The drug finasteride, also known as Propecia or Proscar, treats male pattern baldness and enlarged prostate in millions of men around the world. But new research from the University of Illinois at Urbana-Champaign suggests the drug may also have surprising life-saving effects by lowering cholesterol and reducing the overall risk of cardiovascular disease.
The study, published in the Journal of Lipid Research, found a significant correlation between finasteride use and lower cholesterol levels in men who participated in the National Health and Nutrition Examination Survey from 2009 to 2016. . In mice that took high doses of finasteride, researchers found lower cholesterol levels. Total plasma cholesterol, slowing the progression of atherosclerosis, reducing liver inflammation, and associated benefits.
“When we looked at men taking finasteride in a study, their cholesterol levels were, on average, 30 points lower than men who weren’t taking finasteride. That’s really interesting because I expected to see the opposite pattern.” ” said study lead author Jaume Amengual. , an assistant professor in the Department of Food Science and Human Nutrition and the Department of Nutritional Sciences, part of U of I’s College of Agricultural, Consumer, and Environmental Sciences (ACES).
Although the findings were interesting, they also had limitations. Of the approximately 4,800 survey respondents who met general health criteria for inclusion in the analysis, only 155 (all men over age 50) reported using finasteride. And the researchers couldn’t say how much of the drug the men in their study took, or for how long.
This was not a clinical study where everything could be perfectly controlled. It was more like an observation that made us say, “Okay, this is what people are starting to see.” Let’s see what happens with the mouse. ”
Jaume Amengual, lead study author
But first, why do hair loss and prostate medications affect cholesterol? Researching sclerosis. Scientists have long suspected that the sex hormone testosterone is important in atherosclerosis, as the disease is much more common in men than in premenopausal women, but its role remains unclear. was not clear.
Finasteride works by blocking proteins in the hair follicles and prostate that activate testosterone. The commonality of testosterone was enough to pique Amengual’s interest.
“One day I was reading about this drug and started realizing that there weren’t many long-term studies on the effects of this drug.At first, it was not known that hormone levels affected “It was just my own curiosity at first, based on the fact that it affects atherosclerosis, hair loss, and prostate problems,” he said. “So we decided to dig into it.”
After documenting the first-ever association, albeit observational, between finasteride and lowered cholesterol in men, Dr. Amengual told doctoral student Donald Molina Chavez that the pattern held up in mice. I asked him to confirm whether or not.
Molina Chavez tested four levels of finasteride – 0, 10, 100, and 1000 milligrams per kilogram of food – in male mice genetically predisposed to atherosclerosis. The mice were fed the drug for 12 weeks along with a high-fat, high-cholesterol “Western-style” diet. After the experiment, Molina Chavez analyzed the mice’s cholesterol and other lipid levels, along with evidence of atherosclerotic plaques. He also examined gene expression in the liver, examined bile acid metabolism, and analyzed steroids, triglycerides, immune activity, and more.
“Mice given high doses of finasteride had lower cholesterol levels in their plasma and arteries,” Molina Chavez said. “Lipids and inflammatory markers in the liver were also reduced.”
The effect is only significant at the highest doses, levels that Amengal claims are prohibitive for humans, but he explains that mice metabolize finasteride differently than humans.
“This is an incredibly high level of a drug. But we’re using mice as a model, and mice are very resistant to things that would kill us.” spoke. “So when you think about it that way, it’s not that crazy.”
Humans take 1 or 5 milligrams of finasteride daily for hair loss and prostate enlargement, respectively. The fact that the study of men who were likely taking one of these doses showed a clear pattern suggests that the drug may be lowering cholesterol without the large doses tested in mice. It suggests that there is.
The next step is for doctors to start tracking finasteride patients’ cholesterol or conduct clinical trials to test its effectiveness. Amengual says it may be especially important to understand how finasteride affects transgender people.
“In the past decade, doctors have started prescribing this drug for people transitioning from male to female or female to male. In both cases, hormonal changes can cause hair loss,” he said. . “What’s interesting is that transgender people also have an increased risk of cardiovascular disease, so this drug is not only effective for cis men, but also has potential beneficial effects in preventing cardiovascular disease in transgender people.” There may be.”
Finally, like any drug, Amengual points out that finasteride is not without risks. Consult your doctor for more information.
sauce:
University of Illinois College of Agricultural, Consumer and Environmental Sciences
Reference magazines:
McQueen, P., et al. (2024). Finasteride slows the progression of atherosclerosis in mice and is associated with reductions in plasma cholesterol in men. Journal of Lipid Research. doi.org/10.1016/j.jlr.2024.100507.
