So obviously DHT is the primary cause of male pattern baldness (with the genetic predisposition). What is the cause for those people who don't respond to finasteride then? Or even the more extreme dutasteride? If someone continues to lose their hair at the same rate on or off the drug, then wouldn't something else most likely be causing the loss? Clearly if you lower your DHT levels by 90%, as dutasteride does, it should stop your hair loss or possibly cause some regrowth. But this isn't the case for everyone. Does that mean that some other hormone, such as testosterone, is causing the hair loss for these people, or is this something we just don't know yet?
In People Who Are Not Responsive To Finasteride/dutasteride What Is Responsible For Their Hair Loss?
- Thread starter dralex
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I'm skeptical of the idea that DHT is the only hormone responsible for hair loss.
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The expression of insulin-like growth factor 1 in follicular dermal papillae correlates with therapeutic efficacy of finasteride in androgenetic alopecia.
RESULTS:
IGF-1 was up-regulated by finasteride treatment in 4 of 9 patients. Among the patients with increased IGF-1 expression, 3 of them showed moderate clinical improvement after 12 months of treatment and another patient remained unchanged. In contrast, 3 patients with decreased IGF-1 expression in the balding scalp showed clinical worsening after 12 months. The other 2 patients without noticeable change in IGF-1 expression showed either slight improvement or no change in their hair condition.
https://www.ncbi.nlm.nih.gov/pubmed/12894070
RESULTS:
IGF-1 was up-regulated by finasteride treatment in 4 of 9 patients. Among the patients with increased IGF-1 expression, 3 of them showed moderate clinical improvement after 12 months of treatment and another patient remained unchanged. In contrast, 3 patients with decreased IGF-1 expression in the balding scalp showed clinical worsening after 12 months. The other 2 patients without noticeable change in IGF-1 expression showed either slight improvement or no change in their hair condition.
https://www.ncbi.nlm.nih.gov/pubmed/12894070
I think the simple answer is we dont know.
Playing the what if game though someone could have hair that is very sensitive to androgens where maybe even testosterone or tiny amounts of DHT are enough to keep it going. Also once a hair starts miniaturizing from DHT other factors come into play and its much more complicated. So it could also be an issue of timing. When did you take finasteride/dutasteride? Was it at the absolute first sign of male pattern baldness or before or was it later after male pattern baldness was in gear for years? Taking dutasteride later on might not reverse or stop the process it might be too late. Ounce of prevention worth a pound of cure type of thing.
Playing the what if game though someone could have hair that is very sensitive to androgens where maybe even testosterone or tiny amounts of DHT are enough to keep it going. Also once a hair starts miniaturizing from DHT other factors come into play and its much more complicated. So it could also be an issue of timing. When did you take finasteride/dutasteride? Was it at the absolute first sign of male pattern baldness or before or was it later after male pattern baldness was in gear for years? Taking dutasteride later on might not reverse or stop the process it might be too late. Ounce of prevention worth a pound of cure type of thing.
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Too dumb to figure this out, does this show that finasteride upregulates IGF-1 or that patients with higher IGF-1 levels respond better to finasteride (or both)? If that's the case, IGF-1 has local effects near where it's injected so administering IGF-1 near the scalp could be a good adjunct to finasteride
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The patients who get better hair from finasteride tend to also get more IGF-1 near the hair when using finasteride.
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I see, was tired when I read it. so one of the reasons (big or small) that finasteride works is by increasing IGF-1, it would be nice if there was more evidence showing how big a part IGF-1 plays in hair growth compared to the other growth factors and other effects of finasteride. I wonder if anyone has tried IGF-1 injections or some sort of transdermal IGF-1 on the scalp
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True, there are many finasteride users without any result with this drug.
I take finasteride since 2 months. If i don't see any results after 6 months i will quit with this drug and the only solution is a hair transplant or i shave it off
Here a website where you can see many different results on finasteride + minoxidil:
http://www.beIgraviacentre.com/success-stories/#2555,2530
Some have an amazing result and many people have absolute 0 result with this drug.
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What other hormones do you think could be responsible? DHT is the most potent androgen.
Castration typically stops male pattern baldness, it doesn't cause regrowth, probably because it eliminates estrogen as well.
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Castration typically stops male pattern baldness...
Ok then it's time to kill testosterone
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Castration typically stops male pattern baldness...
Ok then it's time to kill testosterone
Lol ya... kill anything you want, but only in the scalp mate. Also, I tracked down this video, didn't see any evidence of hair regrowth. Does she still have to wear a wig?
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Castration effects a lot of hormones, and some castrated men still go bald. Some women go bald. Men with low testosterone go bald just as often as men with high testosterone.
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I haven't seen this yet. Evidence?
I don't know much about female hair loss but I suppose their bodies still have the ability to make DHT. Different genetics of the hair follicles could mean some women have an unfavorable amount of aromatase in their hair follicles and make more androgens than estrogens as they should. (I don't have evidence for this, just speculating)
Well, that should mean testosterone is not a likely culprit then, don't you think?
https://en.wikipedia.org/wiki/Androgen#Relative_potency_of_natural_androgens_.28.25.29
Here's a list of most major androgens. I don't understand the relative potency as it doesn't sound right. DHT is more potent than T, so I don't understand this measurement.
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What amazes me is that with 20 years of finasteride use that the derm community has made no attempt to find correlations that would predict efficacy.
How about just start somewhere?
Every derm that treats hairloss should order an endocrine panel. The first thing. Not looking at the scalp or hair. No. First get a picture of what is going on in the endocrine system. Plug the panel results into a database so that the panels of finasteride responders could be compared to non responders. There might not be any correlations to be found but we just don't know. It's like derms have no scientific curiosity. This would greatly advance hairloss knowledge.
The obvious starting point would be serum DHT levels. It would seem that someone with high serum DHT levels would also have high levels in the scalp too.
The process of elimination needs to start somewhere.
I was reading a post on Rassman's blog about a presenter at a dermatology conference that proposed that men with low DHT would not be good responders to finasteride.
Really? A drug that can regrow hair by inhibiting DHT has something to do with DHT levels? Eureka!!!
And this was in 2014.
With this kind of genius doing hairloss research, we have a long way to go.
How about just start somewhere?
Every derm that treats hairloss should order an endocrine panel. The first thing. Not looking at the scalp or hair. No. First get a picture of what is going on in the endocrine system. Plug the panel results into a database so that the panels of finasteride responders could be compared to non responders. There might not be any correlations to be found but we just don't know. It's like derms have no scientific curiosity. This would greatly advance hairloss knowledge.
The obvious starting point would be serum DHT levels. It would seem that someone with high serum DHT levels would also have high levels in the scalp too.
The process of elimination needs to start somewhere.
I was reading a post on Rassman's blog about a presenter at a dermatology conference that proposed that men with low DHT would not be good responders to finasteride.
Really? A drug that can regrow hair by inhibiting DHT has something to do with DHT levels? Eureka!!!
And this was in 2014.
With this kind of genius doing hairloss research, we have a long way to go.
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I don't feel like searching for it, but we've seen photos on here. Women do have some DHT but their levels of DHT are very, very low, it's ~3-10x lower in women than in men.
http://www.hemingways.org/GIDinfo/hrt_ref.htm
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Correlation doesn't prove causation here
True, but there are studies showing IGF-1's positive effect on hair growth https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283847/
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this is actually quite interesting i think?
the igf-1 and finasteride connection could be something wroth exploring