Hair loss and David bars - The Next #65

Is finasteride bad for you, why I'm skeptical of David Bars, and more AI!

Hi there, and welcome to The Next - my take on health, wellness, and company building.

In the last few years I’ve founded 3 health brands (Kettle & Fire, Perfect Keto, Surely non-alc wine). I’m now working on Truemed, which allows health and wellness brands to accept HSA/FSA funds. Previously, I worked in tech and had no experience in CPG, DTC, or any other 3-letter industries.

If you missed past episodes, I recommend checking out The Great American Poisoning, my manifesto on what’s going on with our chronic disease crisis. Otherwise, let’s dive in!

🆕 What’s new

This tweet blew my mind:

https://x.com/AnnaLeptikon/status/1923114810025332811

Not to become an AI Guy, but it’s pretty remarkable that - just with a generalized model - GPT can already estimate one’s body fat percentage just by looking at you. And do so at accuracy levels that rival that of a full body DEXA scan - all from a photo!

Try it yourself (take a shirtless selfie and ask it to estimate your body fat percentage), or this other prompt:

https://x.com/jwmares/status/1927751720144117868

I’ve long been a believer that you can learn a lot about someone’s health from just looking at them. There are even whole fields like iridology (granted, not well-viewed by the scientific community) that claim one can get a sense of health issues just by looking at the irises. Much of Traditional Chinese Medicine is also based on these principles, that just by observing things like one’s tongue, you can get a sense for what may be ailing someone.

We will soon find out just how true many of these ideas are. Whether that’s earlobe creases pointing to early signs of heart disease, or thinning eyebrows pointing to thyroid dysfunction, AI tools will soon help us detect potential health issues early and often.

This is a very new idea for me, and one I’ve been thinking about non-stop since seeing the bodyfat data point. If you’re aware of any other relationships (like thyroid + thinning eyebrows) that AI could pick up on, I’d love to hear it. I suspect that always-on, lightweight AI diagnostics will create much more information around our health, and (hopefully) will lead to many more early interventions. And - in my view - create a lot more demand for products and services that can treat or prevent disease early.

💪 Health stuff

As I enter my mid-30s, I’m realizing that guys my age spend a lot of time thinking about their hair. Specifically, about how not to lose it!

I’m in the same camp, and only recently have started to notice my hairline moving just a bit. A friend told me that by the time the average man notices hair loss, they’ve lost about 50% of their hair. Not good!

Fortunately, there’s a magical solve called finasteride (aka Propecia). Today, about 2.6M men take a single pill daily, and keep their hair. Nearly 90% of men see results! FDA-approved! What could go wrong?

Unfortunately for some men, quite a bit.

Many of you may not be aware of something called “post-finasteride syndrome”. PFS is a cluster of symptoms - erectile dysfunction, loss of libido, genital numbness, brain fog, and even depression - that seems to impact 2-4% of people on the drug. And gynecomastia (man boobs!) is a side effect for 0.4–1% of men. Sexy!

Additionally, a survey of 71 healthy men who developed sexual symptoms on finasteride (and then quit) found that 94% still had low libido, and 92% had erectile dysfunction 3+ years after stopping the drug. There’s even a whole Reddit community with testimonials like this where men who’ve taken finasteride for some period of time share their side effects experience.

The Wall Street Journal wrote an entire piece on the popularity of finasteride, and the (disturbing) fact that many finasteride purveyors are not required to mention the side effect profile of this compound. If you’re the drug manufacturer, sure you have to read that long list of side effects. But if you’re simply compounding or re-selling the drug (like HIMS/Ro/etc), well, no disclaimer needed! Just publish your fun little ads wherever you want.

For most men, the effects of finasteride only last as long as you take the medication. Once you stop the drug, hair loss resumes. If finasteride is your only hope to keep your hair, it may make sense to take it. Just be aware that you’ll have to be in on it forever.

As real as the side effects are, they seemingly are not an issue for the majority of men. If you're already on finasteride and feeling fine, you probably shouldn’t panic. But if you’re determined to try out finasteride, there are ways to potentially reduce your risk.

First, I’d lower the dosage. Some studies indicate that lower doses (0.5mg or 0.2mg) still significantly reduce DHT and can improve hair, albeit perhaps slightly less effectively. Additionally, topical finasteride can improve hair growth, but with much lower systemic DHT reduction. Early studies have reported fewer sexual side effects with topical application versus oral, likely due to lower blood levels of the drug.

That said, I have no plans to take finasteride at any point, just given the impact on hormones.

Instead, over the next few months, I’m going to start running some experiments on myself. After doing some digging, I strongly suspect that peptides, supplements, and red light could play a big role in mitigating hair loss (as suggested on this thread) and other research I’ve done. A phase II molecule from a company called Pelage Pharma has found a promising route to working on hair loss by focusing on metabolism.

If hair growth is mediated by metabolism, well, I suspect that by focusing on things like inflammation, stress, red light, and certain peptides, one can probably cue the body into feeling okay to once again direct energy towards hair production. I’m not quite ready to share the stuff I’m trying, but will share a full report in 90 days after sticking to the protocol I’m on 😎. Check back in 90 days!

🤑 Biz stuff

You may have seen the recent news that David protein bar raised a bunch of money and is doing something like $100M+ in revenue within their first year of launch.

Their claim is the highest protein per gram of any protein bar. Here's what's in it:

• Milk protein isolate, collagen, whey

• Allulose, polydextrose, glycerin

• Modified plant fat (EPG)

• Natural flavors

• Cocoa processed with alkali

The key ingredient here is EPG, the modified plant fat ingredient that David Bar relies on to make their claim of the highest protein bar per calorie. Basically, EPG is a fat substitute that gives you the mouthfeel of fat, but with 0.7 calories per gram (instead of 9).

How? By chemically altering seed oils so your body can’t digest them.

I mean this literally: EPG is designed to pass through your digestive system without being absorbed. Why? Because if the body does not fully absorb it, the FDA says that the calories in that compound don’t have to count towards a product’s caloric intake!

The logic here is this: according to the FDA, if you ate a rock in shiny gold packaging, your body wouldn’t digest it. And so you could have a delicious, zero-calorie rock treat, with zero guilt. Awesome!

David Bar is a bit like that: leveraging the (insane) FDA approach to chemical regulation (known as generally recognized as safe, or GRAS) and strange labeling laws to make claims that make the product seem healthy. You see a similar thing with Olipop, a “healthy prebiotic soda” that makes their prebiotic + healthy claims based on being high-fiber… even though they use a liquid fiber that impacts your blood glucose in the same way sugar does!

What frustrates me is that these bars and other fake healthy products is that they’re marketed as "healthy" to people trying to improve their diet. Will David bars kill you? Unlikely, but it's sure not the health product the company would like you to believe.

We evolved to eat whole foods, and never encountered modified plant fats, artificial sweeteners, or isolated protein compounds. Yet today, we're flooding our systems with these lab-created substances. I'm afraid David Bar is just more of the same.

Any time you hear me rant about one of these fake healthy products (Olipop, David bar, whatever), you should both (1) avoid that product and (2) immediately try to invest in that company 😂. I’ve had issues with Oatly, Olipop, Beyond Meat, Impossible Burger… all companies that grew extremely quickly and raised at huge valuations. Most of these companies (with the exception of Olipop) have grown quickly and then quickly come back to earth. I suspect the same will happen with David, but only time will tell.

😌 Dope stuff on the internet

Some of my favorite things since the last newsletter (note: I don’t get paid to recommend anything here):

• 📰Article - Related to our discussion on hair loss earlier, I really enjoyed this piece comparing pharmaceutical drugs to the complexity of herbs and plants. As the article states:
  "There are many cases where a chemical extract that would have adverse effects on its own is nontoxic when the entire herb it came from is used all at once. A classic example is aspirin vs. willow bark, the plant from which aspirin is derived. Long-term use of aspirin (salicylic acid) is heavily correlated with stomach ulcers. Willow bark contains the *precursor* to salicylic acid, though it also contains many other compounds. When willow bark is eaten and first enters your body, it does not contain any compounds with adverse side effects. Willow bark actually does not get metabolized into salicylic acid until it reaches the large intestine, meaning that willow bark is physically incapable of giving you stomach ulcers.
  As another example: Hawthorn (a cardiotonic, or in other words a substance that has a beneficial effect on cardiovascular function) is notorious for its whole-plant synergy. It is empirically proven to be extremely effective when the whole plant is used, but it has no individually “active” constituents that are effective when used in isolation.”
  Biology has a surprising amount of detail. I’m getting quite interested in things like traditional Chinese medicine, herbs, and plant compounds that are underutilized in our modern lives. I suspect there are all kinds of herbs and compounds that could improve many of today’s health remedies that modern medicine ignores. If you know of any starter guides to things like herbs or Chinese medicine, please let me know!
  

• 📚Book rec - I really enjoyed reading Freedom’s Forge, a book about the industrialization of American industry to prepare for WWII. The book covers Henry Kaiser and Bill Knudsen, two titans of industry who led the charge to prepare American industry for the war effort. It’s a truly amazing story: in a matter of 18 months, America went from making tens of tanks and guns to churning out thousands each year.
  In a time when many are down on American manufacturing, I was inspired to read this and learn about a time 80ish years ago when American industry scaled up very quickly in time to win the war effort.
  

• ⌚Cool product - My friend Scott recently launched Conscious Talent, which I’m planning to use for future recruiting needs. I agree with his thesis: employees who are focused on self-development are likely to make better co-workers, partners, and employees. Congrats Scott for launching!
  

• 🎵 Music - This set from my guy Marsh is epic. Enjoy!
  

• 🏀 Random - I’ve been at Edge Esmeralda for the month and it’s been a blast. If you’re free the next 2 weeks, come hang for a bit in Healdsburg, CA with some other folks interested in neurotech, AI, longevity, and all kinds of things.
  

• 🔥Hot take - I suspect that statins are way worse for people than commonly understood, and that they are implicated in all kinds of neurodegenerative diseases (dementia, Parkinsons, etc). I’ll write more about this in the future, but for now am taking nattokinase (via Toku) to work on my lipids and telling healthy friends in their 30s to think hard before opting into a lifetime statin prescription.
  

• 🙋‍♂️ Ask - A friend is working on a book about how therapy can make one feel worse, not better. She’s looking for stories - if you have thoughts or experiences in this area, reach out via DM!

***

That’s all I got this month! Catch you in 30, and may your hair grow beautifully during that time.

• Justin