Mind the gaps: remarks on the evidence base

This post makes a few not-so-obvious points about the sprawling literature on finasteride and 5-alpha syndrome. If you are new to this literature, consider starting with a brief history of the research and a guide for researchers. Those pages describe what is in the literature, but it is also important to discern what is not … Read more

Appendix: response to Trüeb

This appendix accompanies the article: Response to Dr. Ralph Trüeb’s writings on post-finasteride syndrome. Table of competing interests ← back to main article Engagements with Merck re: Propecia Skin Appendage Disorders (journal) (1) International Journal of Trichology (2) Experimental Dermatology (journal) Hair Growth and Disorders textbook (2008) Cited by Trüeb Ralph Trüeb, MD Member, Editorial … Read more

From LSD to Zoloft, drugs can leave lasting damage

SUMMARY: Post-drug disorders are not side effects that linger, but lasting changes that may be severe and irreversible. These disorders are linked to prescribed drugs as well as recreational drugs, and can arise after one dose, long-term use, or abuse. This post covers post-drug disorders linked to use of alcohol, hallucinogens, antidepressants, benzodiazepenes, isotretinoin (also … Read more

Men’s fitness influencers are raising alarms about finasteride risks

Fitness influencers draw in an audience of younger men who want to be stronger, better-performing, and in some cases more attractive. Some guys worry that hair loss will dim their prospects for dating, sex and relationships—or even professional success. In the era of Instagram, body-hacking and telehealth companies such as Hims and Keeps, young men’s … Read more

How Merck buried finasteride’s full impact on hormone signaling

Merck held that finasteride had a simple and selective mechanism. In fact, it disrupts hormonal pathways much more broadly. These pathways support the brain, reproductive system and other organs. Merck’s selective account concealed risks which would surface in the decades after approval of Propecia.

Why is this happening? Undercurrents of the war over finasteride harms

Over the past 25 years, finasteride harms have spread invisibly, altering lives and giving rise to confusion and disagreement. This post identifies common themes across all these spheres. Many of these have to do with biases, omissions and collusion among industry, physicians and regulators.

A rundown of new bibliographies & research guides

The research base spans many disciplines and goes back almost 50 years. To help researchers get oriented, an on-ramp was added. In the Systems & functions area, a new bibliography was added: Adverse effects on skin, comprising nine case reports. The gynecomastia bibliography has been expanded. The bibliography on the musculoskeletal system has been expanded … Read more

Rules of engagement: how sensitive concerns are hidden from drug trials

Alan, a 28-year-old man who experiencing hair loss, is participating in the Propecia clinical trial. Alan brings high hopes that the new drug will stop hair loss. An investigator examines Alan’s scalp and hair, recording figures on a form. She asks Alan if he experienced any side effects. None, he replies. He is then given a form to fill out…