Use of Finasteride to Prevent Hair Loss Presents a Problem for Professional and Olympic Athletes

Choosing Between Doing Their Best and Looking Their Best

Male athletes who aspire to peak performance in competition are also often men who want to present the best possible personal image in public. In the equally competitive marketplace of media appearances and product endorsements by athletes, an image of youthful vigor is most likely to attract sponsors.

Many male athletes are now finding that they cannot qualify for competition in professional or Olympic sports if they also use a highly successful medical treatment for hair loss. The ability to compete and the prevention of progressive balding are incompatible.

The widely disseminated and subscribed World Anti-Doping Agency (WADA) bans the use of the hair-loss treatment finasteride (Propecia®) by competing athletes. The WADA Code is accepted and followed by many professional leagues and teams in a variety of sports, as well as by the International Olympic Committee. A number of professional athletes have been banned from playing in their sports when finasteride was detected in urine samples they provided for “anti-doping” tests.

While finasteride is not, in itself, a performance-enhancing substance, it is known to be a “masking agent” for a number of performance-enhancing steroids banned by WADA. The performance-enhancing steroids are in the class known as anabolic androgenic steroids, which includes the “male hormone” testosterone. Finasteride inhibits the activity of an enzyme that converts testosterone into a form that is metabolically active in hair follicles.

The presence of finasteride metabolites in the urine makes it difficult to impossible to detect the presence of a number of the performance-enhancing steroids banned by WADA.

Studies with volunteers have shown that the presence of finasteride in the blood and urine changes the metabolic profile of some banned steroids. Urinary excretion of some banned steroids is decreased in the presence of finasteride, while urinary excretion of others is increased. The changes in urinary excretion profiles could be detected for longer than eight days after a 1 milligram or 5 milligram dose of finasteride. When finasteride is taken to prevent hair loss, it is taken as a 1 milligram pill once a day.

Investigators who conducted one of the studies noted that the use of finasteride to prevent hair loss may cause serious problems when anti-doping officials try to interpret the results of tests for banned steroids. It may also be difficult to determine whether an athlete used finasteride without knowledge of its steroid “masking effect”, or deliberately in an effort to escape detection of the use of a banned substance.

Finasteride, the WADA Code, and Athletes

The World Anti-Doping Agency (WADA) Anti-Doping Code is an international standard accepted internationally by professional sports teams and their leagues, and by the International Olympic Committee. It is updated annually as testing methods improve and as more substances are identified as performance enhancers.

The “finasteride problem” has tripped up a number of male athletes (the use of finasteride by females is discouraged due to possible effects on an embryo or fetus). Some of the athletes did not know there is a “finasteride problem” until it put them at risk of being rejected for competition.

Zach Lund, a member of the U.S. skeleton team at the 2006 Winter Olympics, was banned from competition after finasteride was detected in his anti-doping urine sample. Lund said he had no intention of providing a faulty urine sample when he took finasteride as a hair loss treatment. The Court of Arbitration for Sport (CAS) agreed that Lund had not tried to cheat the WADA Code; nevertheless, Lund was banned from competition.

Montreal hockey goal tender Jose Theodore had been taking finasteride for eight years as a hair loss treatment-then found out about the “finasteride problem” when he tested positive for the substance in screening of athletes who hoped to compete in the 2006 Winter Olympics. Finasteride is a banned substance under the WADA Code, which is accepted by the International Olympic Committee. He had been taking finasteride with the knowledge and approval of team physician Dr. David Mulder. The positive test resulted in no disciplinary action because testing for finasteride is not included in the National Hockey League’s anti-doping testing program.

Efforts are underway to develop a test that would selectively identify finasteride in a urine sample. Such a test could eliminate finasteride as a problem in anti-doping testing.

What is Finasteride?

Finasteride is a potent inhibitor of the enzyme 5-alpha-reductase Type 2. The enzyme converts the anabolic steroid testosterone into 5-alpha-dihydrotestosterone, an androgen regulating factor in the hair follicle. Increased activity of the enzyme 5-alpha reductase leads to increased concentration of 5-alpha-dihydrotestosterone. This increased concentration of the testosterone metabolite results in a shortening of the anagen-telogen-catagen hair cycle in hair follicles that are sensitized to the activity of 5-alpha-dihydrotestosterone by genetic predisposition.

Most hair loss in men is due to genetically-predisposed male pattern hair loss, also known as androgenetic alopecia. The shortened hair cycle eventually results in the transition of hair from “normal” to “vellus”-a fine, “peach fuzz” hair-and finally to total loss of hair from the affected follicles.

The enzyme 5-alpha-reductase is present in the body in two forms–Type 1 and Type 2. Type 1 is found mainly in sweat glands and hair follicles, Type 2 in prostate tissue and hair follicles.

Do you have Hair Loss Problems, read our Hair Loss Help

TOPICAL MINOXIDIL IS NOT JUST FOR MEN – IT WORKS FOR WOMEN

QUESTION: Does topical minoxidil work for women?

ANSWER: Yes, topical minoxidil potentially can help women who have a certain type of hair loss called androgenic alopecia, the type of hair loss that occurs with aging. Minoxidil is thought to stimulate hair growth by increasing the blood supply that nourishes the hair follicles. It may take four to eight months to see results, and if treatment with minoxidil is stopped, the scalp will revert to its previous state of hair loss.

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The results that can be seen with minoxidil vary from person to person. Side effects include unwanted facial hair growth and scalp irritation. Hives (itching) and swelling occasionally occur. Eye irritation can occur if the solution gets in the eyes. Excessive use of topical minoxidil can result in a drop in blood pressure.

Scientists are studying why hair grows and what signals the body sends to hair follicles to make hair grow.

If your hair is thinning, treat it gently. Avoid hairstyles with braids or other styles that result in hair pulled tightly, since this causes stress on the follicles. Avoid scratching your scalp or twirling your hair. If your scalp is itchy, use a medicated shampoo. See a dermatologist if this problem does not resolve.

There are many reasons for hair loss other than aging, including certain medications, illness, stress and some disease states. For example, certain thyroid conditions can result in hair loss. Certain scalp infections also can result in hair loss.

Do you have Hair Loss Problems, read our Hair Loss Help

The 17th Century solution to hair loss … a handful of dried bees, according to a rare book

If you were losing your hair in 1655 you could rub some dried bees on your head and if you were feeling under the weather you could always drink the fermented juices of thirty vipers.

These medical treatments were the height of sophistication for 17th Century ladies and gentlemen and have been uncovered in a rare book.

Roy Logan inherited a copy of Natura Exenterata or Nature Unbowelled, which gives handy hints for preparing the ancient and unusual potions.

The former policeman said the book includes weird and wonderful medicinal practices that “border on witchcraft”.

Roy Logan inherited the book, which dates back to 1655 and contains bizarre medical treatments

The British Library says there are just 14 copies of the book on record, some in America and some in the UK.

The guide, which dates back to 1655, gives a rather surprising way of healing some wounds.

“There is one remedy which suggests dipping your finger in the blood of a wound and writing a word across the chest of the victim,” said Mr Logan, of Huntingdon, Cambridgeshire.

“My wife was a district nurse for many years and I’m not too sure she ever did that.”

The book is not just a medical journal – it offers more than 1,700 different tips and hints for solving all manner of day-to-day problems.

Mr Logan added: “It is remarkably good condition. The cover is a bit worn as you would expect but the contents are in very good condition and are certainly readable – some of the entries are quite incredible.”

The ancient book almost went up in smoke 20 years ago along with possessions belonging to a relative of Mr Logan’s after his death.

The key to a full head of hair? It certainly was according to Nature Unbowelled

But his father rescued the book from the bonfire and kept it safe before passing it on to his son.

Among the 1,720 entries are:

•A recipe for viper wine using 30 vipers brewed for six months

•A hair-restoration potion involving dried bees

•A mystery broth supplied by Lady Cromwell (Oliver’s grandmother) using garden snails

•Details of how to make different types of lace

The British Library says that the author of the book is unknown, though some sources suggest many of the hints are from Lady Althea Howard, an English Countess.

The preface states that the book was to be sold at stores in Vine Court, Fleet Street and near St Paul’s Church in 1655 – 11 years before the great fire of London.

Mr Logan added: “I wonder if the low number of copies on record has something to do with the great fire.

“Either way, it is a pleasure to be in possession of such a rare book.”

The Renaissance way to make Viper Wine

“Take eight gallons of sack, which is the best wine, and to that add thirty or two and thirty vipers.

Prepare them first in this manner: Put them into bran for four days which will make them scour the gravel and earthy part from them, then stop your vessel or glass you put them in very close until six months be past in which time the flesh of the vipers and vertue of them will be infused into the wine. Although the skins will feel full after which time you take them out if you please and drink of the win when you please best to drink it.”

17th Century Hair Potion

“Take a good number of bees that be labouring to make honey, dry them and make them to powder. Then be put in common oyle and mingle them together and with ointment anoint the place you will have hair and certainly it will come without pain.”

Do you have Hair Loss Problems, read our Hair Loss Help