Do I Remain On Avodart Or Do I Stop?

Rocco M

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Switched to Dutasteride after 5 years of Finasteride with good results and noticed some rapid loss that has yet to stabilize...what do I do now?

So here's my story: I was a good responder to finasteride, which I started at age 29 as my hairline was maturing and saw good maintenance and some regrowth. Stupidly, I was on 5 mg as I was too lazy to cut the pill. Regardless, for the past five years, nobody would look at me and think I had any hair loss. So I was doing a good job and my hair looked great at 5mg Finasteride.

Fast forward to March 2016:

At age 34, just this past March, I noticed a SMALL bit of loss at the temples and my crown. On my own accord, and perhaps due to anxiety, I had a friend who is a doctor start me on 0.5 mg of Dutasteride daily and phased out the finasteride over the course of month. Within a week, I noticed deeper temporal loss. However, I figured it would grow back and my body needed to adjust. Since then, however, not only have I noticed increased shedding, I have also noticed that I lost a lot of ground at my temples very quickly...much more than I was noticing when I made the switch. Some of it looks still looks like it *might* be growing back, but it's been 5 months and I am still worse off than when I started Dutasteride. I'm also seeing some recession at the hairline as well as loss in the other temple and additional frontal thinning at the center behind my hairline, which was definitely *not* a concern when I made the switch to Dutasteride in March.

My question is, should I ride it out, or go back to finasteride?

It's clear that the abrupt changes were caused by Dutasteride, but I would've thought that by the end of July, things would've stabilized. But given the anecdotes about guys who started Dutasteride and lost hair at the hairline/temples, I'm wondering if there was some truth behind the anecdotes.

I really don't think it's possible to have just lost so much ground naturally in a couple of months, and the Internet is filled with people who claim to have lost frontal hair when they started Dutasteride. But few people decided to stick it out from what I can glean from these scattered posts.

So my question is, what do I do?

Do I need to be on Dutasteride longer to see what happens? Is four months enough time? Do I ride it out, or will I never get back what I've lost at the front since starting Dutasteride?

(Note 1: Apologies, I didn't think to take before and after photos, and I should have.)

(Note 2: I have also always been on minoxidil since age 29, which has helped me, but I can't seem to apply it fast enough these days to try to counteract the apparent loss from dutasteride)
 
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abcdefg

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There is no easy answer. Its just a judgement call what you feel more comfortable doing. It could be the larger spike in T for whatever reason hurts your hair in the front. We still lack lots of answers on how hair in front/temples reacts compared to say the crown it might be different.
I would say if its minor loss to just keep on it and hope it grows back. If you quit you know for sure your going to never get it back. Also maybe ask your derm or prescriber what they think? They SHOULD know more then most of us although thats not always the case
 

GoldenMane

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Yeah, I'd say it's safe to assume that as you were starting to lose ground on finasteride, it's unlikely that switching back to finasteride would help. As to why you continued to lose ground on dutasteride, who knows. Could be a shed from which you will recover stronger. Could be androgen receptor upregulation (doubt it), could be that the testosterone ;which increases on dutasteride since it's not converted to DHT, has a greater affect on the hairline and temples. Nobody knows, there are no studies indicating that testosterone causes hair loss but an absence of evidence is not evidence of absence. To a certain degree you're just fumbling in the dark, dutasteride should protect your hair better in theory but it doesn't always seem to be the case. I'd stick with it and pray it's just a shed.
 

Wave

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Eek. Well, looks like you and I are on the SAME EXACT boat. 7 years on finasteride and I started noticing it losing ground. It got pretty bad where I decided to add dutasteride. I've been on 0.5 mg dutasteride for 9.5 months now (still taking 1 mg finasteride) and there is still no sign of hair loss slowing. I don't know if it's just the progression of hair loss I would have faced before starting dutasteride when I was only on finasteride or if it's increased because of adding dutasteride. I'm hoping it's the former. Anyway, I'm going to give it 12 months and if there is no improvement, I'll either A) drop dutasteride and start RU or just B) add RU.
 

hwezdarik

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Eek. Well, looks like you and I are on the SAME EXACT boat. 7 years on finasteride and I started noticing it losing ground. It got pretty bad where I decided to add dutasteride. I've been on 0.5 mg dutasteride for 9.5 months now (still taking 1 mg finasteride) and there is still no sign of hair loss slowing. I don't know if it's just the progression of hair loss I would have faced before starting dutasteride when I was only on finasteride or if it's increased because of adding dutasteride. I'm hoping it's the former. Anyway, I'm going to give it 12 months and if there is no improvement, I'll either A) drop dutasteride and start RU or just B) add RU.

Did you manage to maintain on finasteride for 7 years ? Did you also experience any regrowth ?
 

Ashkan63

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I think you are now in the bad part of dht blockers,when they stop working as great as they used to ,i dont know why but what i know from my experience is that if finasteride does not work probably dutasteride wont work as well so they only solution is to lower your dose gradually and stop it for a while,meanwhile you can buy time with minoxidile to start dht blockers again
 

Wave

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Did you manage to maintain on finasteride for 7 years ? Did you also experience any regrowth ?

Yup. Maintained really well for 7 years. I do not think I got any regrowth, but I couldn't say for sure. Biggest mistake was not taking pictures to document my journey.
 

abcdefg

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If you just stayed on the finasteride I wonder how long you could have maintained. Moral of the story if it aint broke dont fix it. If finasteride is working dont mess with anything until it loses effectiveness on its own if it does.
I do think as you get older the sensitivity part of male pattern baldness continues to change and increase. So with enough time the treatment gradually cant keep pace with the sensitivity increasing.
I still think we could greatly benefit from a CB that attacks the receptors and combing that with dutasteride/finasteride. No angle is perfect so combining two would be much much better.
 

Wave

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If you just stayed on the finasteride I wonder how long you could have maintained. Moral of the story if it aint broke dont fix it. If finasteride is working dont mess with anything until it loses effectiveness on its own if it does.
I do think as you get older the sensitivity part of male pattern baldness continues to change and increase. So with enough time the treatment gradually cant keep pace with the sensitivity increasing.
I still think we could greatly benefit from a CB that attacks the receptors and combing that with dutasteride/finasteride. No angle is perfect so combining two would be much much better.

That's the thing, finasteride did start loosing its effectiveness after year 6ish, and really started noticing in year 7. I started thinning diffusely, especially at the front. I decided this was too much so I jumped on dutasteride. 9.5 months in and not looking good.
 

Rocco M

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That's the thing, finasteride did start loosing its effectiveness after year 6ish, and really started noticing in year 7. I started thinning diffusely, especially at the front. I decided this was too much so I jumped on dutasteride. 9.5 months in and not looking good.


how old are you, and did you notice any crown changes at any time? If finasteride worked I'd assume it worked on the crown too, and knowing whether dutasteride has any effect on the crown for you now could help differentiate if it's just progressive hair loss beyond the help of meds or if it's specifically related to dutasteride's raising scalp testosterone. Wouldn't be conclusive evidence but might shed some light on what *could* be happening for you...

As for me, haven't had any crown changes on dutasteride after regrowth on finasteride; all my dutasteride-associated loss has been on hairline and "deep corners/temples" almost instantaneously (within a couple weeks of adding dutasteride as I phased out finasteride). finasteride had only just started to lose effectiveness and I got greedy by jumping the gun and switching...
 

abcdefg

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The only reason someone could be losing hair on dutasteride seems like just testosterone is causing it. On dutasteride you basically have no DHT left so the only thing that could be happening is receptor upregulation or testosterone taking over or the spike in T from the dutasteride.
 

Rocco M

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The only reason someone could be losing hair on dutasteride seems like just testosterone is causing it. On dutasteride you basically have no DHT left so the only thing that could be happening is receptor upregulation or testosterone taking over or the spike in T from the dutasteride.

This, OR it could be a shed that eventually returns the hair once the hormones have stabilized...which gets us back to the whole original question as to what's more likely to be going on.
 
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