Bryan: dutasteride question for you...

[JWM]

Hi Bryan

On Dr. Cole's website, someone who had been on finasteride for 10 years had his results begin to fade badly. He asked about Dutasteride.

Dr. Cole recommended he take it every day for 2 weeks, then just Monday, Wednesday, and Friday?

What do you think his reason for suggesting this schedule was? Wouldn't the half-life of taking it every day for 2 weeks eventually drop back once you started taking it 3 times a week?

Can you suggest what his rationale might have been?

 

[Bryan]

Sure, the half-life would be shorter at that lower dose, but that's not really the point here. Obviously, Dr. Cole would prefer that people not take the full, FDA-approved (daily) dose of Avodart just for hairloss, but a more medically conservative lower dose. Since a daily dose of only 0.1 mg per day of dutasteride was found experimentally to be almost exactly as effective as taking a Proscar per day, he obviously thinks that taking three Avodarts per week (which averages about 0.214 mg/day of dutasteride) is a more reasonable and safer "in between" dose for use by us baldies, and yet still a bit more effective than finasteride. I can't say that I blame him for his more cautious approach.

 

[JWM]

But why does he recommend taking a pill EVERY day for the first two weeks-- like a loading phase of sorts--BEFORE dropping back to three times a week? That's the rationale I don't get.

 

[AlexD]

Just throwing my 2 cents into it, and this may sound stupid, but my thinking is that it would allow for (with use of Rogaine, for example)) you to clear out most of the DHT deposits blocking the follicles. Then after 2 weeks, when most of the follicles have been cleared out (to a degree), it just maintains the DHT levels so it doesn't build up much more.

That's the best reason I could come up with.

 

[Bryan]

But why does he recommend taking a pill EVERY day for the first two weeks-- like a loading phase of sorts--BEFORE dropping back to three times a week? That's the rationale I don't get.

Like you said, just a loading phase.

 

[hairandthere]

i started dutasteride back on November 8th and took 1.5mg for the first 10 days as shown here:

http://www.hairsite.com/images2/dutaste ... -chart.jpg

 

[JWM]

But why does he recommend taking a pill EVERY day for the first two weeks-- like a loading phase of sorts--BEFORE dropping back to three times a week? That's the rationale I don't get.

Like you said, just a loading phase.

What is the point of a loading phase, Bryan? Even if you took it every day for some time, the half-life would eventually drop-off once you lowered your dose wouldn't it?

 

[JWM]

Bump

 

[Bryan]

What is the point of a loading phase, Bryan?

It's to get blood levels of the drug up, more quickly.

Even if you took it every day for some time, the half-life would eventually drop-off once you lowered your dose wouldn't it?

Yes.

I'm not sure what your main point is.

 

[JWM]

I just don't see the point in the initial loading phase. Why load at all? Your blood levels will eventually drop anyway when you lower the dose.

What advantage--results-wise--would loading have instead of just taking it EOD as you eventually plan to?

Following me?

 

[JWM]

Take creatine for example:

Many have suggested an initial loading dose of 20 mg a day for 5 days. Then, cut back to 5 mg a day for maintenance.

Then they did a study and found taking 5 mg a day from the start EVENTUALLY produced the same results if you had loaded with 20 mg--it just took longer.

I'm not sure this is a fitting analogy/example as creatine is stored differently than dutasteride, and I know nothing about creatine's half-life, but I think what I'm asking is:

If you don't load with dutasteride initially and stick to EOD instead, you will ultimately get the same results, but it will take longer, yes?

 

[Bryan]

I just don't see the point in the initial loading phase. Why load at all? [.....]
What advantage--results-wise--would loading have instead of just taking it EOD as you eventually plan to?

The final blood level of the drug (the steady-state level) just gets there FASTER, when you use a loading dose first. BTW, I don't consider that to be a particularly good reason to use a loading dose. Personally, I would always prefer to approach steady-state more slowly, just in case I happen to start experiencing some side effects along the way!

Your blood levels will eventually drop anyway when you lower the dose.

I extracted that sentence from the middle of your post above, because I want to address it separately. After reading and re-reading your posts in this thread, I think I'm finally starting to understand where you're coming from! Your statement above isn't necessarily correct, because it depends on the exact dosing schedule and size of the doses. When you first start taking dutasteride, the level of the drug in your blood is ZERO. If you begin taking a larger dose for a specific number of days (don't ask me to speculate about what that exact number of days actually is) and then cut the daily dose in HALF, it could very well be at the exact point where you've already reached steady-state for that "half-dose".

See what I'm saying? If you time everything correctly with the correct dosages and time-intervals, you can get to that (lower) steady-state level FASTER, with a "loading dose". When you said in the past that "Your blood levels will eventually drop anyway when you lower the dose", I assumed at that time that you were talking about having already reached a higher steady-state at a higher daily intake of the drug, and for a longer length of time. That's why I agreed with what you said, at that earlier time.

 

[JWM]

Thanks so much, Bryan. Helped clear things up quite a bit.