Hair Loss And Prostate Drug May Cut Risk Of Heart Disease

"When we looked at the men taking finasteride in the survey, their cholesterol levels averaged 30 points lower than men not taking the drug. I thought we'd see the opposite pattern, so it was very interesting," said lead study author Jaume Amengual, assistant professor in the Department of Food Science and Human Nutrition and the Division of Nutritional Sciences, both part of the College of Agricultural, Consumer and Environmental Sciences (ACES) at the U. of I.

According to the researchers, the study found significant correlations between finasteride use and lower cholesterol levels in close to 4,800 men enrolled in the National Health and Nutrition Examination Survey meeting the general health criteria for analysis inclusion.  However, of the 4,800 men only 155 men who were all over the age of 50 reported using finasteride, and the researchers were unable to tell how long they were taking it. The researchers also found a reduction in total plasma cholesterol, delayed atherosclerosis progression, lower inflammation in the liver, and other related benefits in mice studies using high doses of finasteride.

"This was not a clinical study in which you can control everything perfectly," Amengual said. "It was more of an observation that led us to say, 'Okay, now we've seen this in people. Let's see what happens in mice.’" 

"I was reading about this medication one day, and I started to notice that there were not many long-term studies of the implications of the drug. Initially, it was just my own curiosity, based on the fact that hormone levels are known to have an effect on atherosclerosis, hair loss, and prostate issues," he added. "So, we decided to dig into it."

Finasteride works by blocking a protein found in hair follicles and the prostate gland that activates testosterone. After discovering the link between lower cholesterol in men and finasteride, Amengual tasked doctoral student Donald Molina Chaves to investigate if the pattern held in mice who consumed a high-fat, high-cholesterol Western-style diet for 12 weeks. Four levels of the drug were tested: 0, 10, 100, and 1000 milligrams per kilogram of food in male mice that were genetically predisposed to atherosclerosis. 

"Mice that were given a high dose of finasteride showed lower cholesterol levels within the plasma as well as in the arteries," Molina Chaves said. "There were also fewer lipids and inflammatory markers in the liver."

"It's an incredibly high level of the drug. But we use mice as a model, and they are extremely resistant to things that would kill any of us," Amengual said. "So it is not that crazy when you think about it that way."

Humans would take 1 milligram for hair loss and 5 milligrams for enlarged prostate, and the fact that a clear pattern emerged of men taking the drug at these doses suggests that the drug may be lowering cholesterol without the outrageous megadoses that were tested in mice. 

Like any medication, finasteride is not without risks. The next steps would be for physicians to start tracking the effects of finasteride on cholesterol in patients or to conduct a clinical trial to verify the results of this study. 

"Over the past decade, doctors have started prescribing this drug for individuals transitioning either from male to female or female to male. In both cases, the hormonal changes can trigger hair loss," he said. "The interesting thing is that transgender people are also at a higher risk of cardiovascular diseases. So this drug could have a potential beneficial effect to prevent cardiovascular disease not only in cis men, but also in transgender individuals."