Doing A Dosage Experiment To Reduce Side Effects

[Nfoto]

Hey guys, post may be a bit winded but I'm going to relay my story and what I'm doing here in case it helps any others. I've been on a regimen of 1mg finasteride, minoxidil, and ketoconazole shampoo. I really do think this has halted my hairloss and done wonders for my hair. Anyway, I always knew the risk of sides going in and the scare stories...and knew the mental side as well and that worrying about it too much could make you think there's an issue etc.

After this time though I'm starting to think the finasteride may be affecting me. For about a year my depression and anxiety has gotten really bad and my energy levels have crashed. I feel crazy fatigued everyday and I live a pretty healthy lifestyle. Now, this could be anything not necessarily finasteride but what's got me suspicious lately is I've had a pigmentation issue with my skin. After seeing a dermatologist I've been told I have mild melasma. Melasma is an issue most commonly seen in females and usually an issue with hormones/estrogen.

From my understanding finasteride inhibits DHT from being converted from testosterone, which can increase free testosterone/allow there to be more testosterone which can be converted into estradiol. In some guys this means there could be elevated female hormones if they are sensitive too it. Now I know this is rare, but with my weird melasma issue I figured maybe something is going on with my hormones. I don't want to quit finasteride yet because I think my hair would be toast so I did some research.

Through my research I found that a lower dosage of finasteride isn't necessarily great for reducing sides due to the flat curve response of the drug. Basically from .5mg up it inhibits the same amount of DHT and therby would produce the same side effects. It can also be cumulative when taken everyday so a lower dose would still eventually inhibit the same. I attached some charts from studies but basically you can see this result, although I found it interesting at a dosage of about .05mg it inhibited the same amount of DHT present in the scalp, but the serum DHT was significantly higher than the higher doses. I know guys have experimented with microdosing, but my plan for now is to take 1/4 pill (.25mg) of finasteride every 3rd day, which should put me at about .08 mg a day. Finasteride also inhibits DHT up to 4 days after dosing, so hopefully this could put me in a sweet spot between .05mg and .2mg that allows my body to have some more DHT while my scalp remains inhibited. Anyways, that's the experiment. I also have a doctors appointment and plan on getting all my bloodwork done next month as well. If anyone is interested in how this goes I'll keep you updated. Thanks for reading.

 

[Ollie]

You're right about finasteride having a flat dosage response curve - however this is only for blood and some tissue concentrations. Generally speaking the response curve is actually much more linear for other tissues and therefor sides are more linear than one might think as well. I cant be bothered to go and find the paper however it was found that in order to inhibit the same amount of 5ar (and DHT) in the hair follicle as 1mg finasteride does for the prostate, you would need to take 50mg daily. You can assume for other tissue types there might be similar differences. Efficacy i have also found to be more linear than stated as well.

Personally when i started 1mg finasteride over a year ago after about 4 months i started to get lots of regrowth, however pretty much from the go my libido was pretty bad. For me that was the better of the two evils so i soldiered on, however over the months my erection quality started getting worse and worse until i couldn't allow it to continue so i dropped down to 0.25mg ED. After 2 weeks my libido was so high it was borderline unbearable - it was pretty strange being reminded of what a sex drive was meant to actually feel like. However looking back my erection quality took much much longer to come back, perhaps 5-6 weeks.

Fortunately i actually had bloods done and have since come up with the conclusion that my initial libido drop was plain and simply from the DHT reduction. My E however slowly went up over the first 5 months to an insane 62% above baseline !! This i believe further contributed to my low libido but primarily was the main reason that my erection quality got slowly progressively worse over the months. Also (probably due to the E increase) i had a huge increase in prolactin which took me 4x over top of the normal range, also contributing to my libido and erection quality hit.

Im now back on 1mg finasteride and am planning to experiment with keeping my E closer to my normal range using liquid arimidex but only once i have got that regrowth back (from which fell out after a month of dropping down to 0.25mg finasteride.

 

[Nfoto]

Really interesting thank you for sharing this Ollie, I find it fascinating the more I learn about this drug. Crazy your E level went up so high makes sense that it would wreak havoc on your libido and erections. I came across some people using the supplement DIM to help with estrogen levels but I haven't looked too much into it. Interested to hear what happens if you start using the arimidex.

I kind of wish I could get my bloodwork now before I start messing with dosage but I have to wait a month before I can get into the doctor. How have you felt now being back on 1mg? Have you noticed any affect on your libido or ED problems returning?

 

[Ollie]

Really interesting thank you for sharing this Ollie, I find it fascinating the more I learn about this drug. Crazy your E level went up so high makes sense that it would wreak havoc on your libido and erections. I came across some people using the supplement DIM to help with estrogen levels but I haven't looked too much into it. Interested to hear what happens if you start using the arimidex.

I kind of wish I could get my bloodwork now before I start messing with dosage but I have to wait a month before I can get into the doctor. How have you felt now being back on 1mg? Have you noticed any affect on your libido or ED problems returning?

It is a crazy drug for sure.

Its a shame you didn't get bloods before you ever used finasteride as they are pretty important to understanding your own homeostasis. Alarmingly once i had my bloods re-done at the 6 month mark to expose the 62% increase in E, a doctor read my bloods and said they were fine because 'they were all in range'. Whilst yes my E was still in range (albeit in the mid-upper), my natural E levels are way at the bottom end of the range, so me now being at the middle-top im sure is enough to throw me into side-effect territory.

Being back on 1mg my libido is definitely down again however with the use of low dose cabergoline (0.25m twice weekly) i've managed to keep my prolactin levels in range and thus my erection quality is significantly better than it had been when using 1mg of finasteride originally.

Ill be interested to hear how your sides change with change of dose!

 

[Mackenzie Brown]

Will be very interested to see how this progresses, I am considering going back on finasteride 0.5mg to see if this reduces side effects

 

[Nfoto]

Will be very interested to see how this progresses, I am considering going back on finasteride 0.5mg to see if this reduces side effects

yes we'll see! So far 5 days into this experiment. Obviously I don't notice any difference yet but I'll keep this thread updated. I also added 100mg of DIM and 25mg Zinc daily to see if that makes any difference as well.

 

[Michael1986]

You're right about finasteride having a flat dosage response curve - however this is only for blood and some tissue concentrations. Generally speaking the response curve is actually much more linear for other tissues and therefor sides are more linear than one might think as well. I cant be bothered to go and find the paper however it was found that in order to inhibit the same amount of 5ar (and DHT) in the hair follicle as 1mg finasteride does for the prostate, you would need to take 50mg daily. You can assume for other tissue types there might be similar differences. Efficacy i have also found to be more linear than stated as well.

Personally when i started 1mg finasteride over a year ago after about 4 months i started to get lots of regrowth, however pretty much from the go my libido was pretty bad. For me that was the better of the two evils so i soldiered on, however over the months my erection quality started getting worse and worse until i couldn't allow it to continue so i dropped down to 0.25mg ED. After 2 weeks my libido was so high it was borderline unbearable - it was pretty strange being reminded of what a sex drive was meant to actually feel like. However looking back my erection quality took much much longer to come back, perhaps 5-6 weeks.

Fortunately i actually had bloods done and have since come up with the conclusion that my initial libido drop was plain and simply from the DHT reduction. My E however slowly went up over the first 5 months to an insane 62% above baseline !! This i believe further contributed to my low libido but primarily was the main reason that my erection quality got slowly progressively worse over the months. Also (probably due to the E increase) i had a huge increase in prolactin which took me 4x over top of the normal range, also contributing to my libido and erection quality hit.

Im now back on 1mg finasteride and am planning to experiment with keeping my E closer to my normal range using liquid arimidex but only once i have got that regrowth back (from which fell out after a month of dropping down to 0.25mg finasteride.

Was there really a study that measured the DHT inhibition levels of finasteride within the hair follicles themselves? I'd be interested in reading this study if you or anyone else on here might be able to provide me with a link to it. Anyone know if any similar study has been done regarding dutasteride?

 

[BananaBlunt]

You're right about finasteride having a flat dosage response curve - however this is only for blood and some tissue concentrations. Generally speaking the response curve is actually much more linear for other tissues and therefor sides are more linear than one might think as well. I cant be bothered to go and find the paper however it was found that in order to inhibit the same amount of 5ar (and DHT) in the hair follicle as 1mg finasteride does for the prostate, you would need to take 50mg daily. You can assume for other tissue types there might be similar differences. Efficacy i have also found to be more linear than stated as well.

Personally when i started 1mg finasteride over a year ago after about 4 months i started to get lots of regrowth, however pretty much from the go my libido was pretty bad. For me that was the better of the two evils so i soldiered on, however over the months my erection quality started getting worse and worse until i couldn't allow it to continue so i dropped down to 0.25mg ED. After 2 weeks my libido was so high it was borderline unbearable - it was pretty strange being reminded of what a sex drive was meant to actually feel like. However looking back my erection quality took much much longer to come back, perhaps 5-6 weeks.

Fortunately i actually had bloods done and have since come up with the conclusion that my initial libido drop was plain and simply from the DHT reduction. My E however slowly went up over the first 5 months to an insane 62% above baseline !! This i believe further contributed to my low libido but primarily was the main reason that my erection quality got slowly progressively worse over the months. Also (probably due to the E increase) i had a huge increase in prolactin which took me 4x over top of the normal range, also contributing to my libido and erection quality hit.

Im now back on 1mg finasteride and am planning to experiment with keeping my E closer to my normal range using liquid arimidex but only once i have got that regrowth back (from which fell out after a month of dropping down to 0.25mg finasteride.

Finally somebody who has a brain to understand how things really work and takes blood tests, etc... Shame, shame that we have no alternative to inhibit only the DHT in the tissue that is affected, and that's in the scalp... So rudimentary and useless to nuke the whole body's DHT to get a moderate reduction in the scalp tissue that can take months and over a year to take place and give results, besides of what you have to endure because of the serum decrease of DHT... Unbelievable, i don't really understand how the f*** are we in 2019 and still with this shitty rudimentary treatments... Good luck and stay safe, keep posting cos your experience and knowledge could help others understand...

And i really think that the DHT is affecting the tissue because of inflammation and instead of converting the T into estrogen in the follicle to make it grow, it turns it into DHT and therefor it miniaturizes the follicle, i read some interesting stuff lately and transgenders really point this things out with their regimes but it seems that this sh*t science refuses to notice it...

 

[Mackenzie Brown]

It is a crazy drug for sure.

Its a shame you didn't get bloods before you ever used finasteride as they are pretty important to understanding your own homeostasis. Alarmingly once i had my bloods re-done at the 6 month mark to expose the 62% increase in E, a doctor read my bloods and said they were fine because 'they were all in range'. Whilst yes my E was still in range (albeit in the mid-upper), my natural E levels are way at the bottom end of the range, so me now being at the middle-top im sure is enough to throw me into side-effect territory.

Being back on 1mg my libido is definitely down again however with the use of low dose cabergoline (0.25m twice weekly) i've managed to keep my prolactin levels in range and thus my erection quality is significantly better than it had been when using 1mg of finasteride originally.

Ill be interested to hear how your sides change with change of dose!

Do you feel that it may be reasonable to say that by suppressing Estrogen production using something like DIM, it may be in turn possible to suppress the production of prolactin?

 

[Ollie]

Do you feel that it may be reasonable to say that by suppressing Estrogen production using something like DIM, it may be in turn possible to suppress the production of prolactin?

I was actually thinking about if preventing estrogen increase on finasteride would prevent prolactin increase but I don’t believe that even with my sharp E increase that it would alone be responsible for a 4 fold increase in prolactin. Rather I believe there must be another mechanism at work.

Also DIM wouldn’t work - simply not strong enough . You’d need to find the correct dose of arimidex to keep you balanced .

 

[BigOl'BaldingHead]

You're right about finasteride having a flat dosage response curve - however this is only for blood and some tissue concentrations. Generally speaking the response curve is actually much more linear for other tissues and therefor sides are more linear than one might think as well. I cant be bothered to go and find the paper however it was found that in order to inhibit the same amount of 5ar (and DHT) in the hair follicle as 1mg finasteride does for the prostate, you would need to take 50mg daily. You can assume for other tissue types there might be similar differences. Efficacy i have also found to be more linear than stated as well.

Personally when i started 1mg finasteride over a year ago after about 4 months i started to get lots of regrowth, however pretty much from the go my libido was pretty bad. For me that was the better of the two evils so i soldiered on, however over the months my erection quality started getting worse and worse until i couldn't allow it to continue so i dropped down to 0.25mg ED. After 2 weeks my libido was so high it was borderline unbearable - it was pretty strange being reminded of what a sex drive was meant to actually feel like. However looking back my erection quality took much much longer to come back, perhaps 5-6 weeks.

Fortunately i actually had bloods done and have since come up with the conclusion that my initial libido drop was plain and simply from the DHT reduction. My E however slowly went up over the first 5 months to an insane 62% above baseline !! This i believe further contributed to my low libido but primarily was the main reason that my erection quality got slowly progressively worse over the months. Also (probably due to the E increase) i had a huge increase in prolactin which took me 4x over top of the normal range, also contributing to my libido and erection quality hit.

Im now back on 1mg finasteride and am planning to experiment with keeping my E closer to my normal range using liquid arimidex but only once i have got that regrowth back (from which fell out after a month of dropping down to 0.25mg finasteride.

Ollie have you ever tried topical finasteride? It's perfect for microdosing.

 

[Ollie]

Ollie have you ever tried topical finasteride? It's perfect for microdosing.

I’ve thought about this but 1) very wary about losing the efficacy of the pill and 2) I use like 10ml to truly cover my whole scalp so would be worried how much Systemic absorption I’m getting

 

[BigOl'BaldingHead]

I’ve thought about this but 1) very wary about losing the efficacy of the pill and 2) I use like 10ml to truly cover my whole scalp so would be worried how much Systemic absorption I’m getting

Don't studies show that it suppresses about the same amount of scalp DHT as oral finasteride?

 

[Ollie]

Don't studies show that it suppresses about the same amount of scalp DHT as oral finasteride?

I believe you’re right . However I know I’ll routinely forget areas on my scalp .

If I can’t correct my sides with copious amounts of other dangerous drugs though then I will for sure try topical finasteride.

 

[Hairicane]

You're right about finasteride having a flat dosage response curve - however this is only for blood and some tissue concentrations. Generally speaking the response curve is actually much more linear for other tissues and therefor sides are more linear than one might think as well. I cant be bothered to go and find the paper however it was found that in order to inhibit the same amount of 5ar (and DHT) in the hair follicle as 1mg finasteride does for the prostate, you would need to take 50mg daily. You can assume for other tissue types there might be similar differences. Efficacy i have also found to be more linear than stated as well.

Personally when i started 1mg finasteride over a year ago after about 4 months i started to get lots of regrowth, however pretty much from the go my libido was pretty bad. For me that was the better of the two evils so i soldiered on, however over the months my erection quality started getting worse and worse until i couldn't allow it to continue so i dropped down to 0.25mg ED. After 2 weeks my libido was so high it was borderline unbearable - it was pretty strange being reminded of what a sex drive was meant to actually feel like. However looking back my erection quality took much much longer to come back, perhaps 5-6 weeks.

Fortunately i actually had bloods done and have since come up with the conclusion that my initial libido drop was plain and simply from the DHT reduction. My E however slowly went up over the first 5 months to an insane 62% above baseline !! This i believe further contributed to my low libido but primarily was the main reason that my erection quality got slowly progressively worse over the months. Also (probably due to the E increase) i had a huge increase in prolactin which took me 4x over top of the normal range, also contributing to my libido and erection quality hit.

Im now back on 1mg finasteride and am planning to experiment with keeping my E closer to my normal range using liquid arimidex but only once i have got that regrowth back (from which fell out after a month of dropping down to 0.25mg finasteride.

When you can find that paper please post it, when you have time. Everything I've read shows .5 blocks scalp DHT on average by about 64%, while 1mg blocks about 67%.

 

[BigOl'BaldingHead]

I believe you’re right . However I know I’ll routinely forget areas on my scalp .

If I can’t correct my sides with copious amounts of other dangerous drugs though then I will for sure try topical finasteride.

Do you really need to hit every hair with a topical treatment? Doesn't the absorption in the scalp slightly spread it?

 

[Nfoto]

I believe you’re right . However I know I’ll routinely forget areas on my scalp .

If I can’t correct my sides with copious amounts of other dangerous drugs though then I will for sure try topical finasteride.

Don't studies show that it suppresses about the same amount of scalp DHT as oral finasteride?

Thanks for all this info guys, this stuff is really interesting. Is it possible to get topical finasteride in the US right now? Or is that something that has to be made via ethanol/dissolving a pill and applied like that? If I continue to have issues I may try this down the line. I wonder if topically you'd experience less sides and if less goes systemic, I'd like to do some research on this.

 

[Nfoto]

FYI, when I took 1mg EOD I had low libido and watery sperm but when I upped the dose to 1mg every day, that's when all the rest of the usual side effects came. But I also had a complete stop of hairloss.

Was hairloss still noticeable to you while on the EOD regimen?

 

[Baldy12345]

Yes, but it was slowing down I think. It's 4-5 years ago now.

How’s ur hair now after quitting and did u find any alternatives to maintain?

 

[Michael1986]

It is my understanding that it is the DHT within the dermal papillae of the hair follicles which is most significant in hair loss. This is the DHT that needs to be removed to treat hair loss. The late Bryan Shelton who used to be a highly knowledgeable and respected poster on these forums used to say this too. You'll find it in many of the posts he made. Scalp DHT shouldn't matter, unless this DHT is able to somehow make its way into the hair follicles.