anyone here on avodart?

very few people have tried avodart. If you are a male you are much more likely to get prescribed this than a female because as with accutane, they don't want us to get preganant, and in this case with a male, and cause him birth defects (as in less masculine).

Avodart is the same thing as Duatsteride which is supposed to be a 99% Type I & Type II 5-alpha reductase enzyme inhibitor. these enzyms are responsible for the production of DHT, which is supposed to be the BIG bad guy when it comes to acne. However i've heard conflicting results about this drug. It may help with your hairloss, and it may even help with your acne, but some people that NEVER had acne were taking this and it actually gave them a form of acne. Yet, you will be on accutane so you may not get any new acne because of that.

If I was an endocrinologist, knowing that accutane isn't usually permanent, wich in your case seems to be true, I would have given you spiro especially since you've already been given something more potent than Spiro, Avodart, and that has not at all been approved for acne (which is why you are getting if for alopecia). Spiro has never broken anyone out, and it actually seems safer to me, with less physical side effects (no hair loss, extremely dry skin, lips, etc)

So tell me something, why are you going on a 3rd course of accutane? How long did the 1st 2 courses last for you? Did they ever clear you 100%? I ask this because people that accutane doesn't clear, and these people have goine on up to 5 treatments, probably have an underlying hormonal disorder. There are studies with accutane and males that have also further supported this by testing their testosterone levels and found that the males that didn't "take" to accutane had (possibly insulin resistance or hypothyroid induced) Hyperandrogenism or Adrenal Disorder induced hyperandrogensm, which would help explain your androgenic alopeica/male patterned baldness (??). So I'm just wondering if you really think it's worth a 3rd try? Do you actually have a hormonal disorder or have ever been tested to see if you do? If you do, Spiro would be a much better bet for it (especially if avodart does'nt work) or glucocorticoids (if it's adrenal related).

Best of luck

Thanx for your response SweetJade

My Endocrinologist prescribed the Avodart for my hairloss only. He said that although he thought Avodart would help w/ acne, his experience w/ past patients told him it didn't help.

I have taken two courses of Accutane (both full, four moth courses). One six years ago which cleared me completely (head to toe; I get acne everywhere, from my scalp to my thighs). I stayed clear for about a year and a half and then It began to come back, but not as strong as before the Accutane. The large cystic-type acne I used to get before the Accutane on my face (forehead) and back never returned. But little by little it returned on my scalp, arms, butt, thighs (other areas as well but those are the worst).

Then in the spring of 2003 I took Accutane again, but at a higher dosage. I weigh around 180 pounds (im male) and was taking 80mg a day for the first full course. In spring 2003, I was the same weight but taking around 120 a day (hoping the higher dosage would end my acne). For whatever reason the second course did virtually nothing as my acne remained the same if not a bit worse.

All this I explained to my Endocrinologist (who I saw for the first time last week). He said he has has good results w/ a full course of Accutane followed by a low maintenance dose of around 10mg a day or so (whatever would be right for me). He said the Accutane, especially me because I'm male, will have less side effects that Spiro, so better to try that first rather than the Spiro.

We all know of the possible side effects for men taking Spiro, so I won't bother to mention. But he did leave it up to me, he would have prescribed Spiro, but he recommended the Accutane, so I decided to try that route.

I don't know if I have a specific hormonal disorder, although I'm sure I do. Im 31 and have had acne since I was 14. I get it all over my body and my common sense tells me there is something internally wrong.

My Endocrinologist did not test me to see what hormonal disorder I might have, although I know he feels its hormonal. I know I should have asked him to be tested for all the hormonal issues (thyroid, dht, etc.).

During my next visit I'd like to ask to have the tests done. I assume blood work is needed. All he did was give me a quick medical exam. Could you PLEASE tell me what tests to have done and I tell him next visit.

Thanx for your help,
michael

Oh yeah, definately get your endocrinologist to do some blood work. I'm really surprised that he doesn't want to give you spiro due to it's (libido reducing) side effects, when you were taking Proscar and are now on Avodart. Don't those also affect your libido, as I've read that proscar does???

As for the blood tests, well he'll probably run a Male Panel on you which will include your PSA, you Androgens (will include DHT), estrogen, progesterone, along with a liver panel, CBC (complete blood count), and lipid profile. Yet every lab is different, but those are the usual tests run, in particular when taking medication that can mess with your liver.

Now, if you read the last abstract I posted, it mentions that males that accutane didn't work for had either an adrenal dysfunction or had high levels of 5-alpha reductase. Well, you can have a "normal" total testosterone levels, as I do, and yet still have high levels of a form of testosterone. Usually it's going to be DHEA or DHEA-S or Free Androgens that wil be high. Of course, that means that you will probably have high levels of DHT and 3-alpha diol-G which, are supposed to responsible for acne, hirsutism, sebum production, alopecia, and prostate & breast growth problems (like cancer).

Hormonal disorders that you could be checked for may involve one or more of the following: Pituitary, Thyroid, Adrenal gland, Gonads (testes or ovaries), or Liver/Pancreas. It could be a genetic defect, sensitivity, tumor, or greatly influenced (not always caused) by something in your lifestyle (toxins in environment, diet, nutrient deficiency, etc).

So when you think of acne, well when I do, two major forms of treatments come to mind: Androgen Antagonists and Anti-inflammatories. Well it turns out that is basically what happens when you have hormonal disorder (or health problem) that is giving you acne. It usually increases your androgens and/or inflammatory product production!


Basic Hyperandrogenism
Tumor or defect in testes or ovary production

Health/Hormonal Disorder Induced Hyperandrogenism
Adrenal Disorders:
-- Non-classical congenital Adrenal Hyperplasia (NCCAH) or Late-onset adrenal hyperplasia (LOCAH) - too little cortisol could mean too much of the other steriod hormones being produced as a result of the body TRYING to produce more cortisol. There's 5 possible enzyme defects here.

-- Hypercortisolism / Cushings Syndrome - too much cortisol could mean too much of the other steriod hormones being produced as well

-- Hypocortisolism / Addison's Disease - probably similar to NCCAH/LOCAH

Thyroid:
-- Hyperthyroidism / Grave's Disease - not as common for acne, but doctors will usually test this before ANY other hormonal tests (???)

-- Hypothyroidism - more common for acne as it leads to a reduction of SHBG & increased inflammatory products.

-- Thyroiditis / Hashimoto's Thyroiditis - should be the same as for hypothyroidsim

Liver/Pancreas:
-- Insulin Resistance - reduces SHBG & increases inflammatory products
-- Diabetes Type II
-- High Cholesterol - contribute to inflammatory products

Quote from Neca:

Hey SweetJade how's it going :wave: , wow it's good to see that you are still here helping people out with your amazing knowledge. I don't know what a lot of us would do without your insight! Well I was just browsing the forum and have stumbled on a lot of info regarding anti-androgens especially amongst your post and it is beginning to really interest me as I am convinced my acne is hormonal. In your last post you wrote:



Do you know how effective these A/As are at preventing acne and do you have any info regarding the types available, preferably in natural form. I have read that Saw Palmetto is an A/A but many people have suffered from Thyroid problems as a result? So how risky is A/A use and does it need to be carefully monitored by a doc?

Thanks in advance for any info and good to see ya again :)

Oh wow, well thank you =) Regarding Androgen Antagonsits, they fall in many catagories. Some are best used for certain genders, but some of these should probably be used for all genders. The most popular ones used orally for the treatment of acne are Accutane (see previous posts), Spironolactone (androgen receptor blocker), Estrogen/BC (increases SHBG to bind free androgens) & it's questionable when it comes to the prescription specific 5-alpha reductase inhibitors such as Avodart & Proscar.

There's herbals that can act as 5-alpha reductase inhibitors as well as Saw Palmetto is one of these. If you are concerned about it messing with your thyroid, then you can take the active component, Beta Sitosterol instead. I actually have a list of natural androgen antagonists and I look for that and post it for you later.

In the mean time, as for prescription androgen antagonists, there's also the indirect ones such as Glucocorticoids & Insulin Sensitizers. Normally glucorticoids (dexamethasone & prednisone) could induce acne, but if you have an adrenal imbalance they will do the opposite & they are also anti-inflammatory too. The Insulin Sensitizers help to either limit the amount of insulin you produce (Metaformin) or enable your body to better utilize insulin (Avandia). Either way, they both work to lower you androgens, free androgens and boost your SHBG levels, thus help reduce/eliminate acne. The same goes for thyroxine hormone for those that are hypothyroid. Hypothyroids also have a reduced level of SHBG due to lacking thyroid hormone. Boost your thyroid hormone & your SHBG will also increase and thus your acne should also be eliminated.

Depending on the severity, the susceptibility to one's environment (diet, toxins), and perhaps sensitivity, will determine how effective prescription & supplement androgen antagonists are for you. As you may have noted on the board, some of these drugs alone are enough to get people 100% and other times, such as for myself, they were not. I'm more influenced by my diet (which is also an indirect androgen antagonist) and as such I found that I got better results by changing my diet, even when I dropped the avandia (BC, & spiro). I actually have a studyposted around here (bread & acne thread?) that shows that dietary changes with metaformin was no different than dietary changes alone! I'm 24 and have had acne since I was at least 10, yet something that "simple" worked for me. Indeed, the success of any treatment really depends on one's genes & environmental influences.