Finasteride Debt
Counting on finasteride to keep hair may lead to dependence on the drug forever. This is not limited to finasteride but includes all 5 alpha reductase inhibitors like dutasteride. Continued use of the drug over time can result in a biological debt that has to be paid when the treatment is stopped. Once the debt is due, hair loss will accelerate to a point resembling as if you hadn’t taken the drug at all. Using finasteride will not only delay hair loss but the time spent using the drug will have to be accounted for later. Using finasteride is like building a dam and stopping treatment opens the floodgates of hair loss. Those who don’t experience accelerated hair loss after stopping treatment, weren’t destined to lose hair anyway. Like every drug finasteride alters the way your body works and how it responds to maintain stability in the internal environment. It’s a process called homeostasis. For example, when the body gets too hot, it sweats to cool down to a regular temperature of around 37°C, and when it gets too cold, it shivers to reach the same 37°C. The same concept can be applied to drugs, particularly finasteride. DHT is considered the culprit to male pattern baldness and finasteride works to prevent the conversion of testosterone to DHT. When DHT levels are lowered, hair loss slows down significantly. Finasteride is usually taken for years or months to keep DHT levels low and after discontinuation, DHT levels return to normal. However, due to the body always seeking to self-regulate, certain involuntary mechanisms are bound to be triggered which can result in withdrawal symptoms especially accelerated hair loss. It's not known how these mechanisms work but there are many varied hypotheses. Perhaps as finasteride lowers DHT, androgen receptors become more sensitive to DHT over time to develop a biological debt for those who are predetermined to go bald regardless of any treatment. Consequently, rapid hair loss happens after treatment is stopped in order to pay off finasteride debt. In cases where men lose a little bit of hair after stopping only would have lost that little bit without treatment. This leads to the impression that finasteride is working very well. Additional interest and penalties may be charged, manifesting in the form of post-finasteride syndrome. These include persistent sexual, neurological, physical, and mental symptoms. Although the existence of PFS is debated and considered rare, many men still report it online.
Getting finasteride debt is like taking on debt from yourself in a financial or tech sense. You might keep your hair or even experience superficial hair regrowth, but you’ll have to pay it all back plus interest once you stop treatment. Finasteride debt only applies if you would have lost hair, had you not used the drug. The value of that debt is the cost of setting things right. Taking on finasteride debt isn’t inherently bad especially when you don’t know the correct way to regrow hair. It’s a temporary solution until a proper treatment is discovered. It's a matter of a strategic decision, often influenced by personal preferences. You may prioritise short-term gains over long-term costs. Speed over quality. Finasteride is a quick and dirty fix that impacts you in the future.
To explain finasteride debt, imagine two identical twins who are susceptible to androgenetic alopecia, Harry and Ben who are both 20 years old. Harry takes finasteride to keep his hair while Ben lets his hair fall out over a period of 20 years. At age 40, both twins will have different hair profiles. Harry isn’t bald while Ben is. However, if you add an extra 1 year where Harry stops using finasteride, his hair loss will approach the same level as Ben’s hair profile. After withdrawal, Harry’s body will maintain stability by shedding surplus hair retained through medication. Within 3 years, perhaps Harry’s hair will resemble Ben’s hair profile. If Harry doesn’t suffer accelerated hair loss, he may suffer other post finasteride symptoms instead. Harry’s hair profile may not be exactly the same as Ben's because identical twins can experience hair loss at different rates which is accounted for by environmental factors that aren’t identical for the twins.
The body will always try to follow its genetic blueprint, even after years of medical intervention including medications and surgery alike. James B. Hamilton's story shows this when he was studying inmates in Kansas prison. At the time a barbaric practice of castration was used to pacify aggressive inmates who were mentally ill. One day Hamilton came across an identical twin of one of the castrated inmates. The brother came to visit but the distinguishing factor between the twins was their hair profile. The visiting twin was completely bald while his castrated brother had full hair. This proves that hair loss is linked to testicles. Dr Hamilton then put forward the castrated inmate to be injected with testosterone which was allowed. When given testosterone, the castrated inmate gained male characteristics along with high libido. Surprisingly the inmate grew bald within a short time unlike his uncastrated twin who was progressively balding over a period of twenty years. The accelerated hair loss from exogenous testosterone returns the body to its predetermined biological state, causing baldness fast. The addition of testosterone returns the original hormone profile. The withdrawal of finasteride works in a similar way. Once the treatment is discontinued, the body returns to its original hormone profile. The androgen receptors that were kept safe from androgens for so long become over sensitive. In particular the hair follicles that have become over sensitive to DHT due to protection will start responding and shedding hair quickly over a short period of time, transforming the body to how it should have looked.
The perceived success of finasteride stems from what you believe the drug is doing for you which is shaped by perception and perspective. The progression of hair loss is irregular, starting and stopping at random times in life. It's difficult to know whether finasteride stopped hair loss or it stopped on its own. Furthermore, not only does finasteride stop the progression of hair loss or even reverse a little bit of loss but it puts you into a biological debt you must pay after treatment is stopped. The belief that people typically develop after 5 years of treatment is stopped can be categorised into 3 scenarios.
scenario 1
scenario 2
scenario 3
This is not an exhaustive list but the most common scenarios, all leading to a positive perspective, probably pushed by doctors since their income depends on it. Without finasteride, costly hair transplants are worthless because hair loss will continue. For this reason, many have come to depend on finasteride. Withdrawing from finasteride has a psychological component often overlooked. Men who seek medication for hair loss are overly aware of their scalp and how they are perceived by others, often leading to feelings of anxiety and discomfort, particularly in social situations. Hair improvements are known to boost positive social interactions with people. Perhaps you’ll go out more and without taking a hat. All this serves as a positive reinforcement, encouraging continued use of finasteride. Stopping treatment punishes a person socially, serving as a negative reinforcement which creates a long-lasting dependence. In conclusion, over dependence on finasteride can accumulate a biological debt known as finasteride debt.