Cycling off Propecia to reverse tolerance

[Adrian1]

After 6 years of AWESOME maintenance and regrowth using Finasteride, I now find myself (in my seventh year) losing ground fast. I've gone from no noticeable hairloss to noticeable diffuse thinning within less than one year.

After asking around on this site and pressing my derm on the matter, I've learned that it is theoretically possible for the body, after prolonged exposure to Finasteride, to "build" more DHT receptors or "upregulate" the expression of the receptors, making them more sensitive to DHT, thereby causing what you could call "tolerance" to the drug.

Since I'm already splitting Proscar tablets into 4 pieces and don't want to increase my dosage above that, I'm wondering if cycling off the drug for a while would return my receptors to "normal," which would allow me to go back on Finasteride and "start over," so to speak.

Does anyone know if this would work or has tried cycling off then going back on and had success? Any info would be greatly appreciated. Thanks!

 

[damnthis]

Very interesting.

Could you also provide a bit more info on where you were loosing hair etc.

If getting of the drug causes the receptors to go down again and the upregulation to stop then I hopes it happens faster then the time it took to get there (the 6 years)

Do you also experience other signs of male pattern baldness again, for example the famous itching, whispier strands...? (Maybe you are experiencing a synchronized shed (doesn't the hair cycle aproximately every five or six years?))

kee us updated

 

[Adrian1]

Yes, I have clear signs of male pattern baldness. Mostly frontal diffuse thinning, less pronounced thinning on the top. Hair is much whispier than it was even this past summer. If I look at individual hairs after a "pull test," you can easily see how the tips are much more pigmented and robust than the bases, which are extremely light and minituarized. It's THAT obvious. I'm pretty amazed at how dramatic the change has been. It's like my hairloss resumed exactly where it left off 7 years ago.

Yeah, the idea that it could take the same amount of time to return my receptors to normal as it did to render them abnormal is freaky. Upregulation of receptor expression is believed to occur fairly spontaneously, which would explain why after six years of remarkable success using Finasteride, my hairline is suddenly in the toilet. It took six years for me to become tolerant to finasteride, but it could take less with some people, more with others, perhaps never for some.

My big concern is whether or not my receptors will ever return to normal. Am I now and forever ultra sensitive to DHT? Am I more prone to prostate problems? Will the rest of my hair literally shrivel up and my prostate explode the moment I stop using the drug? No one seems to know...

 

[Britannia]

ensativo: Dont know what to suggest. minoxidil? Duta?

 

[mister B]

cycling propecia

I've had the idea of experimenting with cycling the use of propecia, such as 3 mo. on 1 mo. off ....or something similar to prevent exactly what you are describing. Ironic I was already worried about that theory. If you take notice many people report an analogous effect with other meds. One of my parents was recently commenting on how her arthritis medication just doesn't do it anymore. And ironically she has been on it 4-5 yrs......I think your onto something big here.

 

[Private Ryan]

i just completed cycling. i reduced the dosage slowly to 0.5mg for about 1month before going by to 1mg. planning to do this every 2-3months.

 

[Adrian1]

Private Ryan, when you cycle down, do you notice increased shedding?

 

[Private Ryan]

Private Ryan, when you cycle down, do you notice increased shedding?

nope. didn't feel any noticeable different during that period. i took it down nice and slow. starting with 0.5mg every other day with 1mg inbetween and then to 2day 0.5mg and the third day 1mg and so on until reaching 0.5mg for one month.

now back to 1mg.

 

[Adrian1]

Thanks! I'll do the same and keep you posted on how things work out.

 

[mister B]

suggest?

Hey britannia...if you don't know anything to suggest why post?....alot of your posts are like that.....hell...I'm new on this board and sh*t like that makes me wonder. why be a smart a$$ about everything. Why don't you go into the hairloss buisness.

 

[TheOliviaTremorControl]

Wow, that was angry.

Mister B, Brittania was merely suggesting some other medications that Adrian could go on. Minoxidil and Dutasteride are both helpful in the male pattern baldness department.

I have no idea why his post made you so angry. He actually WAS giving suggestions, not just "posting without knowing anything".

I mean, nobody really can know anything about male pattern baldness, anyway, since there is still a lot we don't know.

Regardless, calm down.

 

[Weepy]

After asking around on this site and pressing my derm on the matter, I've learned that it is theoretically possible for the body, after prolonged exposure to Finasteride, to "build" more DHT receptors or "upregulate" the expression of the receptors, making them more sensitive to DHT, thereby causing what you could call "tolerance" to the drug.

Since I'm already splitting Proscar tablets into 4 pieces and don't want to increase my dosage above that, I'm wondering if cycling off the drug for a while would return my receptors to "normal," which would allow me to go back on Finasteride and "start over," so to speak.

Does anyone know if this would work or has tried cycling off then going back on and had success? Any info would be greatly appreciated. Thanks!

The upregulation is probably what is going on. I suspected as much a month or so ago when I was thinking about it. I wrote a post on it back then.

It might be possible to "control" upregulation through "cycling" I suppose. But individual results will probably vary widely. You may actually trigger the exact opposite intended effect by cycling.

Another thing to consider, you may not get the results you want through this "cycling."

If the receptor has been upregulated, it is likely that you will see results with an even more potent inhibitor, such as dutasteride. But carefully weigh this decision.

The bottom line is actually very simple. It is difficult to "fight" genetics, so keep this in mind: finasteride and minoxidil only buy you time. I'd recommend staying the course. If you find that you cannot recover what you've lost, it may or may not be time to consider other alternatives. This includes "alternative" topicals, as well as surgery.

I'm truly sorry you're going through this. It reminds me that I may or may not go through it, too. But more likely than not, I will go through it. Anything else I can say at this point is just this: I fuking hate this.

 

[Weepy]

Since I'm already splitting Proscar tablets into 4 pieces and don't want to increase my dosage above that, I'm wondering if cycling off the drug for a while would return my receptors to "normal," which would allow me to go back on Finasteride and "start over," so to speak.

Sorry, forgot to address this part.

IMO, down regulation is always a possibility, but is an extremely unlikely scenario, I'm sorry to say. Once you've pulled the genetic trigger, there's just no way to retrieve the bullet.

Again, I suggest staying the course. The more logical answer, if you wanted to stick with oral 5AR-inhibitors, would be dutasteride. Alternative therapies abound as well.

Again, I'm truly truly sorry. You have my best wishes.

 

[Britannia]

Re: suggest?

Hey britannia...if you don't know anything to suggest why post?....alot of your posts are like that.....hell...I'm new on this board and $#iT like that makes me wonder. why be a smart a$$ about everything. Why don't you go into the hairloss buisness.

If I was being a smart *** about everything surely I would have simply made something up and pretended I knew what I was taking about, rather than be honest and say I didnt know what to suggest.
Now we are minus SE-Freak and Radio I help out more newbies on this forum than any other when it comes to advice on hair loss treatment. Im constantly getting PM's from newbies after advice or suggestions. I was a newbie once and I know what its like to be lost in a sea of fact, fiction, snakeoil salesmen and scams. That is why I stick around and offer advice where I can, and where I cant - Ill simply admit to that fact. Oh and why I dont go into the hair loss business? I enjoy helping people out for free without having half my mind on profit margins and overheads. If youve got a problem with my posts then simply dont read them.

 

[Weepy]

Re: suggest?

If I was being a smart *** about everything surely I would have simply made something up and pretended I knew what I was taking about, rather than be honest and say I didnt know what to suggest.

No, I believe you were on target, Britannia. As I say, dutasteride may actually "help" with his "tolerance" (for reasons as above).

 

[jumpedthegun]

maybe somebody can explain this to me.

even if it is theoretically possible for your receptors to "upregulate," why would they do so. i could see how some part of your body that needs dht might upregulate to ensure it gets enough, buy dht is an enemy to your hair, it is unwanted, and it makes no logical sense to me that the receptors in your hair follicles would upregulate to try to get more dht.

in other words, just because it is theoretically possible that i could sleep with sienna miller, doesn't mean that's gonna happen. it's only gonna happen if she wants me, just like the receptors are only gonna upregulate if they want more dht.

sienna miller is a sexy beast. jude law is a doosh.

 

[Weepy]

maybe somebody can explain this to me.

even if it is theoretically possible for your receptors to "upregulate," why would they do so.

They upregulate, because they have been chemically induced to do so (if this is, indeed, the mechanism behind "finasteride tolerance"). There's no other value judgement to be made.

 

[jumpedthegun]

maybe you have a degree in a relevant field, as i do not, but they haven't been chemically induced to do anything. finasteride reduces dht; it does not affect your receptors. the only reason for your receptors to upregulate is if they need more dht, which they don't.

now, if you are saying the upregulation happens independent of finasteride, simply because your genetics determine it to happen at some point in your life, then i'll buy that. but, i wouldn't call that a tolerance to finasteride.

 

[Weepy]

maybe you have a degree in a relevant field, as i do not, but they haven't been chemically induced to do anything. finasteride reduces dht; it does not affect your receptors. the only reason for your receptors to upregulate is if they need more dht, which they don't.

now, if you are saying the upregulation happens independent of finasteride, simply because your genetics determine it to happen at some point in your life, then i'll buy that. but, i wouldn't call that a tolerance to finasteride.

No, what I am saying is that there is a dynamic interplay among a number of variables that includes a cascade of events that are poorly understood. Part of the "chemical induction" I am talking about is the reduction of [DHT] by finasteride.

The mechanism I am thinking about is similar to that seen in squalene synthase inhibitors used to treat hypercholestoerlemia. The drug induces upregulation of the LDL receptor by blocking a key step in cholesterol biosynthesis.

If we apply this concept to our situation, this is somewhat similar to the T=>DHT blockade by our friend, finasteride. By blocking this key step, you trigger (through several events) upregulation of the Androgen Receptor.

That's what I am saying. This is the "why." There's no other "why" involved.

 

[jumpedthegun]

Precisely. You couldn't have made my point better.

In the mechanism you use as an analogy, it makes sense your body would upregulate LDL receptors because your cells NEED LDL. Now if you are going to argue that your cells need DHT, and that your body upregulates all receptors, including those in your hair follicles (to our dismay), in order to get DHT where it is needed, then I'll buy that. But I don't think that's the case. While it is possible there may be some function for dht beyond puberty, i think your body gets all potential dht requirements even at finasteride reduced levels.

I understand people want an explanation for reported cases of "finasteride tolerance." I think a better explanation is that as people get older, their receptors get more sensitive to DHT simply because they are genetically predisposed to do so. At some point, that sensitivity reaches a level where even with reduced DHT from finasteride, you are going to start losing your hair again.