Using DHEA to minimize Finasteride Side Effects in Androgenic Hair Loss Treatment: A Personal Exploration

Abstract

Finasteride is a common medication for androgenic hair loss, despite its positive outcomes it can have unwanted side effects. This personal 2-year study explored whether Dehydroepiandrosterone (DHEA) could lessen these side effects in a 30-year-old Caucasian male with early-stage hair loss.

Using a single-subject design, the author incorporated DHEA into his existing treatment regimens, which included minoxidil, biotin, and ketoconazole shampoo. While subjective well-being served as the primary outcome measure, basic lab work and testosterone levels were tracked.

The results suggest that adding DHEA led to a reduction in finasteride-related side effects. However, further research with larger sample sizes is crucial to validate these findings.

Introduction

Androgenic hair loss, also known as male pattern baldness, affects over half of men by age 50. This condition can significantly impact self-esteem, social life, and mental well-being. [1]

While medications like finasteride (Propecia) and minoxidil (Rogaine, Regaine) can slow hair loss and promote regrowth, finasteride can cause side effects like:

• Decreased libido
• Erectile dysfunction
• Symptoms of hypogonadism
• Impaired muscle and body hair development
• Gynecomastia
• Mood changes and decreased energy

Dehydroepiandrosterone (DHEA) is a hormone naturally produced by the adrenal glands and serves as a precursor to androgens. Given its role in hormone synthesis, DHEA has been studied for various health benefits, including potential positive effects on hair growth and hormonal balance. However, its use in conjunction with finasteride to mitigate side effects is not well-documented.

In Finland, DHEA is not commonly used, particularly among men. It is typically prescribed for complications related to menopause, and most doctors have limited experience with it. Furthermore:

• DHEA cannot be imported to Finland, due to anti-doping regulations.
• Only one pharmacy chain in the country can produce DHEA medication on an ad-hoc basis.

This personal study explores whether adding DHEA to one’s treatment regimen could reduce finasteride-induced side effects while supporting hair regrowth. By supplementing with DHEA, the author aimed to evaluate its effectiveness as part of a holistic approach to managing androgenic hair loss.

Literature Review

Existing research on finasteride highlights its mechanism of action as a 5-alpha reductase inhibitor, blocking the conversion of testosterone to dihydrotestosterone (DHT), a hormone implicated in hair loss. While effective, finasteride’s side effects are well-documented, with varying prevalence and severity among individuals.

Limited research exists on using DHEA to mitigate finasteride side effects.

Materials and Methods

This single-subject, self-study spanned two years, with the author serving as the participant. The primary aim was to assess the effects of DHEA supplementation on finasteride side effects in a 30-year-old Caucasian male with early-stage androgenic hair loss.

Participant

No pre-existing medical conditions affecting the study. However, the author developed a propylene glycol allergy, precluding the use of liquid minoxidil.

Lifestyle included a carb-heavy diet, limited exercise (23 minutes intense, 5 minutes vigorous per week), and an average sleep duration of 7 hours and 49 minutes, as recorded by a Garmin fitness tracker.

Intervention

• 25 mg of DHEA daily, increased to 50 mg after a month but reduced back to 25 mg due to weight gain and lack of additional benefits.
• Approximately 1.1-1.2 mg of finasteride daily (by breaking down 5 mg tablets for cost-saving).
• Minoxidil (Regaine, foam version) as a topical vasodilator
• Ketoconazole shampoo once a week to reduce scalp yeast
• 10,000 μ g/day of biotin
• Occasional multivitamins, zinc, and selenium

Outcome Measures

Subjective well-being served as the primary outcome measure, assessed through self-reflection, discussions with friends, and monitoring physical activity and sleep patterns using a Garmin fitness tracker.

Basic lab work and testosterone levels were also monitored occasionally.

Data Collection and Analysis

Data on physical activity and sleep patterns were manually analyzed from the Garmin fitness tracker.

Sleep data averaged 25 minutes of deep sleep, 4 hours and 30 minutes of light sleep, and 2 hours and 53 minutes of REM sleep per night. Basic blood work and testosterone measurements were used to monitor hormone levels and overall health.

Ethical Considerations

As the author and participant, ethical considerations include potential bias, participant safety, and informed consent.

A supervising endocrinologist monitored lab work and provided guidance on DHEA safety, addressing safety concerns. Participation was voluntary and monitored.

Limitations

This study’s single-subject, self-study design limits generalizability. Subjective outcome measures introduce bias. The lack of a control group and placebo makes establishing causality difficult. The absence of standardized data analysis methods limits robustness. Confounding factors like diet, exercise, and sleep habits were not controlled.

Discussion

An important consideration in author’s decision to use DHEA instead of pursuing hormone replacement therapy (HRT) with testosterone was the long-term commitment associated with HRT.

The prospect of being dependent on testosterone for the rest of one’s life was unappealing, especially given the potential complications of maintaining hormone levels over decades. DHEA, by contrast, functions more as a supplement than a replacement therapy, offering a potentially lower-risk approach to managing hormonal balance and addressing the side effects of finasteride.

Author’s personal experience highlights a critical issue in healthcare: the need for more personalized approaches to hormone management. Hormone levels are highly individual, and standard reference ranges – often derived from averages of diverse populations – may not reflect optimal levels for everyone.

The Author’s journey, which involved four years of searching for a doctor willing to prescribe DHEA, underscores the importance of doctors listening to their patients’ subjective well-being rather than relying solely on lab values.

Exploring novel, low-risk treatments like DHEA can be beneficial, particularly when traditional therapies fail to address a patient’s needs. This approach could lead to more effective, individualized care, especially in managing conditions like androgenic hair loss, where hormonal balance is crucial.

Conclusion

Over the past two years on a regimen of 25 mg DHEA combined with approximately 1 mg of finasteride daily, the author has observed a complete resolution of the side effects that previously was experienced when using finasteride alone. The negative impacts, such as decreased libido and mood changes, are no longer present, which has led to significantly improved the author’s quality of life while continuing to manage hair loss effectively.

Interestingly, after the first year, the author discontinued minoxidil due to simple laziness. Despite this, the combination of DHEA and finasteride has successfully halted the balding process. This outcome has given me confidence in the effectiveness of this regimen. The author is of the belief that should minoxidil use be resumed, hair regrowth could have potentially been achieved, a prospect the author is seriously currently considering.

Personally, this approach has proven successful, and a plan to continue with this medication regimen moving forward is in place.

Additionally, there is a notable long-term benefit to staying on finasteride: the potential for reduced risk of prostate issues. Given these outcomes, the author is encouraged to maintain this course of treatment and am optimistic about its continued benefits.

This personal exploration provides a glimpse into the potential of DHEA supplementation for mitigating finasteride side effects. While promising, these findings should be interpreted cautiously due to the study’s limitations. Further research is crucial to validate these observations and explore the potential of DHEA as a complementary treatment for androgenic hair loss.

This study highlights the need for personalized approaches to hair loss treatment, considering individual medical history, genetics, and lifestyle factors.

Using DHEA to minimize Finasteride Side Effects in Androgenic Hair Loss Treatment: A Personal Exploration

Published: 11.11.2024
Stydy and paper: Henri Rantanen
Prepublication review: Victor Savi