Should I Give Finasteride 1mg More Time?

[Pixie]

Alright, so I took the advice of many users here and waited an entire year before evaluating my finasteride results.

While shedding has finally decreased for the past 3 months, I am below baseline. My hair is less dense, and my hairline moved back about a centimeter all around over the course of the past year.

It's about time for me to restock, and I'm not sure if I'm getting the best gains I could get, but at the same time, I'm worried about a dutasteride shed.

Is it normal to lose a whole cm on the first year? I was hoping for maintenance, but now I've JUST hit nw3 and my hair looks like trash no matter what I do with it

 

[frank1980]

Are you on a finasteride only program? Using anything else?

 

[Pixie]

Are you on a finasteride only program? Using anything else?

I also roll 1.5mm/1xWk. I've been doing it for 2-3 months

I do believe I'm seeing minor new growth, but I'm not sure

 

[frank1980]

try minoxidil and see how your handle it. I had 0 sides from it. Stay on the finasteride unless you experienced sides. Also, get a dermapen or stamp. Much better than the roller. You can also get a derminator 2. However, it's ridiculously expensive, but I love it.

 

[SuperDPAsteve]

Pixie, my guy. I suggest you take a lab coat approach to your issue instead of a kitchen sink approach.

Think. Your hair loss at this point is evidently male pattern baldness/Androgenetic Alopecia and not any other problem. male pattern baldness is catalyzed by DHT, but you’re blocking DHT. That leaves a few possibilities:
A.) Your DHT pre-finasteride was so astronomically high that even at 70% reduction there’s enough left to damage your hair
B.) Your follicles are just hopelessly sensitive to DHT
C.) Other androgens are binding to the receptors in your follicles and causing damage

There is also some very, very early research that may support the idea that the inflammatory process started by DHT can continue on its own in DHT’s absence. I’ll cover that at the end of my post. First I’ll go over each point listed above. A proper approach to self diagnosing this problem imo would be to begin ruling things out in order of most to least treatable.

In regards to point A.)
Get a blood test. If your DHT levels are still in the low to medium range, your problem is solved. Someone who responds well to finasteride should have the DHT levels of a post-menopausal woman. Enough, but no more. Typically around <1ng/dl. If you’re higher than that, you just aren’t blocking enough. The solution is to switch to dutasteride. That should give you the DHT levels of a dead post-menopausal woman (zero). I personally would recommend against systemic 5AR inhibition in any capacity at all, but I’m not your mom. If you aren’t getting sides on finasteride, there’s a good chance you won’t on Dutasteride.

In regards to point B.)
A will tell you if B is true.

In regards to point C.)
There are a few ways you can check and see if other androgens are responsible for your hair loss. A good indicator would be if your estradiol or free testosterone levels are abnormally high. A little bit of DHT will damage your hair but a fuckload of regular T will do the same damage. A blood test would be necessary to test for that. Another way would be to try dutasteride. If once your DHT is sufficiently managed you continue to shed, your follicles will likely require total, non-selective androgen deprivation to continue living. That means heavy duty topicals such as flutamide or RU58841. Maybe even pure estradiol. If you decide to go this route, I would recommend tapering off whichever systemic you are taking.

In regards to what I mentioned earlier in my post, there is a hypothesis out there that once DHT has initiated the inflammatory calcification process of male pattern baldness, blocking DHT will do nothing. That’s where drugs like Setipiprant, Fevipiprant and prostaglandin supplements like PGE2 come into play. Instead of trying to halt the balding process at step 1 (DHT), they try to do it at step 4 (inflammation and calcification caused by PGD2). There is a fairly small body of research in existence on this topic in regards to androgenic alopecia but there is a relative dearth of info on these forums about it. Personally I think the theory has some merit to it and if I could afford it I would add it to my regimen. Taking Setipiprant at effective doses orally will cost you around $600/month, Fevipiprant almost double that.

Best of luck and keep us appraised of your situation brother

Edited to add: an alternative to total AA topicals would be systemic hormonal manipulation. Basically, chemically castrate yourself. There’s a 200+ page thread about it on these forums. Essentially, you’d need to be okay with:

- Clinically low testosterone
- female levels of estrogen
- a 40% chance of gynecomastia
- a significantly increased risk of any type of side effect
- a decent chance you’ll be infertile
- chronic testicular pain

But @bridgeburn seems to be doing quite well and has defeated his hair loss. His thread is a long read, but worth it if only for the learnin’

 

[Pixie]

try minoxidil and see how your handle it. I had 0 sides from it. Stay on the finasteride unless you experienced sides. Also, get a dermapen or stamp. Much better than the roller. You can also get a derminator 2. However, it's ridiculously expensive, but I love it.

When I stock up on finasteride or duta this month, I'm most likely going to get minoxidil this time around too. I'm absolutely on board with getting a stamp or derminator too. I pretty much use my roller like a stamp as it is.

Pixie, my guy. I suggest you take a lab coat approach to your issue instead of a kitchen sink approach.

Think. Your hair loss at this point is evidently male pattern baldness/Androgenetic Alopecia and not any other problem. male pattern baldness is catalyzed by DHT, but you’re blocking DHT. That leaves a few possibilities:
A.) Your DHT pre-finasteride was so astronomically high that even at 70% reduction there’s enough left to damage your hair
B.) Your follicles are just hopelessly sensitive to DHT
C.) Other androgens are binding to the receptors in your follicles and causing damage

There is also some very, very early research that may support the idea that the inflammatory process started by DHT can continue on its own in DHT’s absence. I’ll cover that at the end of my post. First I’ll go over each point listed above. A proper approach to self diagnosing this problem imo would be to begin ruling things out in order of most to least treatable.

In regards to point A.)
Get a blood test. If your DHT levels are still in the low to medium range, your problem is solved. Someone who responds well to finasteride should have the DHT levels of a post-menopausal woman. Enough, but no more. Typically around <1ng/dl. If you’re higher than that, you just aren’t blocking enough. The solution is to switch to dutasteride. That should give you the DHT levels of a dead post-menopausal woman (zero). I personally would recommend against systemic 5AR inhibition in any capacity at all, but I’m not your mom. If you aren’t getting sides on finasteride, there’s a good chance you won’t on Dutasteride.

In regards to point B.)
A will tell you if B is true.

In regards to point C.)
There are a few ways you can check and see if other androgens are responsible for your hair loss. A good indicator would be if your estradiol or free testosterone levels are abnormally high. A little bit of DHT will damage your hair but a fuckload of regular T will do the same damage. A blood test would be necessary to test for that. Another way would be to try dutasteride. If once your DHT is sufficiently managed you continue to shed, your follicles will likely require total, non-selective androgen deprivation to continue living. That means heavy duty topicals such as flutamide or RU58841. Maybe even pure estradiol. If you decide to go this route, I would recommend tapering off whichever systemic you are taking.

In regards to what I mentioned earlier in my post, there is a hypothesis out there that once DHT has initiated the inflammatory calcification process of male pattern baldness, blocking DHT will do nothing. That’s where drugs like Setipiprant, Fevipiprant and prostaglandin supplements like PGE2 come into play. Instead of trying to halt the balding process at step 1 (DHT), they try to do it at step 4 (inflammation and calcification caused by PGD2). There is a fairly small body of research in existence on this topic in regards to androgenic alopecia but there is a relative dearth of info on these forums about it. Personally I think the theory has some merit to it and if I could afford it I would add it to my regimen. Taking Setipiprant at effective doses orally will cost you around $600/month, Fevipiprant almost double that.

Best of luck and keep us appraised of your situation brother

Edited to add: an alternative to total AA topicals would be systemic hormonal manipulation. Basically, chemically castrate yourself. There’s a 200+ page thread about it on these forums. Essentially, you’d need to be okay with:

- Clinically low testosterone
- female levels of estrogen
- a 40% chance of gynecomastia
- a significantly increased risk of any type of side effect
- a decent chance you’ll be infertile
- chronic testicular pain

But @bridgeburn seems to be doing quite well and has defeated his hair loss. His thread is a long read, but worth it if only for the learnin’

Thank you so much for this post. It's been extremely informative. I've never had my T or DHT levels checked, but it would give me an objective measurable answer to my question. I will look into getting my levels checked.

If DHT stops being relevant to male pattern baldness after the inflammation process has initiated, it's a bit of a double edged sword. It's great because it means we wouldn't have to take AA's, but it makes our current main treatment ineffective. Unfortunately I can't afford seti either. I've been making an effort to eat an anti-inflammatory diet, and supplement with d3 and magnesium.

I have read through bridges thread, it was extremely inspiring. I actually bought a bottle of cyproterone acetate to start an HRT regimen, but in the end I decided against it because it wouldn't fit my current lifestyle.