spironolactone help

[Dave001]

IFin reduces follicle DHT, but the amount if reduces is between 30-70%

Wha? Where in the follicle?

 

[Red Rose]

[quote="Red Rose":6d572]007 the long and short of it is that if you are taking finasteride and nizoral already, there is no compelling reason IMO to take a topical antiandrogen (dutasteride is a different story) and certainly I do not think the addition of topical spironolactone will give you tangible results as minoxidil might if you threw that into the mix. However, if you are dead against using minoxidil, you could use copper peptides which have shown in a study to have growth stimulating effects comparible with 2% minoxidil.

Why is dutasteride a different story when talking combination with topical antiandrogens? Didn't quite get that. Does it have to do with follicle T levels?[/quote:6d572]

Yeah, I only say that on account of the fact that dutasteride's affect on the 5a-reductase enzyme is that much more pronounced than finasteride's and accordingly the upshot is that body compensates by increasing scalp testosterone levels to a much greater degree, which is a possible explanation for the reports of dutasteride causing a marked increased in frontal thinning among some users. In other words, I'm only perpetuating popular opinion and do in fact have reservations with this argument on the basis that the trade off would be a significant decrease in DHT; so any increase in Test (which has never I believe been shown in vivo to stunt hair growth - could be wrong) should not on its own be adversely affecting the hair follicles to the extent that it allegedly is.

Basically, I suppose the long and short of it is that it is better to be safe than sorry and the addition of some inexpensive spironolactone certaintly can't do any harm.

I was only trying to emphasise to the OP that there was only so much you could achieve with anti-androgen therapy and that was why I invited him to take minoxidil instead of spironolactone which on balance seems more sensible to me but horses for courses!

 

[Red Rose]

Sorry Dave and Red Rose. Inhibit the Type II enzyme, block the AR's, this is WAR baby!! Overkill? Maybe - so what!!??

Red Rose was trying to emphasize that minoxidil would probably offer the best ROI when added to the original poster's existing treatment regimen, and with that I agree. The addition of topical spironolactone could still conceivably help in the long-term, but the effect would not be as robust as what one would expect from minoxidil (this is in the context of someone using finasteride) because they work through completely difference mechanisms.

Yeah exactly. Well said.

 

[Old Baldy]

Sorry Dave and Red Rose. Inhibit the Type II enzyme, block the AR's, this is WAR baby!! Overkill? Maybe - so what!!??

Red Rose was trying to emphasize that minoxidil would probably offer the best ROI when added to the original poster's existing treatment regimen, and with that I agree. The addition of topical spironolactone could still conceivably help in the long-term, but the effect would not be as robust as what one would expect from minoxidil (this is in the context of someone using finasteride) because they work through completely difference mechanisms.

I agree. Dave and Red Rose, you guys have to remember that I'm a little wacko.

 

[mvpsoft]

IFin reduces follicle DHT, but the amount if reduces is between 30-70%

Wha? Where in the follicle?

If finasteride reduces serum DHT levels, that will reduce DHT in the hair follicle. If it doesn't, then it would do no good.

 

[Dave001]

IFin reduces follicle DHT, but the amount if reduces is between 30-70%

Wha? Where in the follicle?

If finasteride reduces serum DHT levels, that will reduce DHT in the hair follicle. If it doesn't, then it would do no good.

Huh? The major benefit of finasteride is thought to result from its inhibition of 5alpha-reductase in the hair follicle, specifically the dermal papilla, in which the type II isoform predominates. What is this 30-70% crap?

 

[mvpsoft]

A more precise statement would be that depending on dosage (and depending on which study one cites, below is one), finasteride reduces scalp DHT levels between 20% and 70%. This is where I get my "30 to 70% crap," which was an approximation. Is making approximations ok with you?


J Am Acad Dermatol. 1999 Oct;41(4):550-4.

"The effects of finasteride on scalp skin and serum androgen levels in men with androgenetic alopecia"

Drake L, Hordinsky M, Fiedler V, Swinehart J, Unger WP, Cotterill PC, Thiboutot DM, Lowe N, Jacobson C, Whiting D, Stieglitz S, Kraus SJ, Griffin EI, Weiss D, Carrington P, Gencheff C, Cole GW, Pariser DM, Epstein ES, Tanaka W, Dallob A, Vandormael K, Geissler L, Waldstreicher J.

University of Oklahoma Health Sciences, Oklahoma City, USA.

BACKGROUND: Data suggest that androgenetic alopecia is a process dependent on dihydrotestosterone (DHT) and type 2 5alpha-reductase. Finasteride is a type 2 5alpha-reductase inhibitor that has been shown to slow further hair loss and improve hair growth in men with androgenetic alopecia. OBJECTIVE: We attempted to determine the effect of finasteride on scalp skin and serum androgens. METHODS: Men with androgenetic alopecia (N = 249) underwent scalp biopsies before and after receiving 0.01, 0.05, 0.2, 1, or 5 mg daily of finasteride or placebo for 42 days. RESULTS: Scalp skin DHT levels declined significantly by 13.0% with placebo and by 14.9%, 61.6%, 56. 5%, 64.1%, and 69.4% with 0.01, 0.05, 0.2, 1, and 5 mg doses of finasteride, respectively. Serum DHT levels declined significantly (P <.001) by 49.5%, 68.6%, 71.4%, and 72.2% in the 0.05, 0.2, 1, and 5 mg finasteride treatment groups, respectively. CONCLUSION: In this study, doses of finasteride as low as 0.2 mg per day maximally decreased both scalp skin and serum DHT levels. These data support the rationale used to conduct clinical trials in men with male pattern hair loss at doses of finasteride between 0.2 and 5 mg.

 

[Dave001]

A more precise statement would be that depending on dosage (and depending on which study one cites, below is one), finasteride reduces scalp DHT levels between 20% and 70%. This is where I get my "30 to 70% crap," which was an approximation. Is making approximations ok with you?

I thought that Bryan's repeated attempts to explain that DHT within the dermal papilla is much more important than the vague notion of "scalp DHT" would've been hammered home by now.

Keep trying Bryan.

 

[mvpsoft]

Are you normally this cantankerous? You first said that the 30% to 70% figure was "crap," then when I cited a study showing that it wasn't, you switched to this scalp/dermal papilla thing.

Since the study that I cited is the same study that Bryan has cited and referred to numerous times when addressing this question, perhaps you should complain to Bryan that he isn't listening to his own advice?

http://www.hairlosstalk.com/discussions ... ide#170955

http://www.hairlosstalk.com/discussions ... ide#170411

http://www.hairlosstalk.com/discussions ... ide#140176

Next time drink decaf, or argue for the sake of arguing with someone else.

 

[Dave001]

Are you normally this cantankerous? You first said that the 30% to 70% figure was "crap," then when I cited a study showing that it wasn't, you switched to this scalp/dermal papilla thing.

There was not any switching involved. The point all along was that a "30-70% scalp DHT reduction" is not very meaningful, because the scalp includes a lot of 5alpha-reductase outside of the hair follicles.

Since the study that I cited is the same study that Bryan has cited and referred to numerous times when addressing this question, perhaps you should complain to Bryan that he isn't listening to his own advice?

http://www.hairlosstalk.com/discussions ... ide#170411

You may have cited the same study, but that doesn't mean that your interpretation was the same.

I agree with what he said (from the above URL):

"3) male pattern baldness is more strongly associated with the type 2 enzyme than the type 1 enzyme, anyway, so I wouldn't be terribly concerned with "scalp DHT". I'm more concerned with follicular DHT."

 

[Old Baldy]

Are you normally this cantankerous? You first said that the 30% to 70% figure was "crap," then when I cited a study showing that it wasn't, you switched to this scalp/dermal papilla thing.

There was not any switching involved. The point all along was that a "30-70% scalp DHT reduction" is not very meaningful, because the scalp includes a lot of 5alpha-reductase outside of the hair follicles.

Since the study that I cited is the same study that Bryan has cited and referred to numerous times when addressing this question, perhaps you should complain to Bryan that he isn't listening to his own advice?

http://www.hairlosstalk.com/discussions ... ide#170411

You may have cited the same study, but that doesn't mean that your interpretation was the same.

I agree with what he said (from the above URL):

"3) male pattern baldness is more strongly associated with the type 2 enzyme than the type 1 enzyme, anyway, so I wouldn't be terribly concerned with "scalp DHT". I'm more concerned with follicular DHT."

Now Dave, you're obviously correct. However, I'll say it again, I WANT all of those da** enzymes that are used to make DHT REMOVED, NEUTRALIZED, and/or BLOCKED!! And I want any "primary" or "ancillary" androgens removed, neutralized and/or blocked also!! (In the scalp that is.)

I HATE scalp DHT, scalp reductase enzymes and scalp androgens!! :evil:

Sorry, I kind of lost it. Carry on guys!