Relax, I'm hilarious's story

[Relax Im hilarious]

Hello all

Well, like many of you I've been reading these forums for a few weeks and finally decided that it was about time I actually shared my story with everyone else.

I first noticed that I was starting to thin around my 26 birthday (happy 26th right?), nothing major but a little bit of thinning at the front. I've definitely got an adult hairline but I'd never really worried about it, I noticed that as I pulled my hair back I could see it just wasn't as strong around the hairline as the rest of the head.

Naturally, I kinda freaked and decided that I wanted to sort this problem as soon as possible. So stupidly I went straight out and being a victim of fantastic marketing, headed straight for some regaine foam. BIG mistake here. I put it all over my frontal hairline (which at the time was actually not that bad) and to cut a long story short, I had to stop after 5 days due to it giving me quite severe headaches. Over the next month I shed like a dog. I've lost about an 1 inch of my entire frontal hairline. After talking to J&J and a dermatologist, I've been told that shedding is normal (even to this level) and that it should come back to what it was pre-regaine in about 3-4 months but suffice to say I regret this whole experience and waiting for hair to regrow is literally torture.

Anyway... after stopping regaine, I still wanted to tackle my hairloss and after talking to my older brother I found that he had a similar experience to me and had begun propecia. He has been on it for 2 years and said it regrew most of the hair he lost and he had no sides from it. So after reading about propecia (and I'm mean seriously reading about propecia), I decided to take the plunge. I've now been on it for about 2 months and have noticed a little diffuse shedding all over (although not too bad so far) and no real side-effects as of yet.

I suppose the point of this thread is just so I can continue to post my progress just so anyone else in the same position as me has someone to compare to. At this point I think it is worth mentioning that I am currently a final year medical student, and if my exams go well, I'll be a doctor come June. I also have a degrees in biochemistry and immunology (I know, I've been in education for WAY too long). This has given me a bit of an insight into understanding exactly what to look out for and what to expect with each of the treatments that I'm trying, as I'm trying to look at this whole event from a scientific perspective. It also means that I've read countless numbers of papers on the effects of DHT blockers on the human body to try and get as much info as possible.

Long term I'm hoping for a positive result as I think I've caught this early but even just stopping further loss would be great and even longer term I guess the aim is to hold on propecia until (fingers crossed) something better comes out. I'm going to try and post once a week or once every other week just to keep updates on where I am and what's going on and hopefully help anyone else in the same position as me. Any input, advice or responses are always welcome!

That's all folks!

 

[Relax Im hilarious]

OK, so one week on and thought I’d put up a little update. I'm now 2 months and 2 weeks into my Propecia (based on the amount of blister packs i'm through) and shedding seems to have slowed slightly. I now seem to shed worse every other day. Some days it's up to 50 hairs other days only about 20, so fingers crossed the shedding could be coming to an end....
No other changes as of yet, still lost the hairs at the front due to my Regaine fiasco but I’m still holding out that that will regrow after a couple more months.

As a side note, for anyone that hasn't yet seen this there was an interesting study into the long term side effects of Finasteride on Japanese men over 3 years, it's the largest study outside of the official Merck one, take a look if interested:

http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract

As someone who was concerned about the side effects (as everyone is I’m sure) I’m going to summarise the key points below in case you can't access the full article:

[*]3177 men treated with finasteride 1 mg tablets who had a diagnosis of Androgenetic Alopecia
[*]January 2006 to June 2009. The total period of study was 3.5 years.
[*]Hair loss patterns of men with Androgenetic Alopecia were classified according to a modified Norwood–Hamilton (N-H) scale based on inspection and photographs of the scalp taken after the diagnosis of Androgenetic Alopecia
[*]The type of hair loss involving the frontal through vertex areas with a preserved frontal hairline was not applicable to the N-H scale. Such cases were classified as diffuse hair loss.
[*]All other hair-growing agents had to be withdrawn during the treatment with finasteride.
[*]Scalp hair was inspected and photographed at pretreatment time and following every 3 months in the clinic
[*]Hair growth was comprehensively reviewed by comparing the baseline and post-treatment photographs and rated according to the standardized 7-point rating scale (7 = greatly increased to 1 = greatly decreased
[*]A total of 3177 patients with a diagnosis of Androgenetic Alopecia at the first visit received finasteride 1 mg tablets. Efficacy was assessed in 2561 patients (efficacy analysis population), excluding 616 who had only baseline (first visit) assessment, among the entire study population. Safety data was evaluated in the entire study population.
[*]In the efficacy analysis population, 2289 patients were classified according to the N-H scale and 272 patients had diffuse hair loss
[*]The response rates ranged 81.0–91.3%, and no remarkable differences were observed among different hair loss patterns except for type I (modified N-H scale), which was slightly lower at 60.6%. The proportion of patients who had no change in hair growth was slightly higher at 39.4% for type I; that of the other types ranged 8.7–18.5%.
[*]The response rate in the efficacy analysis population by age at onset of hair loss was: 83.6% (271/324) for those aged 19 years or younger; 86.3% (986/1142) for 20–29 years; 89.2% (587/658) for 30–39 years; 90.5% (266/294) for 40–49 years; 83.9% (99/118) for 50–59 years; 87.0% (20/23) for 60–69 years; and 50.0% (1/2) for age 70–79 years.
[*]The majority of patients exhibited moderately or slightly increased hair growth. The proportion of greatly increased hair growth was relatively low in patients with hair loss duration of 10 years or more. However, more than 85% of patients with hair loss duration of 15–19 years or 20 years or more exhibited moderately or slightly increased hair growth.
[*]Adverse reactions occurred in 0.7% of the entire study population (23/3177) during the entire period of the study. The reactions include decreased libido (n = 8), hepatic functional disorder (n = 3) and unilateral mammary hypertrophy (n = 2).
[*]Seven of these 23 patients discontinued the treatment due to the adverse reactions; these included decreased libido (n = 3); hepatic functional disorder, disturbance of memorization and unilateral mammary hypertrophy (n = 1 each); and palpitations, febricula and headache (n = 1). Most of them were mild, and the follow-up data is unknown because of loss of contact. Among the adverse reactions, decreased libido with or without orchiatrophy, decreased blood pressure, and hypertrichosis of the forearms showed no change during the treatment period.
[*]In a report from a Turkish study comparing topical minoxidil (5%) and oral finasteride (1 mg/day), the response rate of finasteride was 80%. In this study, the response rate (87.1%) was higher than in the Turkish study (which was being used for comparison)
[*]One of the reasons for this could be the characteristics of scalp hair of Japanese men. Japanese subjects generally have less hair density, larger hair diameter, and black color of hair shaft showing a marked contrast of color of hair compared to thinner and lighter color of the scalp hair in Caucasian men
[*]The response rate improved with increasing duration of treatment. No major relations were observed in terms of N-H scale, age at onset of hair loss and duration of hair loss.


So, the papers seems to say that the efficacy rate is slightly higher than Mercks original ideas and that the adverse reactions are lower, however it must be said that even though small, there were adverse reactions and even though they claim no long term effects they were only followed up over 3.5 years and no very long term studies (such as 10 year usage) were assessed. These results are encouraging in terms of the side effects profile being very low and also they state that when the users stopped finasteride the side effects disappeared.

This paper also has an interesting regression analysis on the different response rates of ages and response rates depending on what type of Androgenetic Alopecia the patient has. One very interesting point is that they actually monitored regrowth in frontal hair in this study (unlike the merck study) and they found that it did regrow hair in that area, however it was less effective in those which had only frontal loss than in those which had loss on the vertex/crown.

I'm currently looking at a few papers concerning the effects of 5-alpha-reductase inhibitors (like finasteride and dutasteride) on the effects of allopregnanolon which is a neurosteroid that is linked in with this system so hopefully my next post will contain some interesting facts about that.

That's all for now folks!

 

[IrishFella]

Hey man, welcome, the best you can do is research the drug, the clinical studies are what you should paying most of your attention to. They have being consistent which is what you want to see.

DO NOT listen to random scare stories on the internet, YOU WILL come across them sooner rather than later.

Good luck, mate.

 

[Cali PokerDealer]

Thank you for sharing. I am on my 40ish day of finasteride, and I must say, I have had no sides.

 

[Relax Im hilarious]

Thanks for the encouragement guys!

As I was saying in my earlier posts, i'm going to keep trying to research all the different papers that may be related to finasteride or similar products and hopefully just try and help break them down so we can all see the scientific fact and not be so concerned with scare stories.

 

[Relax Im hilarious]

2 months and 3 weeks into propecia treatment, and still no problems as of yet to report. My hair shedding seems to have come down a bit to between 20-50 hairs a day which i think is kinda normal (although i don't know because i never really checked before i started the pills), however I’m losing some hair from the back and sides which is weird because i thought they were permanent hairs. I'm attributing this to the stress i was under when i first noticed the hair loss coupled with a few things that have been going on over the past couple of months = little bit of extra Telogen Effluvium to couple with the hair loss. Not to worried about these hairs though, as I’m sure they will return soon. No regrowth on the front still but after i spoke to the people at Johnson and Johnson (regaines manufacturer) they said it can take 3-4 months after a shed for the hair follicle to reorganize itself before regrowth so following that i shouldn't see anything until about Jan/Feb time. They also stated that given my problem with the regaine (see first post) I should get back all the hair shed and go back to my baseline level. They said sheds are usually a good sign and it was a shame that i couldn’t continue with it because it sounded like i would have been a great responder, c'est la vie....

Anyway i promised i was going to do some research each week into finasteride and it's different effects on the body to try and bring some science into the mix so this week, as promised, it's effects on the neurosteroid allopregnanolone:

Allopregnanolone, a.k.a 3?-hydroxy-5?-pregnan-20-one or 3?,5?-tetrahydroprogesterone is neurosteroid present in the blood and also the brain. Being a direct metabolite of progesterone via conversion involving 5-alpha-reductase (the enzyme finasteride lowers), it is a modulator of the GABAA receptors. GABAA receptors control ?-Aminobutyric acid (GABA) levels - the chief inhibitory neurotransmitter in the mammalian central nervous system responsible for regulating neuronal excitability, basically meaning it stops our neurons from overfiring. GABA is also inhibitory for glutamate, epinephrine, norepinephrine and dopamine and can promote relaxation and sleep. Inabilities to produce GABA have been linked with anxiety disorders, depression, MS and other problems. This is basically the current theory behind why 5-alpha-reducatse inhibitors such as finasteride or dutasteride may cause depression or anxiety.

Now the reason I’m mentioning all this is because depression and anxiety is an actual side effect listed on the packaging of finasteride, however whilst the above explanation is one example of how this can happen, the vast majority of people will never experience this. I always remember my endocrinology professor telling me that the human bodies greatest strength was its ability to adapt. Think about it this way, when testosterone and DHT levels drop, such as in aging or in obese individuals you don't suddenly become depressed as the body adapts to these lower levels. This (I believe) is why most people will not see a problem when taking finasteride with mood and depression as the body will adapt to the lower amount of allopregnanolone and reduce or raise tolerances accordingly. The people that need to be more concerned are those with a pre-disposition to conditions such as depression or anxiety. Those who already have an imbalance which causes depression (even if they don't know it) may find it exacerbated when losing another regulatory neuro-steroid, however for everyone else (the majority), they should be fine. I reckon (and again this is just my theory) they may notice a slight change in mood over the first couple of months as their body adapts but then it will return to a normal level, it may be so subtle that you never even notice it.

One point i would like to make is that when i've read a lot of people talk negatively about finasteride in the past they often cite scientific studies that use mice and rat models and not human ones. Whilst rat and mice models are good models to start with they are not human models and therefore their results should be viewed as such. For example, finasteride in rats affects both type I and type II enzyme in equals measures whereas in humans it has a 100 fold affinity for type II over type I. This is just one of many, many, many reasons why rat and mice models are used in science to say more investigation is needed and are not used to say that the effect is the same in humans. For those of you that are more interested in this topic I recommend printing off and reading a paper on this (link below), it is excellent and gives you a full detailed analysis of finasteride and many of its effects, just to give a brief conclusion it states that:
"The fact that finasteride does not appear to produce anxiety, depression, increased seizure susceptibility, sexual side effects or precipitate alcohol withdrawal in a large proportion of patients bodes well for its continued clinical application for the treatment of BPH and androgenetic alopecia. Nonetheless, side effects have been reported with finasteride in a small percentage of patients, suggesting that caution might be warranted regarding the use of finasteride in susceptible populations."

http://onlinelibrary.wiley.com/doi/10.1 ... x/abstract

Right that's your lot for this week. Next post i'm going to try and do some research intot finasteride and memory as people sometime talk about brain fog when on it so i'd like to get to the bottom of that or the effect of finasteride on athletic performance. Being a keen athlete myself and a massive gym rat, I wonder what effect it has. On the two months i've been taking it my workouts have actually got a lot better but I did also change my weights routine which could be the other reason....

Until then take care y'all!

 

[IrishFella]

:agree:

Congrats, bro. You're doing exactly what every should do before they start finasteride, research the drug. It sure did put my mind at ease.

 

[Relax Im hilarious]

Thanks man. I'm just hoping that if i can put some stuff up here it will help put some others peoples mind at ease as well

 

[Relax Im hilarious]

No in depth message this week as i'm stuck revising for exams coming up so just an update on how things are going.

I'm just about coming up to the end of month 3 and as of yet no real change. Like last week i'm still shedding sporadically, some days more than others but haven't really noticed any change, some days about 50 hairs, others about 20. Saying that i wasn't expecting any change yet so i'm not exactly disappointed. Still anxious to see if there will be any regrowth on the front after my regaine foam fiasco but as of yet nothing.... Well i say nothing but i can see a few fine hairs coming through but i'm going to hold out judgement on those at the moment because unless they become thicker and darker then they don't really count. Just as a question if anyone knows if hair can change from small and light to thick and dark as it grows please tell me because i have no idea.
Still no problems with the propecia either although i was using nizoral and had to stop because it was making my scalp really itchy and my hair quality awful. I may try it again when my scalp settles down in a couple of months but i'm not sure if it agrees with my head.

Jut wanted to mention something else, one thing i have discovered is concealer. I'm using toppix and even though people say you can't notice my hairloss, it's noticable to me and that's all that it takes to hit your confidence. I find that some days when i look at it and i'm particularly sensitive about it, using a bit of concealer does the trick to make you feel a lot better about yourself. I know it sounds kinda stupid and vain but it works, so i'd recommend anyone that's thinking of giving concealer a try to go ahead.

I'm still hoping to do some research on the effects of the propecia on exercise and weight lifting, being an ultra keen gym rat and boxer myself i'm particularly interested but i'm just too busy at the moment so will get round to that in a couple of weeks.

 

[Relax Im hilarious]

Hey dav489

I read your story on your thread and have to say, i admire how strong you've been through the whole thing. I can tell you've been through some real lows with this and i can't imagine how hard it has been to deal with it but your really lucky having a really great girl and your ability to persevere through this whole thing is a real inspiration to all the others guys on here! I know how hard it is to talk to people about it and my girl puts up with a lot with me looking at my hair in the mirror and moaning about it, although she does make me go to watch twilight so i guess me and her are even!

I'm on the standard 1mg a day dose, there an interesting paper here which shows the different effects of dosages of finasteride on 18-36 year old men:

http://www.ncbi.nlm.nih.gov/pubmed/10495375

Basically they showed that 0.2mg per day or above was effective but 1mg and 5mg was the most effective. However they showed little statistical difference in effectiveness between 1mg and 5mg dosages. I think i understand the theory behind what hassan and wong are saying, i'm going to take and educated guess and assume that they believe, and the studies they quote, will probably say that taking for more 5-alpha-reducatse inhibitors (taking 2.5mg) will effectively stop more of the enzyme, however as with all enzymes there is a cut off point where adding more and more of the inhibitor will be ineffective, e.g 25mg would be no more effective than 5mg. I'd definitely say consistency is more the key, taking the pill every day rather than every other day would be my advice over uping the dosage as this would help maintain a constant gondal hormonal axis which i personally believe is the key in treatment.
Also it's worth noting that when manufacturers make pills they are not always divided equally so cutting a 5mg pill doesn't necessarily give 2.5mg in each part. It could be that one half has 1.5mg and the other 3.5mg.
From reading on the forums there are plenty of guys who take the whole 5mg a day and are doing fine on it, also the pill was originally developed to treat benign prostatic hyperplasia and was given at a dosage of 5mg, this has been around for over 20 years so there is TONS of info on the the benefits and problems with this dosage over the long term, including how there were debates on giving every man over 50 years old finasteride prophylactically to prevent BPH ever occuring, however people don't usually get BPH until they are in their 50's so the data tends to be on older guys.

As for the hair on the sides of my heads, it has thinned a bit all over, especially at the sideburns area i would say but oddly not the temples, which they do say is more indicative of Telogen Effluvium rather than male pattern baldness, however this could be Telogen Effluvium bought upon by hormonal change which could (and i stress could) be caused by your body adapting to the increased dosage and my body adapting to starting finasteride.

Hope this helps a bit and i'm more than happy to answer any other questions you've got.

 

[Relax Im hilarious]

Thanks man, i'm definately interested to hear about what goes on in regards to you uping the dosage, keep me informed with how the treatments are going and finally good luck!
I'll keep doing more research and posting it on here, my aim is to have a log in a years time that people can look at who are thinking of starting finasteride and see what it's like to take and also so they can read all the evidence about it aswell.
As i mentioned in an earlier post, i'd like to do some research next on exercise and finasteride but i'm busy revising for some paediatrics exams as part of my medical training at the mo which is completely destroying my free time (and sanity). So that will probably be a week or two away i guess.

 

[Relax Im hilarious]

So 3 months and 1 week and not much to report. Still shedding, less than before but still a bit, it's roughly between 20-50 hairs a day. I usually notice 5-10 in the shower, 5-15 when combing/styling my hair and then another 5-10 when brushing my hands through my hair throughout the day. I should also mention, I shed big terminal hairs aswell as more miniaturized ones from the front and the shed is global no localized.
Still no real regrowth at the front after the regaine foam incident and to be honest after 3 and a bit months i've kinda given up hope on that front. @*"%ing regaine.....
I mentioned earlier that i gave up on nizoral because it didn't agree with my scalp but i still had a bit of an itch on my head, i switched to using neutrogena t-gel and that works a treat. Been on that for a couple of weeks now and the itch has pretty much gone completely.

So for this post i decided to get round to doing a bit of research on the effects of finasteride on exercise. As i mentioned before i'm a keen sportsman and weight lifter so i though this would be an interesting topic.
finasteride has been proven to increase you testosterone levels as there is less T converted to DHT as the enzyme is blocked, however given that our hormones are in delicate balance, in order to prevent this T increase that could result in extra estradiol production (as it has to be converted to something) I would have thought that the T levels would decrease slightly to compensate and therefore this would have a negative effect on exercise, that was my theory anyway.
However, this is not the case. Finasteride actual increases serum testosterone over the long term. It also significantly decreases DHT levels, has no significant effect on follicle stimulating hormone (FSH) which is a hormone that is important for spermatogenesis. Luteinizing hormone (LH), a hormone involved in production of testosterone also shows little significant change. Finally serum prostate specific antigen (PSA) is slightly decreased.

http://www.sciencedirect.com/science/ar ... 00076#sec5

So this seems to show that your testosterone is largely unaffected/slightly increased, increases happen all the time though, everything from exercise to eating certain foods can change hormonal profiles that why our bodies are actually pretty good at adapting to change, which in this case is being brought on by the administration of finasteride. Others studies have shown that the greatest testosterone increases come in those men who have low T to start off with and therefore notice the biggest difference:

http://www.ncbi.nlm.nih.gov/pubmed/14624915

Another interesting finding that this study showed was that BMI actually decreased when being given finasteride. Note; this study was done in men taking finasteride for BPH rather than AA, which means the standard 5mg dose, not the 1mg dose of propecia recommended for AA. Also the study indicated that there was an excellent tolerance to the drug and a very low side effect rate and whilst side effects were increased over 1 year when compared to the placebo group, at 2-4 years the side effect profile was almost identical to the placebo group (these were the standard side effects of impotence, sex drive and ejaculation disorder etc...). Also note that the BMI measurement was not the aim of the study and therefore should be taken with caution as it was not fully standardized therefore it should only be considered an anecdotal point, the purpose of the study was the effect on testosterone and safety over long term.

On a personal note my workouts seem to have got a little better but that could all be in my head. What i can be certain of is they have definitely not got worse, i have noticed no difference in my fat composition or gyno etc... and as i maintain a low body fat percentage and a high muscle mass, this means i would notice any change pretty quickly. As for my aerobic fitness, no change there either, i run twice a week (usually between 5-10k) and i box/spa once a week along with 3-4 sessions of weight and i've noticed no negative change, as i mentioned earlier i think it's going better than usually but this could be a placebo effect.

That's all for now, if anyone actually reads this thread and wants to share their own experiences on any of the things i've posted, i'd love to hear about it!

 

[hp6480]

Hey I'm just a little curious why your not using minoxidil? I just want to say I've really enjoyed your posts and the science behind them. Also did you use 1% or 2% nizoral? and how often?

 

[Relax Im hilarious]

Hi hp6480

I tried minoxidil 5% on the front when i used the regaine foam. Unfortunately it gave me really bad headaches, kinda like migranes which were unbearable so i had to stop after only 5 days. However i still got the shed and that's what really screwed up my frontal hairline. 3 months on and no regrowth, it'll be a real kick in the teeth if 5 days of regaine have screwed my hairline up....
I was using the 2% nizoral roughly once every 3 days, i'm not sure why it didn't agree with me but i had no scalp itch before using it and only had scalp itch when using it, since stopping, the itch is going, i guess i just didn't take to well to the nizoral.

 

[Relax Im hilarious]

Hey Dav489. 4 marathons! Woah, that is seriously impressive :bravo:
What sort of training did you have to do to get into shape for running one?
I like your suggestion of the different side effects in different age groups, i think that will be the topic i research next week. Should be loads of data due to the people who take propecia 1mg usually being between 20-40 and the people who take finasteride 5mg for BPH usually being over 50.

 

[hp6480]

Maybe nizoral 1% would work better for you. I've read that even with the 1% it should only be used like twice a week or it will really dry out you scalp. I'm going to see my dermatologist in a week about getting on Propecia... I'm hoping to take .5MG daily but I'm really anxious to see what her thoughts about the drug and dosage amounts are. Did you ever go see a dr about Propecia?

 

[Relax Im hilarious]

Good idea, I may try nizoral 1% in a couple of months to see if that makes a difference.
I didn't go see a Doctor as such. I'm a med student so i'd heard of propecia in its clinical setting as proscar (used to treat BPH) and knew a bit about it to begin with. I then just did loads of reading and talked to a few people who had taken it before and then begun it myself.
I can't claim that it's made any difference yet, and it has made me shed, but then i'm only 3 months in an i won't make judgment until 1 year through (at least) as the studies show that the best results come on average between 18-24 months.
All i can say about it at this point is that i haven't got any sides from it as of yet, no one i know who take it has and the science says that the chance of sides is low. However, there is no way of knowing how effective or whether you get any sides from it until you try, unfortunate i know but you do have to take a bit of a gamble when starting it. The way i looked at it was that when taking it you have the following possible outcomes:

1) Stopped hairloss and regrew hair
2) Stopped hairloss, no regrowth
3) Slowed hairloss
4) Does nothing
5) Any of the above options but with sides

From reading about it the vast majority of people fall in the first three categories. Some will see no effect and a minority will gets side effects. These effects may be mild and disappear over time or may force the patient to discontinue the drug.
For me, looking at it this way helped make my mind up as it showed me all my options. I guess i just have to wait and see now.

 

[Relax Im hilarious]

Right, so i've decided to bite the bullet and upload some pics.
I've tried to take them so you can see them both in natural light and under a flash / halogen bulb that is in the room. Also i have a double crown which is a pain in the ***.
I've also done all the pictures wet because you can see it at its worst then.

Also i want to point out that this is NOT baseline, this is my hair at it's worst after a big shed after applying regaine foam and being on propecia for 3 months which made me globally shed (it's slowing down now but i shed a lot for a couple of months).

Bearing in mind not four months ago my hair looked better than this, you can see the damage a shed has done especially to the front of my hair, however when i comb it forward which i do before i style it, i can hide the problem at the moment without concealers and if i want to add more thickness i use some toppix.

I'm hoping to get back to baseline with the propecia and as everyone says i need to give it a year before i can judge but the waiting is literally torture! Hopefully these pics will provide a reference if i keep taking some every 3 months so i can post my progress.

 

[Relax Im hilarious]

3 months and two weeks in to propecia now and shedding on top seems to have slowed down, however i shed on back and sides (especially temples) still which is a little concerning.
Also the itch on top of my head is drastically reduced from what it was, i attribute this in part to the t-gel shampoo that i started using.
Nothing else to report really, still no problems with the propecia and no real benefits to the hair yet, however as i stated i'm not expecting anything till at least 6 months and even then it could be too early to judge. I am starting to see a few small hairs sprouting up around the hairline and further back, although they are small and not that dark yet so i'm going to wait and see on those ones....
I did go see a hair transplant Doctor to get some advice. They recommended not getting an hair transplant yet and said that they would strongly recommend me giving it between 12-18 months on propecia before making any other decisions, then if the hair looks the same as it does now and hasn't improved that they can do some work on my hairline to restore the density. I was told between 1000-1500 hairs would do the trick. It was nice to be told that at least if the treatments don't make it any better and just help me maintain what i have now that i can get it fixed with an hair transplant at a later date.

Now here's the science bit.... and sorry for the long post (again):
For this week i wanted to talk about long term effects on the hair of propecia for a bit. After reading loads of threads that people made from all different websites i noticed that there seemed to be this idea that propecia reaches it most effective time at the 2 year mark and that after that it's downhill. I decided to look at the data and you can see from the graphs i've attached that that's sort of true but also not the full picture.

The first graph shows the difference that propecia makes to the actual weight of hair strands. So this wasn't measuring any hair growth but instead the effects on hair that is currently there. This showed that it took 132 weeks for the greatest average increase in hair weight to be achieved suggesting that it can take up to 2 and a half years for the hair to thicken up to it's maximum potential. Obviously this is an average result so it will vary in the individual but that shows that it can take a long time. The thickness on average at this 2.5 year mark was +30% which is pretty incredible if you think about it. At 192 weeks (3.7 years) the average increase of thickness over baseline level was +21.6%. So that means that even if you have no regrowth, on average men experienced a 21.6% increase in thickness of the year within 4 years. If you take into account those not taking propecia you can see that the difference in hair weight is around 40% different, so even if propecia doesn't thicken the hair shaft at all it can stop it getting worse.

The second graph most people have probably seen and is taken from the official merck trial. This showed that the greatest increase from baseline in the number of hairs was seen at the 1 year mark. The way they measured it was take take an inch in diameter on the scalp and measure the loss. This was done at the crown and mid anterior vertex (as was measured in the trial) and showed that after 1 year there was an average of an extra 90(ish) hairs per inch above baseline. After five years there was an average of about 40 hairs per inch above baseline showing that although you lose some of the new hair you grow over time, on average the amount of hair that have after five years is still greater than your baseline level which is pretty encouraging. The other thing that they are keen to point out is that that is compared to baseline, if you compare it to guys who didn't take propecia the hair count difference is pretty amazing, after only one year there is are 107 extra hairs per inch, although the non propecia group only lost on average about 20 hairs from baseline, but after five years the non propecia group had lost about 240 hairs per inch which was 277 hairs difference than the propecia group. 277 hairs per inch diameter!!! This is why they argue that even if propecia isn't growing hair for you it could be doing some seriously important work of halting or slowing loss.

Now obviously we are all hoping that we can be the guy that gains 90 hairs per inch and has an increase in density of 40% over 5 years because then we would probably have awesome hair, and for some people this seems to be the case, but even if you had no hair increase but no hair loss with a 20% increase in density it would make a big cosmetic difference and the average result for a guy after 5 years is about +40 hairs per inch and a 20% increase in density which seems pretty good. I reckon at a guess, depending on the size of you head, that's probably going to equate to about an extra 1000-2000 hairs on top of your head plus the increased density of the ones already there.

Right that's all for the next couple of weeks. I'm not posting anything over xmas and new years so i want to take this time to say to everyone merry christmas and happy new year, lets hope that 2012 is more hair year or something like that

 

[Relax Im hilarious]

Right, after a month away from this place i'm back for an update and to wish everyone happy new year!
It has been 4 months and 2 weeks for me on propecia and still no sides or problems from the pills. No change to the hair, it is still the same as the pictures i posted at the 3 month mark. I think i may be shedding a bit more but i'm not sure, my shedding days are really erratic, for example i shed about 15-20 hairs for a couple of days and was thinking great and then the day after, I combed my hair and lost about 60 just combing it. I figure on average i'm losing about 30-40 a day which i think is a good amount and if i am shedding more that seems to coincide with the idea that you shed around the 4 month mark with finasteride because of a Telogen Effluvium type thing as your body adapts to the hormonal change.
A couple more things to mention, I’ve been using neutrogena t-gel for a couple of months now and it has cleared my scalp itch almost completely. For anyone that can't handle nizoral (like myself) i'd recommend using t-gel it's really good.
Also when i first noticed my balding i started using rogaine foam, it's now been almost 5 months since that incident and the hairs i lost did not grow back. I don't want to bad mouth a product because many people have had great success with it, but for me it didn't just not work, it's made it worse and i only used it for 5 days. So if you are thinking about starting rogaine foam learn from my mistake, don't put all over your hairline, try a little first on a small spot and see what happens, just in case.

And now for a little science. This is for anyone who might be reading this and now its the new year has decided to start propecia and i worried about the side effects.

http://onlinelibrary.wiley.com/doi/10.1 ... 563.x/full

This paper measured something known as the "nocebo" effect. I'll quote wikipedia to explain what this means:

"In medicine, a nocebo reaction or response refers to harmful, unpleasant, or undesirable effects a subject manifests after receiving an inert dummy drug or placebo. Nocebo responses are not chemically generated and are due only to the subject's pessimistic belief and expectation that the inert drug will produce negative consequences."

What this paper aimed to measure was if side effects of finasteride were worse if you knew about them before hand. It is worth noting that in this study they look at men with BPH and not balding, this means they were receiving 5mg finasteride and not 1mg which is used to treat baldness (same drug but higher dosage for BPH). They took 120 patient with BPH split them into two groups, group 1 and group 2. Both groups were told that they were to be given a drug that had a proven efficacy for the treatment of BPH for 1 year. Group 1 did not receive any counseling about the drugs sexual side effects but group 2 were specifically told that it may cause ED, decreased libido and problems with ejaculation even though these side effects were rare.
The group 2 patients reported a much higher rate of side effects compared to group 1 (43.6% vs 15.3%) and the rates of ED, decreased libido and problems with ejaculation were significantly higher in group 2 (30.9%, 23.6% and 16.3% for group 2 vs 9.6%, 7.7% and 5.7% for group 1).
The researchers concluded that the nocebo effect has a clear correlation with the rate of side effects in propecia usage and as such must be taken into account.

Now, i understand this is a sensitive issue with many people and i am not wishing to cause an friction here but to all those who are beginning to take propecia or are thinking about it, my advice is stay off the forums for a bit and try not to focus on the negative. Trust your own judgment, if you feel you are experiencing side effects, then ride it out for a bit and if they don't go or are too bad then quit. There are stories of people with serious side effects, no one is denying that, but the overwhelming scientific evidence points to this drug being safe and effective in the majority of cases. Give the drug a chance and see what it does, fighting baldness is half in your head.