Odd blood tests after 8 months on finasteride

1919

Established Member
My Regimen
Reaction score
188
Hi, im new to HairLossTalk.com.
Anyways been taking finasteride 1.25mg (doctor prescribed) for around 8-9 months. 20 years old. I started with a tiny bald spot on my left temple and took finasteride at 19-20. Around 5 months in got a pretty large shed and I think the shed slowed after a month. Have been losing around 30 hairs per shower and my hairline has been thinner over the 8 months quite rapidly. Unfortunately, I never did a blood test prior to starting finasteride so I don't know my baseline. Here are my blood results.
Notable things:
- E2: Doctor claims that it is a high normal and that I should not worry about this number.
- Side effects on finasteride: Ball ache comes and goes depending on how well I sleep (I think).
- High DHT: This is my biggest concern because my DHT is unusually high even on finasteride.
- Normal thyroid levels etc.

Screen Shot 2564-01-15 at 16.21.52.png

1610702601417.png

All guidance is appreciated.
Thanks !
 
Last edited:

GRme11

Established Member
My Regimen
Reaction score
70
Hello @1919 ! Check my thread here: https://www.hairlosstalk.com/interact/threads/all-blood-tests-that-i-have-done-until-now.129791/

Plus latest tests:
Estradiol-E2: 4.5 pg/ml
Total Testosterone: 495 ng/dl
DHT: 550 pg/ml (is bouncing back)

High DHT seems something to worry about. I would suggest to check 3a-Diol-G ( a major DHT metabolite) and PSA+17OHP. These are way stronger indicators from just serum DHT (check the backdoor pathway theory (that's why 17-OHP) as well: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464227/ --- "17-Hydroxyprogesterone (17-OHP) can be converted to dihydrotestosterone (DHT) via an alternative “backdoor” route that bypasses the conventional intermediates androstenedione and testosterone." There are many other studies as well, please check them if you have time). Then, maybe you should need to change to Dutasteride, especially if you don't see results with Finasteride but keep in mind that if you are sensitive to Testosterone as well, it can cause problems to hair. Thank you.
 

1919

Established Member
My Regimen
Reaction score
188
I dont have great progress pictures but Ill attach them anyways. My trichologist has some detailed images which I am in the process of obtaining .

Screen Shot 2564-01-15 at 16.50.10.png

1610704296096.png

1610704345799.png

Starting Finasteride on 28th May 2020:
1610704375371.png
 
Last edited:

1919

Established Member
My Regimen
Reaction score
188
It seems like many of these threads dont have any follow up. Regardless, if the backdoor theory is really the case dustasteride would most likely fail to help me. It seems as though I am doomed to be bald :(((((
I will ask my trichologist for input on these lab results. Perhaps a look into topical AA might yield some results though I am very apprehensive of non-FDA-approved treatments.
 

Selb

Experienced Member
My Regimen
Reaction score
506
Maybe you can target scalp dht with topical dutasteride. If the systemic approach isn’t working well, try adding it to your regimen.
 

1919

Established Member
My Regimen
Reaction score
188
Maybe you can target scalp dht with topical dutasteride. If the systemic approach isn’t working well, try adding it to your regimen.
Interesting, is topical dutasteride a proven treatment and how would one formulate it?
 

Selb

Experienced Member
My Regimen
Reaction score
506
Interesting, is topical dutasteride a proven treatment and how would one formulate it?
There’s a thread on here that goes over people’s experiences with it. It’s fairly effective if we go by their experiences. You can buy it premade, like a .1% you apply every other day. Or you can make it yourself using tablets and some carrier.
 

1919

Established Member
My Regimen
Reaction score
188
There’s a thread on here that goes over people’s experiences with it. It’s fairly effective if we go by their experiences. You can buy it premade, like a .1% you apply every other day. Or you can make it yourself using tablets and some carrier.
Lots of thanks, Ill definitely check that out. Feels really hopeless when finasteride doesnt seem to work.
 

1919

Established Member
My Regimen
Reaction score
188
Hi, so for anyone wondering having the same inquiries with me, here's what my Doctor had to say:
- Serum/ blood DHT level alone is irrelevant in practice and does not indicate that finasteride is not working.
- DHT fluctuates throughout the day for various reasons (the time you take your medication) etc.
- You can switch to topical finasteride or try dutasteride.
- Therefore, don't be alarmed or worried keep with the regiment even if you don't feel like it's working (hopefully its slowing down loss by even a little bit).
There are probably people who can tear the science of this apart but the reality is that I'd happily be ignorant and go about my life a little less worried.
In the meantime, I've made it my goal to stop spending hours and hours of my day stressing about my hair. If the Norwood reaper does not favor me, I can always get a transplant (if I care to by that time and finances allow if not buzz it for a year or two until I can). Plus, even though there aren't that many options for hairloss yet, Im optimistic. CB is almost here and I'll be the first to jump on that train. Haircloning is right around the corner (don't bash me).
So to anyone that stumbles onto this thread in the future, take what you get and roll with the punches. Please dont be like me and waste so much precious time worrying about your hair. I get it, Im a control freak and I want the comfort of knowing I can fix and improve every suboptimal component of my body. The truth is life is too small in comfort and too short for worrying. Go out and have fun. Go workout or start a project.
 
Last edited:

Valkyyr

Member
My Regimen
Reaction score
11
1. you have no hair loss to begin with.
2. you need to repeat the test, it could be just a random fluctuation.
3. what's the testosterone level. you may have an asymptomatic hypergonadism but i doubt it
4. what's the source of fina? pharmacy?
5. your Doctor is full of sh*t regardless serum dht level being an irrelevant marker. it's actually the most relevant one. honestly recommend to ditch the guy.
6. topical finasteride roa is not going to create a stronger response than oral one. there is actually no point in topical application on the scalp, since it inhibits 5-alpha-reductase, it doesn't work on follicle androgen receptors. you can aswell rub it on your buttocks and you will have the same result.
 

1919

Established Member
My Regimen
Reaction score
188
1. you have no hair loss to begin with.
2. you need to repeat the test, it could be just a random fluctuation.
3. what's the testosterone level. you may have an asymptomatic hypergonadism but i doubt it
4. what's the source of fina? pharmacy?
5. your Doctor is full of sh*t regardless serum dht level being an irrelevant marker. it's actually the most relevant one. honestly recommend to ditch the guy.
6. topical finasteride roa is not going to create a stronger response than oral one. there is actually no point in topical application on the scalp, since it inhibits 5-alpha-reductase, it doesn't work on follicle androgen receptors. you can aswell rub it on your buttocks and you will have the same result.
1. The initial images show no hair loss. Starting around 18th feb 2020 I noticed VERY minor thinning. But my dad is pretty much Norwood 4 by 30 so I wanted to do something. Here is a pic of my hairline as of today which shows more receding at the temples and miniaturization as compared to the first pictures. I want to stop this from progressing as I've been experiencing a lot of hair fall in the shower and brushing (> 30 hairs per time) and progressive thinness.
Also, hair looks better in pictures
2. I agree with you. This is something my trich also mentioned. But tests here are quite expensive so it will be unlikely I will have a retest.
3. My testosterone levels are shown above which appears to be at normal levels. Not sure if that's what you are asking about.
4. Using Propecia cut in 4
5. This is hard to comment on because I am not a certified trichologist. I believe the most important marker is scalp DHT over serum DHT. Though my doctor is proven to be apart of much research in this field (including hair cloning which is yet to be successful in humans), so I hope you understand why I am more inclined to trust him. The high serum DHT is an oddity because I am experiencing sides (aching testicles). I am still considering RU but will consult with more professionals (may try dutasteride first).
6. There are papers and professionals that may debate your claim. The point of the topical finasteride is to reduce the change of serum DHT while preserving the reduction of scalp DHT. Thus, lower the side-effect profile of the medication. However, in practicality, this is rather irrelevant given the lack of approved options we have for treatment. If finasteride is not working, I see no harm in trying topicals or any other approved treatment options in case they happen to work well with my body chemistry. Most likely Ill be pushing to try dutasteride though.
BTW, thanks for the reply. Are you on any regimen? How has it worked out for you?
 

Attachments

  • 1611742810155.png
    1611742810155.png
    787.2 KB · Views: 67
Last edited:

Valkyyr

Member
My Regimen
Reaction score
11
The point of the topical finasteride is to reduce the change of serum DHT while preserving the reduction of scalp DHT.

Finasteride doesn't reduce dht, it inhibits 5α-reductase, which is responsible for converting testosterone to dht. Targeting the scalp is pointless.
 

1919

Established Member
My Regimen
Reaction score
188
Finasteride doesn't reduce dht, it inhibits 5α-reductase, which is responsible for converting testosterone to dht. Targeting the scalp is pointless.
Im not solid on the science so Ill leave it to the pros. Do you have any advice for my situation? I don't see many options...
 

1919

Established Member
My Regimen
Reaction score
188
Update 2/2/2021:
Ill use this thread as a journal for my hair loss struggles.
Started minoxidil 12th January. My dad seems to react well with minoxidil so maybe I can hold on to the temples a bit longer until something better comes along for maintenance. After a few months of minoxidil, I plan to consider adding topical AAs if it does not hold well.
 

Ganked By DHT

Established Member
My Regimen
Reaction score
34
Finasteride doesn't reduce dht, it inhibits 5α-reductase, which is responsible for converting testosterone to dht. Targeting the scalp is pointless.
No, it is not pointless. Most of testosterone is converted to the more active metabolite at the local tissue level. There is 5ar activity in the literal hair follicle and dermal papilla cells.
 

Ganked By DHT

Established Member
My Regimen
Reaction score
34
Not much to improve on then, there's still supplements you can target for hair loss. And you should always incorporate 1 or more topical into your regime. The ordinary makes good leave on serum; that will cover you for caffeine and those 3 hype marketing formulas i.e. redensyl. Since you only have hairline issue you can use just few drops on your hairline. It is MUCH harder to apply topical non-wastefully with long hair. There are others as well. And nizoral 2%, leave on for 10 min or whatever u want...
 

1919

Established Member
My Regimen
Reaction score
188
Not much to improve on then, there's still supplements you can target for hair loss. And you should always incorporate 1 or more topical into your regime. The ordinary makes good leave on serum; that will cover you for caffeine and those 3 hype marketing formulas i.e. redensyl. Since you only have hairline issue you can use just few drops on your hairline. It is MUCH harder to apply topical non-wastefully with long hair. There are others as well. And nizoral 2%, leave on for 10 min or whatever u want...
Thanks, Ill look into this. I will say that I am not inclined to add things into my regimen simply because I want to know what is working and what is not (giving some time for minoxidil). If its not finasteride/min/AAs I doubt that it will be strong enough to hold my hairline. What do you think?
Anyways, thank you for the response!
 
Top