Adverse effects with finasteride 5 mg/day for patterned hair loss in premenopausal women

IntroductionMirtazapine is indicated in the treatment of major depressive disorder particularly in selective serotonin re-uptake inhibitors resistance. Its effect on hair loss is rare with no previous documented effect on hair colour.MethodReview of relevant literature and description of a case report of a 54-year-old male patient who developed alopecia and hair discoloration after initiation of mirtazapine treatment.ResultsUpon cessation of mirtazapine treatment full restoration of hair colour and regrowth of hair was attained within 10 weeks.DiscussionThere was clear temporal relationship between experiencing hair loss and commencing mirtazapine treatment. No other more likely medical reason to explain such experience was established. A noticeable restoration of the hair colour occurred following mirtazapine cessation.ConclusionMirtazapine is associated with hair discoloration and hair loss. The possibility of such distressing adverse effects needs to be conveyed to patients by clinicians and to be further explored by researchers.

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Abstract P048: A Model Of Chronic Insufficient Sleep Increases Markers Of Insulin Resistance In Postmenopausal But Not Premenopausal Women

Circulation ◽

10.1161/circ.143.suppl_1.p048 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Faris M Zuraikat ◽

Samantha Scaccia ◽

Ayanna Campbell ◽

Bin Cheng ◽

Marie-Pierre St-Onge

Keyword(s):

Insulin Resistance ◽

Insulin Sensitivity ◽

Adverse Effects ◽

Postmenopausal Women ◽

Menopausal Status ◽

Premenopausal Women ◽

Full Sample ◽

Insulin Levels ◽

Short Sleep ◽

Sleep Condition

Introduction: Insufficient sleep is widely prevalent among US adults and is a risk factor for type 2 diabetes (T2D). Experimental studies show adverse effects of acute, severe short sleep on insulin sensitivity, but it is unclear whether these reflect risks associated with milder short sleep routinely observed in the general population. To date, no study has evaluated the impact of prolonged mild sleep curtailment on markers of insulin resistance in women or whether these effects differ by menopausal status, known to impact insulin sensitivity. Hypothesis: Glucose and insulin levels, as well as a measure of insulin resistance (HOMA-IR), will increase during 6 wk of sleep restriction (SR) relative to adequate sleep (AS). Adverse effects of prolonged short sleep will be exacerbated in postmenopausal women. Methods: Thirty-four women (age: 38±14 y; BMI: 25.6±3.6 kg/m2; n=10 postmenopausal) with adequate habitual total sleep time (TST) (453±33 min) took part in a randomized crossover study with two 6-wk phases: AS and SR. In AS, participants were asked to maintain stable nightly bed and wake times determined from 2 wk of screening with wrist actigraphy and sleep logs. In SR, bedtime was delayed to reduce TST by approximately 1.5 h/night. Sleep was measured continuously using actigraphy and verified weekly for compliance. At wk 0, 3, 4, and 6 fasting blood samples were collected. Outcomes included glucose and insulin levels as well as HOMA-IR scores, calculated from those values. Linear-mixed models tested interactions of sleep condition with week on outcome measures in the full sample and by menopausal status. Results: Sleep condition impacted the change in TST from baseline (P<0.0001), which was reduced in SR and unchanged in AS (-79±6 vs -4±6min). In the full sample, there was no sleep condition by week interactions for glucose (P=0.67), insulin (P=0.14), or HOMA-IR (P=0.16). Similar results were observed in premenopausal women (all P>0.50). However, in postmenopausal women, there was a significant effect of sleep condition on change in insulin (P=0.046) and HOMA-IR (P=0.039) over the 6 wk. In SR, insulin (slope: 0.26±0.28 μU/mL) and HOMA-IR (slope: 0.07±0.08) increased, while AS resulted in reductions in these outcomes (insulin slope: -0.56±0.29 μU/mL; HOMA-IR slope: -0.16±0.08). Conclusions: We provide the first evidence that chronic short sleep, even if mild, adversely affects insulin sensitivity in postmenopausal women. In contrast, maintenance of AS may improve glycemic regulation. Interestingly, prolonged short sleep did not impact markers of insulin resistance in premenopausal women; further investigation into these life-stage related differences, including underlying mechanisms, is warranted. Results suggest that, in postmenopausal women, a group at heightened risk of poor sleep and T2D, achieving adequate sleep may be an effective strategy to improve cardiometabolic health.

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Persistent Sexual, Emotional, and Cognitive Impairment Post-Finasteride

American Journal of Men s Health ◽

10.1177/1557988314538445 ◽

2014 ◽

Vol 9 (3) ◽

pp. 222-228 ◽

Cited By ~ 45

Author(s):

Christine Anne Ganzer ◽

Alan Roy Jacobs ◽

Farin Iqbal

Keyword(s):

Side Effects ◽

Adverse Effects ◽

Hair Loss ◽

Reductase Inhibitor ◽

Psychological Symptoms ◽

Physical Symptoms ◽

Internet Survey ◽

Controlled Trials ◽

Randomized Controlled ◽

Male Pattern

Finasteride is a synthetic 5-α reductase inhibitor, which prevents the conversion of testosterone to dihydrotestosterone and has been used for more than 20 years in the treatment of male pattern hair loss. Randomized, controlled trials have associated finasteride with both reversible and persistent adverse effects. In this pilot study, we sought to characterize sexual and nonsexual adverse effects that men reported experiencing at least 3 months after stopping the medication. Based on previous research on persistent side effects of finasteride, we constructed an Internet survey targeting six domains: physical symptoms, sexual libido, ejaculatory disorders, disorders of the penis and testes, cognitive symptoms, and psychological symptoms and was e-mailed to patients who reported experiencing symptoms of side effects of finasteride. Responses from 131 generally healthy men (mean age, 24 years) who had taken finasteride for male pattern hair loss was included in the analysis. The most notable finding was that adverse effects persisted in each of the domains, indicating the possible presence of a “post-finasteride syndrome.”

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Prevention and Treatment of Adverse Effects of Antineoplastic Therapy and of Delayed-Onset Side Effects: Prevention and Treatment of Hair Loss

Aesthetic Treatments for the Oncology Patient ◽

10.1201/9780203728888-11 ◽

2020 ◽

pp. 51-53

Author(s):

Emma Iglesias Candal

Keyword(s):

Side Effects ◽

Adverse Effects ◽

Antineoplastic Therapy ◽

Hair Loss ◽

Delayed Onset ◽

Prevention And Treatment

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Weight Gain and Hair Loss during Anti-TNF Therapy

International Journal of Rheumatology ◽

10.1155/2012/593039 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 6

Author(s):

Abdo Lutf ◽

Mohammed Hammoudeh

Keyword(s):

Adverse Effect ◽

Weight Gain ◽

Psoriatic Arthritis ◽

Ankylosing Spondylitis ◽

Side Effects ◽

Adverse Effects ◽

Hair Loss ◽

Rheumatology Clinic ◽

Relationship Of ◽

The Relationship

Objectives. To investigate the incidence of weight gain and hair loss as adverse effects of anti-TNF therapy in rheumatic diseases.Methods. Patients using anti-TNF therapy, who are followed in rheumatology clinic, were interviewed using a questionnaire to investigate the side effects of anti-TNF therapy. Patients who complained of hair loss and weight gain were asked additional questions concerning the relationship of these adverse effects to anti-TNF use, whether therapy was stopped because of these adverse effects and if the adverse effects reversed after stopping therapy. The files were reviewed to follow the weight change before, during, and after discontinuation of anti-TNF.Results. One hundred fifty consecutive patients (82 RA, 34 ankylosing spondylitis, 32 psoriatic arthritis, and 4 for other indications) were interviewed .Weight gain was observed in 20 patients (13.3%) with average gain of 5.5 Kg. Anti-TNF was stopped in five patients because of this adverse effect. Hair loss during anti-TNf therapy was reported in five females (3.3%) and anti-TNF therapy was stopped in all of them.Conclusion. Weight gain and hair loss appear to be associated with anti-TNF therapy and may be one reason for discontinuing the therapy.

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The Use of Trilostane for the Treatment of Alopecia X in Alaskan Malamutes

Journal of the American Animal Hospital Association ◽

10.5326/0410336 ◽

2005 ◽

Vol 41 (5) ◽

pp. 336-342 ◽

Cited By ~ 11

Author(s):

F. Leone ◽

R. Cerundolo ◽

A. Vercelli ◽

D.H. Lloyd

Keyword(s):

Adverse Effects ◽

Hair Loss ◽

Adrenocorticotropic Hormone ◽

Hydroxysteroid Dehydrogenase ◽

Elevated Blood ◽

Acth Stimulation ◽

Blood Concentrations ◽

Hair Regrowth ◽

Stimulation Tests ◽

17 Hydroxyprogesterone

Three Alaskan malamutes with hair loss and slightly elevated blood concentrations of 17-hydroxyprogesterone after stimulation with adrenocorticotropic hormone (ACTH) were treated with trilostane. Trilostane, an inhibitor of 3 β-hydroxysteroid dehydrogenase, was given twice daily at a dose of 3.0 to 3.6 mg/kg per day orally for 4 to 6 months. Routine ACTH stimulation tests were performed over 8 months to evaluate the degree of adrenal function suppression. Treatment with trilostane led to complete hair regrowth in all three dogs within 6 months. No adverse effects associated with trilostane were recognized.

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Opportunities of the pharmacogenetic approach to personalized tamoxifen breast cancer therapy: case reports

Modern Oncology ◽

10.26442/18151434.2019.1.190248 ◽

2019 ◽

Vol 21 (1) ◽

pp. 24-30

Author(s):

Marina I Savelyeva ◽

Irina A Dudina ◽

Juliya S Zaharenkova ◽

Anna K Ignatova ◽

Kristina A Ryzhikova ◽

...

Keyword(s):

Breast Cancer ◽

Adverse Effects ◽

Case Reports ◽

Tamoxifen Resistance ◽

Premenopausal Women ◽

Individual Response ◽

Clinical Effects ◽

Active Metabolites ◽

Clinical Value ◽

Luminal A

Tamoxifen is the selective modulator of estrogen receptors. Nowadays, it is widely used for treatment of premenopausal women with ER(+) breast cancer likewise for postmenopausal women with treatment contraindications to aromatase inhibitors. Tamoxifen is a prodrug which is metabolized by cytochrome P450 (CYP): CYP2D6, CYP3A4, CYP3A5, CYP2C9, CYP2C19 to active metabolites. There is high variability in the CYP genes therefore differences in tamoxifen metabolism, tamoxifen individual response and efficacy are observed among patients. This article presents two clinical case reports. Both patients have breast cancer luminal A subtype, similar prognosis and are administered tamoxifen but they have diverse clinical effects. Patients responded to the survey questionnaire, then samples of buccal epithelium were taken for genetic analysis of CYP2D6*4, CYP3A5*3, CYP3A4*17, CYP2C9*2,3, CYP2C19*2,3, ABCB1 gene mutations by use of real time PCR. In patient A samples were detected significant mutations in CYP2D6 (*1/*4), CYP3A5 (*3/*3) и CYP2С9 (*2/*3), but there were no mutations detected in patient B. It is interesting that patient B has had prominent tamoxifen adverse effects, such as flushes, ostealgia, faintness, after 1 month of tamoxifen therapy. Patient A has taken tamoxifen for 19 months without any adverse effects. Also there is a review in this article about clinical value of different CYP2D6, CYP3A5, CYP2C9 polymorphisms. Additionally, we make a suggestion about the role of polymorphisms in tamoxifen adverse effects and the way of solution for problems of tamoxifen resistance. We suppose that routine genetic study before tamoxifen administration would help to predict individual intolerance and increase the efficacy of treatment.

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Efficacy and Safety of Topical Adenosine for Androgenetic Alopecia in Adults: A Systematic Review

Acta Medica Philippina ◽

10.47895/amp.v54i3.1678 ◽

2020 ◽

Vol 54 (3) ◽

Author(s):

Blythe N. Ke ◽

Juan Paolo David S. Villena ◽

Ma. Lorna F. Frez

Keyword(s):

Systematic Review ◽

Adverse Effects ◽

Hair Loss ◽

Treatment Options ◽

Cochrane Collaboration ◽

Androgenetic Alopecia ◽

Cochrane Library ◽

Adult Males ◽

Efficacy And Safety ◽

Participant Satisfaction

Background. Androgenetic alopecia (AGA), also known as pattern hair loss, is the most common type of hair loss in men and women. Due to very limited therapeutic options, search for other effective and safe drugs is necessary. Objectives. This review aims to evaluate the efficacy and safety of a potential treatment option, topical adenosine, for AGA in male and female adults. Methods. A search of databases (Cochrane Library, Pubmed Medline, and others) was performed with no time limitations placed. We included human interventional studies published in English involving the use of topical adenosine for AGA in healthy adult males and females. Risk bias assessment was performed using the Cochrane Collaboration criteria. Results. All four trials in this review, with a total of 260 participants, used 0.75% topical adenosine lotion twice a day for a period of 6-12 months. Comparators were placebo, topical niacinamide, and topical minoxidil. Evaluated parameters include improvement in baldness grading as assessed by dermatologists and investigators, improvement and satisfaction as assessed by participants, anagen growth, thick/thin/vellus hair ratio, and hair density. Two trials found significant improvement with thick hair ratio (>60 or >80 μm) with the use of topical adenosine while two trials showed higher overall participant satisfaction with topical adenosine. Few to no adverse effects were reported with its use. Conclusion. This is the first systematic review involving topical adenosine for AGA. Topical adenosine may be effective in increasing thick hair ratio and improving the self-perception of hair growth. With minimal to no adverse effects, it may serve as an adjunct or alternative to present treatment options. However, more studies are needed to strengthen these findings.

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A Tale of Two Therapies- A Comparison of Armour Thyroid and Levothyroxine

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1678 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A823-A824

Author(s):

Meghna Shah ◽

Rachael Proumen ◽

Akhila Sunkara ◽

Runa Acharya ◽

Amy Patel

Keyword(s):

Weight Gain ◽

Side Effects ◽

Adverse Effects ◽

Hair Loss ◽

P Value ◽

Thyroid Extract ◽

Chi Square ◽

Chi Square Test ◽

The Difference ◽

Loss Of Appetite

Abstract Treatment of hypothyroidism is predominantly with levothyroxine due to its ability to generate stable T3 levels and its long half-life. Many patients report continued hypothyroid symptoms despite normal TSH values on levothyroxine and request to switch to desiccated animal thyroid extract. Desiccated thyroid extract is less used for fear of side effects and risks. There are only a handful of studies available comparing desiccated animal thyroid extract to levothyroxine. We conducted a retrospective study on 250 hypothyroid patients over the age of 18 who presented to our clinic from 2008-2018. We excluded patients who had a history of thyroid cancer and documented non-adherence. We analyzed 125 patients on levothyroxine (males=43, females=82) and 125 patients who were on levothyroxine but chose to switch to Armour Thyroid (males=7, females=118). We examined the following variables; when comparisons of proportions were made between the two groups, N-1 chi square test was used to determine significance. 1. Reason for change to Armour Thyroid from levothyroxine: Top reasons were fatigue (n=51/125, 40.8%), inability to lose weight (n=32/125, 25.6%), mental fog (n=8/125, 6.4%), hair loss (n=8/125, 6.4%) and desire for a natural product (n=7/125, 5.6%) 2. Percentage of patients complaining of fatigue/weight gain in euthyroid state: 16/125 (12.8%) of patients on Armour Thyroid and 29/125 (23.2%) of patients on levothyroxine had complaints of fatigue and weight gain with a normal TSH. This 10.4% difference was significant (p value=0.033, 95% CI 0.84% to 19.8%). 3. Presence of side effects: 24/125 (19.2%) patients on Armour Thyroid discontinued it before 6 months. The top reasons were no improvement of symptoms (n=9/24, 37.5%), palpitations (n=5/24, 20.8%), worsening anxiety (n=3/24, 12.5%), cost (n=2/24, 8.33%), and loss of appetite (n=2/24, 8.33%). 5/125 (4.00%) patients on levothyroxine chose to discontinue it before 6 months. The reasons included presence of palpitations (n=3/5, 60.0%), hair loss (n=1/5, 20.0%), and gluten intolerance (n=1/5, 20.0%). A total of 11/125 (8.8%) had adverse effects from Armour Thyroid while 4/125 (3.2%) of patients on levothyroxine had adverse effects to the medication. The difference of 5.6% leaned toward clinical significance and trended toward being statistically significant (p value=0.06, CI -0.4842% to 12.1677%). Our research shows that patients generally feel better on Armour Thyroid compared to levothyroxine. Armour Thyroid is an effective medication to use for patients who remain symptomatic on levothyroxine and should be considered as a viable option in clinical practice. However, our study also indicated that patients may have more adverse effects on Armour Thyroid when compared to levothyroxine and further studies are needed comparing the two medications. Limitations of our study include the retrospective nature of the study and the sample size.

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