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5-alpha-dihydrotestosterone elevations associated with phentermine use.

Scott M Pearson1, Jennifer M Trujillo2, Michael T McDermott3

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Summary
This summary is machine-generated.

Phentermine use in a patient with metastatic prostate cancer led to significant elevations in 5-alpha-dihydrotestosterone (DHT) levels, despite concurrent dutasteride therapy. Discontinuation of phentermine rapidly lowered DHT, suggesting a direct association.

Keywords:
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Area of Science:

  • Endocrinology
  • Pharmacology
  • Oncology

Background:

  • A 72-year-old male with metastatic prostate cancer was treated with dutasteride to reduce 5-alpha-dihydrotestosterone (DHT) levels.
  • Phentermine was initiated for weight loss, a medication not previously reported to affect DHT levels.

Observation:

  • Upon initiating phentermine 15 mg daily, the patient experienced a rapid and profound increase in DHT levels, from 9.9 pg/ml to 174 pg/ml within weeks.
  • Discontinuation of phentermine resulted in a swift decrease in DHT levels, which returned to baseline (<20 pg/ml).
  • Reinitiation of phentermine led to a recurrence of elevated DHT levels, further supporting the association.

Findings:

  • A strong correlation was observed between phentermine initiation and marked elevations in serum DHT levels.
  • The effect was reversible upon phentermine discontinuation and reproducible upon reinitiation.
  • This association was noted despite the patient continuing dutasteride therapy.

Implications:

  • This case highlights a potential drug interaction between phentermine and DHT levels, which warrants further investigation.
  • Clinicians should consider monitoring DHT levels in patients on dutasteride who are prescribed phentermine.
  • The underlying mechanism for phentermine-induced DHT elevation remains unclear and requires elucidation.