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Serious Side Effects: Post Finasteride Syndrome

An image of someone drawing the chemical formula for Finasteride, the medication that can lead to Post Finasteride SyndromePost finasteride syndrome occurs among men who have been prescribed finasteride for hair loss or prostate enlargement. The medical industry claims that oral intake of finasteride can help regrow lost hair and curb prostate enlargement. However, though the medication is believed to regrow lost hair follicles, hair loss soon returns once the drug is discontinued. Further, many men have reported experiencing severe, persistent side effects from the medication. One of the most concerning side effects is sexual dysfunction, resulting in low libido, impotence, and loss of orgasm. The seriousness of these side effects could make the use of finasteride considerably less appealing.

What Is Post Finasteride Syndrome?

It is a cluster of physical and psychological symptoms related to the use of the prescription medication finasteride, a 5-alpha-reductase type II enzyme inhibitor. The persistent neurological, sexual and physical reactions to finasteride can last years, even after the medication is discontinued. The drug is available under the name Proscar as a prostate medication and Propecia for male hair loss.

Those suffering from the syndrome were reported to be healthy young men until they started taking the drug finasteride for hair loss. The medical community has yet to fully recognize this new illness. With the increasing number of men reporting adverse and persistent side effects of finasteride, the scientific community is now only beginning to realize the need for more research into the scope of this issue.

Some of the characteristics symptoms related to the syndrome include:

Sexual Symptoms

  • Sexual dysfunction
  • Low libido
  • Erectile dysfunction
  • Orgasm disorders
  • Penis and testes shrinkage
  • Ejaculatory disorders

Physical Symptoms

  • Female-like breast enlargement
  • Reduced sebum production
  • Chronic fatigue
  • Muscle weakness
  • Thinning and drying of hair
  • Hearing issues
  • Reduction in body temperature
  • Obesity
  • Melasma

Neurological Symptoms

An image of a woman consoling a man who's dealing with Post Finasteride Syndrome

  • Severe memory impairments
  • Slowed thought processes
  • Insomnia
  • Suicidal tendencies and attempts
  • Depression
  • Anxiety

In addition to direct side effects, sexual and hormonal dysfunction can lead to a vicious cycle of strained relationships leading to increasing depression, anxiety, and suicidal tendencies.

How Finasteride is Supposed to Work

Finasteride is prescribed for men with an enlarged prostate or pattern hair loss. Men with an enlarged prostate have difficulty urinating, hesitancy at the start of urination, decreased urine flow and volume, increased frequency of urination, and often wake up at night for urination. Finasteride reduces the symptoms and cuts down the chances of prostate surgery. The drug may be recommended alone or in combination with other medications. In men with hair loss, finasteride is known to increase scalp hair.

Finasteride works by blocking the action of the 5-alpha-reductase enzyme in the body. Blocking this enzyme raises testosterone which helps to decrease the prostate size and increase hair growth on the scalp. However, the effects of the drug last only as long as you take the medication. Once the medication is stopped, the prostate begins to grow again and hair loss continues.

Taking finasteride can cause severe side effects and lead to post finasteride syndrome. Therefore, it is very important to be informed of the risks involved prior to starting the medication. Further, as finasteride has a direct impact on the hormones, pregnant woman and women trying to conceive are strongly advised to avoid the medication and not handle any broken or crushed tablets. The drug can cause birth defects among male babies.

Finasteride: What Could Happen?

Many take finasteride for the improved self-confidence and attractiveness that is associated with a fuller head of hair. Yet one of its most characteristic side effects is sexual dysfunction and impotence. This side effect destroys any confidence or relationship boost the drug may have provided. Moreover, surveys reveal that the medication is also not so good at regrowing lost hair. Only a small percentage of men claim to have restored their lost hair.

Instead of resorting to finasteride, the 5-alpha-reductase type II enzyme inhibitor can be topically applied to the scalp and can work in conjunction with other hair preservation techniques to attain the desired result. This makes it more likely that the drug will only act on the applied region instead of affecting the whole body.

Further, the medication appears to cause serious changes in hormone levels which can lead to unexpected imbalances. Finasteride raises estrogen levels in males, normally by only 15 percent, but sometimes more, causing breast tenderness and breast enlargement, also referred to as gynecomastia.

An image of a man looking in the mirror at a balding spot on his head while contemplating if possible Post Finasteride Syndrome is worth the risk to regrow his hairTestosterone is a dominant male sex hormone. However, when a male takes finasteride, it causes an increase in estrogen levels. Although it also leads to an increase in circulating testosterone by suppressing conversion of testosterone into another compound, in some this can lead to gynecomastia. Elderly males are at higher risk of having the problem as testosterone levels tend to decline with age.

Taking serious note these side effects, the FDA has ordered the manufacturer to change the warning label of finasteride. But many medical practitioners continue to prescribe it to men with hair loss or enlarged prostate. Men undergoing hair transplant surgery are also placed on the medication.

Some medical professionals have raised questions on whether post finasteride syndrome is real. There are people who believe that the syndrome is just psychological. However, a considerable number of people believe that there exists adequate evidence of potentially severe side effects of the medication.

A Case of 5-Alpha-Reductase Inhibitor Intolerance

Studies show that in at least one atypical case of post finasteride syndrome, the symptoms could not be reversed even after exercise and several rounds of therapy.

According to one study, a 33-year male with a history of hair loss was given dutasteride, a medication similar to finasteride, at a dose of 0.5 mg once a day for a month, and complained of burning micturition, generalized itching, seborrhea, abdominal discomfort, and rise in testosterone levels. When the person discontinued the medication and resorted to regular exercise, the symptoms subsided within two years. After a gap of four years, the man returned for hair loss treatment and was given finasteride at 1 mg, once a day. Similar effects including skin rash, burning micturition, seborrhea, and abdominal discomfort were experienced again. However, this time the symptoms did not subside after discontinuing the medication and practicing regular exercise. The damage caused was found to be irreversible.

With no resolution appearing, a series of tests were conducted, and the man received treatment at three different medical centers. Each of the care providers prescribed a combination of shampoo, cream, and other medications. But the symptoms continued even after completion of the course.

Because burning micturition, seborrhea, and abdominal discomfort did not fit into the typical symptoms of post finasteride syndrome, researchers labeled the case as atypical post finasteride syndrome. However, the drug did appear to cause adverse reactions and permanent harm.

Underlying Link Between Post Finasteride Syndrome and Adrenal Fatigue

The symptoms of post finasteride syndrome can create havoc and stress in your body, leaving you fatigued. The adrenal glands may be taxed to exhaustion from internal stress caused by finasteride use.

Likewise, preexisting stress or hormonal imbalances, which are common in adrenal fatigue, could make hormonal imbalances a more likely result of finasteride use. Symptoms of adrenal fatigue can, therefore, occur concurrently with post finasteride syndrome, and there can be overlap with the symptoms of both conditions.

When you frequently experience extreme fatigue along with symptoms of brain fog, anxiety, insomnia, low concentration levels, low energy levels, lower body temperature, dry skin, loss of hair, palpitations, constipation, difficulty in waking up, low sex drive, stubborn weight gain, or cravings for salty and fatty foods then it could indicate Adrenal Fatigue Syndrome (AFS).

Although many people suffer from adrenal fatigue, conventional medicine fails to recognize the condition. Worse, with many complex health problems, adrenal fatigue might be the unrecognized root cause of many other issues.

Restoring your adrenals under the guidance of an adrenal expert can help correct the problem. The reason is simple. Without an optimized cortisol output from the adrenal glands, the body is often unable to sustain the chronic internal stress. Focusing on supporting the adrenals is a sound strategy whenever possible.

An image of a fatigued man in bed who is dealing with Post Finasteride SyndromeAdrenal fatigue occurs when the level of stress exceeds your bodyā€™s natural stress-fighting ability. The NeuroEndoMetabolic (NEM) Stress Response is your bodyā€™s natural stress-fighting mechanism. It is comprised of six circuits, encompassing many of the bodyā€™s vital organs and systems, which function in close association. Disturbance in any of these circuits can affect the entire stress response system, increasing the chances of developing adrenal fatigue.

A pair of walnut-shaped adrenal glands on top of your kidneys are a vital part of this response system. During stressful situations, the NEM signals your adrenals to secrete the anti-stress hormone cortisol to deal with stress. However, when stress continues, it can exert more pressure on your adrenals, leaving them exhausted. As a result, your adrenals are no longer in a position to secrete adequate cortisol. This imbalance in cortisol level can reduce your bodyā€™s natural stress-fighting ability which can lead to adrenal fatigue.

Post finasteride syndrome and adrenal fatigue can be interrelated. The various symptoms of the syndrome exert high levels of stress on the body, overburden the adrenal glands, and disturb the hormonal circuit of the NEM response system, thus increasing the chances of developing adrenal fatigue. Further, many of the overlapping symptoms of adrenal fatigue and post finasteride syndrome may be associated with adrenal weakness. Therefore, working to fix the symptoms by supporting and restoring the adrenals through nutrition and exercise could prove to be an effective tool for improving post finasteride syndrome.

The Impact of Finasteride on The Hormonal Circuit

NEM Hormone CircuitThe NEM stress response system is made of six circuits that connect several organs and vital systems of the body. The hormonal circuit is one of these. It is comprised of the ovaries/testes, adrenal glands, and thyroid. The Hypothalamus-Pituitary-Adrenal (HPA) axis specifically regulates the adrenal glands, which produces important hormones for specific body functions such as growth, metabolism, and reproduction.

The hormone circuit helps regulate your stress hormone cortisol, body temperature, and thyroid function. Any imbalance in this circuit can give rise to a cascade of symptoms in your body including fatigue, weight gain, emotional swings, reduced libido, infertility, sluggish thyroid, and hair loss.

Taking finasteride can have a negative impact on the hormonal circuit, significantly affecting the quality of oneā€™s sex life. Therefore, when finasteride is recommended for pattern hair loss or prostate enlargement in men, patients should be informed in advance about the potentially extreme side effects of the medication.

So how does finasteride affect the hormonal circuit? Being a 5-alpha-reductase type II enzyme inhibitor, finasteride directly works on the hormonal circuit. It can shift the delicate balance of your hormone system, causing hormonal imbalance and dysfunction of the HPA axis. This can disturb your bodyā€™s entire stress response system, leaving a profound effect. In males, hormonal imbalance can lead to enlarged prostate, low libido, low energy, hair loss, loss of muscle mass and thyroid dysfunction, which are some of the most common symptoms of post finasteride syndrome.

Finasteride is known to cause profound negative effects, especially on male sexual performance. Testosterone is a predominant sex hormone in males primarily produced in the testicles. It plays a significant role in maintaining reproduction, sperm production, mood, and sex drive. The hormone also helps maintain red blood cell production, bone, and muscle strength. Its production begins to increase considerably during puberty and then begins to dip after the age of 35 or so. The adrenal glands also produce testosterone in small quantities in both males and females.

In males, 5-alpha-reductase enzyme converts testosterone to 5Ī±-dihydrotestosterone (DHT), a potent androgen which is responsible for male sexual differentiation. DHT stimulates the development of male characteristics such as facial and body hair, enhanced musculature, thickened larynx, deepened voice, and enlargement of genitals. It is believed that an increase in DHT levels can cause male pattern hair loss. Finasteride inhibits the 5-alpha-reductase enzyme, thus blocking the production of DHT which helps control hair loss in men.

Due to these hormonal actions, taking finasteride, a 5-alpha-reductase type II enzyme inhibitor, can cause serious side effects on the male sex hormones. The medication blocks 5-alpha-reductase enzymes in the body. As a result, testosterone is not converted to DHT, which can lead to sexual dysfunction such as low libido, impotence, low erections, or loss of orgasm that indicate sexual symptoms of post finasteride syndrome.

How to Correct Post Finasteride Syndrome

An image of  couple comforting each other while dealing with the effects of post finasteride syndromeAt present, there is no known cure for the syndrome. Therefore, avoiding intake of finasteride in the first place is the best solution. As the medication is taken for hair loss and prostate enlargement in men, resorting to natural remedies could prove helpful.

Ceasing to take finasteride does not, in some cases, reduce symptoms. For some, the symptoms and side effect persist even after stopping the medication. However, the good news is that making certain changes in your lifestyle can help relieve the symptoms and minimize the side effects to a certain extent to improve your quality of life. As the syndrome is known to share common symptoms with adrenal fatigue, focusing on adrenal fatigue recovery could help provide relief from post finasteride syndrome.

The adrenal fatigue recovery process can help minimize symptoms and provide relief from the syndrome by:

  • Nourishing and recharging your adrenals
  • Boosting metabolism
  • Strengthening immunity
  • Replenishing your bodyā€™s energy reserves
  • Enhancing mood
  • Boosting libido
  • Supporting weight management
  • Reducing muscle weakness
  • Promoting restorative sleep
  • Fighting chronic fatigue
  • Boosting cognitive ability

Supporting your adrenals supports your overall health, and the health of the interconnected systems of your body, including your hormonal circuit. This should at the very least help minimize any symptoms of post finasteride syndrome you continue to experience. The following are key steps to a successful adrenal fatigue recovery process.

Minimize Stressors

With constant stress, your adrenals do not get a chance for recovery. Removing stressors completely from your life can often be impossible. However, you can always work towards minimizing stressors. This is the most vital part of the recovery process as it enables you to heal and restore your adrenals. Stressors related to diet, lifestyle, inflammation, and mindset can trigger fatigue symptoms. Reducing EMF exposure by limiting usage of cell phones and other electrical appliances, avoiding negative thought patterns, eating healthy, getting enough sleep, reducing commuting hours to work, reducing exposure to environmental toxins and food allergies, minimizing intake of caffeine and nicotine, and reducing work-related stress can all greatly help in minimizing stressors.

Eliminate Trigger Foods

Certain foods can tax your adrenals, create inflammation, and interfere with the recovery process. Therefore, it is important to remove such foods from your diet. Consider staying away from caffeine, artificial sweeteners, processed foods, and unhealthy fats.

Maintain a Nutritious Diet

An image of a wooden cutting board with two slices of avocado toast with healthy toppings to help correct post finasteride syndromeA nutritious diet is the cornerstone of adrenal fatigue recovery as it helps nourish and recharge your adrenals. Processed foods are high in synthetic compounds which can cause stress on your body. Eating the natural, unprocessed foods in the adrenal fatigue diet can prove essential for rejuvenating your adrenals and replenishing your bodyā€™s energy reserves, which can also help improve symptoms of post finasteride syndrome.

Over 20 to 30 percent of the adrenal fatigue diet consists of fresh vegetables. Bright colored vegetables, sprouts, baby vegetables, and sea vegetables are high in nutrients. Vegetables frozen post harvesting are also acceptable. To ensure your body absorbs the fat-soluble nutrients, consider serving vegetables with healthy fats such as coconut oil or olive oil. Lean healthy protein should make the other 20 to 30 percent of the diet, and a similar portion should come from healthy fats such as nuts and seeds. Make sure to soak nuts and seeds so your body can easily absorb the nutrients.

The remaining 10 to 40 percent of the diet should come from whole fruits, legumes, whole grains, and beans. Adding Himalayan pink salt to your diet provides your body with essential trace minerals and balances your bodyā€™s sodium level. Drinking plenty of water flushes out harmful toxins from your body and eases the load on the entire system. The adrenal fatigue diet emphasizes having small, frequent meals to maintain your bodyā€™s energy levels, which can be particularly helpful for alleviating chronic fatigue in post finasteride syndrome.

Get Adequate Sleep

Having restorative sleep is an essential part of the recovery process. It helps to relax and recharge your adrenals. Adequate sleep helps to maintain your bodyā€™s natural circadian rhythm. Avoid staying awake till late at night, although people with the syndrome often find difficulty falling asleep. Make sure to sleep in a dark room to enhance secretion of the sleep hormone melatonin. Frequently waking in the middle of the night and an inability to fall asleep could indicate signs of excessive fatigue. Incorporating magnesium-rich foods into your diet could work as a great relaxant and promote sleep.

Try Gentle Adrenal Fatigue Exercises

While exercising is essential for maintaining good health, strenuous exercise can exert more stress on your body, leaving you feeling fatigued. This is particularly true when you are in the later stages of adrenal fatigue or if you have other serious health problems. In this case, very gentle exercise is advised. Practicing mindful meditation, adrenal restorative exercises, adrenal yoga, or adrenal breathing exercises can help alleviate stress by calming the entire nervous system.

Take the Right Supplements

Supplements can help provide your body with the required nutrients. Supplements, in conjunction with a nutritious diet and the guidance of an experienced medical professional, can help in the recovery process.

Stay Positive

It is important to give your body the required time for recovery and healing. Being patient and staying positive will help you stay on the right track for effectively dealing with the problem. Focusing on what is good in your life is also a good way to avoid adding additional stressors for your body to manage.

Simplify Your Life

Consider simplifying your life for a while. This can help enhance your mood and accelerate the recovery process. Minimize stressors, replace antidepressant pills with soothing herbal teas, avoid stimulants such as alcohol, nicotine, and caffeine, limit your use of cell phones and other electrical appliances, and consider spending some time in nature. Practice saying ā€œnoā€ to demands on your time, cut down your commitments, and leave more time unscheduled. In the kitchen, cook simple whole foods, easy recipes, and plan foods in bulk for your week. Do what is simplest for you.

Get Enough Vitamin D

Most people, and many men with post finasteride syndrome, have been found to be vitamin D deficient. This vitamin is critical for many bodily systems. Taking a vitamin D supplement or getting moderate sun exposure on a daily basis could be helpful in restoring your bodyā€™s vitamin D levels.

Consider Maintaining a Food and Mood Journal

People with post finasteride syndrome can have increased food sensitivities, extreme mood swings, and low energy levels. To get an understanding of what you need to do to feel better, you need to understand what makes you feel good and what might be acting as a trigger. Noting how you feel, what you eat, and your mood regularly in a journal could prove helpful for that.

Conclusion

An image of an older man who is frustrated by the symptoms of post finasteride syndromePost finasteride syndrome is a persistent adverse reaction to taking finasteride, a 5-alpha-reductase type II enzyme inhibitor that is extensively prescribed by doctors for hair loss or enlarged prostate in men. The drug can be found under the name Proscar for prostate medication and Propecia for male hair loss medication. There is no known cure for the disorder.

The syndrome is associated with side effects including sexual dysfunction, female-like breast enlargement, chronic fatigue, muscle weakness, reduction in body temperature, thinning and drying of hair, obesity, melasma, insomnia, severe memory impairment, depression, anxiety, and suicidal thoughts.

The medication causes dysfunction of the hormonal circuit, disturbing the entire NEM Stress Response system. Many symptoms of the syndrome can be associated with adrenal fatigue. Therefore, focusing on adrenal fatigue recovery could prove helpful in providing relief from the syndrome and improving quality of life.

This new illness is not yet recognized by the medical community. However, there is evidence of people developing the syndrome after taking the medication. With the increase in men reporting adverse side effects from finasteride, new studies are being conducted on the subject. With such severe side effects involved, men should be informed about the possibility of reactions prior to starting finasteride.

Ā© Copyright 2019 Michael Lam, M.D. All Rights Reserved.

Dr. Lam's Key Question

Presently, there is no sure way to resolve post finasteride syndrome. The debilitating symptoms can persist for years even after discontinuing the medication. However, it has been observed that the syndrome shares common symptoms with adrenal fatigue. Therefore, resorting to adrenal fatigue recovery protocols could prove helpful in providing relief from the syndrome.

There is no current treatment, however there are similarities between Adrenal Fatigue and Post finasteride syndrome. Learning more about Adrenal Fatigue may give you answers on how to get relief from taking finasteride.

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