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Superiority Of Dutasteride Over Finasteride In Hair Regrowth And Reversal Of Miniaturization In Men
- Thread starter Swoop
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BaldingHelpMe
Established Member
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Also after 2 years of treatment, serum DHT is decreased by 94% on dutasteride, and only about 66% on finasteride! This is scary with this much DHT left to do the damage on your hair follicles!
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sh*t man, finasteride isn't doing the job for me, I think I need to bite the bullet and get on dutasteride. I'm just not sure on how to make the switch, I've heard of guys using finasteride for five days in a week and using dutasteride once a week, I guess I'll look into it. Thanks swoop!
Do you guys think it is possible that dutasteride just works faster than finasteride? I would like to see a longer than 24 week study on this because I don't think it is fair to make assumptions in such a short time. Here is an interesting thread on this... http://www.hairlosshelp.com/forums/...=101407&STARTPAGE=1&FTVAR_FORUMVIEWTMP=Linear
Quoting a guy from the thread above:
When people compare dutasteride to finasteride, they always use the 6 month results from Glaxo's phase 2 trial to support the idea that dutasteride is more effective than finasteride. I did the same thing for years.
For reference, here are those numbers that everyone is so familiar with:
After 24 weeks (approx 6 months), hair counts compared to baseline (mean):
0.05 mg (dutasteride) - 24.8
0.1 mg (dutasteride) - 72.3
0.5 mg (dutasteride) - 95.5
2.5 mg (dutasteride) - 109.8
5.0 mg (finasteride) - 73.2
Those numbers show 2.5 mg of dutasteride grew back 50% more hair than 5 mg of finasteride. That comparison is the basis for why everyone believes more DHT suppression is useful and for why some believe type 1 DHT matters (which no study has ever backed up BTW). And I think this logic is faulty.
Now, I am not disputing the validity of these numbers. Nor am I suggesting that at 6 months dutasteride doesn't work better than finasteride. The numbers clearly show it does. But you can't take these numbers in a vacuum. I think you need to compare these numbers to what the numbers were at 3 months to understand the trend and where these counts will likely peak at.
We do not have data passed 6 months for dutasteride, so we can only guess when hair counts would peak, but most people assume dutasteride would peak at one year just like finasteride did in Merck's clinical trials. I however, do not think this is true. And if you look at the data at 3 months from Glaxo, I think you will see why.
Here are the hair counts at 12 weeks (3 months) from Glaxo's trial:
0.05 mg (dutasteride) - 5.0
0.1 mg (dutasteride) - 54.3
0.5 mg (dutasteride) - 71.9
2.5 mg (dutasteride) - 100.4
5.0 mg (finasteride) - 52.1
If you just take those numbers at face value, you would draw the conclusion that dutasteride was not 50% more effective than finasteride, but 100% more effective (52 hairs vs 100 hairs). 2.5 mg of dutasteride is destroying the competition. This is the key right here. Comparing 12 week counts to 24 weeks counts shows that dutasteride is simply working much faster than finasteride (and the more you take the faster it works - because of how it builds up in your system due to the long half life). And it also gives you an idea of when the peak hair counts will come at (which depends on how much you are taking - the more you take the faster you will peak).
If you compare 2.5mg of dutasteride at 12 weeks and 24 weeks, there was only a 9 hair net gain between month 3 and 6. Just 9 hairs. That's it. Based on that trend, you'll be lucky to squeeze another 5 hairs of regrowth from month 7 - 12. You might not get anything. IMO, 2.5 mg of dutasteride has essentially peaked at 6 months (half the time it took finasteride to peak in Merck's study). Finasteride on the other hand went from 52 hairs to 73 hairs (net +21), so it clearly still has some time left before it peaks.
Speaking of which, if you look at the peak hair counts from the finasteride study that Merck did, you'll find that the peak hair counts were just under 100 hairs per square inch (at one year). Most importantly, that number is not very far away from what I believe dutasteride's peak would be (between 110 and 115 for 2.5 mg of dutasteride). And that variance could easily be explained by the fact that they were two different studies with a completely different makeup of people (so direct comparison of hair counts between these studies cannot really be made).
Equally important, you can see from the finasteride studies, that even after 5 years, hair weight remained relatively stable (even if hair counts dropped a little), implying the hair loss process had essentially been halted for people on finasteride.
In summary, there is no clinical data which supports the idea that dutasteride is going to work better than finasteride long term. In fact, I believe there's every reason to believe the peak hair counts from both drugs is very similar, with dutasteride's only true benefit being speed (likely due to the higher level of DHT suppression). This "works 50% better" mantra is IMHO complete fantasy.
Based on all this, I believe there is simply a threshold you need to achieve with regard to DHT suppression. And that percentage is no where near 95+%. In fact, the data suggests it is below 70% (which is all finasteride can manage).
In conclusion, I think people are wasting their time chasing 99% DHT suppression by combining finasteride/dutasteride and topical anti-androgens. IMO, finasteride is all you need as far as anti-androgen therapy goes. But to each their own.
Cheers.
Quoting a guy from the thread above:
When people compare dutasteride to finasteride, they always use the 6 month results from Glaxo's phase 2 trial to support the idea that dutasteride is more effective than finasteride. I did the same thing for years.
For reference, here are those numbers that everyone is so familiar with:
After 24 weeks (approx 6 months), hair counts compared to baseline (mean):
0.05 mg (dutasteride) - 24.8
0.1 mg (dutasteride) - 72.3
0.5 mg (dutasteride) - 95.5
2.5 mg (dutasteride) - 109.8
5.0 mg (finasteride) - 73.2
Those numbers show 2.5 mg of dutasteride grew back 50% more hair than 5 mg of finasteride. That comparison is the basis for why everyone believes more DHT suppression is useful and for why some believe type 1 DHT matters (which no study has ever backed up BTW). And I think this logic is faulty.
Now, I am not disputing the validity of these numbers. Nor am I suggesting that at 6 months dutasteride doesn't work better than finasteride. The numbers clearly show it does. But you can't take these numbers in a vacuum. I think you need to compare these numbers to what the numbers were at 3 months to understand the trend and where these counts will likely peak at.
We do not have data passed 6 months for dutasteride, so we can only guess when hair counts would peak, but most people assume dutasteride would peak at one year just like finasteride did in Merck's clinical trials. I however, do not think this is true. And if you look at the data at 3 months from Glaxo, I think you will see why.
Here are the hair counts at 12 weeks (3 months) from Glaxo's trial:
0.05 mg (dutasteride) - 5.0
0.1 mg (dutasteride) - 54.3
0.5 mg (dutasteride) - 71.9
2.5 mg (dutasteride) - 100.4
5.0 mg (finasteride) - 52.1
If you just take those numbers at face value, you would draw the conclusion that dutasteride was not 50% more effective than finasteride, but 100% more effective (52 hairs vs 100 hairs). 2.5 mg of dutasteride is destroying the competition. This is the key right here. Comparing 12 week counts to 24 weeks counts shows that dutasteride is simply working much faster than finasteride (and the more you take the faster it works - because of how it builds up in your system due to the long half life). And it also gives you an idea of when the peak hair counts will come at (which depends on how much you are taking - the more you take the faster you will peak).
If you compare 2.5mg of dutasteride at 12 weeks and 24 weeks, there was only a 9 hair net gain between month 3 and 6. Just 9 hairs. That's it. Based on that trend, you'll be lucky to squeeze another 5 hairs of regrowth from month 7 - 12. You might not get anything. IMO, 2.5 mg of dutasteride has essentially peaked at 6 months (half the time it took finasteride to peak in Merck's study). Finasteride on the other hand went from 52 hairs to 73 hairs (net +21), so it clearly still has some time left before it peaks.
Speaking of which, if you look at the peak hair counts from the finasteride study that Merck did, you'll find that the peak hair counts were just under 100 hairs per square inch (at one year). Most importantly, that number is not very far away from what I believe dutasteride's peak would be (between 110 and 115 for 2.5 mg of dutasteride). And that variance could easily be explained by the fact that they were two different studies with a completely different makeup of people (so direct comparison of hair counts between these studies cannot really be made).
Equally important, you can see from the finasteride studies, that even after 5 years, hair weight remained relatively stable (even if hair counts dropped a little), implying the hair loss process had essentially been halted for people on finasteride.
In summary, there is no clinical data which supports the idea that dutasteride is going to work better than finasteride long term. In fact, I believe there's every reason to believe the peak hair counts from both drugs is very similar, with dutasteride's only true benefit being speed (likely due to the higher level of DHT suppression). This "works 50% better" mantra is IMHO complete fantasy.
Based on all this, I believe there is simply a threshold you need to achieve with regard to DHT suppression. And that percentage is no where near 95+%. In fact, the data suggests it is below 70% (which is all finasteride can manage).
In conclusion, I think people are wasting their time chasing 99% DHT suppression by combining finasteride/dutasteride and topical anti-androgens. IMO, finasteride is all you need as far as anti-androgen therapy goes. But to each their own.
Cheers.
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@Swoop and @ForeverLacey - I am curious about your opinion on this. If people respond negatively to finasteride and have a lot of negative feedback (oily skin, increased libido, rapid acceleration of male pattern baldness, Telogen Effluvium, etc) do you think dutasteride is still worth an attempt???
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It's weird how the studies consistently show a comparable side effect profile -- that is absurd.
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I initially thought is quite a foolproof method but then i found there are enough horror stories of guys switching that way i.e. dutasteride once a week for first month then twice a week the second month and so on ...
I was on finasteride for half a year and kept losing my hair month by month, so i got tempted into dutasteride, only reading the success stories and disregarding the horror stories. At first i took finasteride + dutasteride everyday and after 2 weeks, i just dont know if it was placebo or what, i felt like im extemely lethargic and brain foggish, i basically felt a tired zombie that couldn't function.
I then started alternating between finasteride and dutasteride for 3 months and all that happened was even more severe shedding. My mental state was in the gutter then i just quit everything , only to later restart finasteride, this time i plan on going for 1 full year first.