower IHD mortality.
Low testosterone is likely a consequence of frailty and DHT and testosterone are linearly linked. The study makes no mention of whether this association was still maintained for men with high testosterone but low DHT (due to genetic factors).
Among 1032 men followed for a median of 9 years, 436 incident CVD events and 777 deaths occurred. In models adjusted for cardiovascular risk factors, total T and cFT were not associated with incident CVD or all-cause mortality, whereas DHT and calculated free DHT had curvilinear associations with incident CVD (P < .002 and P = .04, respectively) and all-cause mortality (P < .001 for both).
Interestingly enough, other studies show that balding is highly correlated with heart disease.
Results showed that men who had lost the majority of their hair had a 32% increased risk of developing coronary artery disease, compared to their peers who maintained a full head of hair.
When the analysis was restricted to men under the age of 55-60, a comparable pattern was revealed. Bald or extensively balding males had a 44% increased probability to develop coronary artery disease.
After examining the other 3 reports, which compared the heart health of men who were bald or balding with those who were not, the experts saw similar results.
The team found that balding men had a 70% higher risk of having heart disease, while those in younger age groups had a 84% elevated chance.
Baldness Linked To Higher Risk Of Coronary Heart Disease
As for:
Among older men, higher levels of DHT were inversely associated with insulin resistance and risk of diabetes over the ensuing 10 years, whereas levels of T were not.
Other observational trials point to finasteride lowering both cholesterol and glucose levels. Results were inconsistent for cvd.
Similarly, LDL-C levels were lower in finasteride users except for those that were neither diagnosed with high cholesterol nor were taking cholesterol-lowering agents (P = 0.074, Table 2).
From the different interaction variables, finasteride consumption was associated with a reduction in blood glucose in those subjects diagnosed with liver condition (P = 0.0418), diagnosed with diabetes, and currently taking antidiabetic medications (P = 0.0033), and diagnosed with high blood cholesterol but not currently taking cholesterol-lowering medications (P = 0.0101).
Finasteride delays atherosclerosis progression in mice and is associated with a reduction in plasma cholesterol in men - ScienceDirect
And for this observational study
Lower T has been associated with CVD events and all-cause mortality. Lower DHT concentrations are associated with higher mortality from ischemic heart disease.
There were actual trials looking into testosterone supplementation
Association studies between testosterone and CVD risk suggest that low levels of endogenous testosterone in men are associated with greater odds of CVD outcomes. However, the effect of exogenous testosterone on CVD risk and atherosclerosis remains elusive: On one hand, the Cardiovascular Testosterone Trial failed to observe alterations in the intima-media thickness of older (+60) cis men with low or low-normal serum testosterone, while a second study with comparable demographics observed an increase in plaque volume (6, 68).
Your observational studies cannot establish a connection between DHT and heart disease or all-cause mortality due to the obvious factor of testosterone. In the studies you posted, there was no mention of low DHT being a risk factor even in men with normal or high levels of testosterone while in mine, there are populations that artificially suppress their DHT but not their testosterone with a neutral or even positive effect on health markers.