Association of Treatment with 5α-Reductase Inhibitors with Time to Diagnosis and Mortality in Prostate Cancer

The conversation concludes that finasteride, a 5α-Reductase inhibitor used for hair loss, does not impair cognition either short-term or long-term. It suggests "brain fog" is not caused by the medication.

A 19-year-old concerned about long-term effects of 5AR inhibitors on physical appearance. They have used finasteride and plan to try dutasteride or RU58841; responses suggest improved skin, hair, and confidence.

FCE 28260 (PNU 156765), an under-explored 5α-reductase inhibitor, showcases promising results in research by Giudici et al., outperforming well-known treatments like Finasteride in reducing the conversion of testosterone to DHT. Its superior efficacy, demonstrated through lower IC50 values in both natural and human recombinant enzyme studies, suggests it could offer more effective management of DHT-related conditions. Additionally, its lower molecular weight hints at better potential for topical application, potentially offering advantages in treating conditions such as androgenic alopecia. Despite its potential, it has not advanced in development, possibly due to financial limitations, leaving its therapeutic prospects and side effect profile largely unexplored.

Dutasteride is associated with increased blood glucose, HbA1c, LDL cholesterol, and liver enzyme activity, potentially leading to diabetes, NAFLD, and liver metabolism changes. The conversation highlights concerns about these adverse effects and calls for more studies, including on finasteride.

The conversation discusses the need for a localized 5-alpha reductase inhibitor that only affects the scalp without systemic side effects, similar to pyrilutamide's approach. Current treatments like topical liposomal finasteride and dutasteride are mentioned, but concerns about their systemic effects and lack of research are highlighted.

The potential health risks associated with long-term use of finasteride and dutasteride, with some responses pointing out the low quality of the journal that published the review article as well as highlighting other alternatives such as keto or minoxidil, and RU58841.