My hair has been constantly miniaturizing all over ever since taking Dutasteride

[Lucus]

So what are you suggest?

From my point of view: some of us have problems with T. dutasteride controls DHT but increases free T.

It´s not something like: dutasteride doesn´t do anything, it´s more like dutasteride is doing me wrong.

Maybe it´s not the point, but it´s the more likely I know.

 

[coco_304]

From my point of view: some of us have problems with T. dutasteride controls DHT but increases free T.

It´s not something like: dutasteride doesn´t do anything, it´s more like dutasteride is doing me wrong.

Maybe it´s not the point, but it´s the more likely I know.

What can block T?

 

[Lucus]

What can block T?

RU, Pyru, Alphatradiol,...

Be careful, T can not be blocked as DHT.

 

[bulli103]

Zero.

I had a heart check-up before starting the treatment, and I have another check-up in December after six months of use. The idea is to keep monitoring it; I think this is extremely important.

your Doctor recommend this even on such a low dosage ?..., it even doesn't change your blood pressure, my Doctor told me when i started...i take 10 mg since more than 20 years, i know guys they take 20 mg/day without problems
pyri doesn't work...add cb0301, it will help you too

 

[Ispita]

So what are you suggest?

Always start battling hairloss with finasteride and only switch to dutasteride if it doesn’t help (after like 1 year and do trichoscopy evaluations, not just looking in the mirror)

How receptors can get upregulated.?

I managed to get in contact with an endocrinologist who saw similar cases before, she explained that the theory is dutasteride so strongly inhibits dht in some individuals (like me) the body “sees” it as a threat and tries to go back into homeostasis. Since the DHT level is lowered it reacts by increasing the sensitivity of the androgen receptors to androgens to maintain the same hormonal uptake = reflex hyperandrogenicity where on paper you have lower DHT levels than a teenage girl in reality however your scalp hair is getting butchered

The only solution is use finasteride (milder 5aRI inhibition) or topical anti-androgen like RU-58841

As for reversing reflex hyperandrogenicity, she said the body eventually should go back to baseline after dutasteride leaves the system (~ 6 months). If it does not, methods to get it back are futile, as RA is not defined officialy in endocrinology textbooks as it is a new phenomenon, people didnt take en masse dutasteride before in history.

Some people I talked to said some possible (very dangerous) methods include topical estrogens, Spironolactone or blasting DHT derivative steroids to reset androgen receptors

 

[BRezende]

From my point of view: some of us have problems with T. dutasteride controls DHT but increases free T.

It´s not something like: dutasteride doesn´t do anything, it´s more like dutasteride is doing me wrong.

Maybe it´s not the point, but it´s the more likely I know.

Its not a question of testosterone because theres people in this fórum who used antiandrogens and estrogens and was still losing hair.

 

[BRezende]

The only solution is use finasteride (milder 5aRI inhibition) or topical anti-androgen like RU-58841

She was right about the reflex hiperandrogenicity explanation but theres no evidence that finasteride or any other medicine can cure this, actually finasteride can also trigger it.

 

[Lucus]

Its not a question of testosterone because theres people in this fórum who used antiandrogens and estrogens and was still losing hair.

But it´s like if I say it´s not a question of DHT because there are a lot of people losing ground on finasteride and dutasteride.

 

[corn_scoops]

Yes it’s kind of a mind f*** tbh. Best to wait till pp405 comes out bc it seems to actually work

 

[Ispita]

Yes it’s kind of a mind f*** tbh. Best to wait till pp405 comes out bc it seems to actually work

Unfortunately I cannot wait, I already regret not starting finasteride in my early 20s, I shouldnt have waited until mid 20s. Sucks that people balding in their current 20s might perhaps be the last or one of the last generations who had to cope with this horrible disease. I’m rather certain in around 20 years time, by the middle of the century we will have hair cloning.

 

[Mr. Slap Head]

Yes it’s kind of a mind f*** tbh. Best to wait till pp405 comes out bc it seems to actually work

Nice pp

 

[BRezende]

But it´s like if I say it´s not a question of DHT because there are a lot of people losing ground on finasteride and dutasteride.

yes its not a question of DHT either for some of us, lncluding myself.

 

[Lucus]

Unfortunately I cannot wait, I already regret not starting finasteride in my early 20s, I shouldnt have waited until mid 20s. Sucks that people balding in their current 20s might perhaps be the last or one of the last generations who had to cope with this horrible disease. I’m rather certain in around 20 years time, by the middle of the century we will have hair cloning.

But ... don´t you feel incredible after "solving" your problem with dutasteride? I mean, I see your hair now and it seems to be thick, full and healthy.

 

[SadAndMad]

My case testifies that at the end of the day, unfortunately, it’s about androgen receptor sensitivity, not DHT level per se. Dutasteride (especially at 2.5 mg ED) obliterates DHT but you will still continue to bald if your receptors get upregulated.

Are you sure it wasn’t oral minoxidil that caused the reversal, rather than quitting dutasteride? You began taking it around the same time you stopped dutasteride, didn’t you?

 

[corn_scoops]

Unfortunately I cannot wait, I already regret not starting finasteride in my early 20s, I shouldnt have waited until mid 20s. Sucks that people balding in their current 20s might perhaps be the last or one of the last generations who had to cope with this horrible disease. I’m rather certain in around 20 years time, by the middle of the century we will have hair cloning.

But aren’t you ok now? I saw your post . If your receptors were truly regulated I don’t think switching to finasteride would’ve helped you but it did

 

[Armando Jose]

I managed to get in contact with an endocrinologist who saw similar cases before, she explained that the theory is dutasteride so strongly inhibits dht in some individuals (like me) the body “sees” it as a threat and tries to go back into homeostasis. Since the DHT level is lowered it reacts by increasing the sensitivity of the androgen receptors to androgens to maintain the same hormonal uptake = reflex hyperandrogenicity where on paper you have lower DHT levels than a teenage girl in reality however your scalp hair is getting butchered

Do you, or your endocrinologist, know that key androgens in hairs are produced inside pilosebaceous unit?
Also, IMHO, increasing sensitivity of androgens receptors explanation is not correct.

 

[Jonah]

Do you, or your endocrinologist, know that key androgens in hairs are produced inside pilosebaceous unit?
Also, IMHO, increasing sensitivity of androgens receptors explanation is not correct.

What do you think the correct explanation is for upregulated androgen receptors?

 

[Armando Jose]

What do you think the correct explanation is for upregulated androgen receptors?

It is fake sci

 

[BT20]

Hello everyone,

as a long time silent lurker of this forum, I finally gathered the mental strength to share how my life have taken a 180 degree turn in the most gruesome sense after I hoped I could keep my androgenic hairloss at bay with Dutasteride.

I write this in complete desperation as nothing seems to be helping my condition at this point.

Before taking Dutasteride, the background context

I am currently in my mid 20s., I first noticed the early signs of androgenic alopecia about five years ago - hair was beginning to turn into baby hair along my hairline around the time I entered my 20s. This progressed on for years, although the recession of my temples have became noticeably faster in the last 1 year.

I was already aware of the range of hair loss treatments years ago, however up until last autumn I just couldn't get a dermatologist to prescribe me an 5-alpha-reductase inhibitor, so the only thing I could use up until that point was topical Minoxidil (which of course on its own does not stop the DHT induced hair miniaturization).

My hairline before hopping on Dutasteride:
https://imgur.com/a/yScdAmR


As visible, my temples have receeded from my original near straight hairline I used to have in my teens, but the density remained very good.

Zero signs of diffuse thinning on the top of the scalp, the hairloss was taking place only at my temples: (May 2024)
https://imgur.com/a/YuZo8JC


Original hair length in autumn - notice how the hair is 20 cm + long on the top:
https://imgur.com/a/HSeznyP

https://imgur.com/a/J6fafq5

Deciding to take Dutasteride
Starting last November, I began taking 0.5 mg of oral Dutasteride daily, in addition to the before mentioned Minoxidil.

I originally was planning to go on Finasteride, however I just couldn't get my hands on it, no matter where I tried, no doctor would prescribe it to me - so I thought... well Dutasteride is a stronger 5-alpha-reductase inhibitor than Finasteride according to clinical data... so even though it would be optimal to start with the weaker first, I had no option, I said go with it.
Aside from a slight tingling in the balls on day 2-3, I haven't really experienced any sympton from the drug up unil 1.5 months into it - zero sexual side effects, change in mood, no shedding etc.

2 months into Dutasteride - the nightmare begins

Then around 6 weeks after starting dutasteride I felt like my hair was thinner than usual after showering but initally I it shrugged off.
Then 2 months into the treatment (middle of January) something began to unfold that I still can't fathom to this day:

During the course of only 1 week the hair on the whole top of my head began to rapidly shrink both in terms of length and in diameter, changing from it's straight texture into lifeless curly one. Yes, this shrinkage took place in real time.

The epicenter of this impossiblly rapid shrinking is the crown area, where I kid you not, hair that was 20 cm+ long shrank into 2-3 cm. Hair began to rapidly shrink everywhere on the top of my head, but near the sides the least and in a narrow strip on the hairline it 'only' shrunk into half of it's original length (into around 10 cm). The shringake was the most extreme on the crown & vertex.

The documentation of the continuing deterioration of my hair in the last few months

January -
when the nightmare began:
extremely rapid thinning on my crown

https://imgur.com/a/XQ9NALo

https://imgur.com/a/1gvezzf

https://imgur.com/a/yQM7Srg

https://imgur.com/a/gZTYRC4

https://imgur.com/a/BXaJorU

experimencing burning inflamation on the top of the scalp

The change in hair texture from the middle to the end of January:
https://imgur.com/a/gZTYRC4
https://imgur.com/a/g1EL84w
the rapid thinning on the crown became especially visible with wet hair
https://imgur.com/a/BXaJorU

February

as visible, hair at the hairline area began to shrink in length at varying degrees, leading to uneven length across it
hair on the crown further kinking in texture
https://imgur.com/a/DCeK2ny

March
https://imgur.com/a/DK4Jyyn
hair became curly all over

April
https://imgur.com/a/hnCKLdW
https://imgur.com/a/A5cCIPD
https://imgur.com/a/DzgavJk
up until that point the hair in the hairline area was relatively thicker than on the crown, now it has started to rapidly thin too

May
https://imgur.com/a/WrloYvk
hairline getting worse - hair is getting critically thin in diameter
up until this point hair has only been miniarutizing, now it has also started to shed - mostly without bulb at the end, in rarer cases with black bulb (never white)
hair on the crown became wisp like in texture, extremely thin, near vellus level of

(I ironed the hair meanwhile, that's why it went back from curly to somewhat straight - still completely thin & lifeless though.)

June
https://imgur.com/a/YMHwh4l
my hair is becoming an unstyleable mess - hair is wispy all around the scalp
the hair on the sides & back of the head has also became thin & curly
endless amount of shedding
the scalp (galea) has become incredibly rigid / tight , I could barely move it - recently got scalp botox on it to supposedly ease tension

July
https://imgur.com/a/iddYkSi
Massive crown thinning, hair is getting wispy all over the top


Hopping on Finasteride

Back when all of this started in January, seeing what was happening so rapidly, I decided to discontinue using Dutasteride and instead kept using Minoxidil while changed to 1.25 grams of Finasteride daily + droplets of RU58841 added in along with microneedling. I have been doing this routine ever since, but to this day the situation keeps getting worse with no end in sight.

Trichoscopy scan

The hair on the top of my hair ever since this whole nightmare started almost half a year ago, haven't grown at all. So in the beginning of June, I got an AI-aided trichoscopy scan done on my scalp by a dermatologist, which has shown:
- the ratio of hair in the anagen / telogen phase is 90% / 10%
- as visually visible, the hair while most of it is still terminal, has become incredibly thin in diameter
- no meaningful change in hair density - as expected, since minimal shedding took place, only miniaturization

corresponding to vertex, frontal, temporal areas:

https://imgur.com/a/OM32InW
https://imgur.com/a/OM32InW

Ruling out other possible factors beside Androgenetic Alopecia

During the course of the last few months I made sure to rule out all possible factors which may cause the rapid deteroriation of my hair - I did multiple bloodworks and they have shown:
- no nutritional deficiency (iron, zinc etc.)
- my thyroid is working perfectly
- my androgenic hormone levels are in the reference range

Besides this,
- no change in lifestyle (physically very active, very mindful of nutrition - low carb, lots of protein)
- no other stress factor or negative life event happene
- no massive sheeding took place so it is not Telogen effluvium

Final thoughts
I am sharing this with you guys since it shouldn't have happened - it goes against all avaible medical data & sctientific consensus about 5aRI blockers. At this point I have visited half dozen dermatologists / trichologists and all of them stood with disbelief as of how is this even possible - so do I.

Dutasteride was supposed to suppress scalp DHT, yet in my case it somehow lead to the rapid miniaturization of all DHT sensitive hair on the scalp simultaneously.

I just don't know what to do at this point, I am completely hopeless, my life got ruined.

Dutasteride is known as the last nuke option. Either it will come to the rescue or it will totally destroy your hair. You can look up thousands of posts regarding this on the internet.

You should have hopped on Finasteride first since its the less agressive DHT inhibitor compared to Dutasteride.

If you regressed on Finasteride then you could take the nuke (dutasteride) option.

All the people telling you exactly on how and why do not have a clue. Everybody is different, your body reacts differently etc so it really depends on each individual how their hormones process this drug.

On Paper it should have worked for you even better than Finasteride but as you documented yourself clearly the opposite happened.

Try taking finasteride with oral minoxidil for the long term. Try different solutions maybe it might work for you.

 

[bsmith]

Dutasteride is known as the last nuke option. Either it will come to the rescue or it will totally destroy your hair. You can look up thousands of posts regarding this on the internet.

You should have hopped on Finasteride first since its the less agressive DHT inhibitor compared to Dutasteride.

If you regressed on Finasteride then you could take the nuke (dutasteride) option.

All the people telling you exactly on how and why do not have a clue. Everybody is different, your body reacts differently etc so it really depends on each individual how their hormones process this drug.

On Paper it should have worked for you even better than Finasteride but as you documented yourself clearly the opposite happened.

Try taking finasteride with oral minoxidil for the long term. Try different solutions maybe it might work for you.

@BT20

Why do you recommend oral Minoxidil, as opposed to topical?

I would think topical Minoxidil has less side effects. Am I wrong?

In the United States topical Minoxidil doesn't require a prescription. They sell it at all pharmacies.