Transcription
Like if I had a high likelihood of developing huge goddamn gynecomastia tits on finasteride, I would want to know beforehand rather than go take it and then find out after.
What's up guys, Derek from replacements.com. Today, we're going to be talking about if you should take finasteride or not. So, you know, this week I've been posting a lot of videos about hair loss. I kind of, uh, you know, giving everyone forewarning. It's not even a word, forwarning. I warned everyone that I was going to have a string of hair loss content. So, you know, the people who are interested in that stuff, it was kind of, you know, meant for you guys. And the rest of you guys, you know, I appreciate you sticking around until the end of this, uh, this onslaught of content that I'm trying to push out. But everything will be going back to scheduled, you know, intermittent, you know, mix of everything in there pretty soon.
But somehow, and the internet always manages to do this, is a minority of individuals completely misinterpret what you say in a video. So, I went over my protocol, which involved oral finasteride. That was the protocol at the time of recording. Um, right now, I'm doing a topical bit compounded with latanoprost, but that's besides the point. I'll be doing videos on that down the line. But anyways, I use finasteride. I also talk about it quite often and talk about how it's a very effective way to slash down scalp DHT levels. I also talk about being prudent about understanding your hormonal balance between estrogens to androgens and assessing the potential downstream consequences that may come from 5-alpha reductase inhibition. Does me elaborating on mechanism of action of a drug and potential side effects and how to be how to approach risk management, does that mean I don't, I'm saying not to use something or that it's a terrible thing to use? No.
I'm not. Like, guys, I lit, I'm sure 99% of you guys already get this. So it's kind of like, maybe I shouldn't even be making this video to begin with because most of you guys are just shaking your head at the fact that somebody could have watched my finasteride videos and somehow concluded that I'm saying finasteride is going to [ __ ] kill you and you should never use finasteride for hair loss. That's not what I was saying at all. I was literally laying out how to prepare if you wanted to be prudent and you had the budget for it to assess your hormonal baseline before introducing a medical intervention that literally slashes the most androgenic hormone in your body down by 50 to 70%, including things upstream that no one's going to talk about, like cascades of neurosteroid production, which are a bit less notable in some cases, but they're still notable nonetheless.
Despite it being affecting a minority of individuals, the, the individuals exist that this stuff happens to where they end up with side effects. I'm neutral enough to understand that there are individuals who, majority don't get side effects. And for those people, you know, finasteride was a good play. For me, good play for somebody who got side effects, they don't see it that way, and justifiably so. I've helped a lot of guys in consultations before too, over Skype, where like the hair loss prevention protocol designed includes a 5-alpha reductase inhibitor. But then I've also helped people who literally come to me to fix their post-finasteride syndrome because it does exist. It's not something that's just, you know, a manifestation of their imagination. Some people do get lasting side effects from this drug. And often, 90 to 99% of the time, it will resolve itself within short order once 5-alpha reductase enzyme activity recovers. It's not a process that just fixes itself within five half-lives with the finasteride clearing your system. The 5-alpha reductase enzymes, they need to recover to baseline. That isn't an overnight process despite the half-life of finasteride being so short. This thing, it's a bodily process that needs to recover. It's almost like akin to aromatase inhibition with something like, um, well, I don't want to get off track, but basically, if you nuke these enzymes and you expect your DHT and your neurosteroid production, everything to just return to baseline within like five days because finasteride on paper should be out of your system, it doesn't work like that. Like, you have to recover all these physiologic functions and restore these cascades from baseline and recover that enzymatic activity, which doesn't just return to baseline in two seconds. It can take like a month plus. And typically, 90 to 90, 99% of individuals who even get a side effect, which is already like 90, 99% of people won't get a side effect, they'll recover fine if they have decent lifestyle, diet practices.
However, there is a minority of individuals who hormonally or genetically, through genetic polymorphisms and different, um, propensities to certain sex hormone metabolism or neurosteroid cascades or deficiencies or what have you, there are plenty of reasons for these issues, including AR density expression, gene transcription, epigenetic modifications caused by, blah, blah, blah. There's a million [ __ ] things you can do to explain it. But the fact is, there's a very, you know, a sliver of individuals who take this drug are not going to respond well. A lot of guys are going to respond okay. And some are going to respond, a lot of guys are going to respond very well and get very good results from it with almost no side effects or no side effects at all. Like, I, I literally took one milligram of dutasteride for a year straight and had no, no negative side effects that I could note. So, no, I'm not opposed to 5-alpha reductase inhibition. I'm not opposed to finasteride. Any of my posts are simply, I try to get both sides of the argument and then give you an informed, an education surrounding the drug from all angles.
I'm never. And then people will complain about like, oh, there's like vested interest because he's linking to a [ __ ] blood test or to where you can get the prescription. It's like, bro, it's either one way or the other. Like, I can link to anything. Anybody can get an affiliate link or [ __ ] private label a product. Why would you not do the things that you actually recommend? Like, it's just nonsensical to think that certain products you can have motivation to sell and then other ones you can't. Like, if I'm going to put my name behind something, it's something that I think works and I use myself, or I see clinical efficacy in, or I just see efficacy in an over-the-counter setting. It doesn't, just because somebody puts a label on something. If I've been talking about it for [ __ ] like eight years, I don't think I need some sort of like get out of jail free card to explain why, you know, my clinic would offer finasteride or why it would offer pre-finasteride blood work when I've been talking about the importance of [ __ ] lab metrics for years. Like, it's obvious why you would want to check your hormone levels or why you might want to inhibit 5-alpha reductase if you want to prevent hair loss.
So anyone who would think I'm anti-finasteride, and by the way, this isn't addressed that anyone on like YouTube or anyone that's posted on social media or anything like that. Like, there was actually a pretty good video put up by Kevin Mann recently, and I responded to it on his channel. And, um, you know, we pretty much have similar views from what I can tell in terms of, um, like the approach to hair loss management. It's kind of like, you know, address androgens at the root of the issue. You know, growth agonists are something to add in that are good, but aren't like, you know, the solution to the problem. They're a band-aid, whereas the androgens are the root of the issue. And blah, blah, blah. Um, we kind of have like an overarching, like similar stance, despite, you know, some of our approaches being slightly different. It doesn't really matter at the end of the day. This isn't addressed that him or anybody else who might have made a video or whatever. This is like, the, the small sliver of people I saw in the comment section or making threads on other areas of the internet thinking that I said, don't take finasteride, it's going to [ __ ] you up and it's like, your health is like going to get ruined by finasteride.
To clarify, none of these things are going to improve your health by inhibiting 5-alpha reductase, inhibiting the most androgenic hormone in your body from being produced. That literally acts to regulate the balance of androgenicity to estrogenicity in the body to a large degree. Yes, free test can pick up the slack. Yes, your, you know, 30 to 40% of residual DHT can pick up the slack. We all know this. I've inhibited my DHT to [ __ ] female baby territory, and I've seen my free T can pick up the slack. We're all well aware of this, or anyone who's seen my content is aware of this. But it doesn't mean it's optimal necessarily. If I was talking about the most optimal thing, like even when we relate this back to bodybuilding pharmacology, my approach for like the most health-focused bodybuilding cycles that have literal, like, it's hard to differentiate, but what I'm trying to say is that have actual the most healthy and productive cycles are not even, are not the same as the ones that I think are the most hair safe. It's like two totally different subjects that you can't, you know, intertwine together and somehow make the same topic.
So to say, you know, I'm saying it's not healthy, it's like, no [ __ ]. Using a topical anti-androgen isn't going to be good for you. Using a 5-alpha reductase inhibitor doesn't necessarily improve your health status. There are a minority of individuals who might benefit from the medical intervention from an actual clinical standpoint that has nothing to do with hair loss. But those, you know, it's few and far between relative to the average person. Has a certain amount of endogenous androgen production. They have a regulated output of 5-alpha reductase activity to spit out a certain amount of androgenic hormones that balance out the estrogenicity in their body and fulfill physiologic functions. This is why we have these enzymes in different tissues at certain concentrations. They're supposed to fulfill certain roles. And there's different activity in these tissues that's regulated through, you know, tightly regulated mechanisms in the body that keep everything in homeostasis. Once you throw something into the equation that puts a [ __ ] blockade in the middle of one of the most androgenic processes in your body, expecting you to be at 100% peak performance in all categories is kind of like delusional in my opinion. Like, I don't personally think that anybody is going to.
Even the point is though, is with finasteride or dutasteride or any of this [ __ ], the majority of people who take it are going to see like, even if you don't have a manifestation of side effects, it might be so negligible, such a minimal hit to X physiologic function that you just don't notice it. You know, like if you have 95% erection quality that you had prior to finasteride, but you can't even tell the difference yourself. Does that mean you have a side effect or you know, it wrecked your [ __ ] dick? Like, I don't know. It's your own perception. But at the end of the day, a lot of the stuff, you know, your body can kind of pick up the slack in different areas. But to say that anything that we do to do with hair loss is healthy necessarily, like that's not the point of it. The point is to get rid of hair loss. And like, yeah, for people who, you have to weigh out the risk to reward here on your health versus keeping your hair. Some people think it's [ __ ] ridiculous to sacrifice any level of health, even if it's a tiny bit, for hair loss prevention. And that's fine. Those individuals do what they want. Get a, get a hair transplant. That'll, you know, make you last a long time. Um, get a hair system. I'm not even against hair systems if you wanted to get one and you were severely balding and you didn't want to expose yourself to drugs. Like, for all I know, down the line, if I get to a point where like these, the experiments I'm doing are like intolerable for some reason or there's some like negative ramification that makes me want to discontinue them, the option is always there to get a hair system or something. It doesn't, you know, like, there's no [ __ ] shame in it in my opinion.
So everyone has their own stance. There's always the people in the comments, the, you know, the random individuals like, oh, why, why would you take this [ __ ]? Oh, just go bald. You know, Statham [ __ ], The Rock [ __ ], Bruce Willis, those guys are bald and sick. It's like, everyone has their own priorities. Like, why do you take gear? You know, like, you could have the same [ __ ] justification for anything. So it's like, your own perception at the end of the day is ultimately gonna dictate what you think is healthy or unhealthy when it comes to finasteride. I'm not saying don't use it. In fact, I think it is one of the most obvious go-to first line of defense when it comes to hair loss. It's like, I always bring up this example of the stream with the current. I always talk about this thing. It's like my example of, you know, the, the battle with androgens and the battle with, uh, you know, trying to stimulate growth and whatnot. It's like, I always say, you know, when you start your hair loss prevention regimen, you're basically fighting an uphill battle against a current in a stream, essentially. You're trying to swim upstream and you're just, you know, slowly losing ground. The first step is always to get the stream to calm down and get to baseline. Because if you just throw a growth agonist at your system constantly, you might get a little bit upstream, but you're eventually gonna get pushed back once you get tired. And that's my, my way to describe, you know, one step forward, two steps back that you get from, you know, artificially inflating your quality of growth, but doing nothing to prevent androgen-induced miniaturization. So you're, you're slowly, you're basically artificially offsetting loss of density or recession through stimulus of growth, but eventually the manifestation of, you know, like cosmetic loss is going to become apparent once you've lost a certain amount of hair follicles on your head because you're still fully exposed to androgens doing what they're doing. So despite being on minoxidil, despite being on whatever, latanoprost, any other growth agonist, if you don't have something dealing with androgens, you can offset visually the representation of like hair loss, but you're not going to actually prevent it until you deal with the androgens.
So that's my, my, you know, visual representation. I always say is get the stream to calm down, which is dealing with 5AR, androgen receptor, whatever it is that you think that you deem suitable for your needs that you're willing to tolerate. Ultimately, this is up to you, the individual, not up to me, what you should be using and what you deem a risk worth taking. However you want to do that, PG D2 antagonism, there's a lot of different things that are worth exploring. There's different ways to go about this. But at the end of the day, that's up to you, not up to me. Once you get the stream to calm down, then you look at the growth agonist, then you try to swim up the stream when the current isn't blasting against you. And that's how you make, you know, two steps forward, zero steps backwards. Then you slowly make two steps forward, two steps forward, and you just keep going. And that has always been my stance to hair loss. And that's what I've always said. And, um, you know, maybe I'm just going a bit on a ramble here, but I don't think any of this stuff is necessarily conducive to longevity, health maximization, any of that stuff. But then again, you could argue on the other side of the spectrum, your mental health degradation from losing your hair, that might kill you faster. All the stress of the stress of it than the actual health outcomes that may come from all this other stuff that you're using. Yeah, like there's different, there's always going to be an argument on one side or the other. And maybe, like, to some, it seems [ __ ] ridiculous. To some, it doesn't seem ridiculous. And ultimately, you should just keep your opinions to yourself if you think about it, or make your own video. Because it's like, um, everyone has their own priorities in life. Everyone deems certain things, you know, a worthy endeavor or a not worthy endeavor. And when it comes to finasteride, again, I'm kind of getting off track, but finasteride itself, does it work? Yes. Is it very well tolerated by the majority of people? Yes. Do you need to get elaborate blood work to assess if you are a, uh, somebody who's likely to encounter side effects and develop gynecomastia from it, or develop hypogonadal symptoms from it, or have some sort of, you know, rare neurosteroid deprivation symptom? No, you don't need to. I just think it would be prudent too. Because at the end of the day, you are never going to see your baseline profile again. And if you are one of the individuals who is genetically prone to gynecomastia, for example, if there are polymorphisms too that you can check in your genome that he would actually show you on paper if you're somebody who's very prone to gynecomastia or not, even at physiologic levels of estrogen, IGF-1, and prolactin, and all this stuff, you can see that beforehand. But somebody who haphazardly jumps into 5-alpha reductase inhibition, maybe they'll end up with a [ __ ] titty that they could have avoided had they, you know, got their bloods done and, you know, got a [ __ ] easy 23andMe test or something like that. It's not that com, like, okay, it's not that complicated. It's very complicated. How could I possibly simplify it into those terms? But what I'm trying to say is, you shouldn't boil this down to who's, you know, what is the right thing to do in taking my, what I deem as worth it or not, as what you should be doing. For me, finasteride is worth the move. The slash and DHT doesn't really affect me yet, and I deem it a worthy treatment option. And for the majority of people, they're going to be side effect-free. For a minority of individuals, they may not be. And for those individuals, they probably wish they had some sort of baseline [ __ ] reference point so then they could have averted this. Because there are ways to circumvent this and or just never do it to begin with because you could have predicted it with reasonable accuracy that something may have happened should you slash your most androgenic hormone by [ __ ] 60% or something like that.
So that's where I stand on it. And a lot of people, they think, you know, the numbers on paper don't mean anything. Like a proxy for function, regardless of AR density or expression, the reference range is so [ __ ] vast in general. Like a 250 to 1000, you're normal. It's not a coincidence that the majority of guys who have symptoms of hypogonadism, just so happen to have free testosterone or free DHT on the low end of the reference range. And the guys who are walking around with high levels of function, building tons of muscle, and blah, blah, blah, also seem to have high normal free, free testosterone and or, um, high levels of function, have higher than the bottom of the [ __ ] barrel DHT levels in some cases. Obviously, you can get away with, uh, you know, if you have a decent free T, you can kind of get away with slashing the DHT a bit, um, as I've proven many times. But, um, at the end of the day, these are all proxies as reference points to, you know, assess with reasonable accuracy if something may or may not happen. Like, I don't think it's rocket science to see that if you have a [ __ ] sky-high SHBG, your estrogen's on the already like bordering high normal, you have a low DHT and a low free DHT, you have like a low free T, you have a genetic polymorphism that says you're prone to [ __ ] more aromatase expression or this or that. And like, there's a million things you can look at. And some of these tests can reveal from with pretty decent accuracy, in my opinion, from what I've seen, if something's gonna happen to you or not.
Now, is it within somebody's budget? Like, no. Some people just can't afford it. In that case, is it a good idea to take finasteride or not? That's your risk, dude. Like, look at the clinical trials and you can see what the outcomes were in terms of how many people got side effects, how many people got gyno, how many people had, you know, erectile dysfunction, how many people had, uh, you know, brain fog, fatigue, whatever. And then you make a judgment call based on that. Like, I can't predict the future for you. And if you don't want to spend the money on a blood test, like that's fine. The likelihood is in your favor that if you're a high level of function to begin with, that baseline, you're probably not going to encounter any issues. And that's fine. You know, like, I jumped into finasteride without having an elaborate panel beforehand, and I was fine. But again, I'm trying to present information that I wish I had accessible to me when I was younger. And that's it. You know, like, you don't have to, uh, read into it more than that. You know, I think 5-alpha reductase inhibition is one of the most effective treatments there is with a relative low incidence of side effects considering the drastic change in your hormone profile that you're doing. So take that with a grain of salt. At the end of the day, finasteride, I [ __ ] use it and it works. And most people aren't gonna get side effects from it. But you might get side effects from it, just like with any other drug. So it would be prudent to understand its mechanism of action, pharmacokinetics, pharmacodynamics before you start ingesting something that's going to reduce the most androgenic hormone in your body.
When it comes to the balance of estrogens to androgens too, like there's a very clear relationship between, just as one example, gynecomastia development and the role androgens play in preventing, not even dominant estrogen. Like, you could have an estrogen level in range, but if you have too low of an androgen profile, or too low of a, what actually matters, a free androgen profile with actual hormones circulating around that aren't bound to SHBG, you can end up with gyno with an in-range estradiol. And this is all stuff you evaluate through blood work. Like, when you take finasteride, you slash your DHT down by, you know, 50, 60, 70% depending on your dose. You have a subsequent spike in estradiol of 15 to upwards of 22% if you're using dutasteride. That's going to have a major effect on how much estrogen-induced RNA transcription you can actually prevent at the receptor site in the breast tissue. So to act like, you know, it has no bearing whatsoever on some sort of outcome in a bad, you know, like a negative context is short-sighted in my opinion. Like, just because the manifestation of side effects don't occur in the majority of individuals, and if you have a decent enough free T and decent enough remaining free DHT after 5AR inhibition that you can still, you know, prevent that issue, it's still something you need to consider. It's not like it doesn't happen. Like, there are people who get gynecomastia from finasteride. That's a real possibility. Is the likelihood high? If you are a lean guy with less aromatase expression, the next you're athletic, you have a good diet in check, you have good hormone levels, you know, you have high free test, or you don't have a sky-high SHBG, or other things that could, you know, negatively negatively affect your outcomes. Yeah, it can all play a significant role.
At the end of the day, it's all just because it has a low likelihood of occurring, you know, people are still worried about it. And that's what prevents some people from taking finasteride to begin with is they have no idea what to expect. So, you know, some people might interpret it as, you know, it's too cumbersome of a process to do all this stuff to even see if you're a good candidate for finasteride or not. You know, I think a lot of people are going to be fine by just taking finasteride without doing all this stuff to prepare. But for some individuals, they will avoid it for life because they're afraid of the chance of this. You know, like, I even have guys who are on literally manipulating their hormone profile and exogenously with like TRT, who are scared to take finasteride because they think they're gonna get low DHT symptoms. And I'm like, dude, you can like literally manually manipulate your hormone profile however you want and you're still scared of it. Like, there's so many people who won't take this drug because they have no idea what to expect and they think they're just going to fall into the camp of individuals who get side effects.
So like, not only will you be able to have a much more confident outlook on if you are likely to encounter issues or not, but you may be an individual that would have otherwise not even used a treatment to begin with if you didn't do this testing first because you can actually see with some relative accuracy what would likely happen to you once you introduce this drug into your system. Like if I had a high likelihood of developing huge goddamn gynecomastia tits on finasteride, I would want to know beforehand rather than go take it and then find out after. And I think most of you guys probably would too. And it does, it still doesn't mean you have to go do any tests or anything like that, but it's, you know, some people would rather the peace of mind. And that's all I'm trying to say. I'm trying to educate on both sides of the equation because at the end of the day, there are always going to be people who come out of the woodwork and say DHT is like super important, don't, don't inhibit it. And then other people are saying, you know, [ __ ] this guy, you gotta just get on fin or else you're gonna lose your hair and that's way worse. And it's like, you know, there's got to be a middle ground of people who are willing to acknowledge both sides of the argument. And that's what I'm trying to do here is establish that there is truth to both sides. But obviously, I'm still somebody who, for me, the trade-off is worth it at least right now. So that's why I use finasteride. But at the end of the day, you have to make that judgment call for yourself. Like, I literally have guys messaging me saying, should I use this? Should I use that? Should I use this [ __ ] steroid for this cycle and this and that? And it's like, beyond the general just like, is this a dumb drug to use in this capacity? Like, I can understand why people who don't really, you know, know for sure what they're doing and don't have confidence in it, why they'd ask. But it's like, at the end of the day, you should understand these drugs before you start introducing them into your system rather than asking some random person who doesn't know how you feel about certain things. Like, what's your [ __ ] like, how risky do you want to be? Like, what do you want to do with finasteride? Fortunately, the risk to reward is typically in favor of the user where you may not need to do anything and you'll probably be side effect-free and get good outcomes with good hair loss prevention. For some, they would have benefited from something like this. And that's just what I'm trying to say.
Thank you guys for watching. Please like, subscribe. Check out my blog, moreplaysmartdates.com. Follow me on Instagram or please understand more dates, Facebook, Snapchat, Bitchu, Twitter, TikTok, Apple Podcast, wherever I am. Talk to you guys soon.