Advice About Oral Minoxidil And Systemic Absorption

[michel sapin]

Hey guy, I am about to make the switch to low ose oral minoxidil but this drug is scary.
I am so so tired of topical version, I have a permanent layer of white flakes with this sh*t.
Do you know what is safer:
- high dose of tpical minoxidil 5% ( like 6 ml per day)
- 1.25 mg oral minoxidil
Which one get the most systemic absoprtion?
Because maybe i will get less side and more result with oral version?
@Wolf Pack what is your opinion?

 

[mvalley]

At this point, I'm just going to go with the oral version. Check out this series of studies: https://www.researchgate.net/public...cia_Tolerability_the_five_C's_of_oral_therapy

At these low doses, no one is really having any issues to speak of. It also solves the whole sulfotransferase enzyme issue where people cannot properly utilize the topical version. (Minoxidil sulfate is the active metabolite required to exert the vasodilatory and hair growing effects of minoxidil. For hair growth, sulfotransferase enzymes expressed in outer root sheath of the hair follicle sulfonate minoxidil. The large intra‐subject variability in follicular sulfotransferase was found to predict minoxidil response and thus explain the low response rate to topical minoxidil in the treatment of androgenetic alopecia.)

 

[Wolf Pack]

Hey guy, I am about to make the switch to low ose oral minoxidil but this drug is scary.
I am so so tired of topical version, I have a permanent layer of white flakes with this sh*t.
Do you know what is safer:
- high dose of tpical minoxidil 5% ( like 6 ml per day)
- 1.25 mg oral minoxidil
Which one get the most systemic absoprtion?
Because maybe i will get less side and more result with oral version?
@Wolf Pack what is your opinion?

Just dump the whole thing, you're practically a full head right from what I saw. Just use Finasteride and get a mini transplant if the front bothers you, but you were like a Norwood 1.5 with no diffuse thinning? Maybe you really want a Norwood 1. Minoxidil is for diffuse thinners and yes like any drug there are risks of sides (skin, heart) and applying topical hassle in this case too. Do the minimum you need to do which in your case honestly finasteride and maybe a transplant though I don't think you need it. It's also largely a junk and archaic treatment compared to finasteride - except for the few diffusers who respond amazingly and even they need finasteride.

I read a study once saying for topical, like 5% max goes systemic each time to use it. Of course cumulative effects can happen. The oral is obviously stronger (more chance of experiencing oedema, pericarditis and so on) but does give better results in those who are respondents. I heard and read of doctors/studies talking about 2.5mg-5mg being a safe daily dose.

You will most likely experience more sides on oral but perhaps less local irritation to the skin.

My advice: drop it totally. Maybe you won't shed so much, maybe you will, that's why it's important to think of all this before jumping on treatment. I don't think your hair will die without Minoxidil since you have a slow pattern and are on finasteride but maybe the dependency on Minoxidil could have happened. You could recover, you may not. I see that you are fixated on this question for years and without actual serious hair problems, I mean it nicely that you should talk to someone about this unnecessary insecurity. Live your life man, enjoy.

 

[AllerganSaveUs]

At this point, I'm just going to go with the oral version. Check out this series of studies: https://www.researchgate.net/public...cia_Tolerability_the_five_C's_of_oral_therapy

At these low doses, no one is really having any issues to speak of. It also solves the whole sulfotransferase enzyme issue where people cannot properly utilize the topical version. (Minoxidil sulfate is the active metabolite required to exert the vasodilatory and hair growing effects of minoxidil. For hair growth, sulfotransferase enzymes expressed in outer root sheath of the hair follicle sulfonate minoxidil. The large intra‐subject variability in follicular sulfotransferase was found to predict minoxidil response and thus explain the low response rate to topical minoxidil in the treatment of androgenetic alopecia.)

You still need the sulfotransferase enzyme for oral minoxidil to work properly. "Oral minoxidil bio-activation by hair follicle outer root sheath cell sulfotransferase enzymes predicts clinical efficacy in female pattern hair loss"

 

[mvalley]

Yes, that's a good paper and what's interesting is how Oral minoxidil can be more effective than topical wrt non-responders due to liver/platelet conversion:

Oral minoxidil bio-activation by hair follicle outer root sheath cell sulfotransferase enzymes predicts clinical efficacy in female pattern hair loss, https://onlinelibrary.wiley.com/doi/abs/10.1111/jdv.15891

While the data set reached marginal significance
(P = 0.06) for an enzymatic activity cut-off of 0.4 OD, the ROC
analysis demonstrated that the optimal cut-off for non-respon-
ders to OM in our study was 0.254 OD. This demonstrates that
a lower follicular enzymatic activity threshold is required for
bio-activation of OM compared to TM. This might be due to a
contribution of liver and platelets on OM conversion and/or
higher follicular accumulation of minoxidil

 

[mvalley]

I'm probably sounding like some kind of oral minoxidil salesman, but another data point on how OM is more effective:


https://www.researchgate.net/public...Pattern_Hair_Loss_A_Randomized_Clinical_Trial

Performance of OM in hair-shedding score was superior to TM, reinforcing
the favorable results reported on telogen effluvium. The increase in total hair
density lied within the TM CI95%, however if the outcomes are taken together,
they suggest a trend towards a greater improvement in the OM group.
Confirmation of this would require larger and longer studies

 

[Warmer82]

Yes, that's a good paper and what's interesting is how Oral minoxidil can be more effective than topical wrt non-responders due to liver/platelet conversion:

Oral minoxidil bio-activation by hair follicle outer root sheath cell sulfotransferase enzymes predicts clinical efficacy in female pattern hair loss, https://onlinelibrary.wiley.com/doi/abs/10.1111/jdv.15891

While the data set reached marginal significance
(P = 0.06) for an enzymatic activity cut-off of 0.4 OD, the ROC
analysis demonstrated that the optimal cut-off for non-respon-
ders to OM in our study was 0.254 OD. This demonstrates that
a lower follicular enzymatic activity threshold is required for
bio-activation of OM compared to TM. This might be due to a
contribution of liver and platelets on OM conversion and/or
higher follicular accumulation of minoxidil

A. Goren at Applied Biology Inc are testing a molecule that upregulates sulfotransferase to increase minoxidil efficiency. It will be a shampoo product that will be released next year if successful.

 

[mvalley]

Sweet, looking forward to the results: https://appliedbiology.com/AppliedBiologyClinicalStudies.html#AB-103 Study 2