Why Does Dht Require Weeks To Recover After Stopping finasteride?

[SomeoneHasToSayIt]

I've heard the common answer that the body requires time to replenish 5AR, but if that's the case, why does DHT fall so rapidly following a single dose? If I'm correct in assuming that rate of 5AR synthesis is proportional to the rate of DHT synthesis, and that this rate needs to be matched to DHT consumption in the body, then it seems we can infer (based on the immediate drop in DHT levels following a single dose of finasteride) that the body consumes DHT/generates 5AR rapidly. In that case, once finasteride is removed from the body in a day or two, why doesn't DHT rocket back up?

 

[whatevr]

Finasteride is not a suicide inhibitor, meaning it can dissociate from the enzyme without rendering it permanently inactive. The body doesn't need to replenish 5-AR because it is not permanently bound to the Finasteride, all it takes is for the Finasteride to "unbind" from the enzyme for it to start working again. It takes up to a week for DHT to return to normal even from a single dose, and the reason for that is that even miniscule amounts of the drug in the circulation still effectively inhibit serum DHT levels, so until several half-lives of the drug have turned over (which can take a couple of days) the small amounts present in the serum will still inhibit the enzyme.

The reason DHT levels fall quickly is that DHT production immediately ceases once the finasteride has bound to 5-AR enzyme, since testosterone can no longer attach to it to be converted. That doesn't take a very long time.

 

[memoryboy]

I have been using 1mg finasteride daily for around 14 years and a couple of times I have done a few months break (up to 2 months break) in taking it and measured my DHT (and other hormones) and with a couple of months being off the drug my DHT didn’t go back to normal but stayed way below range, almost or completely like I hadn’t quit the drug.

The recent doctor (dermatologist) I went to said it could take a year for DHT to recover / go back to normal. I would say he definitely wasn’t the best expert of finasteride but he was knowledgable and very in depth and caring. One of the best doctors I’ve visited. He was quite cautios of the drug and said in his decades of practice he has only given finasteride prescription to handful of patients as he things it can be dangerous.

But nevermind that doctor. I’m a living proof that finasteride can mess up the hormonal balance.

I might be an idiot but I’m still taking it (have recently switched to 0,5mg daily) as I have been reluctant to let go of my hair.

But the first time I made a break my total testestorone crashed (which was really good before) and hasn’t recovered. I now have low total T. But strangely I have a really high bioavailable / free T, so I feel alright. One other doctor (who is very respected andrologist and pro-finasteride) and who tried to convince me all my tests are normal, even had to agree that it was odd.

Second time I made a break in taking finasteride, I noticed really good morning and spontaneous erections returning but they were gone after 2 weeks.

I am now taking the drug again and feel more or less normal. Erections are okay but could have more morning / spontaneous erections. Which I get occasionally. There could be other reasons at play though. Etc.

I’m considereing whether to wean off the drug completely. I am already taking 0,5mg. I was really trying to hold on before something else comes along that I could replace finasteride with. We seemed closed than ever (I know we’re always 5 years away. But the current coronovirus crisis seems to postpone any new promising outrolls of new treatments.