OpenHealth Q&A

Concerns about Finasteride and Minoxidil Oral Pill - Rhabdomyolysis in a 24-Year-Old Cyclist

Hello everyone, I hope this isn’t the incorrect forum for my inquiry—I'm uncertain where this fits best, so any insights would be truly appreciated. For a bit of context, I’m a 24-year-old male who stays quite active, cycling daily (both indoors and outdoors) while also incorporating strength workouts into my routine. I was diagnosed with Coeliac disease at the age of 17 and have maintained a strict gluten-free diet for seven years. On February 1st of this year (2025), I began a treatment regimen that includes a combined oral tablet of finasteride and minoxidil, which I obtained from a prominent online retailer specializing in men's hair health in the UK. Regarding its effect on my hair growth, my experience has been overwhelmingly positive. I’ve observed significant improvements in texture and overall quality, often receiving compliments about my hair. However, I have experienced several side effects that vary in intensity. While I haven't dealt with the commonly reported issues like decreased libido or depressive symptoms, I have had instances of swollen hands and feet, episodes of breathlessness, and a racing heartbeat. After consulting with my doctor, I was told these symptoms are likely to diminish over time, so I continued with the medication. Now, concerning the rhabdomyolysis… Toward late February, approximately three weeks into the pill regimen, I began experiencing muscle cramps in my thighs while walking around my workplace and doing errands. At that time, I was heavily engaged in indoor cycling, so I attributed the discomfort to possible electrolyte imbalances or dehydration, attempting to address it accordingly. However, the cramps worsened over the subsequent week, culminating in my hospitalization on March 1 (after four weeks on the medication). Upon admission, my creatine kinase (CK) level was alarmingly high at 23,000, with both AST and ALT levels also elevated. I underwent aggressive intravenous treatment, and my CK peaked at 44,000 three days later. I endured nearly three weeks of severe cramps and swelling in my legs, which made walking nearly impossible. I was referred to specialists in endocrinology and rheumatology, who conducted extensive testing for autoimmune disorders, all of which returned negative. They recommended that I remain on the finasteride and minoxidil due to the continuous decline in my CK levels. Ultimately, my CK normalized to around 180; even after intense cycling sessions, my levels remained stable. Initially, we attributed the symptoms to some form of viral infection. Fast forward eight months without any complications, and I was feeling well while continuing the treatment. However, at the beginning of December, I began to notice similar cramps in my thighs again. I took the precaution of getting my CK tested, which revealed a level of 1,400. A follow-up test two days later showed an increase to 8,000, with again elevated liver enzyme levels. Ten days later, my CK level has dropped back to around 1,400, but I'm now deeply researching possible causes for these fluctuations. I would appreciate any input or experiences from those who might have faced similar challenges. Given the timeline of my symptoms coinciding with the initiation of the medication, I have decided to stop taking it for now. The swelling has subsided, yet I can't definitively link these episodes of rhabdomyolysis to the medications—perhaps I’ll only be able to make clearer connections much later. To consider against the medication as a cause, here are a couple of additional details: - Occasionally, I cycled without having eaten prior; could this influence my condition? I’ve stumbled upon information regarding CPT II deficiency, but I have no prior symptoms and no history of this condition. - My routine blood tests from 2021 and 2024 revealed elevated CK and liver enzymes (CK levels noted at 600 in 2021 and 1,400 in 2024) despite having no symptoms at the time, as I was actively training. I underwent liver ultrasounds each time, showing no issues, and no further investigations followed. Could the finasteride and minoxidil have exacerbated a pre-existing inclination toward elevated CK levels? I appreciate any thoughts or advice you can share—thank you in advance!

Answers (1)

12/17/2025, 2:50:57 PM

OpenHealth AI

Your experience with rhabdomyolysis, especially in the context of taking finasteride and minoxidil, is understandably concerning. It's wise to approach this situation with careful consideration of both your symptoms and your medical history. Here’s a structured response to your questions:

Main Points

• Rhabdomyolysis can be influenced by various factors, including medications, exercise, and metabolic conditions.
• Your symptoms and elevated creatine kinase (CK) levels should be monitored closely, especially after stopping the medications.
• It's essential to maintain adequate hydration and nutritional support, particularly during athletic activities.

Explanation

Rhabdomyolysis is a serious condition that involves the breakdown of muscle tissue, leading to the release of muscle fiber contents into the bloodstream, which can harm the kidneys. The timeline of your symptoms following the initiation of finasteride and minoxidil does raise questions about their potential role. However, the link isn't definitive, especially since you have a history of fluctuating CK levels.

Possible connections between your medication and symptoms:

• Finasteride and Minoxidil: While primarily used for hair loss, these can have side effects that manifest in various ways. Although less common, muscle effects and alterations in electrolyte balance can occur due to medication interactions.
• Exercise and Nutrition: Intense cycling, especially when not adequately fueled (e.g., cycling on an empty stomach), can contribute to muscle strain and rhabdomyolysis. Electrolyte imbalances from dehydration can also worsen muscle cramps and pain.

Next Steps

1. Stop the Medications: Since you've decided to stop finasteride and minoxidil, monitor how your body responds over the next few weeks. Track any returning symptoms or improvements.

2. Hydration and Nutrition: Ensure you are well-hydrated and consume a balanced diet rich in electrolytes (potassium, sodium, calcium) to support muscle health, especially when exercising. Consider eating a light snack before intense workouts.

3. Monitor Symptoms: Keep a detailed diary of your symptoms, including any muscle cramps, fatigue levels, and dietary habits, to share with your healthcare provider. This can help identify patterns or triggers.

4. Follow Up with Specialists: If your symptoms persist or return, consider ongoing consultations with your endocrinologist and rheumatologist to explore further metabolic or genetic issues such as CPT II deficiency, including testing specifically for fatty acid oxidation disorders if needed.

5. Regular Blood Tests: Given your history, regular monitoring of CK and liver enzyme levels can help guide your activity levels and nutritional needs.

It's understandable to feel concerned about your health, especially when navigating complex symptoms. Remember to take care of your overall well-being, adjusting your exercise and diet as necessary. If you have further questions or specific concerns develop, don’t hesitate to seek guidance from your healthcare team. You're not alone in this, and it's commendable that you're seeking out information.