Borderline Low Testosterone: Take Finasteride?

[finornottofin]

In early 20's and diffuse thinning. If I don't hop on finasteride within the next couple months it's probably over for me in a year or two.

Originally when I went to the doctor they had some blood tests done to rule out stuff aside from male pattern baldness. Nothing really concerning so they referred me to a derm.

At this point my total T was 9 nmol/L. (Borderline Low)

Fast forward 2 months after I finally get a derm appointment they prescribed finasteride. I convince my Doctor to write some more blood tests for me.

My Fsh came our really low at 1 IU. My total T is about the same (9) while my calculated Free T is 270 pmol/L.

Still waiting on results for DHT.

My total and free T levels are low for my age however I have never experienced any symptoms due to them. My libido is really strong, I am hairy and have good facial hair for my age. Also I don't think the tests( atleast for my total T) are inaccurate as the numbers are almost the same months apart.

Given this should I hop on finasteride? I'm worried there may not be enought T to pick up the slack after DHT is lowered. Honestly it's literally on my table and I was excited to pop the first dose until I saw these results.

 

[Charger]

You should get your thyroid checked along with testosterone. Low thyroid function can result in low T and lowered hormones overall. And if your testosterone is low, then obviously your estradiol will be as well, which is beneficial for hair in itself.

It's probably best to rule out all possibilities, especially since you mention diffuse thinning. If your thyroid looks good, then consider finasteride. But at those levels, I'd wager sides are likely.

 

[finornottofin]

You should get your thyroid checked along with testosterone. Low thyroid function can result in low T and lowered hormones overall. And if your testosterone is low, then obviously your estradiol will be as well, which is beneficial for hair in itself.

It's probably best to rule out all possibilities, especially since you mention diffuse thinning. If your thyroid looks good, then consider finasteride. But at those levels, I'd wager sides are likely.

Yes you are right my estradiol near the lower end of the reference range at 70 pmol/L.

I had my TSH checked in the original blood test and it was roughly in the middle of the reference range. Should I check the other indicators for the thyroid like T4, T3?

 

[NickyA]

I had low free T (3.22 ng/ml) in my baseline blood test before starting finasteride, along with low Estradiol/E2, low DHEA-S and average Prolactin. That's why I decided to start with 1 mg of finasteride thrice a week, it's been three weeks already, and so far so good. I plan to up the dosage by March or April if everything's alright. I suggest exercising or doing some sports to stay in a good mindset and raise your testosterone. Finasteride will actually raise your testosterone by 7%-12% depending on the dosage. Most of the people who get physiological side effects get them due to high levels of aromatase activity (And thus a good portion of that extra free T gets converted to Estrogen, Estradiol, etc) and/or higher sensitivity towards DHT, which makes their body more dependant on their DHT levels, which get lowered by 60%-70% once they start taking finasteride.

 

[inmyhead]

Hmm, interesting low T and hair loss. I wonder what your DHT levels are.

 

[finornottofin]

I had low free T (3.22 ng/ml) in my baseline blood test before starting finasteride, along with low Estradiol/E2, low DHEA-S and average Prolactin. That's why I decided to start with 1 mg of finasteride thrice a week, it's been three weeks already, and so far so good. I plan to up the dosage by March or April if everything's alright. I suggest exercising or doing some sports to stay in a good mindset and raise your testosterone. Finasteride will actually raise your testosterone by 7%-12% depending on the dosage. Most of the people who get physiological side effects get them due to high levels of aromatase activity (And thus a good portion of that extra free T gets converted to Estrogen, Estradiol, etc) and/or higher sensitivity towards DHT, which makes their body more dependant on their DHT levels, which get lowered by 60%-70% once they start taking finasteride.

Hey appreciate the response. Are you sure those are the right free T levels because they are way outside the reference ranges I have(much lower than even my free T levels which are on the lower end).

I'm thinking about starting with 0.5 mg every other day and seeing how that goes. I'm just afraid of permanent sides. Going to wait for my DHT results and see what's up. Were yours normal?

Also what was yoir total T level? Did you get shbg tested? From what I understand there are two ways the free T test is done 1) total T + shbg used in a calculation
2) bioavailability measured somehow directly

I think my results were calculated in the first way.

 

[finornottofin]

Hmm, interesting low T and hair loss. I wonder what your DHT levels are.

My shbg levels are pretty low so there may be more circulating DHT aswell or my follicles are way to sensitive in which case it's gg for my hair. I should be able to manually roughly calculate free DHT when I get the total DHT results

 

[9982]

Hey appreciate the response. Are you sure those are the right free T levels because they are way outside the reference ranges I have(much lower than even my free T levels which are on the lower end).

I'm thinking about starting with 0.5 mg every other day and seeing how that goes. I'm just afraid of permanent sides. Going to wait for my DHT results and see what's up. Were yours normal?

Also what was your total T levels? Did you get shbg tested? From what I understand there are two ways the free T test is done 1) total T + shbg used in a calculation
2) bioavailability measured somehow directly

I think my results were calculated in the first way.

I'd say go with the suggested dosage first, then titrate down if necessary.

 

[NickyA]

My shbg levels are pretty low so there may be more circulating DHT aswell or my follicles are way to sensitive in which case it's gg for my hair. I should be able to manually roughly calculate free DHT when I get the total DHT results

My T was in the lower bottom of the range (3.22 ng/ml within a range of 2.41 ng/ml to 8.27 ng/ml) but sadly I don't know more than that since DHT and SHBG aren't measured in my country. There's also the chance that the results are skewed someway and I have average T since the test was done by ECL/Electrochemiluminiscence which is the most common way blood tests are done, since there aren't any labs that do high precision blood tests in my country. I mostly did it for extra peace of mind.

 

[finornottofin]

My T was in the lower bottom of the range (3.22 ng/ml within a range of 2.41 ng/ml to 8.27 ng/ml) but sadly I don't know more than that since DHT and SHBG aren't measured in my country. There's also the chance that the results are skewed someway and I have average T since the test was done by ECL/Electrochemiluminiscence which is the most common way blood tests are done, since there aren't any labs that do high precision blood tests in my country. I mostly did it for extra peace of mind.

I couldn't get the accurate tests either. To be clear is the 3.22 number for total Testosterone or Free Testosterone I've seen you use both.

 

[finornottofin]

I'd say go with the suggested dosage first, then titrate down if necessary.

The thing is if I get sides I know id be too scared to take it even at a lower dosage. Dick >> hair for me and prescense of sides would freak me out. I'd love to keep both healthy but we all just pulled sh*t from the genetic lottery in regards to hair.

 

[NickyA]

I couldn't get the accurate tests either. To be clear is the 3.22 number for total Testosterone or Free Testosterone I've seen you use both.

I don't know for sure, as I said my tests weren't high precision, thus they only say: "Testosterone, Estradiol, Prolactin, etc".

I suggest titrating upwards if you're worried about your results and/or possible side effects. The reason is simple : If you get a strong Nocebo Effect or end up having real side effects with a full dosage of 1 mg daily, you might have to quit cold turkey for 2 or 3 months, maybe even more if you end up with strong side effects or very scared. Whereas if you start slow you sacrifice efficiency at first but if you up the dosage in say 2 or 3 months you'll already be sure that you're not extremely sensitive to finasteride and if you end up getting side effects you can titrate downwards back to a lower dose that works fine for you.

 

[Charger]

Dick >> hair for me and prescrnse of sides would freak me out. I'd love to keep both healthy we all just pulled a shitty generic lottery oh well

You're probably going to be disappointed.

As far as the 'shitty' genetic lottery... for most of us, it's called being a man, unfortunately. Understand what you're taking... most people who actively take finasteride admit to side effects, they just tolerate them.

Ideally you want your TSH to be on the lower side, some people say it's best to have it be below 1. Better to be closer to hyper than hypothyroid, basically.

 

[finornottofin]

I don't know for sure, as I said my tests weren't high precision, thus they only say: "Testosterone, Estradiol, Prolactin, etc".

I suggest titrating upwards if you're worried about your results and/or possible side effects. The reason is simple : If you get a strong Nocebo Effect or end up having real side effects with a full dosage of 1 mg daily, you might have to quit cold turkey for 2 or 3 months, maybe even more if you end up with strong side effects or very scared. Whereas if you start slow you sacrifice efficiency at first but if you up the dosage in say 2 or 3 months you'll already be sure that you're not extremely sensitive to finasteride and if you end up getting side effects you can titrate downwards back to a lower dose that works fine for you.

Then that was probably total Testosterone. My total Testosterone is even lower than yours which is why I'm really worried. I'll titrate upwards after I get my full blood report and discuss with my Doctor.

 

[finornottofin]

You're probably going to be disappointed.

As far as the 'shitty' genetic lottery... for most of us, it's called being a man, unfortunately. Understand what you're taking... most people who actively take finasteride admit to side effects, they just tolerate them.

Ideally you want your TSH to be on the lower side, some people say it's best to have it be below 1. Better to be closer to hyper than hypothyroid, basically.

I guess the shitty part is that it's happening to me in my early 20s. Most people my age have it no where near as bad as me. So I did pull it worse than others. My mom's side is fine but my dad was pretty much at my current status but in his late 20s.

 

[loser]

At this point my total T was 9 nmol/L. (Borderline Low)

Bluepilled. 9 nmol/L is not borderline low, it is over-tier.

 

[finornottofin]

Bluepilled. 9 nmol/L is not borderline low, it is over-tier.

Is this a meme? 9nmol/L is on the low end of the reference ranges.

 

[loser]

Is this a meme? 9nmol/L is on the low end of the reference ranges.

It's a legit low-T. The reference ranges only make sense because the T levels are declining in men. You should strive for the upper range, or at least be in the middle if you can do that naturally. 200-300 ng/dL is only acceptable if you're 60 or more years old, you can google that.

If you're not having low-T symptoms, good for you, but it's possible you don't even know you've been having them.

 

[LouisSarkozy]

Is this a meme? 9nmol/L is on the low end of the reference ranges.

would love to know your dht level . do you have somewhat sharp and well defined facial features despite being low t?

 

[Norwoody]

Offhand I'd suspect low T + hair loss is due to potentially 3 main factors:
1. Relatively increased DHT conversion rate to compensate
2. Upregulation at AR to compensate
3. Lack of T to aromatize to E

As for finasteride being safe for someone in this situation, that is highly speculative. I'd probably opt to trial other pathways first.