Dear Dr. Roach: Baldness treatment unlikely to spark more osteoporosis – Herald & Review

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Dear Dr. Roach: I am a 25-year-old man who was diagnosed with osteoporosis at age 18. It is most likely due to inhaled steroids for childhood asthma, as many other tests by endocrinologists at top institutions have ruled out other possibilities. With six years of exercise, vitamin D and calcium, my bone density is normal in some areas and osteopenia in others.

I also have male pattern baldness, and I am considering taking finasteride. One endocrinologist feels it may interfere with my bone density. I had a second opinion, and the doctor felt 1 mg would not affect my bone density.

I do not want to compromise my bones, but I also do not want to lose my hair.

A: Finasteride and dutasteride work by blocking an enzyme that converts testosterone to dihydrotestosterone. Testosterone is an important hormone in men and women, and it promotes bone mass. Low testosterone is one of the conditions your endocrinologist would have checked you for, as osteoporosis in an 18-year-old man is quite rare. Dihydrotestosterone has few physiological effects in adult men, though it is critically important during puberty. Two effects of DHT are prostate enlargement and male pattern hair loss. Medicines that block the enzyme that allows formation of DHT are used for both these conditions.

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Dear Dr. Roach: Baldness treatment unlikely to spark more osteoporosis - Herald & Review