Do I have to accept being bald? Fog on Microdosed finasteride

[finornottofin]

I originally tried 0.5mg oral finasteride EOD for ~4-5 weeks. 2-3 weeks in I noticed significant brain fog but I had continued with treatment because I didn't really recognize it as a side effect of finasteride. Eventually I caught on with what was going on and had to stop and made a full recovery.

Recently I got some topical finasteride at 0.1mg/ml (0.01%). I have been using this for almost a month and was very happy when I made it past the 3 week mark with no problems. Unfortunately the fog came back recently after about a month. I've still continued but it's been getting significantly worse now and I think I have to either titrate down or just quit finasteride. I have looked into what neurosteroid deficiencies could have caused this but deterministic treatment of those issues would require significant bloodwork and supplementation/drugs (or just trial and error whilst on finasteride) I have no history of depression but I do stress easily also I have had no other side effects on finasteride.

Not sure if 0.005% will accumulate similarly and honestly given how aggressive my loss is for my age I doubt its going to do anything.

Should I just accept being bald at this point? I am not even 25 yet so it does not feel good at all. Since I'm a diffuse thinner, I'm sure minoxidil could buy me a good couple years but i see no difference between balding now and at 28 especially since min isn't doing anything to prevent loss. I was gonna order eucapil but between their shipping times and general uncertainty about its efficacy I'm not even sure if its worth it. Was thinking of doing 0.005% finasteride EOD, eucapil, min + dermarolling but the amount of topicals to deal with here is giving me a headache. No official pharmacist I know is willing to compound min + finasteride at that concentration and so I'd be doing the mixing with crushed tablets in an official min solution( which I have no way of confirming is dissolving equally?) .

Do I waste time on these less efficacious treatments (when it comes to preventing miniaturization) or just move on with my life. I get the feeling its time to move on but I'm sure as you all understand its hard to let go.

 

[user394587]

If I was in your position I personally wouldn't bother with minoxidil alone, it'll buy you a few years at best, especially if you have aggressive diffuse thinning. Unfortunately, finasteride and dutasteride are the only thing we have to fight hairloss long term that has any sort of scientifically proven efficacy.

I'm not a doctor, but with that said, if I recall correctly you did make a post about whether or not you should start finasteride with low testosterone. Your test results were extremely low for total T, which could possibly indicate primary or secondary hypogonadism. I think that regardless of what you decide to do in terms of your hair loss situation, you should go and see an endocrinologist about that. Those are not healthy T levels, especially for someone who isn't even 25 yet.

I bring up your total T levels because one of the common side effects of having low T is brain fog. It could be a case where without finasteride, you're hanging on by a thread because you have DHT in your system. When you take finasteride, you're relying on your residual DHT levels and your T levels to carry out androgen dependent functions in the body. Given that your total T levels are so low, when you're reducing your DHT, I think it might be a case of you just not having enough androgens in the body to avoid having side effects. I'm not surprised to see that you have side effects related to androgen deficiencies.

One possible solution could be to get yourself on TRT (testosterone replacement therapy) with a doctor's supervision, and then use finasteride. In that case, you'd be pushing your T levels into the normal range for someone your age, and also reducing DHT which is the primary culprit for hair loss. I doubt you would be having brain fog side effects if you combined TRT with finasteride.

Keep in mind that with T levels like you have, unless you have a horrible lifestyle (IE, sedentary + obese + bad sleep hygiene), this is something that is only going to get worse with age. By that I mean, if you don't pursue TRT now, you might end up on it in your 30s anyways, and with aggressive diffuse hairloss, you're probably going to hit an advanced hairloss pattern by then.

My tl;dr take is get your T levels where they should be for someone your age, likely through TRT, and then try to save your hair with finasteride.

If you live in America, I would try and get in contact with Marek health, as they're quite knowledgeable about this.

 

[finornottofin]

If I was in your position I personally wouldn't bother with minoxidil alone, it'll buy you a few years at best, especially if you have aggressive diffuse thinning. Unfortunately, finasteride and dutasteride are the only thing we have to fight hairloss long term that has any sort of scientifically proven efficacy.

I'm not a doctor, but with that said, if I recall correctly you did make a post about whether or not you should start finasteride with low testosterone. Your test results were extremely low for total T, which could possibly indicate primary or secondary hypogonadism. I think that regardless of what you decide to do in terms of your hair loss situation, you should go and see an endocrinologist about that. Those are not healthy T levels, especially for someone who isn't even 25 yet.

I bring up your total T levels because one of the common side effects of having low T is brain fog. It could be a case where without finasteride, you're hanging on by a thread because you have DHT in your system. When you take finasteride, you're relying on your residual DHT levels and your T levels to carry out androgen dependent functions in the body. Given that your total T levels are so low, when you're reducing your DHT, I think it might be a case of you just not having enough androgens in the body to avoid having side effects. I'm not surprised to see that you have side effects related to androgen deficiencies.

One possible solution could be to get yourself on TRT (testosterone replacement therapy) with a doctor's supervision, and then use finasteride. In that case, you'd be pushing your T levels into the normal range for someone your age, and also reducing DHT which is the primary culprit for hair loss. I doubt you would be having brain fog side effects if you combined TRT with finasteride.

Keep in mind that with T levels like you have, unless you have a horrible lifestyle (IE, sedentary + obese + bad sleep hygiene), this is something that is only going to get worse with age. By that I mean, if you don't pursue TRT now, you might end up on it in your 30s anyways, and with aggressive diffuse hairloss, you're probably going to hit an advanced hairloss pattern by then.

My tl;dr take is get your T levels where they should be for someone your age, likely through TRT, and then try to save your hair with finasteride.

If you live in America, I would try and get in contact with Marek health, as they're quite knowledgeable about this.

Thanks for your thoughtful reply. I forced my doctor to refer me to an endocrinologist after they said I was fine because I was within the reference range. Had to wait months for an appointment only to be told by the endocronologist that's just the way some ppl are. I even went down the line of bringing in the research about why I likely have secondary hypogonadism. I have borderline low total T and low LH so it's not that my balls aren't creating enough T but rather they aren't being signalled to create anymore than they are. Unfortunately the endo was adamant that there was no problem bc I was still in the reference range, had no libdo issues and had lots of facial and body hair (even on finasteride I didn't even suffer from watery semen or ball ache from what I could tell). The only side effects (from low total T) I was potentially feeling was low energy but he said that was likely due to other things. I am unable to get a second opinion bc no one will refer me :/

For the hair side of things, if you take a look at my levels you will find that I had/have borderline low DHT aswell and was STILL losing hair. Something like TRT is bound to increase T and thereby DHT and I did some rough math given the research on this and based on the level increased by TRT (I went conservative with the amount of target T and average with the amount 5-ared to dht) I will end up with roughly the same serum levels if I manage to take 1mg finasteride a day. The thing about TRT which scares me is the whole fertility thing. If I'm bound to lose my hair either way (based on my calculations) I don't wanna go on TRT since my current levels aren't causing me any problems. I would love to get an expert opinion on this but the only private clinics in my country are really expensive and so I'm just stuck.

Now like you say it's possible I could hop on TRT, lower my dht to lower than it is currently with possibly finasteride but likely dutasteride and reverse my hair loss without side effects. Just that to me this seems like a long shot. I'm currently planning to get a sleep study and see if I have obstructive sleep apnea (could lead to low GNRH -> LH) and potentially solve the problem at the root to obtain normal hormonal operation. Just sucks that unless one's rich we're stuck with docs which won't do anything unless your problem is bad enough that it exceeds a threshold.

 

[user394587]

Thanks for your thoughtful reply. I forced my doctor to refer me to an endocrinologist after they said I was fine because I was within the reference range. Had to wait months for an appointment only to be told by the endocronologist that's just the way some ppl are. I even went down the line of bringing in the research about why I likely have secondary hypogonadism. I have borderline low total T and low LH so it's not that my balls aren't creating enough T but rather they aren't being signalled to create anymore than they are. Unfortunately the endo was adamant that there was no problem bc I was still in the reference range, had no libdo issues and had lots of facial and body hair (even on finasteride I didn't even suffer from watery semen or ball ache from what I could tell). The only side effects (from low total T) I was potentially feeling was low energy but he said that was likely due to other things. I am unable to get a second opinion bc no one will refer me :/

For the hair side of things, if you take a look at my levels you will find that I had/have borderline low DHT aswell and was STILL losing hair. Something like TRT is bound to increase T and thereby DHT and I did some rough math given the research on this and based on the level increased by TRT (I went conservative with the amount of target T and average with the amount 5-ared to dht) I will end up with roughly the same serum levels if I manage to take 1mg finasteride a day. The thing about TRT which scares me is the whole fertility thing. If I'm bound to lose my hair either way (based on my calculations) I don't wanna go on TRT since my current levels aren't causing me any problems. I would love to get an expert opinion on this but the only private clinics in my country are really expensive and so I'm just stuck.

Now like you say it's possible I could hop on TRT, lower my dht to lower than it is currently with possibly finasteride but likely dutasteride and reverse my hair loss without side effects. Just that to me this seems like a long shot. I'm currently planning to get a sleep study and see if I have obstructive sleep apnea (could lead to low GNRH -> LH) and potentially solve the problem at the root to obtain normal hormonal operation. Just sucks that unless one's rich we're stuck with docs which won't do anything unless your problem is bad enough that it exceeds a threshold.

Your point about DHT would stand if it wasn't for the fact that DHT is paracrine hormone. That means that its produced primarily in the tissues in which it exerts its effects. Serum DHT in the context of hair loss is completely meaningless. It's entirely possible to have mid to low DHT in the blood but high DHT in the hair follicles.

I would strongly suggest that you fight to get a second opinion regarding your T levels. If I recall correctly, you were barely in the reference ranges for men. If you look at studies regarding T levels by age, your total T of roughly 270 ng/dL is equivalent to something around a 80 year old man. You haven't even hit the age where T levels should begin to decline. With low LH and FSH, to me it looks like you have secondary hypogonadism, as you also eluded to.

On a side note, sleep loss can absolutely destroy your T levels, so that's probably something that's worth looking into anyways. If you don't mind me asking, which country are you located in?

 

[jamesbooker1975]

I originally tried 0.5mg oral finasteride EOD for ~4-5 weeks. 2-3 weeks in I noticed significant brain fog but I had continued with treatment because I didn't really recognize it as a side effect of finasteride. Eventually I caught on with what was going on and had to stop and made a full recovery.

Recently I got some topical finasteride at 0.1mg/ml (0.01%). I have been using this for almost a month and was very happy when I made it past the 3 week mark with no problems. Unfortunately the fog came back recently after about a month. I've still continued but it's been getting significantly worse now and I think I have to either titrate down or just quit finasteride. I have looked into what neurosteroid deficiencies could have caused this but deterministic treatment of those issues would require significant bloodwork and supplementation/drugs (or just trial and error whilst on finasteride) I have no history of depression but I do stress easily also I have had no other side effects on finasteride.

Not sure if 0.005% will accumulate similarly and honestly given how aggressive my loss is for my age I doubt its going to do anything.

Should I just accept being bald at this point? I am not even 25 yet so it does not feel good at all. Since I'm a diffuse thinner, I'm sure minoxidil could buy me a good couple years but i see no difference between balding now and at 28 especially since min isn't doing anything to prevent loss. I was gonna order eucapil but between their shipping times and general uncertainty about its efficacy I'm not even sure if its worth it. Was thinking of doing 0.005% finasteride EOD, eucapil, min + dermarolling but the amount of topicals to deal with here is giving me a headache. No official pharmacist I know is willing to compound min + finasteride at that concentration and so I'd be doing the mixing with crushed tablets in an official min solution( which I have no way of confirming is dissolving equally?) .

Do I waste time on these less efficacious treatments (when it comes to preventing miniaturization) or just move on with my life. I get the feeling its time to move on but I'm sure as you all understand its hard to let go.

Sorry, by from where you go tit is finasteride or nothing ? All you need to do , is a good pharmacy that compound it, we are in 2021, you will tons, except if you live in Cuba, Venezuela or North Korea .
Minoxidil 5 % plus tretinoin 0.025 %
Ketoonazole shampoo 2 % , every day , leave it for 20 minutes before clean it.
Finasteride ? no need it .
Why this regimen works ? go to pubmed.gov and READ studies .
You can thanks me, this advice worth 1000s of dollars, and most probably, you will not even consider cause you are obsessed with finasteride.

 

[jamesbooker1975]

Your point about DHT would stand if it wasn't for the fact that DHT is paracrine hormone. That means that its produced primarily in the tissues in which it exerts its effects. Serum DHT in the context of hair loss is completely meaningless. It's entirely possible to have mid to low DHT in the blood but high DHT in the hair follicles.

I would strongly suggest that you fight to get a second opinion regarding your T levels. If I recall correctly, you were barely in the reference ranges for men. If you look at studies regarding T levels by age, your total T of roughly 270 ng/dL is equivalent to something around a 80 year old man. You haven't even hit the age where T levels should begin to decline. With low LH and FSH, to me it looks like you have secondary hypogonadism, as you also eluded to.

On a side note, sleep loss can absolutely destroy your T levels, so that's probably something that's worth looking into anyways. If you don't mind me asking, which country are you located in?

"Your point about DHT would stand if it wasn't for the fact that DHT is paracrine hormone. That means that its produced primarily in the tissues in which it exerts its effects. Serum DHT in the context of hair loss is completely meaningless. It's entirely possible to have mid to low DHT in the blood but high DHT in the hair follicles."

Exaclty, BUT, merck killeds 10000 of brains by going with the oral route saying " DHT is the evil hormone that you must shut down, it is useless " Worst part is that they doing by killing not just serum DHT, they did it by killing a serun enzime that is part of at least another 6 ( and counting ) reactions in the body . So, it is just not the problem of killing DHT, you are killing many other hormones, for example allopregnolone ( that why many people feel more anxiety, depressed, etc ) . And Allopregnolone is need it in stress situation, the big ones.

 

[finornottofin]

Sorry, by from where you go tit is finasteride or nothing ? All you need to do , is a good pharmacy that compound it, we are in 2021, you will tons, except if you live in Cuba, Venezuela or North Korea .
Minoxidil 5 % plus tretinoin 0.025 %
Ketoonazole shampoo 2 % , every day , leave it for 20 minutes before clean it.
Finasteride ? no need it .
Why this regimen works ? go to pubmed.gov and READ studies .
You can thanks me, this advice worth 1000s of dollars, and most probably, you will not even consider cause you are obsessed with finasteride.

I am using ketaconazole and leaving it on ~ 10 mins 5 - 7 days in the shower. Minoxidil is a stimulant (does not prevent miniturization) and I believe tretinoin has a similar function + increases absorption of minoxidil. My hair loss is aggressive. Like we said above minoxidil will buy me a couple of years at most but the miniturization will catch up to me. All large reputable studies agree that minoxidil does in no measurable way prevent miniturization. Most people losing their hair slowly can buy years from stimulated growth from minoxidil and tretinoin. Someone like me who is diffusing to a NW7 under 25 years will not achieve the same results unless I prevent miniaturization.
I believe you have good intentions and appreciate your response but everyone is working with different cards. People facing with hairline recession in their 30's have a different rate of miniturization than someone as young as me diffusing in a NW6/7 pattern.

It's entirely possible to have mid to low DHT in the blood but high DHT in the hair follicles

Yes this is true and I would love to know a way to measurably decrease DHT only in the tissue on my scalp. Unfortunately even low dose topical finasteride went somewhat systemic for me giving me brain fog. Only thing I know that could work is the topical dutasteride people are referring to here and there is insufficient evidence + it is way more potent and has a much longer half life which is why I'm scared to take it. And aside from eucapil I'm not sure of any clinically and commercially approved ar receptor antaganist (obviously except keto which im using).

 

[finornottofin]

Your point about DHT would stand if it wasn't for the fact that DHT is paracrine hormone. That means that its produced primarily in the tissues in which it exerts its effects. Serum DHT in the context of hair loss is completely meaningless. It's entirely possible to have mid to low DHT in the blood but high DHT in the hair follicles.

I would strongly suggest that you fight to get a second opinion regarding your T levels. If I recall correctly, you were barely in the reference ranges for men. If you look at studies regarding T levels by age, your total T of roughly 270 ng/dL is equivalent to something around a 80 year old man. You haven't even hit the age where T levels should begin to decline. With low LH and FSH, to me it looks like you have secondary hypogonadism, as you also eluded to.

On a side note, sleep loss can absolutely destroy your T levels, so that's probably something that's worth looking into anyways. If you don't mind me asking, which country are you located in?

Yeah man I'm barely in the references ranges (and I had done two tests months apart) but the multiple doctors I spoke to think I'm a hypochondriac about my borderline low T which kinda drives me insane. As for my country i dmed you.

 

[jamesbooker1975]

"Your point about DHT would stand if it wasn't for the fact that DHT is paracrine hormone. That means that its produced primarily in the tissues in which it exerts its effects. Serum DHT in the context of hair loss is completely meaningless. It's entirely possible to have mid to low DHT in the blood but high DHT in the hair follicles."

Exaclty, BUT, merck killeds 10000 of brains by going with the oral route saying " DHT is the evil hormone that you must shut down, it is useless " Worst part is that they doing by killing not just serum DHT, they did it by killing a serun enzime that is part of at least another 6 ( and counting ) reactions in the body . So, it is just not the problem of killing DHT, you are killing many other hormones, for example allopregnolone ( that why many people feel more anxiety, depressed, etc ) . And Allopregnolone is need it in stress situation, the big ones.

I am using ketaconazole and leaving it on ~ 10 mins 5 - 7 days in the shower. Minoxidil is a stimulant (does not prevent miniturization) and I believe tretinoin has a similar function + increases absorption of minoxidil. My hair loss is aggressive. Like we said above minoxidil will buy me a couple of years at most but the miniturization will catch up to me. All large reputable studies agree that minoxidil does in no measurable way prevent miniturization. Most people losing their hair slowly can buy years from stimulated growth from minoxidil and tretinoin. Someone like me who is diffusing to a NW7 under 25 years will not achieve the same results unless I prevent miniaturization.
I believe you have good intentions and appreciate your response but everyone is working with different cards. People facing with hairline recession in their 30's have a different rate of miniturization than someone as young as me diffusing in a NW6/7 pattern.



Yes this is true and I would love to know a way to measurably decrease DHT only in the tissue on my scalp. Unfortunately even low dose topical finasteride went somewhat systemic for me giving me brain fog. Only thing I know that could work is the topical dutasteride people are referring to here and there is insufficient evidence + it is way more potent and has a much longer half life which is why I'm scared to take it. And aside from eucapil I'm not sure of any clinically and commercially approved ar receptor antaganist (obviously except keto which im using).

"Minoxidil is a stimulant (does not prevent miniturization)"
Can you please post any study at all showing this ? The exactly mechanism of action is unknow . So how you do you know that it don't prevent miniturization. Exactly what I told you , instead of going to pubmed.gov and READ studies you are telling me "I believe you have good intentions" . Lol. But, hey, you have broscience and you might even saw some youtube influercers ! So, hell, pubmed sucks, lol .
Kiddo, you clear have no idea of what are you doing . Plus, you are also wrong about Tretinoin, let me show you :
Tretinoin enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes
See , how wrong you are ? Just shave it, really, do something to stop hair loss without side effects need you to be smart, and you arent' You keep on " hey , if I use finasteride 0,0000000001% eod, will that work ? "
So shave it , and keep live it .
Le me put it on a youtube video , so will be easier for you to understand :

 

[Pacho]

i think its over for you hair. just accept it

 

[Pacho]

Sorry, by from where you go tit is finasteride or nothing ? All you need to do , is a good pharmacy that compound it, we are in 2021, you will tons, except if you live in Cuba, Venezuela or North Korea .
Minoxidil 5 % plus tretinoin 0.025 %
Ketoonazole shampoo 2 % , every day , leave it for 20 minutes before clean it.
Finasteride ? no need it .
Why this regimen works ? go to pubmed.gov and READ studies .
You can thanks me, this advice worth 1000s of dollars, and most probably, you will not even consider cause you are obsessed with finasteride.

wishful thinking

 

[jazz1]

The sides should subside with Tolocal Finasteride over time, try adding zinc and horny goat weed.

 

[nwreaper]

if your test is 270 ng/dl, I would try to increase it first. Low test can also contribute to Alopecia Androgenetica. This is because low test causes 5 alpha reductase to upregulate to compensate for your lack of androgenicity. Low t women who are given test have an increase in hair growth. Sometimes even men when starting trt report some hair regrowth. You should check if you have any tumors in your brain and if not and you aren;t taking any suppressive substances on the hpta, I would jump on trt and then fluridil or finasteride. Also, if you have sleep apnea it may contribute to your lack of t.