The drug finasteride, also known as Propecia or Proscar, treats male pattern baldness and an enlarged prostate in millions of men worldwide. But a new University of Illinois Urbana-Champaign study suggests the drug may also provide a surprising and life-saving benefit: lowering cholesterol and reducing the overall risk of cardiovascular disease.

Study, published in Journal of Lipid ResearchA significant correlation was found between finasteride use and lower cholesterol levels among men who participated in the National Health and Nutrition Examination Survey between 2009 and 2016. In mice given high doses of finasteride, researchers found that total plasma cholesterol decreased, atherosclerosis was delayed, and inflammation was reduced. In the liver, and related benefits.

“When we looked at the men taking finasteride in the survey, their cholesterol levels were an average of 30 points lower than men who weren’t taking the drug. I thought we’d see the opposite pattern, so it’s very interesting.” was interesting,” said the study’s lead author Jaime Amengol. , assistant professor in the Department of Food Science and Human Nutrition and the Division of Nutritional Sciences, both in the College of Agricultural, Consumer and Environmental Sciences (ACES) at U.

As interesting as the survey results were, they had their limitations. Of the nearly 4,800 survey respondents who met general health criteria for inclusion in the analysis, only 155, all men over the age of 50, reported using finasteride. And the researchers couldn’t say how much or for how long the men in the survey had taken the drug.

“This was not a clinical study in which you can completely control everything,” Amengual said. “It was more of an observation that led us to say, ‘OK, now we’ve seen this in people. Let’s see what happens in mice.’

But first, why would hair loss and prostate medicine affect cholesterol? Amenual studies atherosclerosis, a condition in which cholesterol plaque narrows the arteries, leading to stroke, heart attack, and other types of heart disease. Because the disease is more common in men than in premenopausal women, scientists have long suspected that the sex hormone testosterone is important in atherosclerosis, although its role is not entirely clear.

Finasteride works by blocking proteins in hair follicles and the prostate gland that activate testosterone. The common thread, testosterone, was enough to pique Amengual’s interest.

“I was reading about this drug one day, and I started to realize that there hadn’t been many long-term studies done on the implications of this drug. Initially, it was just my own curiosity, the fact that “Based on what hormone levels are known to affect atherosclerosis, hair loss, and prostate problems,” he said. “So, we decided to dig into it.”

After first documenting the link, albeit an observational one, between finasteride and lower cholesterol in men, Amengol teamed up with doctoral student Donald Molina Chavez to see if the pattern held in mice.

Molina Chavez tested four levels of finasteride — 0, 10, 100, and 1,000 milligrams per kilogram of diet — in male rats genetically predisposed to atherosclerosis. Mice fed a high-fat, high-cholesterol “Western” diet for 12 weeks. After the experiment, Molina Chavez analyzed cholesterol and other lipid levels in the mice, along with evidence of atherosclerotic plaques. He also tested gene expression in the liver, looked at bile acid metabolism, and analyzed steroids, triglycerides, immune activity and more.

Rats given high doses of finasteride had lower plasma as well as arterial cholesterol levels, Molina-Chavez said. “There were also lower lipids and markers of inflammation in the liver.”

Although the effects were only noticeable at the highest doses, a level Amengual calls provocative for humans, he points out that rats metabolize finasteride differently than people.

“It’s an incredibly advanced drug. But we use mice as a model, and they’re extremely resistant to things that could kill any of us,” he said. . “So it’s not that crazy when you think about it that way.”

For hair loss and enlarged prostate, men take doses of 1 mg or 5 mg of finasteride daily, respectively. The fact that a survey of men showed a clear pattern that possibly taking one of these doses suggests that the drug is lowering cholesterol without the megadoses tested in mice.

The next step is for clinicians to begin monitoring cholesterol in finasteride patients or conduct clinical trials to confirm the effect. It may be especially important to understand how finasteride affects trans people, Amengol says.

“Over the last decade, doctors have started prescribing this drug for people who are transitioning from male to female or from female to male. In both cases, hormonal changes can cause hair loss,” he said. Can,” he said. “Interestingly, transgender people are also at increased risk of heart disease. So this drug could potentially have a beneficial effect in preventing heart disease not only in men but also in transgender people. “

Finally, Amengual notes, like any drug, finasteride is not without risk. People should consult their doctors to learn more.