Success With Dutasteride When Failed With Finasteride

[Michael Bonawitz]

Greetings all!

I'm a long time lurker on this forum. I have been dealing with Androgenetic Alopecia since I was 21 years old.
I started taking generic finasteride and using Rogaine in August of 2017, and for the first year, I held on to the hair I already had and grew a little bit around my temples.
Around November of that same year, my progress fell way beyond baseline and sent me into a panic.
I currently live in Japan, and went to a Androgenetic Alopecia specialist. After explaining my situation, they perscribed me Zagallo (name brand dutasteride for Androgenetic Alopecia in Japan).
I stopped finasteride immediately and starting taking dutasteride in December of 2018. I also bumped my topical minoxidil to 15 %.

The above pictures were the condition of my hairline in March of this year. Fast forward to September...

So after taking Dutasteride for 9 months and upping the minoxidil, I finally feel like I'm making progress.

My current regimen is:

I take 0.5mg of dutasteride EOD
2.5mg of Oral minoxidil ED
15% or Topical Minoxidil twice a day

I'm also 26 years old, haven't experienced any physical side effects. Mental on the other hand, I find it more difficult to deal with stress at times, but besides that everything is fine.

Please feel free to ask any questions!

 

[DuckThisSheet]

First of all, that regrow is f*****g nice, congratz

In your regimen there is also oral minoxidil - Do you take it, what is the dose>?
What dose of Duta are you taking? Do you take it everyday?
Did you shed when you switched to duta>?
Did you consider taking both finasteride and Duta?
Would you advice ppl to switch from Fina to Duta to see better results?

 

[Michael Bonawitz]

Thanks mate!

I forgot to mention, so I'll eddit my main post.

Along with the dutasteride, my dermatologist in Japan perscribed oral minoxidil as well (another common treatment for Androgenetic Alopecia here).

I take 0.5mg of dutasteride EOD
2.5mg of Oral minoxidil ED
15% or Topical Minoxidil twice a day

When I switched from finasteride to dutasteride, I did have a pretty massisve shed about 3 months into the treatment, which last for what felt like 2 months. I began to doubt if this regime was going to help me or not. But I just stuck it out and surely enough I stared to get decent regrowth about 2 months ago.

I would recommend dutasteride to anybody who has been taking finasteride for at least a year, doesn't have adverse side effects, and have not gained desirable results.

 

[baldingviking]

Congrats! Huge thanks for sharing that!

 

[DuckThisSheet]

Do you have any photos of hairline in December of 2018? Would give me more info than photos in March when you have been shedding :x

I really consider switching from Fina to Duta, but im still not sure

 

[Michael Bonawitz]

All my photos from when I started Fina are gone since that phone broke. My hairline did not get worse when I switched to Duta, I just had shedding all over my scalp.

 

[Harv]

I also recently made the switch, however i was on finasteride for 8months in combination with duta for 6months.
The regime was working well as i wasnt shedding or felt scalp inflammation/tingling.
Ive dropped fina for 3 days now and my scalp is tingling again and hairs falling out, assume the dht has crept back in my scalp.
Im just bemused how this is happening as im still on advodart and been on it for 6months.
Could it be that when taking both together ia more potent?

 

[Michael1986]

I also recently made the switch, however i was on finasteride for 8months in combination with duta for 6months.
The regime was working well as i wasnt shedding or felt scalp inflammation/tingling.
Ive dropped fina for 3 days now and my scalp is tingling again and hairs falling out, assume the dht has crept back in my scalp.
Im just bemused how this is happening as im still on advodart and been on it for 6months.
Could it be that when taking both together ia more potent?

I think this must be a placebo effect. Taking both finasteride and dutasteride together will not be any more potent than taking dutasteride alone. Furthermore, it would take longer than just three days for DHT levels to reduce significantly as a result of stopping finasteride usage (which would not happen anyway if you are continuously using dutasteride during and after stopping finasteride, as in your case).

 

[Harv]

I think this must be a placebo effect. Taking both finasteride and dutasteride together will not be any more potent than taking dutasteride alone. Furthermore, it would take longer than just three days for DHT levels to reduce significantly as a result of stopping finasteride usage (which would not happen anyway if you are continuously using dutasteride during and after stopping finasteride, as in your case).

logically i agree with what your saying and thats why i dropped fina, HOWEVER, 100% my scalp became more oily and tingling returned and alot of hair easily comming out, its not a placebo effect.
One theory someone told me is that my body was used to being on fina for 8months and quiting cold turkey was going to cause some sort of reaction to my system.
Its so strange as it seems like finasteride was suppressing the dht better. Fina shot up my testerone as it was converting the dht to Testerone and consequently my i had an increased libido.
As soon as i dropped finasteride my libido went down and producing less sperm.
I understand that finasteride takes a couple weeks to get out of the system so should i expect the dht to gradually or perhaps duta is waiting for fina to get out the system so it can overtake as bizzare as that sounds

 

[Michael1986]

logically i agree with what your saying and thats why i dropped fina, HOWEVER, 100% my scalp became more oily and tingling returned and alot of hair easily comming out, its not a placebo effect.
One theory someone told me is that my body was used to being on fina for 8months and quiting cold turkey was going to cause some sort of reaction to my system.
Its so strange as it seems like finasteride was suppressing the dht better. Fina shot up my testerone as it was converting the dht to Testerone and consequently my i had an increased libido.
As soon as i dropped finasteride my libido went down and producing less sperm.
I understand that finasteride takes a couple weeks to get out of the system so should i expect the dht to gradually or perhaps duta is waiting for fina to get out the system so it can overtake as bizzare as that sounds

The way that 5ar inhibitors work chemically is that if you are using the two together, the effect of the stronger one will override the effect of the weaker one. They do not work synergistically with one another. Dutasteride removes more DHT than finasteride does for at least 99% of people (and probably more like 99.99% of people), the exception being a tiny number of people who carry (and would most likely need to be homozygous for) a very rare mutant variant of the 5ar type 2 allele that happens to display a higher affinity to finasteride than to dutasteride. This was demonstrated in a study I read recently. Unless you are one of these very rare people, dutasteride (at the usual dosing scheme of 0.5mg a day) will inhibit more of your DHT than finasteride will, and taking both drugs together will not result in any more DHT inhibition than just taking dutasteride on its own would. Therefore, I don't see a way whereby there could be a change in your DHT levels after stopping finasteride, as you are continuing to use dutasteride. Consequently, I don't see how there would be any withdrawal effects, as it is the change in DHT levels that causes any such withdrawal effects in the first place. So to conclude, if the symptoms you are experiencing are not a placebo effect, it would seem to me that there must be some other unrelated cause for these symptoms.

 

[Harv]

The way that 5ar inhibitors work chemically is that if you are using the two together, the effect of the stronger one will override the effect of the weaker one. They do not work synergistically with one another. Dutasteride removes more DHT than finasteride does for at least 99% of people (and probably more like 99.99% of people), the exception being a tiny number of people who carry (and would most likely need to be homozygous for) a very rare mutant variant of the 5ar type 2 allele that happens to display a higher affinity to finasteride than to dutasteride. This was demonstrated in a study I read recently. Unless you are one of these very rare people, dutasteride (at the usual dosing scheme of 0.5mg a day) will inhibit more of your DHT than finasteride will, and taking both drugs together will not result in any more DHT inhibition than just taking dutasteride on its own would. Therefore, I don't see a way whereby there could be a change in your DHT levels after stopping finasteride, as you are continuing to use dutasteride. Consequently, I don't see how there would be any withdrawal effects, as it is the change in DHT levels that causes any such withdrawal effects in the first place. So to conclude, if the symptoms you are experiencing are not a placebo effect, it would seem to me that there must be some other unrelated cause for these symptoms.

appreciate the response, the above of what you said I do understand and knew about it but its definately dropping the fina caused it, its no concidece that the first few days without fina all these symptoms came back. I dont have an underlying issue as I had my blood test done, only worrying thing was i have a low white blood cell count which apparently i have most likely a viral infection which i have no idea what could be as im not ill.
i really just think generic fina hit my system much harder in blocking dht, im just going by how my body reacts because othweriwse i have no logical explanation.

 

[Sonic777]

Thanks mate!

I forgot to mention, so I'll eddit my main post.

Along with the dutasteride, my dermatologist in Japan perscribed oral minoxidil as well (another common treatment for Androgenetic Alopecia here).

I take 0.5mg of dutasteride EOD
2.5mg of Oral minoxidil ED
15% or Topical Minoxidil twice a day

When I switched from finasteride to dutasteride, I did have a pretty massisve shed about 3 months into the treatment, which last for what felt like 2 months. I began to doubt if this regime was going to help me or not. But I just stuck it out and surely enough I stared to get decent regrowth about 2 months ago.

I would recommend dutasteride to anybody who has been taking finasteride for at least a year, doesn't have adverse side effects, and have not gained desirable results.

Above 5 % Minoxidil dose NOT work !!! 15% is a scam ! If you don’t believe me go online and listen to Dr. Russel Knudsen THE HAIR LOSS SHOW from Sidney Australia he was one of 5 doctors who did the trials in 1984 to 89.

 

[abovedagame]

Above 5 % Minoxidil dose NOT work !!! 15% is a scam ! If you don’t believe me go online and listen to Dr. Russel Knudsen THE HAIR LOSS SHOW from Sidney Australia he was one of 5 doctors who did the trials in 1984 to 89.

There’s even a study on pubmed that shows 5% minoxidil works better than 10%

 

[Sonic777]

There’s even a study on pubmed that shows 5% minoxidil works better than 10%

YES ! After 5% there’s very sharp drop of in potency MASSIVE SCAM

 

[BigBadBaldie]

YES ! After 5% there’s very sharp drop of in potency MASSIVE SCAM

Well yes and no. That study does show that but at the same time some hairloss experts have hypothesised that higher percentages might be useful in non responders. But the jury is still out on that. At one of the hairloss conferences a speaker suggested this I wish I could find the link to it but I can’t.
In general though it’s definitely overhyped. I’d try 5% before I ever considered using a higher percentage.

 

[Einstein]

Now that's interesting.

5% Minoxidil solution contains 50mg/mL

From my understanding, by using more than 1mL of minoxidil you're increasing the %age of the solution. 2mL would yield 10% minoxidil (100mg/mL).

If that's the case, then how would people who require more than 1mL in order to cover a large area go about using minoxidil without inadvertently causing dimishing results? Use 2.5mL of the 2% solution?

 

[Einstein]

After reading the study you guys referred to, they must've been conducting their 2% vs 10% comparison of the crown region, as minoxidil was originally FDA approved for the crown. It's probably safe to assume you can use 1mL to the crown region and 1mL to the frontal regions without having to worry about the diminishing returns.

​

​

Efficacy and safety of a new 10% topical minoxidil versus 5% topical minoxidil and placebo in the treatment of male androgenetic alopecia: a trichoscopic evaluation​

Soheir Ghonemy 1, Abeer Alarawi 1, Hagar Bessar 1
Affiliations expand

• PMID: 31403367
• 
  
• DOI: 10.1080/09546634.2019.1654070

Abstract​

Introduction: Androgenetic alopecia is a stressful condition for males. Minoxidil 2% and 5% have been FDA approved for treatment of this condition. In literature, all studies have compared minoxidil 5% with 2%. Although other concentrations (2% to 12.5%) are available nowadays, we believe our study is the first to compare 10% versus 5% topical minoxidil in treatment of Androgenetic Alopecia.
Objective: To compare the efficacy and safety of 5% topical minoxidil with 10% topical minoxidil and placebo in Androgenetic Alopecia treatment.
Materials and methods: 36-weeks, double-blinded, placebo-controlled, randomized trial. A total of 90 men with Androgenetic Alopecia. First group have applied 5% minoxidil solution, second group applied 10% minoxidil solution; or third placebo group. Efficacy was evaluated clinically and trichoscopically.
Results: After 36 weeks of therapy; 5% topical minoxidil (0.47 ± 0.26) (0.59 ± 0.64) was significantly superior to 10% topical minoxidil (0.05 ± 0.13) (0.45 ± 0.74) and placebo (0.01 ± 0.05) (-0.03 ± 0.08) in terms of change from baseline in total vertex and frontal hair mean count respectively. Pull test change to negative in minoxidil 5%: (37%) patients after 6 month treatment, Minoxidil 10% group (37.5%) patients changed and in placebo group all patients after 6 month were the same (0%) change. No reported sexual dysfunction in all three groups.
Conclusion: Five percent of topical minoxidil was moderately superior to 10% topical minoxidil and placebo in increasing hair regrowth opposite to the expected, the irritation was marked for 10% topical minoxidil. Psychosocial stress after 10% usage were worsen by the shedding, irritation compared to their high expectation in comparison to 5% usage.

Efficacy and safety of a new 10% topical minoxidil versus 5% topical minoxidil and placebo in the treatment of male androgenetic alopecia: a trichoscopic evaluation - PubMed

Five percent of topical minoxidil was moderately superior to 10% topical minoxidil and placebo in increasing hair regrowth opposite to the expected, the irritation was marked for 10% topical minoxidil. Psychosocial stress after 10% usage were worsen by the shedding, irritation compared to their...

pubmed.ncbi.nlm.nih.gov