0.25 micro-dosing of finasteride
HI Ciccione!
For a long while i did hesitate to start finasteride, also because of (1) fear of side effects and (2) costs. Because i'm, as a researcher at a university, familiar with reading and comparing a lot of published articles, I also read almost all the puplished articles on finasteride (Merck and not Merck funded). I came to the conclusion that the 1mg is the most sufficient (like Merck), with in most articles a medium serum DHT-decrease between 69 end 73% and scalp DHT levels with a similair decrease, hair counts in the study by Roberts et al. were +65 (scalp inch) for the 1mg group after 6 months. But the 0.2 mg finasteride group did also have a significant inhibition of serum DHT at about 62%, so a little bit lower, scalp DHT levels were still reduces to the same as in the 1mg group. Hair counts for 0.2 mg group were around +38, so still increasing hair counts. In the placebo group there was a decrease in hair counts. Even 0.05mg finasteride was enough for a DHT decrease of 50%!
So if you want battle hairloss with finasteride (mainly maintaining), I think 0.2 is OK. 1mg is more effective, but also more expensive and if you will have side effects they will probably be worse than with the 0.2 mg dose, because there is less serum DHT (but this is speculation).
Personnaly I'm using 0.16mg finasteride. I cut the Propecia pill in 6.
here are some abstracts from articles:
Clinical dose ranging studies with finasteride, a type 2 5alpha-reductase inhibitor, in men with male pattern hair loss.
Roberts JL, Fiedler V, Imperato-McGinley J, Whiting D, Olsen E, Shupack J, Stough D, DeVillez R, Rietschel R, Savin R, Bergfeld W, Swinehart J, Funicella T, Hordinsky M, Lowe N, Katz I, Lucky A, Drake L, Price VH, Weiss D, Whitmore E, Millikan L, Muller S, Gencheff C, et al.
Northwest Cutaneous Research Specialists, Portland, Oregan, USA.
BACKGROUND: Androgenetic alopecia is a common condition of adult men. Finasteride, a type 2 5alpha-reductase inhibitor, decreases the formation of dihydrotestosterone from testosterone. OBJECTIVE: Two separate clinical studies were conducted to establish the optimal dose of finasteride in men with this condition. METHODS: Men from 18 to 36 years of age with moderate vertex male pattern hair loss received finasteride 5, 1, 0.2, or 0.01 mg/day or placebo based on random assignment. Efficacy was determined by scalp hair counts, patient self-assessment, investigator assessment, and assessment of clinical photographs. Safety was assessed by clinical and laboratory measurements and by analysis of adverse experiences.
RESULTS: Efficacy was demonstrated for all end points for finasteride at doses of 0.2 mg/day or higher, with 1 and 5 mg demonstrating similar efficacy that was superior to lower doses. Efficacy of the 0.01 mg dose was similar to placebo. No significant safety issues were identified in the trials. CONCLUSION: Finasteride 1 mg/day is the optimal dose for the treatment of men with male pattern hair loss and was subsequently identified for further clinical development.
J Am Acad Dermatol. 1999 Oct;41(4):550-4. Related Articles, Links
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.
