Topical Dutasteride Case Assessment Thread

[sonictemples]

Things are looking bright. Corkmeister was able to dig up a study from Olsson Gisleskog who worked for GSK at the time. From the graphs, one-time usage of 0.1 mg of oral dutasteride has only blocked around 30-40% of serum DHT which recovered fully after a week, the dutasteride also gets out of the system in less than a week. From this, as long as our topical applications don't result in more than 0.1 mg systemic absorption, we are in the saw palmetto territory orally while possibly having a similar efficacy to oral finasteride in the scalp.

Also, some friends have provided us with bloodwork which shows that scalp DHT can be decreased way more while serum DHT can be less affected.

So yeah most people should get away with using the topicals at the right dose and the most important, at the right frequency. Just book a consultation with your doctor, discuss, get him to prescribe, get blood levels, apply the topical dutasteride, in the next 1-7 days get your serum DHT checked again and see if there is a change or not. Also report to us so we can build data.

 

[Selb]

Wouldn’t this require an extensive amount of blood tests for users to figure out the right ratio of topical application and frequency? Maybe even external conditions like wet scalp.

 

[sonictemples]

Wouldn’t this require an extensive amount of blood tests for users to figure out the right ratio of topical application and frequency? Maybe even external conditions like wet scalp.

Well, technically yes. But after seeing people who applied it daily for a month or so, every single day yet their serum DHT inhibition was lower than oral finasteride's, safe to say that it has relatively limited systemic absorption

 

[sonictemples]

And yes, we need all the blood tests and user data we can get to standardize.

 

[sonictemples]

Never expiring link once again https://discord.gg/9jdbBPA

 

[Canuto]

Im considering mesotherapy myself. However I have doubts. Looking at the literature, there aren't many case studies on this. We've got some study with a small sample but good results:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596657/

I would like to understand how they got good results with such a tiny dose? We are talking 1ml intradermal injection every 3 months, at a dose of 0.01%. That, compared to the oral regimen, is tiny. That's basically a dose of 2 0.5mg pills at once every 3 months. The half life of dutasteride may be longer when delivered intradermally?

I have access to a clinic that is willing to inject me once a month, and I will try to convince them to inject at least 2ml. Overall clinics are pretty ignorant in this field, it's a novel treatment, im just making sure they have the right dosages. There's not too much margin of movements since we don't have much literature on this. Im in France but you should be able to find these treatments in many European countries now, not sure about the US.

Is no one here exploring this route? Seems interesting. The molecular weight of dutasteride isn't too big to work in traditional topical vehicles? this could solve this. However like I said before, I have my doubts about such small dosages working... at least judging by the pic on that study it did, however, im not sure how, like I said, and assuming it's legit.

You can do it by yourself if you're not scared of insulin syringes and if you can find a liquid solution of dutasteride on the market. you can find all the info about syringes and solution on the Egyptian pilot study.

 

[Canuto]

Any new updates from our discord friends?

To summarize what Sonic said, the drug goes systemic, as everything applied topically.
From the data we have now, you can get a good scalp DHT inhibition with less systemic absorption than oral.
If you're looking for the Holy Grail that nukes DHT in the scalp, without affecting other tissues look somewhere else, a portion will go systemic.
I also think you will need a topical AA to take care of the spike in testosterone from dutasteride, but that would be step 2.

 

[Canuto]

Still looks interesting even if a small part goes systemic, might help many people who get sides from oral AA's.

Absolutely, I'm a big advocate of topicals to target local enzymatic activity, rather than throwing in something oral to target a single tissue.

 

[Mustang]

To summarize what Sonic said, the drug goes systemic, as everything applied topically.
From the data we have now, you can get a good scalp DHT inhibition with less systemic absorption than oral.
If you're looking for the Holy Grail that nukes DHT in the scalp, without affecting other tissues look somewhere else, a portion will go systemic.
I also think you will need a topical AA to take care of the spike in testosterone from dutasteride, but that would be step 2.

Dutasteride will not spike testosterone. Let's stop with that lie. It will only temporarily increase free test that will envetually lead to more aromatization signaling excess E2 into the hypothalamus therefor decreasing total testosterone and free test as a consequence. There are several studies on this. Even with Finasteride.

The majority of men with PFS are nothing but hypogonadal men with chronic low testosterone due to the imbalance of the negative feedback loop that is created when blocking the action of the 5 alpha reductase

Topical Dutasteride nukes scalp DHT while having a very small reduction on plasma DHT when used correctly as I explained on this thread. Once a week or once every 10 days.

If you are on TRT or have high levels of testosterone despite using Finasteride/Dutasteride which can happen then yes, you will need CB or RU as a compliment to prevent further miniaturizations caused by other androgens, mainly test.

 

[Dimitri001]

Update to my previous post and repost from the discord. This is less than perfect data and so usefulness is limited.

As a reminder a while back I used the topical dutasteride for the first time. I mistakenly applied ~4mL of 0.5% topical liposomal dutasteride immediately after a hot shower and with an open wound on my head. I experienced what seemed like side effects in the following days (ball ache, lower libido).

View attachment 145980

16 days after applying this mega dose (comparable to putting 40 Avodart capsules on my head) my serum DHT was reduced to 37 ng/dL. Relative to my "baseline" of 49 ng/dL this is a 25% decrease 16 days after the dose. This 25% decrease 16 days after the dose is compared to a ~61% serum DHT decrease when on 0.5mg daily oral finasteride. After a solid 4 weeks I was feeling great again. I assume that soon after the dose my trough serum DHT was much lower than the 37 ng/dL, and was then increasing over the subsequent 16 days, something like below:

View attachment 145981

I know definitively the two green data points based on blood tests, but I don’t know what the red data points are. What would be more useful is a follow up DHT test 24 hours after the application, then again 7 days after the application. This would give a more complete picture of the serum DHT response to the dose.

My hope/goal is to figure out a dosing concentration, amount, and frequency that will result in a response more like the red line below (grey dotted line is the mega dose for comparison). I’m hoping by applying a smaller amount and concentration every ~7-10 days I can minimize serum DHT reduction to ~10%. If I still feel like sh*t at 10% reduction oh well it was a good try!

View attachment 145982

So yesterday morning I got a full blood panel, came home and immediately applied the 1 mL of recently received 0.1% liposomal dutasteride, left it on my head for 3 hours before showering it out, then today about 24 hours after applying that dose I got a serum DHT blood test. If my schedule allows, I'll get the same DHT test next week (7 days after applying). I realize this is a pretty weak dose by comparison but at this point would rather start on the weak side and build up if the dose is tolerated. Feeling fine so far.

I'll update with results when I get them. based on discord discussion seems like everyone is different so yall won't know till you try

Thanks for the info!

Regarding your last sentence, have people been getting significantly different degrees of reduction with the same dose?

 

[Canuto]

Dutasteride will not spike testosterone. Let's stop with that lie. It will only temporarily increase free test that will envetually lead to more aromatization signaling excess E2 into the hypothalamus therefor decreasing total testosterone and free test as a consequence. There are several studies on this. Even with Finasteride.

The majority of men with PFS are nothing but hypogonadal men with chronic low testosterone due to the imbalance of the negative feedback loop that is created when blocking the action of the 5 alpha reductase

Topical Dutasteride nukes scalp DHT while having a very small reduction on plasma DHT when used correctly as I explained on this thread. Once a week or once every 10 days.

If you are on TRT or have high levels of testosterone despite using Finasteride/Dutasteride which can happen then yes, you will need CB or RU as a compliment to prevent further miniaturizations caused by other androgens, mainly test.

It's a clear mechanism that happens through the so called negative feedback loop, but it doesn't happen in everyone. Everyone has his own genetic allowance for an x amount of testosterone (since the negative feedback can happen through test levels as well) and E2 in tissues. Some people report a constant increased libido linked to an increase of T and E2 that never fades away. But vast majority of people will have a lowered androgenic profile due to the negative feedback loop.

You had a reduction of 40% of serum DHT with topical liposomal dutasteride, that in any case doesn't tell you much of the local activity of DHT in tissues. I wouldn't call that a "small" reduction. I also don't know what you mean by "used correctly like you explained" since you contradicted yourself several times, as you can see from the screenshot attached.
We had a guy joining yesterday the discord channel who used it topically daily and he has shown limited serum DHT reduction, while other people using it once weekly reporting side effects.
So it's still not a straight outcome as you're claiming.

 

[Mustang]

40% was with a massive overdose (done purposely)

 

[dgadgdea]

Alright dudes I did the experiment. Spoiler alert the results are confusing. I’m going to post lots of detail in hopes that some of the hormone-savvy folks can help me figure out what the hell is going on.

The Experiment:

• 9/22/20 @ 10am got a comprehensive blood panel. Results of these “baseline tests” are in the 9/22/20 column in the image further down. This was a little over 5 weeks after applying that large dose of topical dutasteride. I have been pretty healthy in the interim, and I felt like this would be a good reflection of my “naturally optimized” hormone profile. Have been taking a lot of supplements like a multi, zinc, magnesium, iron, boron, vitamin D, fish oil, CoQ10, turmeric
• 9/22/20 @ ~10:30am (immediately after baseline test) I applied 1 mL of the 0.1% liposomal topical dutasteride to a dry healthy scalp (didn’t shower that morning)
• Only left it on my head about 3 hours before showering off (weak dose I know)
• 9/23/20 @ ~10am (next morning, 24 hours after application) I went to the same lab and got a DHT test only
• 9/29/20 @ ~10am (7 days after the application) I went to the same lab and got a DHT test only
• All tests were Quest test code #90567, specimens were sent to the same lab for analysis, methodology was Chromatography/Mass Spectrometry

Results:

• “Baseline” DHT was 45 ng/dL (slightly down from my previous high of 49)
• 24 hours after application DHT was 43 ng/dL (only 4.5% decrease!)
• 7 days after application DHT was 60 ng/dL
  • WHAT THE HELL IS THIS???
  • This is WAY higher than my DHT has EVER been

If anyone has any ideas/theories what this is about I would appreciate your thoughts. To be honest it gave me some lack of confidence in the results. Is there some hormone conversion cascade that would lead to this? I obviously wish I got the full hormone panel for all 3 tests but that would be getting cost prohibitive.

I still don’t feel this is the best version of this experiment -- Putting 1 mg of liposomal dutasteride on your head probably can’t lead to much systemic absorption. Less than 10% could go systemic I would think right? I will probably become bolder as the weeks go on and up the dosage and maybe even give the 0.5% formulation another shot. That will depend on what I observe with my hair which will take time. I’ve begun meticulously counting/charting my daily shower hair loss so will share those results once relevant. Also taking photos obviously

The good news is I felt totally fine from what I remember. There was one point on day 2 I thought I might be getting some ball ache but probably imagined it. And by day 7 felt pretty damn good. Must be all that DHT.

Below are my blood test results from the handful of tests I’ve gotten this year. I’m 31 years old. This particular “experiment” began in the 9/22/20 column. The prior tests are there for context and show where I was while on 0.5mg daily finasteride, when I had been off finasteride for 5 weeks, then the DHT test from 16 days after that mega dose I applied. A couple questions for the hormone hackers below --

• Somehow my Estradiol went through the roof. Any idea what could cause this? How could this manifest? Is it bad?
• I was hoping I would be setting a new total Test record due to exercise and diet regimen but it actually went down quite a bit over the prior ~40 days. Not sure what could have caused this
• I started taking boron after my prior test showing pretty low Free T. Free T did go up so that was good to see
• Once again the record-high DHT in the 9/29 test was weird
• LH was in the toilet but came up a bit
• Albumin is pretty high
• DHEA sulfate is always high, think I saw somewhere this wasn’t a cause for concern but welcome opinions
• T4 way off the charts. Cause for concern?
• Insulin is in the toilet. Cause for concern?
• AST out of range. Cause for concern?

I have lipids as well which are all on the high side. Let me know if you think those are relevant and I’ll post

Thanks for any amateur or professional opinions!

 

[Canuto]

First of all @dgadgdea, thanks for taking the time and spending money on this experiment.
I took my time to look at this data and I'll tell you my opinion based on the experience I gained throughout the years studying and checking studies about endocrinology and hormones optimization. I will take for granted that you didn't change any other variable during this period, like food consumption, sleep, training and alcohol intake. I also appreciate you used LC/MS/MS as a measuring tool for DHT and E2, which is way more reliable, unless the guys at the lab were inexperienced and unable to run it properly.
Consider also that supplements like boron, zinc, vitamin D and turmeric have an effect on sex hormones that will eventually level out. This is a variable not easy to track unfortunately.

To keep it short, I think the baseline value you got after 5 weeks of clearance was biased by the fact that you were still having some duta in your body from the megadose and both 5-ar and aromatase weren't back to baseline. I say that because your testosterone was lower than on finasteride and E2 higher, which makes me think the HPTA was trying to compensate the spike in testosterone and E2 from dutasteride slowing down GnRH release from the hypothalamus. You catched a snapshot in time with that test, where T and DHT were going back up and E2 was going back down. I can say that from the fact that the day after 1 mg of dutasteride topical your DHT was basically the same, which we all know by now it's unlikely, since the drug goes systemic to a certain degree and will affect 5-ar, due to the really steep inhibition curve.
There are 2 other markers that makes it clear for me that the drug went systemic, which are liver enzymes (ALT and AST). We have data showing how dutasteride is detrimental to liver health, way worse than finasteride, hence the spike in liver enzymes. Nothing to worry about, a cycle of 1/2 months of silymarin will clean your liver back to baseline.

The high albumin and low insulin tells me you are doing a high protein/low carbs diet. Is that correct? In any case, it is not a cause of concern, it just means you are sensitive to insulin and it's actually a good thing. You don't want to be on the other side with insulin resistance.

Last thing is boron: when did you start it exactly? We have data on boron showing it lowers SHBG, freeing more T, E2 and DHT, but it also increases E2 after the first few weeks.

 

[FilthyFrancis]

First of all @dgadgdea, thanks for taking the time and spending money on this experiment.
I took my time to look at this data (...)

CANUTO PRESIDENT, CANUTO PRESIDENT!

EDIT: dgadgdea VP, dgadgdea VP!

 

[sonictemples]

By the way the ALT and AST levels were from his first megadose experiment which failed. He didn't get any tests other than DHT pre and post 0.1%

 

[Mustang]

You are over analyzing things.

1) Total test is irrelevant. The only test that matters if your free Test. It went up and your SHBG went down. Well done. Be happy.
2) E2 fluctuates constantly. I have had 60 pg/dl one week at 35 pg/dl the next. You are within range. Nothing to worry about but if you can get it down further (no dairy, alcohol, losing body fat and taking DIM then your Total T will increase further)
3) DHT spike is also irrelevant if you are not losing hair, topical dutasteride is there to nuke scalp DHT, not plasma. It will fluctuate. Mine is 350 now and still not losing any hair.
4) A low free T4 with high TSH means Hypothyroidism. A high free T4 with low TSH or mid low TSH could mean Hyperthyroidism. Your TSH is normal. You enjoy good high free levels of T4 which is not a bad thing.

What is your current diet?

 

[Canuto]

By the way the ALT and AST levels were from his first megadose experiment which failed. He didn't get any tests other than DHT pre and post 0.1%

From what I see in his table, they first values were from oral finasteride. This shows how worse is dutasteride in terms of liver toxicity.

You are over analyzing things.

1) Total test is irrelevant. The only test that matters if your free Test. It went up and your SHBG went down. Well done. Be happy.
2) E2 fluctuates constantly. I have had 60 pg/dl one week at 35 pg/dl the next. You are within range. Nothing to worry about but if you can get it down further (no dairy, alcohol, losing body fat and taking DIM then your Total T will increase further)
3) DHT spike is also irrelevant if you are not losing hair, topical dutasteride is there to nuke scalp DHT, not plasma. It will fluctuate. Mine is 350 now and still not losing any hair.
4) A low free T4 with high TSH means Hypothyroidism. A high free T4 with low TSH or mid low TSH could mean Hyperthyroidism. Your TSH is normal. You enjoy good high free levels of T4 which is not a bad thing.

What is your current diet?

You're outdated. I don't know what you gain trying to convince people the drug doesn't go systemic if applied topically, but there are tons of papers on topicals and anecdotal evidences proving you wrong.

1) New research has shown that total T is not irreversibly bound to SHBG. Some of it can get unbounded if necessary and SHBG works mostly as a carrier and determine the clearance rate of sex hormones. Hence why you don't want SHBG too low.
His went down due to the well-known effect of boron.

2) If you didn't measure it with LC/MS/MS in a lab experienced running this method, your values are off. Ranges are just indicative of a wide range of population, that it's usually symptomatic. Having your DHT at 250 pg/mL like a 80 years old man it's in range, but it doesn't mean healthy.

3) You are clearly clueless of how a paracrine hormone works. I usually use the pools and pipes analogy, where the pools are the tissues and the blood is the pipe that connects the pools. What you see in the blood is just the leakage from tissues and you can't determine how much water there's in the pools. It's an irrelevant value that can get used though as a reference for an educated guess of what's happening in tissues through a percentage. 3-alfa androstanediol is a way better marker for local DHT activity, but far from being conclusive.
You just need to go below a determined threshold of 5-ar inhibition in some tissues to experience side effects. That threshold is subjective to each individual.

4) The first part is correct, the second is wrong. The American society of endocrinology is moving the TSH optimal value below 2-2.5. Free T4 is the inactive thyroid hormone, that needs to converted into free T3. What happened in his second lab test is that T4 is pooling, as they say in layman terms. It doesn't convert well anymore to T3 and it's confirmed by the fact that TSH went up, as it's asking for more thyroid hormone to be produced. I know at least a couple of doctors in the US that would consider this a sub-clinical hypothyroidism, but I wouldn't advise to touch the thyroid, as it was healthy before the experiment with duta. If the slowing down of the thyroid is linked to dutasteride usage I don't really know, I've never seen any paper on that.

 

[Canuto]

Mustang says only a part of the topical duta will go systemic though, he doesn't deny that some of it can and will go systemic.

Anyway nice experiment and interesting discussion.

It will go systemic to a certain degree enough to trigger side effects in a good amount of people, as per the discord channel.
It's interesting though that @dgadgdea has shown that 1 mg topically brings DHT back to baseline after a week.
I would be curious to see a scalp biopsy to determine how much DHT is still inhibited after 7 days on the scalp.
What's more worrisome is the liver toxicity of dutasteride compared to oral finasteride.

 

[Mustang]

From what I see in his table, they first values were from oral finasteride. This shows how worse is dutasteride in terms of liver toxicity.



You're outdated. I don't know what you gain trying to convince people the drug doesn't go systemic if applied topically, but there are tons of papers on topicals and anecdotal evidences proving you wrong.

1) New research has shown that total T is not irreversibly bound to SHBG. Some of it can get unbounded if necessary and SHBG works mostly as a carrier and determine the clearance rate of sex hormones. Hence why you don't want SHBG too low.
His went down due to the well-known effect of boron.

2) If you didn't measure it with LC/MS/MS in a lab experienced running this method, your values are off. Ranges are just indicative of a wide range of population, that it's usually symptomatic. Having your DHT at 250 pg/mL like a 80 years old man it's in range, but it doesn't mean healthy.

3) You are clearly clueless of how a paracrine hormone works. I usually use the pools and pipes analogy, where the pools are the tissues and the blood is the pipe that connects the pools. What you see in the blood is just the leakage from tissues and you can't determine how much water there's in the pools. It's an irrelevant value that can get used though as a reference for an educated guess of what's happening in tissues through a percentage. 3-alfa androstanediol is a way better marker for local DHT activity, but far from being conclusive.
You just need to go below a determined threshold of 5-ar inhibition in some tissues to experience side effects. That threshold is subjective to each individual.

4) The first part is correct, the second is wrong. The American society of endocrinology is moving the TSH optimal value below 2-2.5. Free T4 is the inactive thyroid hormone, that needs to converted into free T3. What happened in his second lab test is that T4 is pooling, as they say in layman terms. It doesn't convert well anymore to T3 and it's confirmed by the fact that TSH went up, as it's asking for more thyroid hormone to be produced. I know at least a couple of doctors in the US that would consider this a sub-clinical hypothyroidism, but I wouldn't advise to touch the thyroid, as it was healthy before the experiment with duta. If the slowing down of the thyroid is linked to dutasteride usage I don't really know, I've never seen any paper on that.

1) It doesn't matter. His Free Test levels are higher and healthy.
2) My father owns a clinic and a lab. Labs are run with liquid chromatography
3) Irrelevant. You have to go with the average "leakage" to asses hormonal panels.
4) Some endo's are indeed moving the TSH down to 2.5 as a limit. Some 3.0, some insist 4.5. My TSH is 2.5 and I have low free T4. We all know it's a prohormone of T3, you ae barking at the wrong tree.

Dutasteride might very well affect thyroid function. Mine certainly did but I can't attribute it to topical dutasteride.

I have never said that Topical Dutasteride doesn't go systemic. I have actually stated the exact opposite. Read properly.