ropcat said:
Thanks everyone. Yeah, looking at the Propecia charts seems consistent with what DrinkRum says. The inhibition of DHT is not going to increase that much if I up my dose. I guess the DHT that finasteride isn't inhibiting is continuing to chip away at my hair -- although I suppose I'm lucky that I got a five-year reprieve.
I'm getting more interested in switching to Dutasteride, or a generic equivalent, though. The biggest deterrent until now for me was the price tag. But looking at the prices on imported generics has made me a bit more positive about the idea. I wish I could consult a dermatologist about this, rather than self-medicating. But my derm would never even go into the topic of using a drug not currently indicated for male pattern baldness, much less using an imported generic...
We'll see. I'm putting off any decisions on regimen changes until the summer, and then I'll also maybe start researching surgical options... Good luck to everyone! finasteride DOES work -- just not forever.
Finasteride DOES work forever. As long as you take it, it will continue to suppress DHT production. But the body changes with time and as you grow older, your follicles might become more susceptible to the remaining DHT, etc. The science behind this part of balding is still being reasoned out by the medical community.
Imagine never taking finasteride. You would've started balding at, say age 19, and the balding process would have accelerated for five years, so at age 24, the rate at which you are balding would be greater than at age 19. This is simply the process of balding as we know it. As mentioned, while this is well documented, the exact mechanism of this "balding acceleration" is unknown, but it is believed that the follicles are programmed genetically to become more susceptible to DHT as the balding process progresses.
While taking finasteride, this "acceleration" still goes on. So while you might be doing a good job blocking a lot of DHT, in the long-run, you might start to slowly bald again (but not as fast as if you hadn't taken finasteride). But the balding process works differently for each individual -- some people can take finasteride their entire lives and never be bothered with balding again -- maintaining their hair count for 10-15+ years. For other people, finasteride just doesn't work at all.
So while dutasteride does inhibit more DHT (90%) than finasteride (70%), the "acceleration effect" might still prevent complete hair loss prevention. Also, it could be that as DHT levels decrease in the body, the body increases sensitivity to DHT and DHT uptake. And DHT, since it inhibits both enzymes that produce DHT, can create more side-effects and has unknown long-term consequences. The AR-1 isozyme (finasteride only inhibits AR-2) is found in scalp skin but has been found in brain tissue (myelin sheath in neural cells!) and in connective tissue -- thus making it a potentially very dangerous enzyme to inhibit almost completely.
This is a long enough post, so I will end it here. I hope some of you out there can now better understand how this sh*t works. 8)
D.
