A Post-Androgen Deprivation Syndrome: A literature review

A Post-Androgen Deprivation Syndrome: A literature review

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Some patients develop persistent and severe multisystemic health problems following exposure to the 5 alpha reductase inhibitor finasteride. Serious and permanent harm is not correlated positively to exposure and can follow as little as one dose. This has been termed “Post-Finasteride Syndrome” (PFS). Importantly, patients continue to find our site who are suffering an ostensibly identical syndrome following exposure to a range of pharmaceutical and nutraceutical products capable of antiandrogenic endocrine disruption, including many forms of antidepressants and the anti-acne drug Accutane (isotretinoin).

The administrators of propeciahelp have written a literature review entitled Post-Finasteride Syndrome as an Epigenetic Post-Androgen Deprivation Syndrome: A potential pathological link between Drug-Induced Androgen Receptor Overexpression and Polyglutamine Toxicity

The document was written to summarise research conducted into the Post-Finasteride Syndrome, to present relevant mechanistic information to inform future investigations, and to comment on the increasing and unsustainable burden we face due to clinical and regulatory failures. This is intended for the consideration of research professionals not currently engaged with the issue who may be able to help practically investigate the condition. 

We hypothesise a clinically significant and tissue-specific AR deregulation is an aberrant manifestation of a conserved mechanism of cellular adaptation to lowered levels of availability of androgenic ligand or interruption of appropriate transactivation of androgen regulated genes. Alteration of the epigenetic program and chromatin structure is an observed consequence of androgen deprivation. Polyglutamine toxicity has been demonstrated to be recapitulated through overexpression of the wild type androgen receptor in a number of contexts across cell lines, and a toxic gain of function and loss of AR function may provide a mechanistic explanation for multisystemic symptoms in PFS and novelties including the frequent intensification of symptoms often colloquially described as a “crash” following withdrawal. 

We urge clinical education to end psychosomatic misdiagnosis, aid patient management and ensure a genuinely informed consent before prescription of Finasteride to young men for hair loss. We urge molecular-level investigation of PFS patients to achieve pathomechanistic understanding and inform potential treatments. Discovery of predisposing genetic and epigenetic factors will aid in assessing the suitability of young patients for therapies with antiandrogenic modality, while promising translational insight to a range of disease states often associated with the ageing process.

We are extremely grateful to scientific professionals for their time and consideration. If you are a specialised scientist working in next-generation sequencing, genomics, epigenetics or androgen receptor signaling and are interested in researching this important disease, please email us at: contact@propeciahelp.com. If you are an endocrinologist with a clinical interest in the condition and would like to serve as a PI for potential collaboration with university-linked research centres that would conduct practical analysis, please contact us at the aforementioned email address, as the site staff are in contact with research professionals. Volunteer staff of the site would be willing and able to assist in the application to rare disease funding.

Notable Replies

  1. Massive thanks to those who wrote this, it’s great to have this information collected in one document and hopefully this will generate more interest in the condition.

  2. Impressive work indeed! Thanks to everyone involved in this!

  3. @awor @axolotl

    I was wondering if this could be made into a pdf format. I want to show it to my doc who is powerful and connected. He will enjoy it but I want it to look professional. I could probably print it out and make it look nice if I had to, but you know what I mean

  4. No worries man, thanks anyways I’ll be alright. Good luck hope to see you soon

  5. Yes, you can download here.

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