Cutting thirds of Finasteride 5mg into 6ths and then taking
- Thread starter AlexD
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Good question. While the blood half-life of finasteride is only a few hours, it forms an essentially irreversible bond with the active site of type-2 5-AR. This means restoration of enzyme activity requires synthesis of new enzyme, a matter of several days, at least.
That is, inactivation of 5-AR is only perpherally-related to Finasterides' pharmacokinetics--- 5-AR stays inhibited long after the drug has left the blood-stream. Moreover, the dose-response curve for finasteride is essentially flat over a broad range. I.e, a little works as well as a lot.
This means that there is no point in trying to micromanage blood levels and that there is a lot of treatment leeway. E.g., back before finasteride was available in the 1 mg. propecia dosage, some docs used a 5 mg proscar tablet every three days or so. This seemed to work about as well as using it every day. Many of my patients quarter a proscar tablet as well as they can (lots of lee-way here too). Then use one-quarter a day, more or less, and skip every fifth day.
Peter H. Proctor, PhD,MD
That is, inactivation of 5-AR is only perpherally-related to Finasterides' pharmacokinetics--- 5-AR stays inhibited long after the drug has left the blood-stream. Moreover, the dose-response curve for finasteride is essentially flat over a broad range. I.e, a little works as well as a lot.
This means that there is no point in trying to micromanage blood levels and that there is a lot of treatment leeway. E.g., back before finasteride was available in the 1 mg. propecia dosage, some docs used a 5 mg proscar tablet every three days or so. This seemed to work about as well as using it every day. Many of my patients quarter a proscar tablet as well as they can (lots of lee-way here too). Then use one-quarter a day, more or less, and skip every fifth day.
Peter H. Proctor, PhD,MD
Thank you very much for that post, it was very informative. I have another question if you have the time to answer, as I'd imagine you are very busy:
I had been taking 1/4th a pill of 5mg Finasteride and 2ml of Rogaine (5% minoxidil) for about half a year, and it worked great. Then I started experiencing massive shedding, and my doctor bumped me up to 1/3rd of a pill a day.
Now the thing is, after a little over a year, I am losing all my hair again. Literally, EVERY time I run my hand through the top of my head I am finding 4-5 hairs in it. Then when I run it through the sides nothing falls out. I am on 1/3rd a pill of 5mg Finasteride nightly and Rogaine, and am suddenly seeing massive regression in all the hair I gained. What could be causing this? It is causing me a great deal of distress
This started in November, and has only gotten worse. What could be the cause?
I had been taking 1/4th a pill of 5mg Finasteride and 2ml of Rogaine (5% minoxidil) for about half a year, and it worked great. Then I started experiencing massive shedding, and my doctor bumped me up to 1/3rd of a pill a day.
Now the thing is, after a little over a year, I am losing all my hair again. Literally, EVERY time I run my hand through the top of my head I am finding 4-5 hairs in it. Then when I run it through the sides nothing falls out. I am on 1/3rd a pill of 5mg Finasteride nightly and Rogaine, and am suddenly seeing massive regression in all the hair I gained. What could be causing this? It is causing me a great deal of distress
This started in November, and has only gotten worse. What could be the cause?
Possibilities:
You hair growth has gotten synchronized. This damps out after a while.
You might have developed tolerance though this seem far too early
Also Remember, hair stays in the loss phase for 2-4 months and then sheds. So there is always a 2-4 month lag in shedding from whatever caused it.
Peter H. Proctor, PhD,MD
You hair growth has gotten synchronized. This damps out after a while.
You might have developed tolerance though this seem far too early
Also Remember, hair stays in the loss phase for 2-4 months and then sheds. So there is always a 2-4 month lag in shedding from whatever caused it.
Peter H. Proctor, PhD,MD
Once again, thank you for the post. I am hoping it's just a shedding and not actual loss - would the fact that a lot of the hairs have those white bulbs on the ends mean it's better than not? (The reason I ask is because when I first started experiencing hairloss, the hairs didn't have bulbs on the end and were generally MUCH thinner than the end that was cut).
What causes a tolerance to finasteride, and what can be done to avert/compensate for the tolerance? Would an increased dose help? And for other options, I know of dutasteride, but doesn't that function very similarly to finasteride except it also blocks another enzyme?
Thanks for the info
What causes a tolerance to finasteride, and what can be done to avert/compensate for the tolerance? Would an increased dose help? And for other options, I know of dutasteride, but doesn't that function very similarly to finasteride except it also blocks another enzyme?
Thanks for the info
White bulbs mean regular telogen shed hair. If there is not this bulb, it is likely just hair breakage. Unless you are on chemotherapy for cancer.
1. Reflex hyperandrogenicity. Increased testosterone plus increased testosterone.
2. Just because. E.g., the balding process has just progressed even without androgenic stimulation. DHT (or whatever ) is just the initiator of a long chain of events which leads to balding. Once the process initiates, other things become more important.
Solution is to use agents that work further down the chain that leads to balding. In deference to our host, I won't list them.
So is the verdict that the hair loss is simply shedding? I understand without pictures this doesn't help, but I am still wondering. I feel rather obtuse in understanding if this is due to a bad batch of Finasteride or because of a shed. Either way, it has/had me somewhat anxious.
AlexD said:
Depends. "Shedding" is part of the normal hair cycle. Normal shedding is 50-150 hairs per day . Sometimes this can seem like an awful lot. Normal shed "telogen" hairs all have a little white bulb on the end. So this means nothing.
Peter H. Proctor, PhD,MD
I'm losing more than 50-150 hairs a day; every time I run my hand through my hair I come out with 4-5 hairs, whereas a few months ago I could do the same thing and nothing would come out. Also an increased amount of hair in the sink and on books while studying, both of which didn't happen last spring/summer.
I guess I should go to a doctor, but the one I went to for Finasteride in the first place is in a city 200 miles away (that I live in when I'm not at school), so what should I do? And what should I ask for?
I guess I should go to a doctor, but the one I went to for Finasteride in the first place is in a city 200 miles away (that I live in when I'm not at school), so what should I do? And what should I ask for?
AlexD said:
No way to tell for sure, not medical advice, ymmv, consult your local dermatologist, etc. etc. But 4-5 hairs when running your hands thru your hair is probably not abnormal, depending.
Anyway, pattern loss is primarily not a matter of losing too fast, but of not replacing what you lose. As for previously getting "nothing"-- in some persons, the rate of shedding is very cyclical. The standard 50-150 hairs a day is merely an average. Remember, no hair in males lives for more that 2-4 years or so. If you worry about every shed hair, you will drive yourself crazy.
Peter H. Proctor, PhD,MD
Haha fair enough. Well you've been a huge help in helping me become informed, and I just have one question: Is it a good sign if the hair on the bulb end is thicker than the other side? Because for a lot of my hairs that seems to be the case; the reason I ask is because from what I remember regarding hair loss, the follicles get smaller and smaller until they close due to DHT (I may be reciting this incredibly wrong, but that was my general understanding). Or is it also inconclusive? Otherwise, I guess it's off to visit a dermatologist to ask away, haha.
Thanks again for the information.
Thanks again for the information.
AlexD said:
Inconclusive. Normally ( but arguably not always ), as baldness progresses hairs get progressively miniaturized with each succeeding hair cycle, not during the hair cycle itself. However, people on medical treatment sometimes do find hair coarsens during the cycle. I.e., the part closer to your scalp grows out thicker than the hair further out as treatment starts to work.
Peter H. Proctor, PhD,MD
Hmm. Out of curiosity, would you be able to PM me, or could anyone post here, other treatments in addition to Minoxidil/Finasteride that work well? I know Nizoral does, but from what I've heard it makes your hair look really crappy after using it. I kind of want to avoid that <.<
And also, any studies with those hair loss treatments that show positive results - we all know how popular things like Nioxin and Kevis are.
And also, any studies with those hair loss treatments that show positive results - we all know how popular things like Nioxin and Kevis are.
AlexD said:
There are lots of other treatments that can be helpful. In fact, I have patents on some of them. Our host asks that people not market here. so I will not.
The drug companies gave up on this area a decade or so ago. Not enough of a market to justify the $500 million plus to do the trials. So we fall back on the older methodology of clinical observation and cross-overs to determine what works. This was how drugs were developed in the golden age of drug development (about 1935-to about 1964 ) when the majority of presently-used classses of drugs were discovered.
Some examples: SODs (superoxide dismutases ) stimulate hair regrowth. Examples include copper peptides and nitroxides such as TEMPOL. TEMPOL is currently in clinical trials for radiation-induced hair loss at http://www.mitos.com. It also works for pattern hair loss. In fact, the animal trials show TEMPOL may work more by stimulation of hair regrowth after radiation than by preventing the hair from falling out in the first place.
Anti seborrheic dermatitsi agents such as nizoral, etc. can also help. In fact, the use of "tar"to treat hair loss is noted by a 1st century Greek medical writer. There is no money in any of these for a drug company, so again trials have not been done. I could go on and on.
Peter H. Proctor, PhD,MD
This is all really interesting. I did not know trials were that incredibly expensive; nor did I know that there were a lot of options. Seeing as I'm studying economics, I've always been behind the school of thought that if the demand is great enough, there will eventually be a source of supply. The costs for these trials are astronomical, but if things such as that new experimental drug (RU *numbers*) work as well as smaller scale tests say, how could any major pharmaceutical NOT step up and pay the cost? 500,000,000 is a lot, but with the number of people going bald, and with that number most likely remaining at the same % amount, wouldn't some of the more effective products have a large enough market to warrant the cost?
This is diverging from the original intent of the topic, but as I am losing more hair I get more and more curious on alternate methods. And also, on the good news side, I am seeing a bit of regrowth on the temples where I was losing a ton of hair, but now I'm starting to see somewhat of a more distinct horseshoe, which I hope gets covered up by the regrowth. We shall see, we shall see: I'm in a race at this point, get in sub-10% bodyfat levels before I need to shave my head, haha.
This is diverging from the original intent of the topic, but as I am losing more hair I get more and more curious on alternate methods. And also, on the good news side, I am seeing a bit of regrowth on the temples where I was losing a ton of hair, but now I'm starting to see somewhat of a more distinct horseshoe, which I hope gets covered up by the regrowth. We shall see, we shall see: I'm in a race at this point, get in sub-10% bodyfat levels before I need to shave my head, haha.