just starting out -- dutasteride (avodart) questions

[agingdisgracefully]

hello,

i've been reading the forum for a couple weeks now, just got my prescription for avodart and wanted to post with a couple questions before i begin.

the back story: in a nutshell, i started losing my hair when i was 25 (i am now 35). it was slow at first, and using rogaine even just once a day has until recently been enough to keep further loss at bay. i've just now switched to the recommended 2x daily. i am about halfway between a norwood II and III vertex. i wasn't too worried about my receeding hairline at first because i actually like a nice M line. but of course it won't simply stop where i want it to so now i've gotta work to contain it.

i've noticed over the last few months that my hair loss has really sped up, and it's spurred me to take an aggressive approach. i talked to my gp and got a prescription for avodart. i went stratight for the dutasteride because my research indicates that it's more effective for blocking dht. however, i read here that these treatments can lose efficacy over time. one user suggested to another with beginning hairloss start off with a lower dose of finasteride than what he was taking so that he could increase the dose later on when he needed it more. my first questions is this: does that rationale hold up? do the dht blockers lose effectiveness because your body gets desensitized, or because your follicles become more sensitive to dht over time? i'm wondering if i should start first with finasteride and then move to dutasteride, or if i should just stick with dutasteride because it'll work for however long it'll work and that's that.

second question: what dosage should i use? i have .5mg pills, which is the only dosage currently manufactured (pls correct me if i am wrong). they're not soft or squishy, but i hear they are actually gelcaps so you can't cut them in half. should i take a pill daily? every other day? i know i have this medication prescribed off-label so it's all a bit experimental, but what's the conventional wisdom regarding dosage?

third question: is shedding common with finasteride/dutasteride? do these drugs affect the current growth cycle of hairs? when i started rogaine i had a noticeable shed. also, my hair is very sensitive to stress. any time i go thru something really really stressful (ie rough breakup, getting attacked/mugged) it's really common for me to shed and lose a ton of hair. it mostly grows back, but it's alarming. anyhow, if shedding is a side effect, i'm probably ripe for it. i just want to be prepared. maybe i'll shave my head this summer.

i realize this post is long -- apologies and thanks for any help and input. also, if all this information already exists in a section of this forum, i apologize for being repetitive -- i just haven't found it yet! links/suggestions greatly appreciated.

cheers!
-kevin

 

[Innermind]

holy f***. I wrote this whole long thing only to have it fashfpdoasfasdpo deleted by some f*****g click. So i will summerize it cause i do not want to repeat it god damnit.


Get on finasteride, specifically proscar and cut it into fifths. Approx cost 15$ USD a month. Your hairloss does not justify you using dutasteride, as side effects are more common and long term side effects are not known(most users are 60+ year old men who die soon anyway, so long term effects of dutasteride are not know). finasteride has a semi long term good track record(10-15years) now in terms of side effects and health when used for hair. Also, yes, it is theorized that DHT blockers lose there effectivness over time. So its best to start at the lowest dose and than increase as nessecary.

dutasteride, finasteride do not cause much shedding, but it does happen. I will say, however, that it is no where near as bad as the minoxidil shed.

Get on copper peptide product as well. I reccomend Folligen as its cheap and lasts forever. This can reduce shedding and has also been proven to be as effective as 2% minoxidil. This can also help with shedding from stress.

As far as shedding from stress, coppper peptides can help, but you should also think of adding an anti inflammatory product like emu oil. Also, Nizoral and shampoo containing pirolocone olamine have shown to increase hair count and diameter and reduce inflammation, as stress can cause inflammation and cause your body to attack the follicle which could be causing your shedding when you are stressed out.

Good luck. sorry if spelling is bad i just dont feel like checking it after my :sobbing: previous post got deleted.

 

[metropolis]

1) I've been using Proscar 1/4 for the last 13 years and it's still working.

2) I believe 1 mg finasteride is the most sensible option. If it doesn't work, increase the dosage.

3) I have no idea. No shedding in my case.

 

[monitoradiation]

I didn't know GP's would prescribe dutasteride before finasteride... That's news to me.

dutasteride blocks both type 1 and 2 AR whereas finasteride only blocks type 2; I'm not aware of any studies detailing the consequences of long-term blocking type 1 AR, but there are some functions of it in the brain. This is why I don't know why your GP would prescribe you dutasteride for hairloss, something that they deem purely cosmetic in nature.

In any case, yah I've been wondering about why it is that people report drugs losing their potency over time; I think it's probably because not 100% of follicle DHT is blocked and is hence still able to attack some of your follicles; over time the damage builds up. Like skin damage; you can wear all the sunscreen you want, but if you're out in the sun, unless you've got 100% protection like a lead dome over you, your skin will still get some damage.

 

[agingdisgracefully]

thanks for all the input thus far!

monitoradiation: she prescribed it because i asked for it. told her i wanted to hit it hard and fast, and dutasteride -- according to all my research -- is stronger than finasteride. she did her research and wrote the prescription. she's more like a partner in my healthcare than a gatekeeper. that's why i like her. she knows i do a lot of reasearch before putting anything in my body, and she trusts me to be honest and upfront with her regarding side effects.

i'm aware that finasteride could work just fine. however i'm in a place now where i don't want to dilly around for 6 mos to a year figuring out if finasteride works while, if it doesn't, i lose more follicles. my objective right now is to STOP the loss. once i'm successful in that, i may decide to scale back and see if i can make due with finasteride. not sure tho. there's something about the whole 'start-finasteride-first-in-case-it-loses-efficacy' thing that doesn't quite add up. but that's another post.

currently, my regimen is .5 duta daily, minoxidil 5% 2x daily, and nizoral 4-5 days a week. this is my first week on that regimen (up from only minoxidil 1x daily and tar shampoo for the related dandruff 3x a week). it's far too soon to notice any changes in hair growth/loss, tho i'm happy to announce that the god-awful itching seems to have stopped. NICE.

i'll report back if/when i notice any change in shedding/growth/loss.

cheers!

 

[metropolis]

I didn't know GP's would prescribe dutasteride before finasteride... That's news to me.[...]

Yeah, I think it's crazy to jump directly into Avodart without giving finasteride a try first.

 

[agingdisgracefully]

why crazy? it seems logical to me to want to attack a problem using the strongest resources available. while not as thoroughly tested for hair loss *specifically*, dutasteride has been thoroughly tested and deemed as safe to take as pretty much any other similarly aged drug on the market now, regardless of the ailment it's prescribed for. in other words, i'm pretty certain that taking dutasteride poses no more long term health risk than the medicines i take for asthma or anxiety. there is risk of course, but it is a reasonable and calculable risk i'm willing to take.

like i said, once i halt the shed i've been experiencing over the last year i'll regroup and experiment to see what the lowest possible dosage/least potent medicine i can subsist on. kinda like how i used minoxidil. i started out several years ago following the instructions to the letter. but once i stopped losing hair and began regrowing, i slowly ramped down to see how little i could get by on. rogaine 1x a day did the trick for a couple years.

had the efficacy of my regimen declined more slowly, i probably would have started by just going back to minoxidil 2x a day, and then perhaps trying finasteride. as it happened, my previous success with rogained lulled me into comfort and complacency -- it was only a few months ago that i kinda woke up and realized that my M line had thinned considerably. i'd gotten so accustomed to watching the 2 points of my M line for recession that i completely missed that my hair was also thinning, not just receeding. yipes!

to reiterate, i'm open to hearing differing opinions on why i should take a different approach. it's just that so far a lot of that advice seems based on as much supposition as my decision to bypass finasteride for avodart. for the time being, i'd rather err on the side of the stronger drug. i may well change my mind down the road.

cheers!

 

[monitoradiation]

As long as your GP knows what you're doing and agrees, I have no problem with that.

You mentioned that you use Nizoral 4-5 times a week? I used to do that; at first it reigned in the irritation but later on I think it dried out my scalp to the point where it again became irritated. Just a personal anecdote; it might be just fine for you.

Keep us updated.

 

[Innermind]

you'd rather err on the side of a stronger drug? lol. Okay, thats got to be one of the most ignorant statements regarding personal saftey and health than any I've ever heard.

Your hairloss is not that severe, propecia, along with your current regieme minus the dutasteride, would probably stop your hairloss. Long term saftey regarding dutasteride hasnt really been studied, yes its been around for a while, but most of the people who take it are 60+ and die soon anyway. And there is evidence to suggest it could affect the brain. If you are to err, err on the side of caution. You should have given finasteride a chance for at least 6 months before deciding to go hardcore. dutasteride is probably safe for you, but honeslty, why take the unnesscary chance, and dont say to "not f*** around" or some other gung ho statement regarding your mild hairloss which finasteride could most likely take care off.

 

[HughJass]

And there is evidence to suggest it could affect the brain.

got any links for that?



I was under the impression that nothing more than a large question mark hung over the the issue of weather or not inhibiting type 1 could cause neurological problems...

 

[Innermind]

I dont have evidence that it does effect the brain. I state.... it could....
It has been shown that type I enzyme is found in significant quantities in the brain. This is evidence it could effect the brain,...key word could. Imo, its just not worth the risk. There are also forum posters who have switched from finasteride to dutasteride and experience increased "brain fog" and increase incidents of depression.

 

[HughJass]

This is evidence it could effect the brain,...key word could.

Well, it's not really evidence then. Just a possibility based on what we know about where DHT is found in the body.


If I sound a stickler for terminology, it's because I scare easily