Dutasteride confusion!

[confuzzledt]

Hello!

I've been researching Dutasteride a bit here and on some other forums and have come across some conflicting information.
My regimen, currently, is:
Finasteride 1 mg
Saw Palmetto
nizoral 1%
spironolactone 100mg
and some natural stuff with biotin in it once in a while.

My hair has sort of been thinning out recently.... I've been on finasteride for two years and originally saw some pretty positive results.

Anyway, I continually see reports of people on Avodart or .5mg of Dutasteride here or on hairlosstalk or something, but I'm confused...

One: It appears, without a doubt, that 2.5mg of Dutasteride is the best option of all of them, but you can't get a prescription for 2.5mg of Dutasteride at the moment.
Two: I've read some conflicting information. In one study, finasteride of 5mg was compared to Dutasteride of various levels... and Dutasteride was superior.
However, in another study, it appeared that 1mg of Finasteride was superior to 5mg of Finasteride AND .5mg of Dutasteride... but that 2.5mg of Dutasteride was superior to Finasteride of any dosage. In this study, they had an inverse correlation (less Finasteride was better, more Dutasteride was better). Is any of this true?
I would love to speak to a doctor about all of this, but they are so out of the loop when it comes to hair restoration. Half of the doctors I've seen are unaware of anything beyond Rogaine.

I'm nervous to switch out 1mg of Finasteride for a potentially less effective .5mg dosage of Dutasteride, but I don't know where to get 2.5mg of Dutasteride.
Though I may be misinformed about the effectiveness of a .5 dose of dutasteride and could see some regrowth were I to switch. I don't know?
I also only recently started nizoral, so maybe I should just wait a bit and see what happens with that and go from there?

Any information is appreciated.
Thanks,
S

 

[zzzzz]

anything over .1mg daily of dutasteride will be more potent than finasteride even at 5mg. As you approach 2.5mg daily of dutasteride sides begin to become very common and it is expensive as well. dutasteride .5mg will lower your dht levels about 4x lower than they would be on finasteride

 

[xRedStaRx]

anything over .1mg daily of dutasteride will be more potent than finasteride even at 5mg. As you approach 2.5mg daily of dutasteride sides begin to become very common and it is expensive as well. dutasteride .5mg will lower your dht levels about 4x lower than they would be on finasteride

Actually it's only 20% lower for serum DHT compared to baseline.

Finasteride at optimal levels inhibit 65-80%, while dutasteride at 0.5 mg inhibit 85-90%.

 

[zzzzz]

Actually it's only 20% lower for serum DHT compared to baseline.

Finasteride at optimal levels inhibit 65-80%, while dutasteride at 0.5 mg inhibit 85-90%.

dutasteride levels: 8% of baseline

finasteride: 30% of baseline

30/8= 3.75x

I thought dutasteride inhibited 92% at .5mg daily

 

[xRedStaRx]

dutasteride levels: 8% of baseline

finasteride: 30% of baseline

30/8= 3.75x

I thought dutasteride inhibited 92% at .5mg daily

Why are you calculating it the other way round? We are supposed to compare the amount of DHT inhibited, not the amount that remains.

Finasteride blocks ~70% serum DHT (let's assume almost all 5-AR II), while Dutasteride at 0.5 mg blocks ~90% serum DHT, so it effectively blocks 28% more serum DHT than finasteride, not 275%.

 

[Vlatch]

Why are you calculating it the other way round? We are supposed to compare the amount of DHT inhibited, not the amount that remains.

Who said that ? It inhibits "only" 20% more DHT that's true, but if finasteride blocks 70% DHT and dutasteride 90%, it still means finasteride users have three times more serum DHT than dutasteride users, that's an interesting fact.

 

[xRedStaRx]

Who said that ? It inhibits "only" 20% more DHT that's true, but if finasteride blocks 70% DHT and dutasteride 90%, it still means finasteride users have three times more serum DHT than dutasteride users, that's an interesting fact.

3 times more serum DHT? Who said that?

Again, dutasteride is 28% more effective at reducing serum DHT levels. Nothing more, nothing less.

If serum DHT was 1 ng/dl after Dutasteride compared to 3 ng/dl after finasteride, then there is only a 2 ng/dl difference between them. Even though the second is 'three times' the first. We are comparing efficacy of two drugs, one is 1.25 stronger than the other, that's it. Does that mean 2.5 mg of dutasteride is 10 times more powerful than 0.5 mg of dutasteride?

Biology is more complicated than arbitrary values.

It's also interesting to note that serum DHT is an almost useless measurement.

 

[Vlatch]

It explains why dutasteride works for some people who have had absolutely no results with finasteride.

Let's say your DHT levels are 600 pg/ml.
If you take finasteride, your DHT levels will be 200 pg/ml.
If you take dutasteride, they will be at 60 pg/ml.

Now if your follicles start miniaturizing at 300 pg/ml, you'll be fine with finasteride, however if they start miniaturizing at 100 pg/ml, you'll need dutasteride and finasteride will do almost nothing to help your condition, it won't just be 20% less effective.


About serum DHT, if you only consider type 2 DHT (from 5ar2), which is the most responsible for hair loss, serum DHT inhibition and scalp DHT inhibition is the same with finasteride (70% for both) and the same with dutasteride (90% for both).

However, if you consider type 1 and 2 DHT together, finasteride 5mg inhibits 70% serum DHT and 38% scalp DHT, when dutasteride 0.5mg inhibits 90% serum DHT and 54% scalp DHT.

Both measures are interesting but it's easier to talk about serum DHT for hair loss. Dutasteride 2.5mg inhibits 80% scalp DHT but isn't two times more effective than finasteride 5mg.

 

[xRedStaRx]

It explains why dutasteride works for some people who have had absolutely no results with finasteride.

Let's say your DHT levels are 600 pg/ml.
If you take finasteride, your DHT levels will be 200 pg/ml.
If you take dutasteride, they will be at 60 pg/ml.

Now if your follicles start miniaturizing at 300 pg/ml, you'll be fine with finasteride, however if they start miniaturizing at 100 pg/ml, you'll need dutasteride and finasteride will do almost nothing to help your condition, it won't just be 20% less effective.


About serum DHT, if you only consider type 2 DHT (from 5ar2), which is the most responsible for hair loss, serum DHT inhibition and scalp DHT inhibition is the same with finasteride (70% for both) and the same with dutasteride (90% for both).

However, if you consider type 1 and 2 DHT together, finasteride 5mg inhibits 70% serum DHT and 38% scalp DHT, when dutasteride 0.5mg inhibits 90% serum DHT and 54% scalp DHT.

Both measures are interesting but it's easier to talk about serum DHT for hair loss. Dutasteride 2.5mg inhibits 80% scalp DHT but isn't two times more effective than finasteride 5mg.

Both of these are wrong. Which is why dutasteride is only ~10-20% more effective than finasteride in improving hair, simillar to serum DHT levels.

 

[Vlatch]

Both of these are wrong. Which is why dutasteride is only ~10-20% more effective than finasteride in improving hair, simillar to serum DHT levels.

On average yes, I never said dutasteride was miraculous, it doesn't change the fact that serum DHT levels are three times lower in dutasteride users compared to finasteride users (and yes dutasteride results aren't three times better than finasteride, let's agree on that) ^^"

Otherwise : http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/81479

Look at the reference values, am I missing something here ?

About serum and scalp DHT (type 2) levels : http://www.ncbi.nlm.nih.gov/m/pubmed/10495374/

 

[padsch]

serum dht doesnt matter. the dht is build in the follicle..
finasteride inhibits 5AR 2+3. nobody knows how much the 5AR3 is also in the follicle..
dutasteride inhibits 5AR1+2 (2 3-4x better than finasteride, 1 about 45 times i think... but dutasteride isnt as good in inhibiting 5AR3 as finasteride!). so combine it

this forum is soo bad
topical dutasteride works also
http://www.odermatol.com/wp-content/uploads/file/2013 1/9_Evaluation of the effect-Sobhy N.pdf


I`ve got all my hair back with finasteride orally + dutasteride topical + RU!

 

[Vlatch]

this forum is soo bad

I want to slap this smiley so badly.

 

[xRedStaRx]

On average yes, I never said dutasteride was miraculous, it doesn't change the fact that serum DHT levels are three times lower in dutasteride users compared to finasteride users (and yes dutasteride results aren't three times better than finasteride, let's agree on that) ^^"

Otherwise : http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/81479

Look at the reference values, am I missing something here ?

About serum and scalp DHT (type 2) levels : http://www.ncbi.nlm.nih.gov/m/pubmed/10495374/

No you're not. I was thinking about ng/dl, since that's the more commonly used unit for T and DHT.

You've mentioned before that finasteride only inhibits 38% of scalp DHT, which is closer to the real value of around 25%. But I don't think scalp DHT measurements are fair because there is type I DHT, as well as the methods used to derive the measurement varies wildly between studies, so they aren't comparable. The study you cited in the latter post should be a little misleading, as shown by later studies on the issue. There is even a wide variance between 0.05 and 0.2 mg, which belittles it's credibility in my view.

Anyway, we know that non-balding follicles have around 40% less DHT levels than balding follicles, so one would assume that there is a threshold between that range that triggers the genetic coding for Androgenetic Alopecia. And with that said, if finasteride inhibits follicular DHT levels similar to non-balding follicles, then that should halt the miniaturization process. I don't have access to two studies that can show the exact values for those, but I'm assuming they are more than the 25% reduction of scalp DHT levels, probably closer to that 40%.

http://www.ncbi.nlm.nih.gov/pubmed/14757277
http://www.ncbi.nlm.nih.gov/pubmed/16536818

However, one old study from 1994 shows that it does actually reduce it to non-balding levels, at least on the scalp region.

http://www.ncbi.nlm.nih.gov/pubmed/8077349

- - - Updated - - -

serum dht doesnt matter. the dht is build in the follicle..
finasteride inhibits 5AR 2+3. nobody knows how much the 5AR3 is also in the follicle..
dutasteride inhibits 5AR1+2 (2 3-4x better than finasteride, 1 about 45 times i think... but dutasteride isnt as good in inhibiting 5AR3 as finasteride!). so combine it

this forum is soo bad
topical dutasteride works also
http://www.odermatol.com/wp-content/uploads/file/2013 1/9_Evaluation of the effect-Sobhy N.pdf


I`ve got all my hair back with finasteride orally + dutasteride topical + RU!

Who cares about 5-AR III. Both finasteride and dutasteride effectively block all of it at therapeutic doses.