Old drug now called a "magic pill" because it regrows hair and improves heart health

A prescription medication that has been available in the U.S. since 1992, which many people recognize for treating hair loss and enlarged prostate, seems to have another significant health benefit.

Recent research suggests that a drug called finasteride could lower cholesterol levels and reduce the risk of heart disease. That’s a surprising twist for a drug that’s been around for decades.

Curiosity led Dr. Jaume Amengual, an assistant professor in the Department of Food Science and Human Nutrition at the University of Illinois, to explore this unexpected connection.

After noticing something unusual in a national survey, he decided to dig deeper.

“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,” Dr. Amengual enthused.

Lowering cholesterol with finasteride?

The initial clue came from the National Health and Nutrition Examination Survey conducted between 2009 and 2016.

This survey collects health information from thousands of Americans. In this data, men using finasteride as a hair loss treatment had significantly lower cholesterol levels compared to those who weren’t on the medication.

A 30-point difference is substantial and caught the researchers’ attention. But observational studies have limitations. The sample size of men over 50 using finasteride was small.

“This was not a clinical study in which you can control everything perfectly,” Amengual noted. “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.'”

From observation to experimentation

To get a clearer picture, the team turned to laboratory mice. Doctoral student Donald Molina Chaves conducted experiments on mice predisposed to atherosclerosis — a condition where arteries narrow due to plaque buildup.

The mice were fed different doses of finasteride along with a high-fat, high-cholesterol diet.

“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.”

These findings suggested that finasteride doesn’t just lower cholesterol in the blood but might also reduce inflammation and plaque formation in arteries.

While the highest dose had significant effects, it’s not a dose humans would take.

“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 explained. “So it is not that wild when you think about it that way.”

The results in mice provide a direction for future human studies.

Finasteride, testosterone, and heart disease

So why would a hair loss drug affect cholesterol levels? It comes down to hormones.

Finasteride works by blocking a protein that activates testosterone, specifically reducing levels of dihydrotestosterone (DHT). DHT is linked to hair loss, prostate enlargement, and, as it turns out, possibly heart disease.

“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,” Amengual said.

“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. So, we decided to dig into it.”

Testosterone and its derivatives can influence the development of atherosclerosis. By altering these hormone levels, finasteride might indirectly impact cholesterol metabolism and inflammation, leading to improved heart health.

More surprises from finasteride

Interestingly, these findings might benefit more than just men dealing with hair loss or prostate issues.

Transgender individuals undergoing hormone therapy often face a higher risk of heart disease due to hormonal changes.

Finasteride is sometimes prescribed during gender transitions to manage hair loss triggered by hormone treatments.

“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,” Amengual 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.”

This opens up the possibility that finasteride could serve a dual purpose for transgender patients, helping with hair loss while also reducing heart disease risk.

What’s the catch? Understanding finasteride risks

Of course, no medication is without risks. Finasteride can cause side effects, and it’s important to consider them.

Some users experience sexual side effects like decreased libido, erectile dysfunction, and reduced ejaculate volume. These effects happen because finasteride reduces DHT, which plays a role in sexual function.

There have also been reports of psychological effects such as depression, anxiety, and mood changes. While not everyone experiences these, they’re important to monitor.

Physical side effects can include breast tenderness or enlargement, rashes, and swelling in the hands or feet. Rarely, finasteride can affect liver enzymes, so regular medical check-ups are recommended.

A small percentage of users report persistent side effects even after stopping the medication, a condition referred to as Post-Finasteride Syndrome (PFS).

Symptoms can include ongoing sexual dysfunction and psychological issues. Research is ongoing to understand and address these concerns.

What the future holds for finasteride

These discoveries suggest that finasteride could have a role in heart health beyond its current uses. More research is needed, though.

Clinical trials involving people would help determine if the cholesterol-lowering effects seen in mice also occur in humans at practical doses.

“This was not a clinical study in which you can control everything perfectly,” Amengual emphasized. “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.'”

If future studies confirm these benefits, finasteride could become part of a strategy to prevent heart disease, especially in populations at higher risk.

A new hope? Proceed with eyes wide open

Finasteride has been around for a while, helping many with hair loss and prostate issues. Now, it might have a new role to play in promoting heart health.

This could be significant not just for men but also for the transgender community and others at risk of cardiovascular disease.

As with any medical treatment, it’s crucial to consult healthcare providers before making changes. Finasteride’s potential benefits must be balanced with its risks. But this research opens up exciting possibilities.

The full study was published in the Journal of Lipid Research.

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