A long-used prescription drug in the U.S. since 1992, known for its effectiveness in treating hair loss and enlarged prostate, appears to have an additional health benefit.
Recent studies indicate that finasteride may help lower cholesterol levels and reduce heart disease risk—a rather unexpected outcome for a medication that has been on the market for so long.
Dr. Jaume Amengual, an assistant professor in the Department of Food Science and Human Nutrition at the University of Illinois, was intrigued by this unusual connection. He delved deeper after spotting some peculiar trends in a national survey.
“When we analyzed data from men taking finasteride, their cholesterol levels were on average 30 points lower than those not using the drug. Honestly, I expected the reverse, so it was quite fascinating,” Dr. Amengual expressed.
Lowering cholesterol with finasteride?
The first hint came from the National Health and Nutrition Examination Survey (NHANES), conducted from 2009 to 2016. This survey gathers health information from thousands across the U.S. From the data, it became clear that men using finasteride for hair loss had distinctive lower cholesterol levels compared to those not on the medication.
A difference of 30 points is substantial and indeed piqued the researchers’ interest. However, observational studies can come with limitations—a relatively small number of men over 50 were on finasteride.
“This wasn’t a controlled clinical study where you could dictate every variable,” Amengual pointed out. “It was more of an observation which led us to investigate further, starting with mice.”
From observation to experimentation
To clarify things, the team turned to lab mice. Doctoral student Donald Molina Chaves conducted experiments on mice genetically predisposed to atherosclerosis, where arteries become narrower due to plaque buildup.
The mice were given differing doses of finasteride alongside a high-fat, high-cholesterol diet. “Mice on a high dose of finasteride showed lower cholesterol levels both in the plasma and the arteries,” Molina Chaves mentioned. “We also observed reduced lipids and inflammatory markers in the liver.”
These results hint that finasteride might not only decrease cholesterol in the bloodstream but also help reduce inflammation and plaque formation in arteries. Still, the highest dose used is far beyond what would be safe for humans.
“It’s an incredibly high amount of the drug. Mice can tolerate doses that would be lethal for us,” Amengual clarified. “So it’s not as wild as it might seem.”
The mouse studies could pave the way for future investigations involving humans.
Finasteride, testosterone, and heart disease
So, how does a medication known for treating hair loss affect cholesterol? It all connects back to hormones.
Finasteride inhibits a protein that activates testosterone, particularly lowering levels of dihydrotestosterone (DHT). DHT is associated with hair loss, prostate enlargement, and potentially heart disease.
“I stumbled across this medication and realized there weren’t many long-term studies on its broader implications,” Amengual shared.
“My curiosity was sparked by the fact that hormone levels affect atherosclerosis, hair loss, and prostate health. Therefore, we decided to dig deeper.”
Hormones like testosterone can influence the progression of atherosclerosis. By modulating these hormones, finasteride might indirectly improve cholesterol metabolism and inflammation, thereby supporting heart health.
More surprises from finasteride
Interestingly, these findings could extend beyond men facing hair loss or prostate issues.
Transgender individuals undergoing hormone therapy are often at an elevated risk for heart disease due to hormonal fluctuations.
Finasteride is sometimes prescribed during gender transitions to address hormone-related hair loss.
“In recent years, doctors have increasingly prescribed this drug for individuals transitioning between genders. The hormonal shifts can lead to hair loss,” Amengual explained.
“What’s notable is that these individuals also face a higher risk of cardiovascular diseases. So, this drug could potentially help prevent heart disease in both cisgender men and transgender people.”
This implies that finasteride could serve a dual purpose for transgender patients—combining hair loss treatment with a potential reduction in heart disease risks.
What’s the catch? Understanding finasteride risks
Of course, no medication is entirely risk-free. Finasteride can lead to side effects that need to be taken into account.
Some individuals may experience sexual side effects, including lowered libido, erectile dysfunction, or reduced ejaculate volume. This occurs because finasteride acts by lowering DHT, which is crucial for sexual health.
There have also been occasional reports of psychological effects such as anxiety, mood swings, or depression. While not everyone experiences these, it’s crucial to keep an eye on them.
Physical side effects could range from breast tenderness, rashes, or swelling in extremities. In rare cases, finasteride may impact liver enzymes, so regular health check-ups are advisable.
A fraction of users have reported enduring side effects even after discontinuing the medication, a condition termed Post-Finasteride Syndrome (PFS).
This can lead to ongoing sexual and psychological issues. Research is ongoing to gain better insights into these risks.
What the future holds for finasteride
These findings suggest that finasteride might play a larger role in heart health beyond its current applications. However, further research is necessary.
Clinical trials involving human participants are essential to check if the cholesterol-lowering effects observed in mice can also be replicated in humans at safe doses.
“This wasn’t a clinical study with perfect controls. It’s more about observing trends that led us to investigate with animal models,” Amengual reiterated.
If upcoming studies validate these findings, finasteride might become a useful component in preventing heart disease, especially for higher-risk groups.
Proceed with eyes wide open
Finasteride has been around long enough to support many individuals experiencing hair loss and prostate concerns. Now, it appears it might have a new role in promoting heart health.
This could be particularly important for men as well as the transgender community and others at heightened risk for cardiovascular issues.
As with any treatment, consulting with healthcare professionals is vital before making any adjustments. The potential advantages of finasteride need to be balanced against its risks. But these new insights certainly open up some intriguing possibilities.
The complete study can be found in the Journal of Lipid Research.
