Propecia twice a week?

[Petchsky]

ohh nooooo!! Please don't ban me from this great forum full of great positive people.I need this forum so i can get places in life,Without it i will be nothing!!

:roll: just can't help yourself can you tboy.

 

[SoThatsLife]

CCS: If it was a Doctor at Bosley/DHI giving that advice I wouldn't trust it, but these are respect Doctor's that have a rumor of being nice men and not into trapping men into the "hair transplant spiral".

If the DHT reduction drops 10% after the first two hours and then drops slowly(for about a week or so) then it seem to not be the huge difference in ED or EOD, since it drops fast the first hours and then slows down the reduction. Of course, ED is the best way to go, even upping the dose is a little better, but the difference is not that huge. One should use what dose that don't cause side effect, so one have the motivation to use the drug for a long time. Dr. Proctor says 1mg finasteride EOD and 0.5mg ED has the same pharmaceutical values, but I have read some docs say 1mg EOD is a little better than 0.5mg ED, again, the difference in all these doses are not that huge(at least in theory). And 1mg EOD is just easier to do than 0.5mg ED.

A man with aggressive hair loss is of course more dependent on more DHT reduction, in combo with something topical like keto and maybe prox-n, or even spironolactone. You could maybe use the keto foam in addition to a P-O shampoo that is in studies a little "better" than keto shampoo, but I guess don't have the low anti androgen effect that keto somewhat have .

You could read what Dr. Jerry Colley says(guess I can't post a link to another forum):
"Hi guys. I do have an opinion on this topic. Propecia is approved by the US FDA for once a day use. This does not mean it is the best dosage, only the one that was studied and approved. The average serum "half-life" of finasteride 1mg is about 5 hours in young men and 8 hours in older men. This does not mean that half of the medicine is out of your body in that time period though. The finasteride molecule is distributed throughout the body where it binds to the type II 5-alpha-reductase enzyme, thereby inhibiting conversion of testosterone to dihydrotesterone. Serum DHT is reduced about 65%, and less DHT means less balding. But several studies show that a single dose of finasteride suppresses serum DHT for 7 days or more (Eur J Drug Metab Pharmacokinet. 1991 Jan-Mar;16(1):15-21, J Clin Endocrinol Metab. 1990 Apr;70(4):1136-41, Prostate. 1989;14(1):45-53). So the finasteride is leaving the bloodstream, entering the tissue throughout the body, and binding to the typeII 5AR enzyme, resulting in long lasting DHT suppression.

I do not "recommend" my patients take finasteride daily, every other day, twice weekly, etc. Rather I feel it is my duty as their doctor to advise them of the known facts about this medication. Most of my patients choose to take it on a Mon-Wed-Fri schedule, which is rational from my point of view. Many of my younger patients take it daily 'just to be sure' while my older patients are happy to take it two or three times a week. There are no clinical studies showing that less than daily dosing is as effective at treating hair loss as daily dosing and for obvious financial reasons, the pharmaceutical company making finasteride has no incentive to fund such a study."

Grantspots: Do you have any links to studies that show the difference in "hormone unbalance" between DHT inhibitors? Since the reducing of DHT slows down slowly after the fast drop the first hours I have a hard time seeing that there is much difference in ED and EOD. Of course if one use it as infrequently as Toyboy says, one would get somewhat of a hormone roller coaster.

ToyBoy: Could you name your "hair specialist"? Is she just a normal derm or is she Vera Price? I have no reason to not believe what your docs says, but I guess she pointed out that 1mg ED is the "best" dose, but that there is not an extreme difference in the doses she explained for your.

 

[Toyboy]

CCS: If it was a Doctor at Bosley/DHI giving that advice I wouldn't trust it, but these are respect Doctor's that have a rumor of being nice men and not into trapping men into the "hair transplant spiral".

If the DHT reduction drops 10% after the first two hours and then drops slowly(for about a week or so) then it seem to not be the huge difference in ED or EOD, since it drops fast the first hours and then slows down the reduction. Of course, ED is the best way to go, even upping the dose is a little better, but the difference is not that huge. One should use what dose that don't cause side effect, so one have the motivation to use the drug for a long time. Dr. Proctor says 1mg finasteride EOD and 0.5mg ED has the same pharmaceutical values, but I have read some docs say 1mg EOD is a little better than 0.5mg ED, again, the difference in all these doses are not that huge(at least in theory). And 1mg EOD is just easier to do than 0.5mg ED.

A man with aggressive hair loss is of course more dependent on more DHT reduction, in combo with something topical like keto and maybe prox-n, or even spironolactone. You could maybe use the keto foam in addition to a P-O shampoo that is in studies a little "better" than keto shampoo, but I guess don't have the low anti androgen effect that keto somewhat have .

You could read what Dr. Jerry Colley says(guess I can't post a link to another forum):
"Hi guys. I do have an opinion on this topic. Propecia is approved by the US FDA for once a day use. This does not mean it is the best dosage, only the one that was studied and approved. The average serum "half-life" of finasteride 1mg is about 5 hours in young men and 8 hours in older men. This does not mean that half of the medicine is out of your body in that time period though. The finasteride molecule is distributed throughout the body where it binds to the type II 5-alpha-reductase enzyme, thereby inhibiting conversion of testosterone to dihydrotesterone. Serum DHT is reduced about 65%, and less DHT means less balding. But several studies show that a single dose of finasteride suppresses serum DHT for 7 days or more (Eur J Drug Metab Pharmacokinet. 1991 Jan-Mar;16(1):15-21, J Clin Endocrinol Metab. 1990 Apr;70(4):1136-41, Prostate. 1989;14(1):45-53). So the finasteride is leaving the bloodstream, entering the tissue throughout the body, and binding to the typeII 5AR enzyme, resulting in long lasting DHT suppression.

I do not "recommend" my patients take finasteride daily, every other day, twice weekly, etc. Rather I feel it is my duty as their doctor to advise them of the known facts about this medication. Most of my patients choose to take it on a Mon-Wed-Fri schedule, which is rational from my point of view. Many of my younger patients take it daily 'just to be sure' while my older patients are happy to take it two or three times a week. There are no clinical studies showing that less than daily dosing is as effective at treating hair loss as daily dosing and for obvious financial reasons, the pharmaceutical company making finasteride has no incentive to fund such a study."

Grantspots: Do you have any links to studies that show the difference in "hormone unbalance" between DHT inhibitors? Since the reducing of DHT slows down slowly after the fast drop the first hours I have a hard time seeing that there is much difference in ED and EOD. Of course if one use it as infrequently as Toyboy says, one would get somewhat of a hormone roller coaster.

ToyBoy: Could you name your "hair specialist"? Is she just a normal derm or is she Vera Price? I have no reason to not believe what your docs says, but I guess she pointed out that 1mg ED is the "best" dose, but that there is not an extreme difference in the doses she explained for your.

Her name is Dr J Martinick.She has been studying hairloss for years.

 

[Bryan]

If the DHT reduction drops 10% after the first two hours and then drops slowly(for about a week or so) then it seem to not be the huge difference in ED or EOD, since it drops fast the first hours and then slows down the reduction.

Do I assume correctly here that you're referring to daily use of finasteride in that sentence? If you take just a SINGLE dose of finasteride, the lowest point of serum DHT is achieved in less than a day.

 

[SoThatsLife]

To be honest I was referring to regular use in general. What I thought was that the biggest reduction of DHT was around a half an hour after consuming the pill, when the drug gets into the bloodstream. And then after 1-2 hours afters consumption the 10% drop of DHT inhibition ,that CCS talks about, is a reality. But after the "big" drop of 10%, the reduction of DHT goes slowly back to baseline to levels before one used finasterid.

Correct me if Im wrong.

 

[Bryan]

You may be confusing some of that with the fact that it's serum levels of finasteride that reach a peak about a couple of hours or so after taking the drug. Serum levels of DHT are another matter. Take another look at the following often-posted graph, which shows blood levels of DHT after various SINGLE doses of finasteride. As you can see, it reaches its lowest level within 24 hours, then slooowly rises over the next 1-2 weeks back to baseline:

http://www.geocities.com/bryan50001/graph8.htm

 

[SoThatsLife]

Thats quite interesting Bryan! I wonder what CCS meant by the 10%.

It seems like 0.5mg have a almost steady state between day 1 and 2, but 1.5mg have a steady state between day 2 and 3, quite weird. That graph is really interesting, but it so hard to tell if there is any real life difference. I have to go on what DR. Cooley and the ISHRS study says that there is just a marginal difference between 1mg ED and 1mg EOD, at least on the short term basis. Have Merck released any studies/graphs from their on studies. Would be exciting to see hair counts on one EOD group and one ED group.

I guess this discussion comes up every other month.

 

[Grantspots]

I'm pretty sure she would know more then some deadshit hair-loss forum moderator

On the contrary, the information she gave you questions her level of education on the topic. To establish or refute that, you were asked to get the data source from her. Instead of doing this, you've replied with vulgarity and name calling. On a larger scale, you will learn more from someone on this website who focuses on hair loss research every day, than you will ever learn, even from most dermatologists. Definitely most GP's. Information is information, and is available to anyone who seeks it out. I have found that doctors, even dermatologists, know maybe 1/10th what most people here know about hair loss, and its treatments.

The Dr told me about using finasteride twice a week about 3 years ago and I thought she was crazy

Did you call her a deadshit moron too? As for the graph, everyone is different. The admin of this site can comment from personal experience that this graph of Mew's is subjective. He could not miss a dose of finasteride without experiencing severe migraines due to the hormonal fluctuations. If you really believe that everyone responds identically to treatments, you are incorrect. Consistent dosing is very important. You will experience more side effects if you don't keep a consistent dose. If you don't believe me, try the 3 day dosing schedule. You can spend the next 10 years of your life sitting on Mews site complaining about side effects, rather than out living your life.

-G-

 

[Bryan]

Thats quite interesting Bryan! I wonder what CCS meant by the 10%.

I do, too. What exactly did he say about this "10%"?

It seems like 0.5mg have a almost steady state between day 1 and 2, but 1.5mg have a steady state between day 2 and 3, quite weird.

Oh, I wouldn't get too caught-up in such minor anomalies as that. Those are just the result of relatively small sample sizes, and the inevitable fluctuations in the laboratory testing of blood samples. It's the Big Picture you have to focus on!

That graph is really interesting, but it so hard to tell if there is any real life difference. I have to go on what DR. Cooley and the ISHRS study says that there is just a marginal difference between 1mg ED and 1mg EOD, at least on the short term basis.

I agree that it's just a relatively minor difference.

Have Merck released any studies/graphs from their on studies. Would be exciting to see hair counts on one EOD group and one ED group.

I don't think there are any studies which tested finasteride EOD versus ED, but I would certainly expect there to be only relatively minor variatons in efficacy, just like there were for various dosage levels in Merck's early "dose-ranging" study. Here's a scan of that trial:

http://www.geocities.com/bryan50001/finasteride ... anging.htm

I guess this discussion comes up every other month.

More often than that!

 

[Old Baldy]

You found the doctor's discussion on finasteride. dosage SoThatsLife! (It was Dr. Cooley, who is a respected hair transplant surgeon.)

Btw, he stated finasteride. reduces the Type II, 5-alpha-reductase enzyme. My original post about androgen receptor recovery was a stupid typo on my part. NOT Dr. Cooley's, he NEVER said that.

Thanks for finding that advice from Dr. Cooley SoThatsLife.

Carry on guys!

Edit: You can see, for all intents and purposes, that Bryan agrees with Dr. Cooley IMHO.

 

[Toyboy]

I'm pretty sure she would know more then some deadshit hair-loss forum moderator

On the contrary, the information she gave you questions her level of education on the topic. To establish or refute that, you were asked to get the data source from her. Instead of doing this, you've replied with vulgarity and name calling. On a larger scale, you will learn more from someone on this website who focuses on hair loss research every day, than you will ever learn, even from most dermatologists. Definitely most GP's. Information is information, and is available to anyone who seeks it out. I have found that doctors, even dermatologists, know maybe 1/10th what most people here know about hair loss, and its treatments.

The Dr told me about using finasteride twice a week about 3 years ago and I thought she was crazy

Did you call her a deadshit moron too? As for the graph, everyone is different. The admin of this site can comment from personal experience that this graph of Mew's is subjective. He could not miss a dose of finasteride without experiencing severe migraines due to the hormonal fluctuations. If you really believe that everyone responds identically to treatments, you are incorrect. Consistent dosing is very important. You will experience more side effects if you don't keep a consistent dose. If you don't believe me, try the 3 day dosing schedule. You can spend the next 10 years of your life sitting on Mews site complaining about side effects, rather than out living your life.

-G-

Nope.You are wrong and don't know what you are talking about.The Dr i speak of is a world renowned hair surgeon and is known for researching hair-loss.Lets compare you and her shall we? You are a moderator on a hair-loss forum,Nuff said.

 

[Old Baldy]

Toyboy: If I'm reading the graph correctly, you would get to about 32 ng/dl with 1.5mg of finasteride. at day one? At day four, you'd be at about 39 ng/dl?

At 1.25mg dosage, maybe the numbers would be 34 ng/dl at day one and 41 ng/dl at day four? At 1.0mg dosage, maybe the numbers would be 37 ng/dl at day one and 44ng/dl at day four? (On your second dosage of the week, you'd only have three full days of delay in dosage, so the differences would be smaller [i.e., assuming a Monday and Friday dosing schedule] .)

Not too bad a fluctuation, on average, IMHO. Plus, the 1.25mg dosage gets it lower than the recommended 1.0mg dosage. Probably not much at all but still a little more inhibition. I mean, look at how flat that curve gets between the 1.5mg and 5.0mg doses.

I wonder if the M, W, F dosage is just easier to remember? No, Monday and Friday dosage is easy to remember. I'd say, go for it.

Have you ever thought of dutasteride. one day and finasteride. the other day (i.e., relative to your two doses a week question)?

I say this because, after getting my 2nd hair transplant, I don't want to take as much as two dutasteride caplets a week and might use them up and go on a three times a week finasteride dosage.

(Yes, I think I might go to one dutasteride. a week and one finasteride. a week until the dutasteride. is used up. [I'm just thinking to myself. I'm kind of like CCS that way! Sorry CCS, I couldn't resist.] )

I don't mind reducing DHT a little for male pattern baldness and for my famiily history of prostate cancer, but I want to go as little as possible.

Now that I'm retired and can get an hair transplant whenever I want, I'll try and limit my DHT serum reduction a little more than I am currently. Enough of this crap!! (I have enough hair now Toyboy, I'm just being greedy at this point in time. :mrgreen

Yes, I think it's time for finasteride. again. The big boy (dutasteride.) is going to be retired over the next couple of years!! I'm going on one dutasteride. a week and one finasteride. a week until the dutasteride. is used up.

I'm glad this subject comes up regularly. With my memory, I need refresher training consistently!! :blush:

Thanks guys for the great discussion!! Now, where the heck did I put that Proscar splitter knife?!

http://www.geocities.com/bryan50001/graph8.htm

 

[SoThatsLife]

The important thing is that it is not as good, but ALMOST as good. One with much thinning should not try to "push the limits" of finasteride. But EOD seems to be a good close second to ED if one gets small sides from finasteride.

 

[kento]

I don't see any other reason in lowering the dosage, maybe because of financial reason but finasteride is not so expensive. About the sides don't know because i got them even with low finasteride dosage.