Higher Dose of finasteride or Dusteride?

s322

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I have been on finasteride for about 2 years, and it has slowed the hair loss, but it's 50/50 whether it has stopped it completely or not. Haven't done minoxidil, but might try it. The real question is if finasteride at 1mg isn't giving the full desired effect, should I up the dose (1.5mg I guess) or give Dusteride a shot? My two concerns with Dusteride are of course side effects and transition. Less risky would be upping finasteride, but not sure it would have a greater effect. Some people say yes, some say no. thoughts?
 

talmoode

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some guy on this forum said that he upped the does from 1 mg to 1.25 or 1.65 (?)mg and he got some impressive results. but then again, I have seen studies on finasteride's flat does response. So I guess the best way to find out is to try yourself?
 

antman

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the study that found finasteride to have a flat high bioavailablity (80%) is wrong (1). finasteride can have low oral bioavailability (range 34 - 108%) (2). I'm pretty sure i have seen another study state 22% as the low end, but i can not find it.

1.Pharmacokinetics and oral bioavailability of the 5a-reductase inhibitor finasteride in man (1990)
2. Finasteride: the first 5 alpha-reductase inhibitor (1993)

A higher dosage of finasteride would the easiest and safest option (other than discontinuing taking finasteride of course). finasteride has ready had a positive effect on your hairloss but you don't know about dutasteride.

If you have the resources, topical finasteride (given the correct vehicle) is another viable option (3,4).
3. Comparing the therapeutic effects of finasteride gel and tablet in threatment of androgenetic alopecia
4. Efficacy of 3% Minoxidil Versus Combined 3% Minoxidil and 0.1% Finasteride for Male Pattern Hair Loss: a Randomized, Double-blinded, Comparative Study
 

Lukas73

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the study that found finasteride to have a flat high bioavailablity (80%) is wrong (1). finasteride can have low oral bioavailability (range 34 - 108%) (2). I'm pretty sure i have seen another study state 22% as the low end, but i can not find it.

1.Pharmacokinetics and oral bioavailability of the 5a-reductase inhibitor finasteride in man (1990)
2. Finasteride: the first 5 alpha-reductase inhibitor (1993)

A higher dosage of finasteride would the easiest and safest option (other than discontinuing taking finasteride of course). finasteride has ready had a positive effect on your hairloss but you don't know about dutasteride.

If you have the resources, topical finasteride (given the correct vehicle) is another viable option (3,4).
3. Comparing the therapeutic effects of finasteride gel and tablet in threatment of androgenetic alopecia
4. Efficacy of 3% Minoxidil Versus Combined 3% Minoxidil and 0.1% Finasteride for Male Pattern Hair Loss: a Randomized, Double-blinded, Comparative Study

Hey, so you believe that in some people the increased dose might have more of an effect thanks to bio-availability? I would definitely agree with you.
It's interesting (and sad) that many doctors do not view it like that and only prescribe 1mg to everyone.
On the other hand, do you think that the higher dose could in some people cause more harm that good hair-wise?
 

Heyman

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the study that found finasteride to have a flat high bioavailablity (80%) is wrong (1). finasteride can have low oral bioavailability (range 34 - 108%) (2). I'm pretty sure i have seen another study state 22% as the low end, but i can not find it.
So what has bioavailability to do with it? If 0.2mg surpresses pretty much as much DHT as 1.0 mg does (in the scalp), then even if you had only 20% of the bioavailable in 1.0mg, you'd still have the same effect pretty much?

Edit: I'm not able to find the "Pharmacokinetics and oral bioavailability of the 5a-reductase inhibitor finasteride in man " study. Where is it from?
 

antman

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I do not know if too much finasteride can result in worse results for hair but I am pretty sure some people (not many) would have better results with more finasteride.


I can’t find an electronic copy of the study sorry (1)

(1) G. A. Wind, S. Gregoire, M. L. Constanzer, B. K. Matuszewski, and P. J. DeSchepper: Pharmacokinetics and oral bioavailability of the 5a-reductase inhibitor finasteride in man. Pharmaceut. Res. 7, (Suppl.) 251 (abstr.)(1990)

I have a copy of the review
(2) Clinical Pharmacokinetics and Pharmacodynamics of Finasteride (1996)
https://www.dropbox.com/s/v7osmfcpkv716j4/Clinical%20Pharmacokinetics%20and%20Pharmacodynamics%20of%20Finasteride%20%281996%29.pdf
(if you get error 404 try a different browser)

Scalp DHT is suppressed more at high dosages (3)

0.01 mg finasteride = 14.9% scalp DHT decline
0.05 mg finasteride = 61.6% scalp DHT decline
0.2 mg finasteride = 56.5% scalp DHT decline
1 mg finasteride = 64.1% scalp DHT decline
5 mg finasteride = 69.4% scalp DHT decline

(3) The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia (1999)
https://www.dropbox.com/s/7obzuq004i20ej9/Finasteride androgen Skin (1999).pdf
(if you get error 404 try a different browser)
 

s322

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So, more finasteride's not gonna help that much. I hate to say it, but 1mg isn't getting the job done. Slow hair loss still. When I see this;

1 mg finasteride = 64.1% scalp DHT decline

That's like saying the flood gates are 64% closed. That's a lot getting through to cause hair damage unless I am incorrect. Regardless, advice from here guys? Here are my options as I see them;

*minoxidil. Not excited, but not excited about hair loss either
*More finasteride. 1.25 or 1.5
*dutasteride. This is potentially scary, but maybe not.

I went to a hair transplant Doctor and he said I was still in a place where it could be saved without surgery, said if it progressed come back in a year or two. I am not bald but my hair is thin, high hair line and real thin at crown. I'm in my late 30's, so less disturbed by it, but who wants to lose their hair lol?

How do you all think I should proceed? Appreciated on that input.
 

Lukas73

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20x more finasteride = 1.04x more DHT reduction.
Where did you get the numbers for 20mg of finasteride? or for 100mg of finasteride?
Based on the scalp DHT reduction in the study posted by antman finasteride at 1mg is 92.36% as effective as 5mg. So you get roughly 7.64% increase in effectiveness by taking the whole 5mg pill. Since you don't have numbers for the higher amount of finasteride and scalp DHT reduction its all just a speculation.
And 5x (5mg) more finasteride (1mg)= 1.0826x scalp DHT reduction!
 

antman

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The side effects with dutaseride are not exactly random. Being healthy will reduce your chance of getting sides.

Dutasteride side effects (n= 8231)
Age, International Prostate Symptom Score, Body Mass Index, diabetes and glucose intolerance, but not serum testosterone or Total Prostate Volume, were significant independent predictors of sexual dysfunction. (1)

(1) Low serum testosterone levels are poor predictors of sexual dysfunction. 2010


There was another study that measured scalp DHT reduction (2) and got very different results. Which, to me, makes it questionable about the accuracy of measurement or it may mean that there is a large variation in people’s responses or something else.

The dusteride dose of 2.5-mg was better than the dutasteride dose of 0.5-mg at suppressing scalp DHT (79% vs 51%),
5 mg finasteride suppressed scalp DHT to a similar degree as 0.1 mg dutasteride group (41% and 32%, respectively).
The 2.5mg group had the highest satisfaction in scalp hair growth of 72% compared with 56% from 0.5mg.

There were no significant differences in total adverse events, serious adverse events, or withdrawals due to adverse events among any of the treatment groups, including placebo.

The only subject to develop gynecomastia was in the placebo group.

(2) The importance of dual 5a-reductase inhibition in the treatment of male pattern hair loss: Results of a randomized placebo-controlled study of dutasteride versus finasteride. 2006 (n=416)

o6mJAXQ.png
 

s322

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Looks like dutasteride 2.5 is the big winner in that study. I guess more people don't use it because of feared side effects.

Back to it though, as much as these stats are interesting, would appreciate some input on what I posted up as far as which way to go;

Here are my options as I see them;

*minoxidil. Not excited, but not excited about hair loss either
*More finasteride. 1.25 or 1.5
*dutasteride. This is potentially scary, but maybe not.

Because right now holding steady with 1mg of finasteride and Nizoral twice a week isn't cutting it. Still getting a gradual decline. Appreciated on the advice.
 

antman

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Because right now holding steady with 1mg of finasteride and Nizoral twice a week isn't cutting it. Still getting a gradual decline. Appreciated on the advice.

From my experience - i recommend 2.5 mg finasteride, cut from 5 mg finasteride tablets.


This is why:
I was on 1 mg finasteride and had some results. i switched to dutasteride 0.5 mg because i wanted more.

But on dutasteride my hair started going back to the way it was pre-finasteride which was
- positive pull test
- wispy hair
- less colour

Now i am back on finasteride and my hair is going back to post-finasteride
- negative pull test
- stronger hair
- more colour

finasteride has already produced some positive effect on you hair, if you drop it, then you risk losing a lot of ground and not being able to recover it.
 

dickhair

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dutasteride isn't working for me. I don't understand why people think it's better than finasteride (which is pretty useless too).
 

Balding_1

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Hey all, I've been taking finasteride (proscar cut up into 4ths) since I was 22 years old (I'm now 31) and have maintained. Probably should write something up in the success section I guess. I've never experienced any noticeable side effects either. Over the last few months I've noticed some thinning pretty much all over my head, but these things are hard to tell since I have fine/thin hair naturally; maybe I'm just being paranoid. Either way, I'm considering dutasteride, but maybe I'll try upping my finasteride dosage for awhile to see how it goes. Thanks for the info.

It freaks me out a little that people experience negative growth when switching from finasteride to dutasteride. Especially when looking at the posted studies; shouldn't dutasteride blow finasteride out of the water every time and for most people? I don't get it.

For the curious: Trust in the big three! They have definitely worked for me. I've tried other stuff like foligen and tricomin but I've never used them consistently. They might help, but money is probably best spent elsewhere!
 

Ventures

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According to data from @Atman on previous page of this thread. How it is possible that 0.05 mg finasteride reduces 61.6% scalp DHT and 0.2 mg 56 % . So I don't get it how 0.05 mg finasteride (which is 4 time less then 0.2 mg) reduces more scalp DHT ?
 

Ventures

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Scalp DHT is suppressed more at high dosages (3)

0.01 mg finasteride = 14.9% scalp DHT decline
0.05 mg finasteride = 61.6% scalp DHT decline
0.2 mg finasteride = 56.5% scalp DHT decline
1 mg finasteride = 64.1% scalp DHT decline
5 mg finasteride = 69.4% scalp DHT decline

(3) The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia (1999)
https://www.dropbox.com/s/7obzuq004i...(1999).pdf
(if you get error 404 try a different browser)"

how it is possible that 0.05 mg finasteride reduces 61.6% scalp DHT and 0.2 mg 56 % . So I don't get it how 0.05 mg finasteride (which is 4 time less then 0.2 mg) reduces more scalp DHT ?
 

psyhotria

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how it is possible that 0.05 mg finasteride reduces 61.6% scalp DHT and 0.2 mg 56 % . So I don't get it how 0.05 mg finasteride (which is 4 time less then 0.2 mg) reduces more scalp DHT ?
They intentionally twisted the numbers :D
 
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