sup jumes so I am back with another video about everybody's favorite obsolete blood pressure medication that has been reappropriated as a hair loss treatment oral [Applause] minoxidil so yeah I know I said I hate talking about this subject but after my last video I got really interested in some of the more recent research on the connection between oral monoxy and heart problems in my last video on lowd do oral monox for treating hair loss I talked about the flaws and biases in the existing review articles that present oral monoidal in a favorable light as well as bringing some attention to concerning new details that prove oral monoxil most serious side effects like paracardial affusion can happen even at doses as low as 0.25 millgram daily paracardial Fusion is a buildup of fluid around the heart this fluid can interfere with the pumping of the heart and when that happens it's called a cardiac tood and the fluid has to drained urgently or you can die from it we know that paracardial diffusion was frequently reported when oral oxidal was used as a blood pressure medication for example in this report from 1981 paracardial affusion was seen in 4.8% of people on oral monoidal we also know that paracardial affusion can happen with lowd do oral minoxidil because it was documented in a recent case report of a 40-year-old woman who developed it after taking just 0.25 mg of oral mon oxidal for 3 weeks we also know that the studies touting the safety of lowd do oral mon oxal for hair loss are based on retrospective analyses which are biased towards including subjects who do well on oral monoxido for example this study that some people brought up in the comment section of the last video I made on oral monoxido it seems to show a low incidence of side effects from lowd do oral mon oxidal however the study only included people who were on oral mon oxidal for at least 3 months so this study would not even have included someone like the woman in the case report who developed a paracardial fusion after only 3 weeks of oral Min oxidal usage unfortunately to get a real idea of the incidence of serious side effects from lowd do oral mon oxidal you would have to do a prospective trial and that has not been done and maybe is never going to ever be done on oral mon oxidal all of this is pretty scary stuff especially considering how virtually everybody is buying oral monoxido through gray Market sources or getting prescriptions from dermatologists who don't have any training in Internal Medicine and don't do any cardiac monitoring whatsoever but this all may be one why is it that oral minoxidil is so damn dangerous to human beings well fundamentally minoxidil was developed as a blood pressure medicine and all blood pressure medications can cause serious side effects they all have the risk of dropping the blood pressure too much which can cause people to pass out but minoxidil is peculiar in two ways number one is that it causes hair growth which is something that no other blood pressure medicine does but we're lucky that it does of course since it turned out to be the best General hair growth stimulant available which remains true even today but at the same time minox also has the potentially deadly side effect of pericardial affusion and cardiac componant that's also something that no other blood pressure medication causes so topical minoxidil was developed specifically to minimize the amount of minoxidil that gets absorbed into the bloodstream and in the decade since topical minoxidil was made available it looks like it has not been associated with any documented cases of paracardial affusion but unfortunately that is not the case with oral monox which is what I showed in my last video as there is still a risk of paracardial affusion even with doses as low as 0.25 Mig per day so no other blood pressure medicine causes hair growth but no other blood pressure medicine causes this weird buildup of fluid around the heart either so what is it that makes oral monoidal so different not to mention so dangerous compared to other blood pressure medications all this really made me wonder if there's possibly some association between minoxidil ability to grow hair and its propensity to cause fluid buildup around the heart so I decided to do some balls deep research on this subject and as it turns out there is indeed a link between oral mon oxidal ability to grow hair it also caused fluid buildup around the heart the research which addresses this hypothesis comes from my favorite hair loss researcher of all time the great Dr Tru also known as the morn soless scientist salarian of the hair loss research field just last year Dr Tru published a letter to a medical journal about the risk of paracardial affusion with lowd do oralin oxidal in the letter he commented on the same case report that I covered in my last video namely the 40-year-old woman who developed paracardial affusion on just 0.25 Mig of oral mon oxidal in this letter Dr trua brings up yet another case from his own practice of a young woman who developed paracardial affusion this time on 1.25 milligram a day of oral mon oxidal which is still within what is defined as lowd do oral monoidal by a lot of dermatologists most studies of lowd dose oral mon oxidal have doses ranging anywhere from 0.25 Mig daily to 5 Mig daily so we're not talking about the 10 to 40 milligrams of oral mon oxidal used to treat high blood pressure these are doses comparable to what most people are now using to treat their hair loss this woman on just 1.25 migs of oral mon oxidal per day develops shortness of breath discomfort while breathing when lying down chest pain Li headedness and swelling in the legs a cardiac ultrasound showed fluid build around the heart this all developed within just a few weeks of starting lowd do oral minoxidil so this is yet another documented case of paracardial Fusion from lowd do or mon oxidal but what is really interesting about this letter from Dr trou is that he proposes an extremely interesting not to mention highly plausible Theory as to what causes paracardial affusion from oral minoxidil it turns out there is a rare genetic disease called kantu syndrome now genetic diseases are due to defects in our genes even though most genetic defects are incurable scientists have nevertheless still managed to learn a lot about what the different genes in her body do by studying people with genetic defects a good example of this is the families who were first found in the Dominican Republic back in the 1970s who turned out to have a genetic defect in the gene that makes the five Alpha reductase type 2 enzyme men who were found to have this defect did not develop hair loss acne or enlarge prostates and this was the clue that showed that the trash hormone DH T was responsible for causing all these horrible problems this led to the development of 5 AR blockers like finasteride and dutasteride which we all of course benefit from today so contrary to popular belief finasteride was not some prostate drug that was discovered to stop hair loss by accident it was developed knowing full well it would treat hair loss it was just approv to treat en large prostate first as that was considered a more serious issue minoxidil hair growth benefits on the other hand truly were discovered by accident because no one expected a blood pressure medicine would cause hair growth so kantou syndrome is another disease caused by a genetic defect and one of its features is that people with the Syndrome have thick scalp hair that extends onto the forehead and generally increased body hair overall now this Syndrome has other abnormalities associated with it but what is most interesting though is that 80% of cases have some heart abnormalities and 25% of cases have pericardial affusions so there's some very clear similarities to Minoxidil here and that we see increased hair growth as well as pericardial affusions in people who have Cantu syndrome so that raises the question is this just a coincidence if not then what is the genetic abnormality in kantu syndrome and is there any relationship to how minoxidil works well the exact mechanism of how minoxidil Works isn't fully known but probably the most likely mechanism is the effect minoxidil has on a specific potassium channel in cell membranes this channel is called an at P activated Channel and minoxidil actually opens up this channel which is a completely unique mechanism that no other blood pressure medications have opening this channel is thought to trigger the antigen growth phase of the hair growth cycle however these pottassium channels are located not just in the hair follicles but also in other organs including the heart so just to reiterate a point that often comes up the mechanism of an oxol has nothing to do with being a vasodilator in enhancing blood flow all blood pressure medications enhance BL flu but only minox increases hair growth and the reason for that is its unique mechanism of opening up the specific potassium ion channel in the hair follicle cells so here's where things get really interesting jumes you see most cases of Cantu Syndrome have now been linked to a mutation in a gene called abcc9 what protein does this Gene encode for you may Wonder well it encodes for the exact ATP activated potassium channel that minoxidil opens up not only that the abnormality in the channel caused by the mutation is a gain of function abnormality which means it makes the channel more active it is an activating mutation so it actually does the same thing that minoxidil does it opens up the channel so minoxidil when taking orally effectively puts your body in the same state that it would be if you have kantu syndrome so it will regrow your hair while putting your cardiovascular system in serious Jeopardy so this similarity between kantu syndrome and Min oxidal was actually not first noted by Dr Tru in an article published in 2006 the connection between Cantu syndrome and minoxidil was first proposed but Dr trab unlike the average dermatologist prescribing oral oxal is very well read and a well-published researcher who I should note is also very skeptical of the reality of postf finasteride syndrome but that is another topic I've already published many videos about and I'll link a few of them below if you're interested in learning more about that so from this research we know that opening up this specific ION channel can lead to hair growth par cardial affusion and other cardiac abnormalities it doesn't matter if you open it up because of a genetic defect or through the use of a drug like minoxidil the effects will be the same so This research goes a long way towards explaining why minox has both hair growing properties and a risk of cardiovascular complications also with the addition of Dr tru's case report there are now two documented cases of paracardial affusion with lowd do oral oxidal and I imagine we're going to keep seeing these case reports piling up due to the sudden Surge and pop popularity of oral Min oxidal for hair loss which was considered obscure up until a few years ago so some people might think these dangers may also apply to topical minoxidil fortunately though paracardial diffusion with topical minoxidil usage has never been reported in a peer-reviewed journal despite the hundreds of thousands or possibly even millions of people who have used topical minoxidil over the past few decades it is an over-the-counter drug after all so very likely it is completely safe and whatever the case it is clear that topical monoxy is definitely the safer way to use Minoxidil to treat hair loss so Dr trou closes all this with a note of warning that I'll read in full quote lowd do oral minoxidil has gained popularity as an off-label pharmacologic treatment for cosmetic conditions however as such it should be prescribed with caution and monitored by physicians experien and aware of the adverse effects of the drug and potential medical legal issues nevertheless the drug is currently available online although the practice of unattended consumer use of the drug is discouraged for obvious reasons of consumer safety unquote I don't think I can add much to that but next time someone wants to write a comment about how there are doctors who disagree with me well here is Dr trp easily one of the most accomplished hair loss researchers in human history who shares my concerns about oral monoidal so if you'd rather listen to a pro- oral monoidal doctor like Dr Gary linkov who conveniently just so happens to sell and profit off of oral mon oxidal instead of Dr Tru who has no conflict of interest whatsoever then that of course is your business and I don't judge you for that like I have said I am libertarian when it comes to the subject of drugs but please make sure you are aware of the risk and also make sure you have a doctor who has training in Internal Medicine or Cardiology before embarking on what could be a perilous course of action and with that I think I'm going to lay off the oral mon oxidal content for a bit otherwise the salt from the oral mon oxidal Fanboys is going to raise my own blood pressure and give me a heart attack so we'll move on to other hair loss subjects soon so I'll see you next time God bless