No result w/ finasteride. Will dutasteride have some ?

[Reivax]

Hi all, I've been reading this forum for some time now and here's my first post.

I am a mid 30 guy and a good NW3 with huge temple recession and thining on top (no problem with the crown though).
Start to loose my hairs early, but it was a long slowly process.

I've taken in the past minoxidil with some results on the top but could not stick with the 2 applications times a day so
I switched to finasteride(pecia) 1mg/day more than 18months ago and have got no result so far: same amount of hairs lost in the shower,
vaccum still full of my hairs (of course no regrowth. But no side effects whatsoever).

It seems unlikely that Finpecia will help me to save my hairs so I am considering Dutasteride.

My question is: did you see somebody no responding to finasteride that had some results with dutasteride ?


Thanks for your help.

 

[Vlatch]

Your DHT levels have to be low enough to reach a non balding threshold. If they're not low enough on finasteride, they could be on dutasteride, even if dutasteride inhibits "only" 20% more DHT than finasteride.

A brief explanation I made in a previous post about why it may work :

"Let's say your DHT levels are 600 pg/ml.
If you take finasteride, your DHT levels will be 200 pg/ml.
If you take dutasteride, they will be at 60 pg/ml.

Now if your follicles start miniaturizing at 300 pg/ml, you'll be fine with finasteride, however if they start miniaturizing at 100 pg/ml, you'll need dutasteride and finasteride will do almost nothing to help your condition, it won't just be 20% less effective."


It would be interesting to see a study about the effectiveness of dutasteride on previous finasteride users, comparing three groups :
-Men who continued losing hair after 2 years with finasteride taking dutasteride for a year.
-Men who improved after 2 years with finasteride taking dutasteride for a year.
-Men who improved after 2 years with finasteride takin finasteride for one more year.

Though I'm affraid studies related to hair loss are over for dutasteride =\

 

[mmac22]

Yes. I was on finasteride for 8 years and continued to lose hair everyday. finasteride certainly slowed hair loss but even with it i was well on my way to baldness. Switched to dutasteride three months ago and the hair loss pretty well stopped completely within a few days. I wish I switched earlier! I am still not losing hair and am just starting to see some slight signs of regrowth but its probably a bit early to really tell definitively.

 

[xRedStaRx]

Your DHT levels have to be low enough to reach a non balding threshold. If they're not low enough on finasteride, they could be on dutasteride, even if dutasteride inhibits "only" 20% more DHT than finasteride.

A brief explanation I made in a previous post about why it may work :

"Let's say your DHT levels are 600 pg/ml.
If you take finasteride, your DHT levels will be 200 pg/ml.
If you take dutasteride, they will be at 60 pg/ml.

Now if your follicles start miniaturizing at 300 pg/ml, you'll be fine with finasteride, however if they start miniaturizing at 100 pg/ml, you'll need dutasteride and finasteride will do almost nothing to help your condition, it won't just be 20% less effective."


It would be interesting to see a study about the effectiveness of dutasteride on previous finasteride users, comparing three groups :
-Men who continued losing hair after 2 years with finasteride taking dutasteride for a year.
-Men who improved after 2 years with finasteride taking dutasteride for a year.
-Men who improved after 2 years with finasteride takin finasteride for one more year.

Though I'm affraid studies related to hair loss are over for dutasteride =\

I've said this a hundred times throughout this forum, but I don't mind saying it again.

Serum DHT doesn't mean anything.

 

[californiaoceans911]

Before starting dutasteride I would ask you three questions:

Where are you getting finpecia from? Do you have a script? Buying from a jenky online pharmacy?

Why did you stop minoxidil? (not that I'm saying you should start just wondering).

Have you been using keto shampoo?


I feel that with proper finasteride that you know is legit, and keto shampoo, you might see different results. I know a lot of people don't handle Reddy's well. If you have a script try switching to Activis Finasteride, or if you can afford it, Propecia.

I know a lot of people say finasteride IS finasteride, but really it's not sometimes. Depending on someone's specific body chemistry, uptake and absorption of finasteride can be different depending on the inactive ingredient. Ever had a blood test while on finasteride to check your DHT level? (not saying serum DHT matter but just to see if his body is absorbing the finasteride well).

Any thoughts Redstar?

 

[xRedStaRx]

Before starting dutasteride I would ask you three questions:

Where are you getting finpecia from? Do you have a script? Buying from a jenky online pharmacy?

Why did you stop minoxidil? (not that I'm saying you should start just wondering).

Have you been using keto shampoo?


I feel that with proper finasteride that you know is legit, and keto shampoo, you might see different results. I know a lot of people don't handle Reddy's well. If you have a script try switching to Activis Finasteride, or if you can afford it, Propecia.

I know a lot of people say finasteride IS finasteride, but really it's not sometimes. Depending on someone's specific body chemistry, uptake and absorption of finasteride can be different depending on the inactive ingredient. Ever had a blood test while on finasteride to check your DHT level? (not saying serum DHT matter but just to see if his body is absorbing the finasteride well).

Any thoughts Redstar?

I think finasteride is finasteride. Even if we assume one brand is cheaper and less bioavailable than the others, it still should be pretty effective. The way I see it, it must be completely bunk for that to happen.

The people who report finasteride suddenly stops working fall under two categories.

1) It does not, they don't take photographic evidence either.

2) Aging, whereas even dutasteride fails to compromise.

 

[Vlatch]

I've said this a hundred times throughout this forum, but I don't mind saying it again.

Serum DHT doesn't mean anything.

Okay, fine, but the thing that bothers me about scalp DHT measures is this (quote from a dutasteride study) :

"The 2.5-mg dutasteride dose was consistently superior to 0.5-mg dutasteride in promoting scalp hair growth. The 2.5-mg dose was also better than the 0.5-mg dose at suppressing scalp DHT (79% vs. 51%), whereas it was only marginally better at suppressing serum DHT (96% vs. 92%). This difference in the dose-response of serum and scalp DHT to inhibition with dutasteride is likely to be due to the greater contribution of type 1 5α-reductase to scalp DHT concentrations."

The results in scalp hair growth of 2.5mg dutasteride were superior than 0.5 dutasteride, so it must have inhibited more 5ar2 in the scalp, but if a lot of the DHT in the scalp comes from 5ar1, then aren't measures of scalp DHT levels biased ? (From what I've read, DHT resulting from 5ar1 contributes a lot less to hair loss than DHT resulting from 5ar2)

 

[Geiri]

I thought the point of the drugs was to decrease DHT. Then how can it not mean anything?

 

[xRedStaRx]

Okay, fine, but the thing that bothers me about scalp DHT measures is this (quote from a dutasteride study) :

"The 2.5-mg dutasteride dose was consistently superior to 0.5-mg dutasteride in promoting scalp hair growth. The 2.5-mg dose was also better than the 0.5-mg dose at suppressing scalp DHT (79% vs. 51%), whereas it was only marginally better at suppressing serum DHT (96% vs. 92%). This difference in the dose-response of serum and scalp DHT to inhibition with dutasteride is likely to be due to the greater contribution of type 1 5α-reductase to scalp DHT concentrations."

The results in scalp hair growth of 2.5mg dutasteride were superior than 0.5 dutasteride, so it must have inhibited more 5ar2 in the scalp, but if a lot of the DHT in the scalp comes from 5ar1, then aren't measures of scalp DHT levels biased ? (From what I've read, DHT resulting from 5ar1 contributes a lot less to hair loss than DHT resulting from 5ar2)

We do not have data past 6 months for dutasteride, and peak numbers were not really any better than finasteride (you just get them faster). The 10 year finasteride study showed 90+% of guys stabilizing their hair loss.

In the 6 month dutasteride study. If you look at the higher doses, you see two things:
1. Higher hair counts earlier
2. Also peak hair counts earlier

But you need to look at the 3 month numbers to see this. Take 2.5mg of dutasteride. Hair counts were 109 at 6 months right? They were already at 100 at 3 months. How many more hairs do you think those people were getting between months 6 and 12? Pretty sure the answer is close to zero.

So 2.5mg of dutasteride got peak regrowth at or around 6 months, while finasteride in the Merck study took twice as long where peak hair counts were in the 90s as well, close to 0.5 mg of Dutasteride, and not far off from the 2.5 mg of dutasteride.

I suspect if the dutasteride study had gone more than 6 months we would have seen that clearly. The general consensus based on the accumulation of different literature, is that dutasteride is not that much better than finasteride for Androgenetic Alopecia. Even though it does a much better job at suppressing DHT at the scalp level. That should tell us that more DHT inhibition and hair retention is not a linear relationship, but an exponential one, where crossing a certain "threshold" or range of levels can halt the miniaturization process, and even allow for DNA repair and regrowth.

I thought the point of the drugs was to decrease DHT. Then how can it not mean anything?

Because serum DHT levels are not a reliable measure of DHT concentrations inside the hair follicle, which is what matters in the end.

 

[Geiri]

Alright thanx for explaining.

 

[Vlatch]

Interesting theory. It didn't answer my question about scalp DHT levels though ^^"

About your theory, we know finasteride inhibits 70% of 5ar2 (edit : okay wrong, most of it) only one day after the first pill, so why do you think dutasteride would only (well mostly) give results faster ?

I mean, if the non-balding threshold is met, it shouldn't matter how much more DHT is suppressed, unless some areas of the scalp have a different threshold than others. The follicles that miniaturize first having the lowest threshold, the follicles that remain having a higher one. That means a better potential for regrowth in favor of dutasteride.

But, we can only reactivate follicles that have been miniaturized for a few
years, so that's true there should be a certain limit for regrowth compared to DHT inhibition.

By the way here is a more recent study (conducted in 2010, published in 2012) comparing finasteride and dutasteride for 6 months (again, I have to admit it's weird they never did a longer study comparing the two drugs) : http://clinicaltrials.gov/ct2/show/results/NCT01231607?sect=X01256#all

 

[xRedStaRx]

Interesting theory. It didn't answer my question about scalp DHT levels though ^^"

About your theory, we know finasteride inhibits 70% of 5ar2 only one day after the first pill, so why do you think dutasteride would only (well mostly) give results faster ?

I mean, if the non-balding threshold is met, it shouldn't matter how much more DHT is suppressed, unless some areas of the scalp have a different threshold than others. The follicles that miniaturize first having the lowest threshold, the follicles that remain having a higher one. That means a better potential for regrowth in favor of dutasteride.

But, we can only reactivate follicles that have been miniaturized for a few
years, so that's true there should be a certain limit for regrowth compared to DHT inhibition.

By the way here is a more recent study (conducted in 2010, published in 2012) comparing finasteride and dutasteride for 6 months (again, I have to admit it's weird they never did a longer study comparing the two drugs) : http://clinicaltrials.gov/ct2/show/results/NCT01231607?sect=X01256#all

Finasteride inhibits almost all of 5-AR II in normal doses.

Yes scalp DHT measures are biased if you're comparing a dual inhibitor to a single inhibitor.

 

[Reivax]

Hi all, thanks for your answer.

Before starting dutasteride I would ask you three questions:

Where are you getting finpecia from? Do you have a script? Buying from a jenky online pharmacy?

No script but before taking finasteride I consulted a clinic specialized in hairloss (quite a booming industry in Japan) and had blood test, advices etc..
The finasteride the clinic proposed was not Propecia but a generic. That convinced me be to buy F-pecia.
I got it from a Japanese site hair2go specialized in imported hairloss products. The F-pecia I recieved is coming directly from India. I have no doubt this is real finasteride.
I tend to think that a molecule is a molecule and if no result with F-pecia, no chance I would with Propecia.

Why did you stop minoxidil? (not that I'm saying you should start just wondering).

Not worth for me. I cannot stick w/ 2 applications a day. I am wearing quite long hair which is not convenient. The results I had (a little bit less hairs in the shower) was not enough
so that I would pursue for years those applications, and also considering that any gain would be lost if stopped.

Have you been using keto shampoo?

I am using Revita which contains Ketocozanol 1%.

Yes. I was on finasteride for 8 years and continued to lose hair everyday. finasteride certainly slowed hair loss but even with it i was well on my way to baldness. Switched to dutasteride three months ago and the hair loss pretty well stopped completely within a few days. I wish I switched earlier! I am still not losing hair and am just starting to see some slight signs of regrowth but its probably a bit early to really tell definitively.

Thank for your account. (Encouraging though for myself I have got no result at all with finasteride and in 8 years I will be NW4-5)

As for the debate about DHT serum level, seems there is no solid facts to base a decision on. I understand that if I am not trying dutasteride, I won't know if I can get results, so
I will consider to take the leap with Advo after consulting a doctor.
What bothers me with "no result with finasteride after 18+months", is the following conclusion taken from the 10 years study of finasteride:

One of the most interesting findings is that patients who had hair growth in their first year of treatment are more likely than others to have better hair growth after 5 years. About half of patients experienced good hair growth in their first year, and about 53% of those patients went on to see improved growth over time. However, of the group with unchanged or worse results in their first year, only 25% saw improved hair growth after 5 years. After 10 years, almost 69% of patients who experienced growth in their first year experienced continued growth. Only 32% of those who saw unchanged or worse results after their first year had growth at 10 years.

In my case, it means that I will not benefit in any case of finasteride on the long-term.

 

[esernecipp]

Now, I am using finasteride. If I don't see any results my way will be like that: Finasteride < Dutasteride < Oral spironolactone < Androcur.

 

[MikeJay]

Before starting dutasteride I would ask you three questions:

Where are you getting finpecia from? Do you have a script? Buying from a jenky online pharmacy?

Why did you stop minoxidil? (not that I'm saying you should start just wondering).

Have you been using keto shampoo?


I feel that with proper finasteride that you know is legit, and keto shampoo, you might see different results. I know a lot of people don't handle Reddy's well. If you have a script try switching to Activis Finasteride, or if you can afford it, Propecia.

I know a lot of people say finasteride IS finasteride, but really it's not sometimes. Depending on someone's specific body chemistry, uptake and absorption of finasteride can be different depending on the inactive ingredient. Ever had a blood test while on finasteride to check your DHT level? (not saying serum DHT matter but just to see if his body is absorbing the finasteride well).

Any thoughts Redstar?

the inactive ingreditiens in propecia are mainly fillers, coloring and caking agents which appear to do nothing . for absorption