I seem to be losing on Dutasteride. Any advice for me?

PleaseGrow

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I started losing hair at 16 (I am 27 now). Debatable whether it was anything drastic, but at that time I noticed my left temple was more sparse than my right. Finally, I turned 19 and started taking 1mg finasteride daily. I didn’t notice a difference to my hair on finasteride, but no further loss.

In 2020, I got a buzz cut. I was quite surprised to see thin coverage on top (compared to back and sides), so I decided to strengthen my fight against male pattern baldness and get on dutasteride 0.5mg/day (Aug 20).

Leading up to the switch, I had researched dutasteride extensively. The consensus was that it would reduce more DHT than finasteride, which seemed backed by studies where men taking dutasteride would see a greater increase in hair count when compared to finasteride.

So I was pretty shocked that, despite my good faith and best efforts, I saw my hair get progressively worse, and at what seemed an accelerated pace. I kept referring to online forums where people said to trust the process and ride it out, but at 18 months I was honest with myself that my hair wasn’t getting better. All the hair on top of my head had thinned. Now under bright light, my entire hairline, and hair on top is sparse, and my shiny scalp is noticeable.

I was perplexed… how could reducing my DHT result in much more loss? Then I read that dutasteride could increase T, which made sense since I have high libido on dutasteride. T can also miniaturise hair follicles, though not as much as DHT. I read about RU58841. A topical anti-androgenic solution which could compete against scalp T & DHT. Naturally I ordered it and started applying ~75mg every night to my scalp. I’ve been using it 4 months and cannot see any improvements. Perhaps it’s too soon, but I am tired/frustrated/depressed that nothing is working.

Surely I should make a change somehow? I thought about maybe having a regimen where I take a combination on finasteride and dutasteride. For example, finasteride 4x a week, and dutasteride 3x. The logic being that it may reduce T? Do you think it’s worth having my bloods done to see my T/DHT levels? I wouldn’t have anything to compare them to but I assume there are standard markers for high/low T.

I know a lot of people on this forum seem to be quite clued up, and are kind enough to give advice. So I would really appreciate any ideas or tips. Thank you so much for reading

I also posted a photo of my sparse hairline as it appears today.
 

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PleaseGrow

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Try dropping duta and using finasteride instead. You could have lots of T sensitive follicles
Is it possible that follicles can be effected more by T than DHT? Would you recommend I drop it completely for finasteride? Or gradually taper off dutasteride?
 

losingbattle88

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Is it possible that follicles can be effected more by T than DHT? Would you recommend I drop it completely for finasteride? Or gradually taper off dutasteride?
U cant taper dutasteride just quit it Right now. I did and my thinning slowed down after dropping it .......
 

Mr. Slap Head

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Is it possible that follicles can be effected more by T than DHT? Would you recommend I drop it completely for finasteride? Or gradually taper off dutasteride?
I believe it is possible. T sensitivity is pretty evident in female pattern baldness as they often have very little DHT. If you stop taking dutasteride, it will gradually be excreted from your system because it has a half life of 5 weeks, so there’s nothing wrong with making an immediate switch. The reason I suggest trying it is because dutasteride increase scalp T by 200%, whereas finasteride only increases it by about 25%.
 

losingbattle88

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I believe it is possible. T sensitivity is pretty evident in female pattern baldness as they often have very little DHT. If you stop taking dutasteride, it will gradually be excreted from your system because it has a half life of 5 weeks, so there’s nothing wrong with making an immediate switch. The reason I suggest trying it is because dutasteride increase scalp T by 200%, whereas finasteride only increases it by about 25%.
Well 200% is from 2.5mg. 100% is from 0.5mg. fina 1mg raise scalp T by 23%.
 

Dr sanches

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I started losing hair at 16 (I am 27 now). Debatable whether it was anything drastic, but at that time I noticed my left temple was more sparse than my right. Finally, I turned 19 and started taking 1mg finasteride daily. I didn’t notice a difference to my hair on finasteride, but no further loss.

In 2020, I got a buzz cut. I was quite surprised to see thin coverage on top (compared to back and sides), so I decided to strengthen my fight against male pattern baldness and get on dutasteride 0.5mg/day (Aug 20).

Leading up to the switch, I had researched dutasteride extensively. The consensus was that it would reduce more DHT than finasteride, which seemed backed by studies where men taking dutasteride would see a greater increase in hair count when compared to finasteride.

So I was pretty shocked that, despite my good faith and best efforts, I saw my hair get progressively worse, and at what seemed an accelerated pace. I kept referring to online forums where people said to trust the process and ride it out, but at 18 months I was honest with myself that my hair wasn’t getting better. All the hair on top of my head had thinned. Now under bright light, my entire hairline, and hair on top is sparse, and my shiny scalp is noticeable.

I was perplexed… how could reducing my DHT result in much more loss? Then I read that dutasteride could increase T, which made sense since I have high libido on dutasteride. T can also miniaturise hair follicles, though not as much as DHT. I read about RU58841. A topical anti-androgenic solution which could compete against scalp T & DHT. Naturally I ordered it and started applying ~75mg every night to my scalp. I’ve been using it 4 months and cannot see any improvements. Perhaps it’s too soon, but I am tired/frustrated/depressed that nothing is working.

Surely I should make a change somehow? I thought about maybe having a regimen where I take a combination on finasteride and dutasteride. For example, finasteride 4x a week, and dutasteride 3x. The logic being that it may reduce T? Do you think it’s worth having my bloods done to see my T/DHT levels? I wouldn’t have anything to compare them to but I assume there are standard markers for high/low T.

I know a lot of people on this forum seem to be quite clued up, and are kind enough to give advice. So I would really appreciate any ideas or tips. Thank you so much for reading

I also posted a photo of my sparse hairline as it appears today.
So you maintained on finasteride from 19-26?
 

RagnarLothbrok

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There is very little evidence that T causes significant enough hair loss to that extreme point to make dutasteride worse than finasteride, in every single trial and metanalysis comparing finasteride vs dutasteride, 0.5mg dutasteride outcompetes every finasteride dose, even >5mg. By sheer logic moving back to finasteride should be even worse in most cases.

In any case, might be helpful to test your hormones. Maybe you're paranoid about T and you have sh*t T levels after all. Or maybe you have supraphysiological T levels and you are on to something. Maybe your systemic DHT is still high. Only way to know is to test it so you know if dutasteride is working as intended or not
 

RagnarLothbrok

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I really wanna see a study on 10 years of finasteride vs 10 years on finasteride and minoxidil .
mm thats interesting. Most people who have been fighting hairloss for many years usually don't have a great opinion on minoxidil (but still take ARIs)
 

losingbattle88

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that is the thing, i lost ground on finasteride, too, otherwise i wouldnt have switched...
some say that you better not switch back, though...
Switch? To ? I lost ground fast on duta but thinning wayyy slower ever since dropping it and starting finasteride. Dutasteride made me feel like i was on steroids man. I dont feel like that on finasteride.
 

Dr sanches

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mm thats interesting. Most people who have been fighting hairloss for many years usually don't have a great opinion on minoxidil (but still take ARIs)
I wanna see how long the efficacy of finasteride + min is vs finasteride Alone
 
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