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Health Risks Associated with Long-Term Finasteride and Dutasteride Use

Source: The information in this article is based on the study by Abdulmaged M. Traish titled “Health Risks Associated with Long-Term Finasteride and Dutasteride Use: It’s Time to Sound the Alarm,” published in the World Journal of Men’s Health. For a more detailed examination, you can access the full study here.

In the pursuit of managing benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA), many men have turned to 5α-reductase inhibitors like finasteride and dutasteride. These drugs, widely regarded as “tolerable and safe,” work by inhibiting the conversion of testosterone to its more potent form, 5α-dihydrotestosterone (5α-DHT). However, growing evidence suggests that this inhibition could come with serious, long-term health risks that have not been fully recognized. It’s time to sound the alarm on the potential dangers of these drugs.

The Unseen Danger: Androgen Deficiency Beyond Testosterone

5α-DHT plays a crucial role in the physiological functions of several tissues, including the liver, pancreas, kidneys, and eyes. While finasteride and dutasteride effectively lower 5α-DHT levels, this reduction can lead to a novel form of tissue-specific androgen deficiency, independent of circulating testosterone levels. This state of androgen deficiency could contribute to a range of metabolic dysfunctions that are only now beginning to be understood.

1. Non-Alcoholic Fatty Liver Disease (NAFLD) and Liver Steatosis

Research has shown that inhibition of 5α-DHT can lead to significant liver issues. Studies on animal models have demonstrated that finasteride and dutasteride can induce hepatic steatosis, a precursor to more severe liver conditions like NAFLD. This is particularly concerning given that NAFLD is a major risk factor for liver fibrosis and cirrhosis. [1]

2. Increased Risk of Type 2 Diabetes (T2DM)

Men treated with finasteride or dutasteride have shown an increased risk of developing insulin resistance (IR) and T2DM. Studies indicate that these drugs impair insulin sensitivity in peripheral organs, leading to significant metabolic changes. A large population-based study revealed that long-term users of these medications had a higher incidence of T2DM compared to those treated with other medications for BPH. [2]

3. Ocular Dysfunction and Dry Eye Disease

The role of 5α-DHT in maintaining ocular health has been underestimated. Inhibition of this hormone has been linked to the development of dry eye disease, characterized by reduced tear production and increased inflammation of the lacrimal glands. These changes can severely impact the quality of life for patients, yet they are often overlooked in clinical assessments. [3]

4. Potential Kidney Dysfunction

Emerging evidence suggests that finasteride and dutasteride may also impair kidney function. These drugs have been shown to reduce androgen receptor expression in kidney tissues, leading to histopathological changes such as glomerulosclerosis and tubulointerstitial fibrosis. Such alterations could predispose long-term users to chronic kidney disease (CKD). [4]

Understanding the Broader Implications

These findings suggest that the risks associated with long-term use of finasteride and dutasteride extend far beyond the well-known sexual side effects. The reduction in 5α-DHT can disrupt various physiological processes, leading to significant metabolic and organ dysfunctions. This calls for a reassessment of the safety profile of these drugs, especially considering the millions of men who use them for extended periods.

Conclusion: The Need for Vigilance and Further Research

While finasteride and dutasteride have provided relief for many men suffering from BPH and AGA, it’s imperative to acknowledge the potential long-term health risks they pose. Healthcare providers must consider these risks when prescribing these medications and closely monitor patients for any signs of metabolic or organ dysfunction. Further research is urgently needed to fully understand the breadth of these drugs’ effects on human health.

For patients, it’s crucial to have informed discussions with your healthcare provider about the potential risks associated with these treatments. If you experience any unusual symptoms, such as changes in vision, liver pain, or signs of diabetes, seek medical attention immediately.

At SIDEfxHUB, we are committed to raising awareness about the potential dangers of long-term finasteride and dutasteride use, and we actively support research through fundraising efforts. If you are suffering from finasteride/Propecia side effects, you can find help on our WhatsApp community by joining here.