philistine
New Member
- Reaction score
- 1
The Internet is a wasteland of information. For anyone who has truly gone on a journey to find the hair retention grail, you know how exhausting mulling through all the studies, the fake postings, the BS hypotheses, and the sales pitches really can be.
I would estimate that I have spent 500+ hours researching the hormonal cascades, the side effects, the pros and the cons that 100's of users have shared. I have purchased every seemingly functional therapy, all in search of something with the greatest gains and the least side effects.
Something that took me a long time to realize, was that most people who post on the Internet are disgruntled, frustrated, and looking either for validation or a place to vent. Just consider consumer reviews. When an electronic item you've purchased works, you're far less likely to shout it out to the world. It's when something doesn't work that you feel the need to share. Keep this in mind when reading about things that don't work.
For this reason, I wanted to share my back-story; the knowledge that I have gained, and hopefully create a posting that will be extremely informative. Having read extensively about every possible treatment, and tried all of them (with the exception of overpriced topical/pill formulas), let me share what I have learned.
First, no one treatment is EVER going to fit all. We all have different hormonal profiles. How our bodies respond to treatments will differ. One thing is for sure, when you take something that alters your hormones, there will be side effects. The severity will depend on your baseline. For this reason, before you start ANY treatment, do not hesitate. Go see an endocrinologist (or just your general doctor) and get a full test of DHT, testosterone, estrodiol, progesterone, etc. This may seem unnecessary, but it's the only way to accurately gauge side effects. Even if you have been on a treatment, go get the tests done.
We live in a society that wants a single pill to fix a problem. However, a single pill that stops one thing often prevents other things from functioning correctly as well. Think of your body as an ecosystem. When one animal goes extinct, whatever fed off that animal may also die off... or else look for another food source. ANY time you are taking an internal supplement, you are effectively killing off much of a population, or increasing a population, and changing the balance of your body.
All that being said lets start with Propecia.
PROPECIA
For me, this was extremely effective at growing back hair initially, then retaining that growth. While on Propecia, I experienced several issues. Small gynecomastia (breast tissue), Peyronie's (penile damage), and a general increase in anxiety. Does this mean you will experience these same issues? Certainly not. I have an extremely high natural testosterone level.
Effects on the Brain
As you probably know, Propecia binds exclusively to the 5-AR (Type-II) receptor, blocking upwards of 70% of DHT creation. It has no effect on Type I which is expressed in the brain (it's effects there are unclear). That does not mean that Type II does not impact brain chemistry. Type II binds with progesterone (a major 5-AR inhibitor), which converts to allopregnalone. Allopregnalone is vital for the creation of gabba in the brain, is related to memory, and all higher cognitive function. While on Propecia, your body will create less allopregnalone. This effect will vary from person to person. However, if you experience any anxiety or depression, it may be caused by this. If you find yourself drinking more while on Propecia, and feeling "clear headed", it's because alcohol supports allopregnalone production. This information was not available (studies had not been done) at the time Propecia was approved by the FDA. There was not scientific evidence that connected 5-AR to your brain. It was 1998.
Effects on Estrogen Levels
It's likely that your Estrodiol level will increase while on Propecia. Here is the main reason: When you block 5-AR, the testosterone that would have converted to DHT is still hanging around. Increasing. Your body has another important androgen receptor called aromatase. This is responsible for converting Testosterone into Estrogen. Now, it is possible that your body won't produce more aromatase. If it continues to produce the same amount, all that will happen is your testosterone will continue to climb. However, the body has a way of balancing itself out. There's a reason 5-AR exists. So when you block it, it's likely that three things may happen. 1) your body may produce more 5-AR Type 1, 2) your body may produce more aromatase, 3) your body will produce less testosterone. If the first one happens, you will see an increase in DHT in the blood. If the second happens, you will see an increase in estrogen levels. Odds are, if you use Propecia long enough, both will happen to some degree. This is why the hormone test is so important. Your body could also respond by producing less testosterone. If this happens, you get even worse problems. Extreme erectile dysfunction, libido decrease, etc. However, these side effects should only happen if you had low-mid testosterone levels to begin with. In most men, these will be mild.
DHT is a penile building block
The tissues in your penis are regenerated/repaired largely by DHT. If you block too much of it, damage is more likely to occur and softening is also a potential hazard. This seems to be the cause of peyronie's in some men. After quitting propecia, I found that my penile tissue started to repair itself, though the bend did not go away. Not really a big deal. This could also be exacerbated by an increase in Estrodiol.
CONCLUSIONS
Propecia is effective at treating hairloss in most men. However, if you're going to use it make sure you get blood work done every 6 months. People who drink a lot of alcohol may have further complications over time. I would recommend taking DIMM to help metabolize any increase in Estrogen. It has proven results. I would also recommend taking 5-htp when you go to sleep. SSRI's have a proven history of increasing allopregnalone levels. If you read all of the comments from people at propeciahelp.com, be wary. In the same way (in most cases) it took many months or years for their bodies to have issues, it can take just as long to get one's body back on track. No doubt, you're playing a risky game with Propecia. Most likely if you quit it, your body will quickly return to its original state. But there's no way to know that unless you get your hormonal profile before starting. One thing seems certain; the rate of side effects from Propecia is much higher than Merck would have you believe.
Also, remember that Merck has a vast marketing campaign. Much of their money is dumped into advertising on hairloss websites, funding studies that play to their advantage, funding studies that show other things don't work as well, writing articles that denounce the competition and praise their product assuring safety based on a 1998 study, and worst of all, virally influencing forums with fake posts. Also, don't trust your doctor. Doctors have some of the biggest egos in town, and those who have been prescribing Propecia for years will not easily admit that they have been prescribing something potentially hazardous. They will site the 1998 study. Just remember all of the drugs in the past that took years to show were toxic or damaging, but we now look back on and wonder how we could have ever been so foolish. Most doctors have done little of their own research on the matter. This posting is more well-informed than your doctor, unless they spent 100's of hours studying the subject, and didn't just trust the "hired-out-of-high school cheerleader sales rep" who showed up at their door 10 years ago and told them how safe Propecia is.
Additionally, if you took Propecia for a long time, and are scared by the posts you've read, know that most people return to a balanced state after quitting. Some take longer than others. If you're concerned, go to an endocrinologist.
SAW PALMETTO
I have been off and on with Saw Palmetto 85-95% sterols and lipids, 550mg 1 per day at night. This treatment has been as effective as Propecia for me. My hair loss went from 50 hairs per day to 10. The reason I'm not taking it every day is because I really don't know what it's doing to my system. There is NO STUDY anywhere that will tell you exactly what Saw Palmetto's effect on your hormonal system is. Some people say it blocks 5-AR Type 2, some say it blocks both. Others say it binds to DHT, nullifying it. Still others say it binds at receptor sites, blocking the DHT from having an effect. After extensive research, what does seem proven is that DHT blood serum levels do not decrease while taking Saw Palmetto. This was reaffirmed in a study conducted by Merck. What this suggests is that 5-AR is not affected by Saw Palmetto, and that it functions in a totally different way.
People will generally site the Benign Prostate studies in Europe as examples of Saw Palmetto's transitive efficacy on male pattern baldness. There have also been a few 10-50 person studies done where people had improvements over time.
In a massive study done in Germany for efficacy on BPH, side effects reported were less than the placebo control group. This should seem promising. I'm sure you've seen the 2006 study by now done in the US with a 1,000+ group to test its effectiveness on BPH. The results didn't seem very positive. There have been a lot of questions about the accuracy of that study. Please note, BPH isn't treated with Finasteride. It's treated with Proscar at a much higher dosage. Odds are, if you treated BPH with finasteride, you would also see mild effects on BPH. In no study has Saw Palmetto been proven to cure serious BPH. Neither has finasteride. So, do not think, even for a second, that this study proves anything in relation to whether or not Saw Palmetto assists in the slowing of hair loss.
In my opinion, from personal experience, the stuff works. It stopped my hairloss and grew some back. I've found many unsolicited comments on forums from users with a similar experience. The question is how it works and is it safer than Propecia?
Lets consider the two ways in which Saw Palmetto might work. We can assume it doesn't inhibit 5-AR (otherwise blood serum DHT levels would decrease, which they didn't in the BPH studies). If this is the case, the good news is that all 3 of the major hormonal shifts I described on Propecia should not happen on Saw Palmetto. You are going one or two steps down the chain. SP is either binding to DHT or to the receptor sites. What seems most likely is that it is binding to the receptor sites, essentially blocking the DHT from binding itself. This is conjecture based on the maintained DHT levels seen using SP.
This should mean that SP will affect whatever DHT does to the male body. Since DHT is a potent androgen, you will still possibly see a slightly flaccid penis, and perhaps less ejaculate. It seems the SP will not affect your hormonal profile. Again, make sure you get your hormonal tests.
The only way that SP would be able to have an affect on neural function would be if the active ingredient that binds with receptor sites is capable of crossing the blood/brain barrier. This is unlikely.
And for those who think SP might binds to both 5-AR types 1 and 2 (or one of them) and binds to receptor sites, consider this: DHT doesn't bind to 5-AR. Why would the active ingredient in SP be capable of binding to both 5-AR and the same thing DHT binds to? It wouldn't. It's one or the other.
However, despite all of this evidence I still feel like it's impacting my allopgregnalone production. My thoughts seem slightly more scattered while using SP, in a way similar to using Finasteride. But, logic suggests that this is more of a placebo effect than a reality. Again, no side effects were reported in any of the BPH studies. None. The placebo control groups had more complaints.
CONCLUSION
Saw Palmetto will likely be effective for you if Propecia was effective. Like Propecia, shedding will occur, and results will be seen in 3-6 months. Don't expect to be able to move directly from Propecia to Saw Palmetto without some shedding. It is highly recommended that you get your hormonal profile in order before trying Saw Palmetto. There is still a potential for side effects, because you are impacting DHT. Despite the studies, there is still a slight chance that Saw Palmetto operates on 5-AR and not the receptor sites or on DHT itself. If somehow this is true, it could theoretically bind to both Type 1 and 2 of 5-AR. However, there would be serious side effects consistent with using Duasteride if this was the case. Expect side effects to be consistent with less DHT uptake, like lessened ejaculate and potential softening of penile tissue. Anywhere that DHT binds will likely be affected from taking SP. However, given that you're only blocking what has been proven to be 40-50% in BPH cases (from testing presence of DHT in penile tissue), you'll see an equivalent exchange in all places that DHT operates. I.e. its influence on ejaculate in some men... expect 40% decrease in replenishment. Given that estrodiol levels (even if within range) can affect penile tissue, when using Saw Palmetto I take DIMM to help metabolize some of the estrogen. If you're going for internal fixes, I would recommend Saw Palmetto over Propecia without hesitation.
Hypothesis
If there were a way to deliver the active ingredient in Saw Palmetto directly to the scalp and have it penetrate to the level where the DHT builds up, you would eliminate almost all side effects. However, the berry in liquid form is quite potent and dark in tone. I have not tested anything that effectively delivers saw palmetto to the scalp. However, the less that gets into your bloodstream and while targeting the desired area, the better. If, as some people have suggested, beta sitosterol is the active ingredient, then applying this topically with a delivery agent may be the safest way to achieve hair growth.
MINOXIDIL
This system works, and has worked for many men, myself included. Again, some men will experience side effects. Don't think you're using something that isn't getting into your blood. Also, don't think this isn't a potent drug. If a cat even comes in contact with it, Minoxidil is capable of killing it. It's obnoxious to apply, but once you get in the habit, not such a big deal. Many studies have shown it's effective at treating both the crown of the head and the receding hairline. It's hard to apply equally. You need to do it twice a day for maximum effect, though some men have reported equal gains using 5% once a day. The twice a day study was conducted using 2%. Studies have also shown that you will achieve maximum regrowth at the end of year 1. Within 5 years, you will retain 50% of your regrown hair, which will still be more than you started with. Downsides include potential scalp irritation (I didn't experience this), slight hair damage (did experience this), and impact on your blood pressure (experienced this at first). While your body will likely adapt to the drug after a few applications, be aware that Minoxidil was designed as a potent internal drug to deal with blood pressure. Applied topically, a small % still gets into your system. While you will likely develop a tolerance, headaches, nausea, etc., may occur. I would recommend this over Propecia. This drug should not affect your hormones, libido, etc. at all. Of course, every body is different, but its function has nothing to do with your hormones. In fact, if anything you may experience better erections because of the improved blood flow.
LASER THERAPY
I purchased one of the high power 50 laser systems LaserMax 50. There is nowhere and nobody who is going to say that the lasercomb does anything but waste your money and time. However, many will argue that a high-powered system such as this, with lots of lasers is effective (the lasercomb had only a couple diodes). There are studies that show this is an effective way to stimulate your hair follicles. It has no effect on DHT. Many users report improved quality of hair. Some report a stoppage of hair loss. Admittedly, I haven't found many positive objective reviews. Overmachogrande's site has most of the studies and positive statements about the technology. It seems unbiased, but it's hard to say. Most clinics will say it's best for "hair retention". I can't say I've seen a lot of improvement using the technology. Mine cost $350 for 50 lasers. It's a bit of a hassle to use every other day for 25 minutes a day. If anyone has seen success using one of these machines without any other supplements or topicals, I'd like to hear about it. The study posted on machogrande's site seems promising, but I've had no experiential evidence after 5 months of solo use to suggest it works. It might make for nicer, more shimmering hair, but it's not going to regrow anything. It may stop further loss. If you have the money for a 50+ laser system, it's worth a shot if you're going to be consistent about it.
EQUOL
A gut bacteria converts Genistein and daidzein to equol which binds directly to free DHT. Only 30% of men have the gut bacteria. It's an extremely promising solution for that 30%. There's no way to test for Equol in your system to my knowledge. Supplements that will produce more Equol include Genistein. Apparently, Equol can be purchased but only for lab use. Merck recently filed something in relation to it. If you could take equol directly, this may be the most promising solution to date. It is not presently available. Note that taking Genistein may increase your Estradiol.
NITRIC OXIDE
This is something I was recently introduced to. NO is used to help replenish and clean out excess buildup in your body's cells. There are theories that suggest; as you get older you produce less of it. It helps your cells repair and cleanse. Some people have had success using this. I recently started taking it. You can create NO with Arginine/Citrulline and a small amount of other basic aminos that are already in your diet. In general, this avenue has not been well explored. However, it seems likely that in the same way Minoxidil help clean out the follicles, NO will do it on a cellular level. Side effects for me have included increased aggression or agitation, but have diminished as my body became more used to the supplement. Body Builders have been using NO for some time to help build and replenish muscle. I've read a few postings from people who had success doing this with hairloss. NO was chemical of the year in (I think) 1998. NO may also assist with things like erections. Nitric oxide (NO) contributes to vessel homeostasis by inhibiting vascular smooth muscle contraction and growth, platelet aggregation, and leukocyte adhesion to the endothelium. If you have a high platelet count (in your blood test), it might suggest that you're low on NO.
I've read multiple accounts from people who have taken serious blood thinners for extended periods of time and experienced serious regrowth. Blood thinners are TERRIBLE for you in the long term, and by no means a solution. However, their efficacy suggests that anything that increases blood flow oxygenates the cells, and clears out buildup (like DHT) may assist in dealing with hairloss. However, there are currently no valid studies supporting the hypothesis that orally-ingested NO actually will cause vasodilatation.
This area is less explored. There is no harm in adding this supplement to your regiment, especially before a workout.
PROGESTERONE
Using a Progesterone lotion will block conversion of 5-AR to DHT and increase allopregnalone production. Again, you're messing with hormones if you go down this road. Though, you're not just "blocking" 5-AR like with Propecia, you're utilizing it. No studies have been done to show that this is an effective treatment for hairloss, though its active function would suggest it could assist if not prevent (by decreasing DHT). Progesterone has no feminizing characteristics. It has been shown to prevent maturation of sperm. So in essence, it functions as a form of male birth control. Progesterone also metabolizes estrogen. If you read anywhere that this is a bad hormone for men, or something that transgenders take, they are grossly misinformed. It's a vital hormone in men. Again, no studies have been done to prove its efficacy. It's illegal in the state of California.
NETTLE ROOT EXTRACT
Some have suggested this binds to both 5-AR and combats Estrogen. I'm more inclined to believe it's an estrogen metabolite. High estrogen levels are often associated with hair loss in men. The opposite is true in women. However, there is little information showing its exact effects. Other evidence shows that is increases levels of Free Testosterone and decreases bound testosterone. My opinion is that this is an ineffective solo tool when treating hairloss, and its effects are unclear. If you're going to take something every day, you should have a reasonable understanding of what it's doing to your system. All supplements are forms of drugs.
OVERALL
I've tried to give you my best assessment of everything that has been tried by men for years, and that I have personally tried. Please, save yourself time and don't waste the 100's of hours researching, and years testing supplements like I have. Your regiment should be based on personal experience and hormonal profiling. There is no one size fits all. Patience and persistence are the keys to success when it comes to treating hairloss. You must get your hormone/blood test done. Please save yourself the trouble.
Propecia, Minoxidil, Saw Palmetto, and Equol are all proven solutions to treating hairloss. However, the supplementation to create Equol will only work in 30% of men. Look for more information on direct Equol supplementation in coming years. It should be an extremely safe way to manage DHT. In my opinion, avoid Propecia. Don't even consider touching it if you have low testosterone. Use Saw Palmetto for 6 months first. If it doesn't work for you, try anything... ANYTHING else. At worst Saw Palmetto operates in the same way as Propecia (though as explained above, this is highly unlikely). At best, it only has minimal side effects from a reduction of 40-50% at DHT receptor sites. Taking a supplement like MSM or Nitric Oxide should assist in cleaning out additional DHT buildup (no guarantees, but it has worked for me). NO make work against hair-loss by itself. Saw Palmetto used in conjunction with Minoxidil will have additive effects. If you are uncomfortable with the side effects caused by Saw Palmetto, then just use Minoxidil. It works, but is a hassle. If you must, then go on Propecia. There is no doubt; you're messing on a higher level with your hormones. DO NOT trust the % of men who say they have side effects from the initial study done 10 years ago. We now understand much more about the role of 5-AR and DHT than we did then. Lawsuits have been filed in Canada and other countries with the intent of banning the drug.
There are other people who will say they have found a "cure". Certainly, new things will crop up beyond what has been listed on this page. There's also a few I didn't include that had no effect for me. In general, I wouldn't recommend anything that advertises to you. You can buy the supplements for a fraction of the cost from a vitamin store. If you are utterly convinced that I'm full of BS and Propecia is the way to go, then get Proscar (your insurance will cover it) and cut it into 5 pieces. It will save you tons of money. Also, take 5-HTP and DIMM with it. That will help offset some of the negative effects Propecia will have on your system.
Here's my hierarchy of safety (from safest to highest risk):
1) Laser Therapy
2) Nitric Oxide
3) Genistein (creates Equol with gut bacteria), take with DIMM
4) Minoxidil
5) Saw Palmetto
6) Progesterone
7) Propecia
Here's my hierarchy of effectiveness (from most to least)
1) Propecia
2) Saw Palmetto
3) Minoxidil
4) Genistein (for 30% of men)
5) Nitric Oxide
6) Progesterone
7) Laser Therapy
Feel free to post your experiences below. But if you haven't tried any of the aforementioned solutions for at least 3 months consistently, then don't consider your results to be valid. Also, be wary of fake user posts. There's a lot of them out there.
Remember, patience and persistence!
I would estimate that I have spent 500+ hours researching the hormonal cascades, the side effects, the pros and the cons that 100's of users have shared. I have purchased every seemingly functional therapy, all in search of something with the greatest gains and the least side effects.
Something that took me a long time to realize, was that most people who post on the Internet are disgruntled, frustrated, and looking either for validation or a place to vent. Just consider consumer reviews. When an electronic item you've purchased works, you're far less likely to shout it out to the world. It's when something doesn't work that you feel the need to share. Keep this in mind when reading about things that don't work.
For this reason, I wanted to share my back-story; the knowledge that I have gained, and hopefully create a posting that will be extremely informative. Having read extensively about every possible treatment, and tried all of them (with the exception of overpriced topical/pill formulas), let me share what I have learned.
First, no one treatment is EVER going to fit all. We all have different hormonal profiles. How our bodies respond to treatments will differ. One thing is for sure, when you take something that alters your hormones, there will be side effects. The severity will depend on your baseline. For this reason, before you start ANY treatment, do not hesitate. Go see an endocrinologist (or just your general doctor) and get a full test of DHT, testosterone, estrodiol, progesterone, etc. This may seem unnecessary, but it's the only way to accurately gauge side effects. Even if you have been on a treatment, go get the tests done.
We live in a society that wants a single pill to fix a problem. However, a single pill that stops one thing often prevents other things from functioning correctly as well. Think of your body as an ecosystem. When one animal goes extinct, whatever fed off that animal may also die off... or else look for another food source. ANY time you are taking an internal supplement, you are effectively killing off much of a population, or increasing a population, and changing the balance of your body.
All that being said lets start with Propecia.
PROPECIA
For me, this was extremely effective at growing back hair initially, then retaining that growth. While on Propecia, I experienced several issues. Small gynecomastia (breast tissue), Peyronie's (penile damage), and a general increase in anxiety. Does this mean you will experience these same issues? Certainly not. I have an extremely high natural testosterone level.
Effects on the Brain
As you probably know, Propecia binds exclusively to the 5-AR (Type-II) receptor, blocking upwards of 70% of DHT creation. It has no effect on Type I which is expressed in the brain (it's effects there are unclear). That does not mean that Type II does not impact brain chemistry. Type II binds with progesterone (a major 5-AR inhibitor), which converts to allopregnalone. Allopregnalone is vital for the creation of gabba in the brain, is related to memory, and all higher cognitive function. While on Propecia, your body will create less allopregnalone. This effect will vary from person to person. However, if you experience any anxiety or depression, it may be caused by this. If you find yourself drinking more while on Propecia, and feeling "clear headed", it's because alcohol supports allopregnalone production. This information was not available (studies had not been done) at the time Propecia was approved by the FDA. There was not scientific evidence that connected 5-AR to your brain. It was 1998.
Effects on Estrogen Levels
It's likely that your Estrodiol level will increase while on Propecia. Here is the main reason: When you block 5-AR, the testosterone that would have converted to DHT is still hanging around. Increasing. Your body has another important androgen receptor called aromatase. This is responsible for converting Testosterone into Estrogen. Now, it is possible that your body won't produce more aromatase. If it continues to produce the same amount, all that will happen is your testosterone will continue to climb. However, the body has a way of balancing itself out. There's a reason 5-AR exists. So when you block it, it's likely that three things may happen. 1) your body may produce more 5-AR Type 1, 2) your body may produce more aromatase, 3) your body will produce less testosterone. If the first one happens, you will see an increase in DHT in the blood. If the second happens, you will see an increase in estrogen levels. Odds are, if you use Propecia long enough, both will happen to some degree. This is why the hormone test is so important. Your body could also respond by producing less testosterone. If this happens, you get even worse problems. Extreme erectile dysfunction, libido decrease, etc. However, these side effects should only happen if you had low-mid testosterone levels to begin with. In most men, these will be mild.
DHT is a penile building block
The tissues in your penis are regenerated/repaired largely by DHT. If you block too much of it, damage is more likely to occur and softening is also a potential hazard. This seems to be the cause of peyronie's in some men. After quitting propecia, I found that my penile tissue started to repair itself, though the bend did not go away. Not really a big deal. This could also be exacerbated by an increase in Estrodiol.
CONCLUSIONS
Propecia is effective at treating hairloss in most men. However, if you're going to use it make sure you get blood work done every 6 months. People who drink a lot of alcohol may have further complications over time. I would recommend taking DIMM to help metabolize any increase in Estrogen. It has proven results. I would also recommend taking 5-htp when you go to sleep. SSRI's have a proven history of increasing allopregnalone levels. If you read all of the comments from people at propeciahelp.com, be wary. In the same way (in most cases) it took many months or years for their bodies to have issues, it can take just as long to get one's body back on track. No doubt, you're playing a risky game with Propecia. Most likely if you quit it, your body will quickly return to its original state. But there's no way to know that unless you get your hormonal profile before starting. One thing seems certain; the rate of side effects from Propecia is much higher than Merck would have you believe.
Also, remember that Merck has a vast marketing campaign. Much of their money is dumped into advertising on hairloss websites, funding studies that play to their advantage, funding studies that show other things don't work as well, writing articles that denounce the competition and praise their product assuring safety based on a 1998 study, and worst of all, virally influencing forums with fake posts. Also, don't trust your doctor. Doctors have some of the biggest egos in town, and those who have been prescribing Propecia for years will not easily admit that they have been prescribing something potentially hazardous. They will site the 1998 study. Just remember all of the drugs in the past that took years to show were toxic or damaging, but we now look back on and wonder how we could have ever been so foolish. Most doctors have done little of their own research on the matter. This posting is more well-informed than your doctor, unless they spent 100's of hours studying the subject, and didn't just trust the "hired-out-of-high school cheerleader sales rep" who showed up at their door 10 years ago and told them how safe Propecia is.
Additionally, if you took Propecia for a long time, and are scared by the posts you've read, know that most people return to a balanced state after quitting. Some take longer than others. If you're concerned, go to an endocrinologist.
SAW PALMETTO
I have been off and on with Saw Palmetto 85-95% sterols and lipids, 550mg 1 per day at night. This treatment has been as effective as Propecia for me. My hair loss went from 50 hairs per day to 10. The reason I'm not taking it every day is because I really don't know what it's doing to my system. There is NO STUDY anywhere that will tell you exactly what Saw Palmetto's effect on your hormonal system is. Some people say it blocks 5-AR Type 2, some say it blocks both. Others say it binds to DHT, nullifying it. Still others say it binds at receptor sites, blocking the DHT from having an effect. After extensive research, what does seem proven is that DHT blood serum levels do not decrease while taking Saw Palmetto. This was reaffirmed in a study conducted by Merck. What this suggests is that 5-AR is not affected by Saw Palmetto, and that it functions in a totally different way.
People will generally site the Benign Prostate studies in Europe as examples of Saw Palmetto's transitive efficacy on male pattern baldness. There have also been a few 10-50 person studies done where people had improvements over time.
In a massive study done in Germany for efficacy on BPH, side effects reported were less than the placebo control group. This should seem promising. I'm sure you've seen the 2006 study by now done in the US with a 1,000+ group to test its effectiveness on BPH. The results didn't seem very positive. There have been a lot of questions about the accuracy of that study. Please note, BPH isn't treated with Finasteride. It's treated with Proscar at a much higher dosage. Odds are, if you treated BPH with finasteride, you would also see mild effects on BPH. In no study has Saw Palmetto been proven to cure serious BPH. Neither has finasteride. So, do not think, even for a second, that this study proves anything in relation to whether or not Saw Palmetto assists in the slowing of hair loss.
In my opinion, from personal experience, the stuff works. It stopped my hairloss and grew some back. I've found many unsolicited comments on forums from users with a similar experience. The question is how it works and is it safer than Propecia?
Lets consider the two ways in which Saw Palmetto might work. We can assume it doesn't inhibit 5-AR (otherwise blood serum DHT levels would decrease, which they didn't in the BPH studies). If this is the case, the good news is that all 3 of the major hormonal shifts I described on Propecia should not happen on Saw Palmetto. You are going one or two steps down the chain. SP is either binding to DHT or to the receptor sites. What seems most likely is that it is binding to the receptor sites, essentially blocking the DHT from binding itself. This is conjecture based on the maintained DHT levels seen using SP.
This should mean that SP will affect whatever DHT does to the male body. Since DHT is a potent androgen, you will still possibly see a slightly flaccid penis, and perhaps less ejaculate. It seems the SP will not affect your hormonal profile. Again, make sure you get your hormonal tests.
The only way that SP would be able to have an affect on neural function would be if the active ingredient that binds with receptor sites is capable of crossing the blood/brain barrier. This is unlikely.
And for those who think SP might binds to both 5-AR types 1 and 2 (or one of them) and binds to receptor sites, consider this: DHT doesn't bind to 5-AR. Why would the active ingredient in SP be capable of binding to both 5-AR and the same thing DHT binds to? It wouldn't. It's one or the other.
However, despite all of this evidence I still feel like it's impacting my allopgregnalone production. My thoughts seem slightly more scattered while using SP, in a way similar to using Finasteride. But, logic suggests that this is more of a placebo effect than a reality. Again, no side effects were reported in any of the BPH studies. None. The placebo control groups had more complaints.
CONCLUSION
Saw Palmetto will likely be effective for you if Propecia was effective. Like Propecia, shedding will occur, and results will be seen in 3-6 months. Don't expect to be able to move directly from Propecia to Saw Palmetto without some shedding. It is highly recommended that you get your hormonal profile in order before trying Saw Palmetto. There is still a potential for side effects, because you are impacting DHT. Despite the studies, there is still a slight chance that Saw Palmetto operates on 5-AR and not the receptor sites or on DHT itself. If somehow this is true, it could theoretically bind to both Type 1 and 2 of 5-AR. However, there would be serious side effects consistent with using Duasteride if this was the case. Expect side effects to be consistent with less DHT uptake, like lessened ejaculate and potential softening of penile tissue. Anywhere that DHT binds will likely be affected from taking SP. However, given that you're only blocking what has been proven to be 40-50% in BPH cases (from testing presence of DHT in penile tissue), you'll see an equivalent exchange in all places that DHT operates. I.e. its influence on ejaculate in some men... expect 40% decrease in replenishment. Given that estrodiol levels (even if within range) can affect penile tissue, when using Saw Palmetto I take DIMM to help metabolize some of the estrogen. If you're going for internal fixes, I would recommend Saw Palmetto over Propecia without hesitation.
Hypothesis
If there were a way to deliver the active ingredient in Saw Palmetto directly to the scalp and have it penetrate to the level where the DHT builds up, you would eliminate almost all side effects. However, the berry in liquid form is quite potent and dark in tone. I have not tested anything that effectively delivers saw palmetto to the scalp. However, the less that gets into your bloodstream and while targeting the desired area, the better. If, as some people have suggested, beta sitosterol is the active ingredient, then applying this topically with a delivery agent may be the safest way to achieve hair growth.
MINOXIDIL
This system works, and has worked for many men, myself included. Again, some men will experience side effects. Don't think you're using something that isn't getting into your blood. Also, don't think this isn't a potent drug. If a cat even comes in contact with it, Minoxidil is capable of killing it. It's obnoxious to apply, but once you get in the habit, not such a big deal. Many studies have shown it's effective at treating both the crown of the head and the receding hairline. It's hard to apply equally. You need to do it twice a day for maximum effect, though some men have reported equal gains using 5% once a day. The twice a day study was conducted using 2%. Studies have also shown that you will achieve maximum regrowth at the end of year 1. Within 5 years, you will retain 50% of your regrown hair, which will still be more than you started with. Downsides include potential scalp irritation (I didn't experience this), slight hair damage (did experience this), and impact on your blood pressure (experienced this at first). While your body will likely adapt to the drug after a few applications, be aware that Minoxidil was designed as a potent internal drug to deal with blood pressure. Applied topically, a small % still gets into your system. While you will likely develop a tolerance, headaches, nausea, etc., may occur. I would recommend this over Propecia. This drug should not affect your hormones, libido, etc. at all. Of course, every body is different, but its function has nothing to do with your hormones. In fact, if anything you may experience better erections because of the improved blood flow.
LASER THERAPY
I purchased one of the high power 50 laser systems LaserMax 50. There is nowhere and nobody who is going to say that the lasercomb does anything but waste your money and time. However, many will argue that a high-powered system such as this, with lots of lasers is effective (the lasercomb had only a couple diodes). There are studies that show this is an effective way to stimulate your hair follicles. It has no effect on DHT. Many users report improved quality of hair. Some report a stoppage of hair loss. Admittedly, I haven't found many positive objective reviews. Overmachogrande's site has most of the studies and positive statements about the technology. It seems unbiased, but it's hard to say. Most clinics will say it's best for "hair retention". I can't say I've seen a lot of improvement using the technology. Mine cost $350 for 50 lasers. It's a bit of a hassle to use every other day for 25 minutes a day. If anyone has seen success using one of these machines without any other supplements or topicals, I'd like to hear about it. The study posted on machogrande's site seems promising, but I've had no experiential evidence after 5 months of solo use to suggest it works. It might make for nicer, more shimmering hair, but it's not going to regrow anything. It may stop further loss. If you have the money for a 50+ laser system, it's worth a shot if you're going to be consistent about it.
EQUOL
A gut bacteria converts Genistein and daidzein to equol which binds directly to free DHT. Only 30% of men have the gut bacteria. It's an extremely promising solution for that 30%. There's no way to test for Equol in your system to my knowledge. Supplements that will produce more Equol include Genistein. Apparently, Equol can be purchased but only for lab use. Merck recently filed something in relation to it. If you could take equol directly, this may be the most promising solution to date. It is not presently available. Note that taking Genistein may increase your Estradiol.
NITRIC OXIDE
This is something I was recently introduced to. NO is used to help replenish and clean out excess buildup in your body's cells. There are theories that suggest; as you get older you produce less of it. It helps your cells repair and cleanse. Some people have had success using this. I recently started taking it. You can create NO with Arginine/Citrulline and a small amount of other basic aminos that are already in your diet. In general, this avenue has not been well explored. However, it seems likely that in the same way Minoxidil help clean out the follicles, NO will do it on a cellular level. Side effects for me have included increased aggression or agitation, but have diminished as my body became more used to the supplement. Body Builders have been using NO for some time to help build and replenish muscle. I've read a few postings from people who had success doing this with hairloss. NO was chemical of the year in (I think) 1998. NO may also assist with things like erections. Nitric oxide (NO) contributes to vessel homeostasis by inhibiting vascular smooth muscle contraction and growth, platelet aggregation, and leukocyte adhesion to the endothelium. If you have a high platelet count (in your blood test), it might suggest that you're low on NO.
I've read multiple accounts from people who have taken serious blood thinners for extended periods of time and experienced serious regrowth. Blood thinners are TERRIBLE for you in the long term, and by no means a solution. However, their efficacy suggests that anything that increases blood flow oxygenates the cells, and clears out buildup (like DHT) may assist in dealing with hairloss. However, there are currently no valid studies supporting the hypothesis that orally-ingested NO actually will cause vasodilatation.
This area is less explored. There is no harm in adding this supplement to your regiment, especially before a workout.
PROGESTERONE
Using a Progesterone lotion will block conversion of 5-AR to DHT and increase allopregnalone production. Again, you're messing with hormones if you go down this road. Though, you're not just "blocking" 5-AR like with Propecia, you're utilizing it. No studies have been done to show that this is an effective treatment for hairloss, though its active function would suggest it could assist if not prevent (by decreasing DHT). Progesterone has no feminizing characteristics. It has been shown to prevent maturation of sperm. So in essence, it functions as a form of male birth control. Progesterone also metabolizes estrogen. If you read anywhere that this is a bad hormone for men, or something that transgenders take, they are grossly misinformed. It's a vital hormone in men. Again, no studies have been done to prove its efficacy. It's illegal in the state of California.
NETTLE ROOT EXTRACT
Some have suggested this binds to both 5-AR and combats Estrogen. I'm more inclined to believe it's an estrogen metabolite. High estrogen levels are often associated with hair loss in men. The opposite is true in women. However, there is little information showing its exact effects. Other evidence shows that is increases levels of Free Testosterone and decreases bound testosterone. My opinion is that this is an ineffective solo tool when treating hairloss, and its effects are unclear. If you're going to take something every day, you should have a reasonable understanding of what it's doing to your system. All supplements are forms of drugs.
OVERALL
I've tried to give you my best assessment of everything that has been tried by men for years, and that I have personally tried. Please, save yourself time and don't waste the 100's of hours researching, and years testing supplements like I have. Your regiment should be based on personal experience and hormonal profiling. There is no one size fits all. Patience and persistence are the keys to success when it comes to treating hairloss. You must get your hormone/blood test done. Please save yourself the trouble.
Propecia, Minoxidil, Saw Palmetto, and Equol are all proven solutions to treating hairloss. However, the supplementation to create Equol will only work in 30% of men. Look for more information on direct Equol supplementation in coming years. It should be an extremely safe way to manage DHT. In my opinion, avoid Propecia. Don't even consider touching it if you have low testosterone. Use Saw Palmetto for 6 months first. If it doesn't work for you, try anything... ANYTHING else. At worst Saw Palmetto operates in the same way as Propecia (though as explained above, this is highly unlikely). At best, it only has minimal side effects from a reduction of 40-50% at DHT receptor sites. Taking a supplement like MSM or Nitric Oxide should assist in cleaning out additional DHT buildup (no guarantees, but it has worked for me). NO make work against hair-loss by itself. Saw Palmetto used in conjunction with Minoxidil will have additive effects. If you are uncomfortable with the side effects caused by Saw Palmetto, then just use Minoxidil. It works, but is a hassle. If you must, then go on Propecia. There is no doubt; you're messing on a higher level with your hormones. DO NOT trust the % of men who say they have side effects from the initial study done 10 years ago. We now understand much more about the role of 5-AR and DHT than we did then. Lawsuits have been filed in Canada and other countries with the intent of banning the drug.
There are other people who will say they have found a "cure". Certainly, new things will crop up beyond what has been listed on this page. There's also a few I didn't include that had no effect for me. In general, I wouldn't recommend anything that advertises to you. You can buy the supplements for a fraction of the cost from a vitamin store. If you are utterly convinced that I'm full of BS and Propecia is the way to go, then get Proscar (your insurance will cover it) and cut it into 5 pieces. It will save you tons of money. Also, take 5-HTP and DIMM with it. That will help offset some of the negative effects Propecia will have on your system.
Here's my hierarchy of safety (from safest to highest risk):
1) Laser Therapy
2) Nitric Oxide
3) Genistein (creates Equol with gut bacteria), take with DIMM
4) Minoxidil
5) Saw Palmetto
6) Progesterone
7) Propecia
Here's my hierarchy of effectiveness (from most to least)
1) Propecia
2) Saw Palmetto
3) Minoxidil
4) Genistein (for 30% of men)
5) Nitric Oxide
6) Progesterone
7) Laser Therapy
Feel free to post your experiences below. But if you haven't tried any of the aforementioned solutions for at least 3 months consistently, then don't consider your results to be valid. Also, be wary of fake user posts. There's a lot of them out there.
Remember, patience and persistence!
