#22

Do I need a prescription for Tadalifil in the USA? Or Viagra? Are they OTC?

#23

Yes, you need a prescription.

1 Like
#24

whatever you take, make sure you add this one:

GNWrX7uW4AAI_pQ

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#25

I have looked extensively over existing research and have concluded that 5ar inhibitors are safe and effective. DHT, after puberty, has barely any function left in the human body other than in the production of brain neurosteroids (which is not affected by finasteride in humans and doesn’t seem to be an issue with dutasteride either despite the latter being a dual 5ar 1/2 inhibitor). The association studies done on either drug actually point to both drugs making men live longer (though I don’t care about association studies because they are worthless).
Watch haircafe on youtube as he goes over existing research. Or Brad Stanfield for that matter, especially on finasteride and prostate cancer prevention.

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#26

Some other person mentioned CostPlusDrugs.com , and yes, their prices are great:

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and

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#27

Yes, 5mg daily is recommended by the Mayo Clinic, my doctor, and seems to be the general guideline. I started at 2.5mg the 1st month to access side effects, then went to 5.

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#28

Chris, you do so much that is good and yet you can’t bring yourself to do some resistance training. I think, therefore, you need an easy way into this. I suggest you buy a waited vest. One of those where you can simply add 1kg weights one at a time.
Just wearing that with say 5kg in will start eating up some of those excess calories, but then it will be super easy for you to start doing a few squats - with the vest on that’s your first bit of resistance training.
Maybe then a few press-ups.
Then with that pile of kilogram weights yet to be added you might consider picking up a few and doing some bicep curls or overhead presses.
Before you know it you will be doing 15 minutes a day without even leaving your apartment - and then it will be easy to go up to half an hour as you realise how easy it really is, and by now you’ll have 10kg or more in the vest (you probably won’t be squatting any more than when you first started because you will most likely have lost weight).
Go on, give it a try!!

6 Likes
#29

I usually go with 5 mg/day, but then if ED is present, if needed either take a 10 mg an hour before (max dose 20 mg/day) or some people seem to do better with Sildenafil, so I’ll just have them take a modest dose of that. But the approach if just for longevity and neurocognitive decline, probably 5, max 10 mg daily has been my approach.

4 Likes
#30

CostPlusDrugs was started by Mark Cuban. Nice to see a billionaire doing something to address healthcare costs.

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#31

Great idea! I recently bought a goruck mini backpack. On occasion, I’ll wear it around the house while doing chores and love that it’s accidental resistance training when just doing regular stuff. Or I’ll use it for a 20 minute walk, so I’m getting more out of it when I’m not motivated to do anything longer (which is quite often!).

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#32

I believe you are incorrect regarding finasteride/dutasteride not affecting neurosteroids. In rats neurosteroid levels are definitively impacted. There’s also rather strong evidence in humans. Please see Melcangi R.C., Santi D., Spezzano R., Grimoldi M., Tabacchi T., Fusco M.L. Neuroactive steroid levels and psychiatric and andrological features in post-finasteride patients. J Steroid Biochem Mol Biol. 2017;171:229–235.

Also Motofei I.G., Rowland D.L., Tampa M., Sarbu M.I., Mitran M.I., Mitran C.I. Finasteride and androgenic alopecia; from therapeutic options to medical implications. J Dermatolog Treat.

The latter study showed decreased P4, DHP, THP, as well as reductions in CSF DHT and T.

Alteration of neurosteroids fits with the not uncommon side effects of depression, sexual dysfunction, and apathy associated with 5-AR blockade.

5-AR blockade also decreases dopaminergic transmission in the brain and inhibits neurogenesis in the hippocampus in rat models.

Please see:
The post-finasteride syndrome: possible etiological mechanisms and symptoms. Leliefeld, et al. 2023.

The above review has an excellent explanation regarding the lipophilic nature of dutasteride/finasteride. Easy access across the blood barrier and inhibition of 5-AR1/AR2 which are both present in the brain. Also provides references regarding alteration of neurosteroids in humans and how these alterations can remain permanent despite d/c of the drug in both humans and rodents.

Metabolically we have evidence for insulin resistance, increased adiposity, bone loss, muscle loss, and reduced clearance of glucocorticoids. I can provide additional references at your preference.

Majority of the above are studies looking at PFS (post finasteride syndrome) which I fully admit the exact etiology is unknown. Nonetheless the studies provide ample evidence of the deleterious effects of 5-AR blockade with the potential for some of these effects to be permanent.

On the contrary, I’m not aware of any evidence that these drugs prolong human longevity or health span and the reduction in Gleason 6 prostate CA is of questionable clinical benefit given the standard of care for this type of prostate cancer is simply active surveillance.

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#33

Cialis is available in 2.5mg and 5mg in the US.

1 Like
#34

Humans are not rats. In humans, finasteride is a selective 5ar2 inhibitor while the brain predominantly contains 5ar1. Dutasteride may inhibit brain neurosteroids but despite that, the side effect profile appears to be the same as finasteride.

In the present study, we were able to provide strong biochemical evidence for the predominant, if not exclusive, activity of the 5α-reductase type 1 isozyme in the human brain by determining the inhibitor sensitivity of the in vitro reaction ( Figs. 1–3123). We could demonstrate the presence of 5α-reductase and colocalized 3α-HSD in the brain tissue biopsies of all patients under investigation

Finasteride is a potent inhibitor of human 5α-reductase type 2 (with an IC50 value of approximately 5 nmol/L) and a poor inhibitor of the type 1 isoform (with an IC50 value of approximately 500 nmol/L).

Characterization of the 5α-Reductase-3α-Hydroxysteroid Dehydrogenase Complex in the Human Brain1 | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic (oup.com)

Regarding post-finasteride syndrome, in 2022 the FDA did not find a causal connection between finasteride and persistent side effects.

The US Food and Drug Administration (FDA) had advised that the PFS petition “does not provide reasonable evidence” of a link to suicide, but in August 2022 added suicidal ideation (SI) and behaviour to the adverse reactions listed for finasteride. According to the FDA statement, the PFS petition “does not provide reasonable evidence” of a causal link between finasteride and persistent SD, depression, or suicide.

US Food and Drug Administration Warning Regarding Finasteride and Suicidal Ideation: What Should Urologists Know? - ScienceDirect

#35

Humans are not rats. In humans, finasteride is a selective 5ar2 inhibitor while the brain predominantly contains 5ar1. Dutasteride may inhibit brain neurosteroids but despite that, the side effect profile appears to be the same as finasteride.

You completely ignored the references I provided showing definitive changes in neurosteroids in both humans and rats.

Dutasteride seems like a no bainer for hair, prostate and skin health. Plus it stacks well with tadalafil for additional prostate protection and zero risk of side effects.

Your original post mentions dutasteride as a “no brainer” which is incongruent with your argument above regarding isoforms of 5-AR in the brain. Dutasteride inhibits AR1 and 2 so you are most definitely altering brain neurosteroids. This is also seen with Finasteride (despite AR2 selectivety) in the human studies I provided.

Regarding post-finasteride syndrome, in 2022 the FDA did not find a causal connection between finasteride and persistent side effects.

They didn’t find a connection, but they added suicidal ideation and behavioral changes to the side effect profile. They also recommend mental health screening prior to drug initiation.

I’ll let you interpret that as you wish.

You haven’t provided any evidence that neurosteroids aren’t affected by 5-AR blockade. Contrarily, I have provided animal and human evidence of the effect along with numerous other potential deleterious effects. I’m also interested in the proposed longevity/healthspan benefits as I see none?

I have no concern with you wanting to be on the medication as you have apparently researched it to your satisfaction, but representing it as a “no brainer” and “zero risk of side effects” on a public forum to people who may seek out the medication without fully understanding the potential risk involved is questionable.

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#36

The study/ies in question were done on people who allegedly suffered from PFS. They took blood samples from them and supposedly found changes that differed from “normal” human parameters. But since this was neither a randomized, placebo-controlled trial nor a in-vitro study done on human tissue, causality is impossible to prove. Selection bias is also a huge issue.

They didn’t find a connection, but they added suicidal ideation and behavioral changes to the side effect profile. They also recommend mental health screening prior to drug initiation.

It’s probably a good idea to keep hypochondrics from taking finasteride, dutasteride, ssri, accutane, statins, ozempic or any of the other drugs that are unjustifiedly villified by online grifters.

You haven’t provided any evidence that neurosteroids aren’t affected by 5-AR blockade.

I did. My study done on human brain simples offers a direct mechanistic evidence of finasteride not affecting brain neurosteroid production in humans. Unless you can find a randomized, placebo-controlled study of people with finasteride suffering from a higher incidence of mental side effects compared to placebo, this study is much stronger evidence than anything you have provided.

and “zero risk of side effects” on a public forum to people who may seek out the medication without fully understanding the potential risk involved is questionable.

I made that statement in the context of stacking dutasteride with tadalafil.

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#37

Guys - the issues around Dutasteride and Finasteride have been debated ad nauseam in this other thread, no need to re-debate them. Anyone interested in this discussion, please see here: Opinion about Finasteride and DHT

related: Can I take dutasteride with rapamycin - #5 by RapAdmin

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#38

I’ll digress at the request of admin, but if anyone is interested there’s a 2009 paper showing alteration of several hormones/neurosteroids pre-/post- finasteride in BPH patients. Duskova is the author.

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#39

I will stop posting about it too after clarifying the study you mentioned.
@RapAdmin If you are moving my post, please also move @Shady’s post.

You are refering to Finasteride treatment and neuroactive steroid formation - PubMed (nih.gov)

Which haircafe discusses in the following video, stating that serum allopregnanolone levels do not (necessarily) correlate with brain allopregnanolone levels.

The reason finasteride decreases serum allopregnanolone levels is very likely due to its inhibition of spine (and other) allopregnanolone production which is indeed affected by a selective 5ar2 inhibitor.

Allopregnanolone: An overview on its synthesis and effects - PMC (nih.gov)

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#40

@RPS, I started walking in a weighted vest several years ago and honestly feel like it’s one of the best things I’ve done for my body composition.

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#41

That’s great! I just paid $29.87 for 90 Tadalafil, 5mg with GoodRx. CostPlus would be ~$9.50 cheaper for the 90 days.

1 Like