Gish

Take a look at this thread if you want a but more info. This guy reported a similar experience to your own. http://www.hairrestorationnetwork.com/eve/163398-propecia-losing-its-efficiency.html

Search some of my old posts, I go into greater detail about such things. To be a bit nit-picky, there is no such thing, medically speaking, as a "DHT Inhibitor". Finasteride Inhibits an enzyme (one of two iso-forms) that converts testosterone to DHT. It partially 'blocks' it. Localized scalp measurements are more difficult to obtain, but serum levels of DHT drop by an average of 85% when one takes finasteride.

Just a quick note, finasteride is measured in mg not ml. I'm sure there are people on here taking more then the recommended 1mg of finasteride. I know of a number of people on HHL and HHT who are. To take more then 1mg is, for all intents and purposes, as safe as taking 1mg. Men who take finasteride for BPH take 5mg. Granted, these men are usually much older. Take a look at some of the figures in this link. No Title It shows that serum DHT levels are reduced by the same amount for all doses above .2mg. BTW. Sugahighs...have you gotten around to digging up those photos yet?

DHT effects the development of external male genitalia during embryo genesis. Obviously this role ceases to exist once one becomes an adult. Also, T still has affinity for the androgen receptors, just at a lower rate then DHT, so its not like the receptors are going completely barren. In regards to dosage, I've posted this a few times. The dose response rate is so flat it doesn't really matter. The difference between DHT levels between 1mg and 5mg is negligible. I've seen it talked about so many times on here and other forums...members talking about fine tuning their doses as if it will accomplish something in the grand scheme of things when it likely will not. No Title

Interesting post Mahhong. I agree with you, I think people feel the need to address it and humor is the most acceptable way. On the other hand, I think this works only for people who you know semi well. It is odd when other people comment on your hair loss as if you haven't noticed it yet. There is a strange personality trait in many of the humans i have come across, often enough, in my 21 years alive and that is the need to point out perceived flaws in others. If I talk to someone with some 'physical flaw', whether it be something as mild as hair loss or severe as deformity or a missing limb, I don't feel the need to point it out or show the person I acknowledge their unfortunate condition. I just try and talk to them like I would any other person. I think most people do this, but a few don't and I try and understand, whenever I am the victim of someone who feels the need to point out any one of my many flaws, that those who have their own problems.... ones far worse then my hair loss. Hair loss has caused me a lot of grief, but at the same time I think it has made me a better person in the way I treat others. When something happens to you that you strongly dislike, and that something you have absolutely no control over, it was just the way you were born, I think you can sympathize with others a bit more. Maybe it has to do with growing up as well, but I feel it has had this effect on me. On a side note, I was pleased with the fact that Wayne Rooney went so public with his hair transplant (granted, he pretty much had to otherwise every media outlet in England would be commenting on it). The way he did it gave a boost to the societal impressions on treating hair loss. People have come to terms with people dying hair, using make up, get plastic surgery, but treating hair loss is still seen as overly vain and comical.

Good call, I had never thought of this before. In reality, I should get hair cuts more often then I do. At the right length and style my hair can look pretty good. But I always wait to long and then it becomes embarrassing as they wet and come back my mass of hair to see the recession and the thinning hiding below. I always find it odd how the barbers feel the need to comment on it, as it you hadn't noticed. The main problem with hair cuts, for me, is that it looks really good for about a month, then once my hair starts to grow it gets worse, even a bit, it can look a lot worse. Perhaps a stylist can plan a haircut for me that takes into consideration future growth.

some might, it is different for everyone, although recently miniaturized follicles may start producing decent hairs again. Granted, I would get your hopes up. Internal AAs should be seen an a maintenance regimen and not a regrowth regimen

some might, it is different for everyone, although recently miniaturized follicles may start producing decent hairs again. Granted, I would get your hopes up. Internal AAs should be seen an a maintenance regimen and not a regrowth regimen

What data showed more regular doses did help? By regular I assume your meaning more then once per day. My understanding is that it is not an issue with half life. The bond formed between 5AR ll and finasteride is so strong that it would take over a day for your body to synthesize new enzymes.

Spiro doesn't have estrogen in it. It competes for the androgen receptors. I doubt upping your dose will help, if you look at the data the level of 5AR type 2 inhibition is pretty flat with fin. I don't think your body "gets used to it". Any proposed mechanism by which this would happen? Sugar highs decline in effectiveness is a 'text book case'. He needs to reduce the androgen stimuli or continue to loose hair, albeit at a still much slower rate then without fin. If you put Dut and other harsh, or otherwise experimental, topical AA aside this is what your left with. -Topical Spiro -Minoxidil (not an AA) -Copper peptides (folligen, Tricomin...mechanism not fully understood...is it a growth stim, an AA, or does it work on some other aspect of MPB?) -Proxiphen (Dr Proctors prescription version) -Proxiphen-N (Non-prescription version) -17a-estradiol topical -Revivogen I have not personally tried to majority of the treatments listed above, but have seen pictures, and read reports, about the effectiveness of them...all to varying degrees of course.

I don't think you would be worse off. Think about it this way, minoxidil does nothing to interfere with the actual balding process, it just gives cosmetically significant offset growth to which sort of masks the balding process. Think of it this way, everyone couple of months a man is loosing height. To offset the height loss he puts blocks in his shoes. He appears the same height, although he is constantly getting shorter. When he stops using the blocks he has still lost X amount of height. Minox is the same. Any worse off you are after you stop minox will just be the normal rate at which you are balding in the first place. For this reason, I dont use minoxidil. For the annoyance of putting stuff on my scalp I would rather use a topical AA then a cover up. I have always thought of minoxidil as a biotech hair piece.

Anti androgens do work on the hairline, its just often the hairline is in a much more drastic state of miniaturization compared to the rest of the scalp. Most people notice hair loss via a receding hairline...most men are most bald at/around their hair line. Fin/dut certainly works on the hairline...but you just have to remember what 'working' means. Taking fin/dut is not ill-advised per se, its just there would be no point. Iirc, dut inhibits 99% of 5AR type 2 and a large portion of 5AR type 1. If you were to take dut, do it on its own to save money. Flut is not commonly used and there is some debate over whether or not any benefit is due to systemic absorption. I use RU so there is no point of using Flut. I have said before, on other forums, that if one was really serious a regimen of RU/Dut would very likely halt any further hairloss. Once you reduce the androgen stimuli below a certain level AGA cannot progress. An interesting case is that of pseudo hermaphrodites. These individuals are men who are 5AR type 2 deficient. These guys do not go bald unless they receive DHT. Also, castrates do not continue to loose hair, assuming they were going bald in the first place.

Sounds good! I look forward to the possibility of seeing some pictures. If/when you decide what your next course of action is please update us.

Sugarhighs, I am always very excited to see posters who have been on finasteride for a decade. Do you by chance have any pictures that document baseline to now? Or, even just a baseline picture and a current one? Unfortunately, it is likely that what you are experiencing in terms of perceived decreased effectiveness from finasteride is the same kind of decrease that is seen in the literature after 10 years of use. Take a look at the graph I uploaded, It shows a quick mean increase in hair count within the first year of use, a considerable slow down in the rate of hair gain between first and second year of use, and a drop in hair count between year two and year 5. If the graph was to continue on in that fashion you would end up back at baseline at around 10 years of use, after which point the average person would continue to loose hair and be below baseline. This is just averages, some men may start to go below baseline much sooner, some much later, but the majority right around the 10 year mark. It is striking just how much finasteride slows down the progression of MPB. Look at the difference between the experimental group and the placebo group at year 5. That is a lot of hair!. As far as your speculations go... I very much doubt that normal weight lifting will effect your hairloss. More testosterone does not exactly equal more DHT. The amount of DHT in our bodies relies on the amount of 5alpha reductase, both isophorms, that are present....In our case, the amount of 5alpha reductase type 1 and 5alpha reducaste type 2 not inhibited by finasteride. Men on finasteride experience a roughly 5-15% increase in testosterone levels due to non-converted T "lingering around", yet we have ~85% less DHT. Its a complicated issue and not black and white, but I think your safe. Doesn't really matter when you take finasteride during the course of the day. The time it takes for your body to make more 5AR type 2 can be over a day. I think at this point you should ask yourself exactly what kind of goals you have, and how important those goals are to you. If preventing any further progression of hairloss is your goal you basically have to reduce the androgen stimuli to the hair follicles. Whether you do this by taking a stronger internal anti androgen like dutasteride, or a topical anti androgen, like spiro, fluridil, flutimide etc, is your call. You have options, but they are less conventional and more experimental then finasteride. It is important to remember that, to best of our knowledge, finasteride is still working as effectively as it always has, its just over the years the remaining androgen stimuli has been slowly damaging the follicles. The S5 cream is a good start, if it wasn't such a pain to apply to the whole head it would be quite a good adjacent treatment. I would recommend getting a bottle of Nizoral 2% shampoo, it is commonly used as another side kick treatment for MPB. One study showed it effectiveness to be greater or equal to that of a 2% minoxidil solution. A hair transplant is also another option to consider, perhaps even experiment with some PRP injections as well if you have some extra money kicking around. Best of luck to you, if you have any other questions I'll be happy to anser them to the best of my knowledge.

I had often felt that for a grown man a nw 1 ( or 0 depending on your use if the terminology) looks a bit goofy. Such hairlines, in my opinion, are child like hairlines and most suitable for children. A bit of temple recession with still solid density is, i think, the most flattering hairline for a grown man. Sort of a sign of virility... Then again, I feel like the male image has been pushed towards a more feminine pole in the last decade or so. When I watch older movies men are portrayed as if Hemingway was the model for every male character in film and television. The movies if my generation seem to portray the majority of men in a much more feminine light. Cleaner cut, hair styled, tighter fitting clothes, etc. Anyways, got a bit off topic.

Good point RCWest. Since proscar was out before propecia but both owned and marketed by merck, I wonder if they ever looked at sales for proscar in the years prior and observed any increase in sales since propecia came to the market (and any fluctuations in the rated of BPH accounted for). I would also venture to guess that those "in the know" already had strong suspicions that finasteride would be a viable treatment for MPB and we somehow procuring proscar. I dunno, once again this is speculation outside of the realm of MPB science, but still kind of interesting.

87, I'm studying biotechnology at school so my course work is heavy in biochem and genetics material...the perfect stuff for understanding hair loss! Also, I volunteer in a lab that looks at some of the molecular aspects of prostate cancer. you may be surprised to find out just how much overlap there is between the important aspect of both prostate cancer and MPB. I sometimes think it is somewhat strange, but the more I learn about hair loss the more it becomes interesting to me, perhaps because I care about the material beyond a purely theoretical level...hair loss matters to me. I am still considering a transplant as well, and have the same concern as you do, returning to work/school and looking funny. I am not looking for much though, just a reduction in the angle of my temporal loss. Which doctors have you been looking at/considering?

Good luck restoration87. You sound like you are in a similar position to me in regards to thinking about a HT. Perhaps my hairline isn't quite a NW3 yet. Pictures are in this link if interested. http://www.hairrestorationnetwork.com/eve/163258-comments-advice.html. I still feel you may be unnecessarily paying much more for Propecia, but the choice is yours and I respect that. Please keep me updated on future developments, and consider topical spiro lotion to apply on the hairline. Good luck man.

Hey restoration 87, Merck found that, although the dose response rate for fin was very flat once you reached dosages of .2 mg, they decided that 1 mg was the most beneficial dose. This likely translates to something along the lines of "1mg of finasteride inhibits 5% more 5AR type 2 then .2mg". Given the cost of proscar, I have always just cut it up into fourths. There would be no reason to mess around with doses other then to save cost, in my opinion. Granted, I have read posts from people on other forums saying that when they decreased their dose from say 1,g to .5mg their side effects went away. Its always hard to evaluate these sorts of claims, but take it for what it is. If it is true, your bodies response to 5AR 2 inhibition must be very fine tuned to the point where flucuations of single percents of inhibiton could be the breaker for side effects vs no side effects. in regards to your question about 1mg every 2nd day vs .2 mg every day I am not sure. If I was to guess, I would say to take 1mg every other day. Waiting two days you might see your 5AR levels start winding up. I haven't looked into alternative dosages much as I have been quit happy with cutting my proscr into quarters. 1mg every day has been shown to work time and time again, I see little reason to not go that route. Out of curiosity, why is it so important to you that you get the exact same dose every time. Spironolactone is not a big guns treatment for sure, but is a good adjacent treatment to be used along with an internal AA. It has a different mode of action then fin so you are saving the follicles in two different aspects. Please note thought that I am talking about topical spironolactone. Oral spiro would be quite a heavy duty hairloss treatment, one which some people I know have gone on (with surprisingly few side effects mind you). Topical keto is good as well, but I don't think you need to use a cream, just use nizoral 2% shampoo every other day or so. Should be about as effective as applying a cream. How bad is your hair.

If you look at the merck data you will see that finasteride has a very flat dose-response rate. iirc .2mg worked inhibited ~5% less 5AR II compared to the full 1 mg. In the rat prostate studies the inhibition for 72mg/kg/day was nearly the same as 7.2mg/kg/day. Goes to show, the difference between either a very little or a lot can be quite marginal. Also consider that finasteride binds with the 5AR type 2 enzyme so strongly that even though it has a half life of only 8 hours it takes the metabolic synthesis of new 5AR type 2 much longer to restore normal activity. I remember reading it can take anywhere from a single to several days. In regards to your thoughts about using Dut instead of fin, I think you should do a bit of your own research. We have no long term models of 5AR type 1 inhibition to observe so it can be more difficult to say exactly what the long term implications of inhibiting the enzyme may be. It have often read forum posters say that 5AR I is found in the brain, and that it serves as a precursor, or a part of a metabolic pathway, for a certain neurosteroid. Of course, the question is does 5AR type 1 actually matter in terms of hair loss? I have always felt that the added bennefit some people see from Dut is due to the higher rate in inhibition of 5AR type 2 and not 1. I have heard stories about a topical 5AR 1 anti androgen developed by merck in the early days of testing 5AR inhibition, and that it did nothing for MPB. You may want to look into topical spironolactone if you are wanting to strengthen your regimen. Such a product has been studied quite a bit for the application of acne and has shown to be quite safe.

I think anyone who made the claim that it could regrow a full head of hair is greatly mistaken. Anti androgens don't 're grow' hair. At best, follicles that may have recently undergone miniaturization past the point of producing cosmetically significant hairs may be brought back to life, so to speak, by the cessation of the androgen stimuli. Even castrates don't regrow much, if any, hair. Anti androgens have shown to be very effective of stopping further hairloss, or follicle damage, but not to great in terms of regrowth. The reason(s) why RU58841 was never brought to market has been a complete mystery. All signs points to it as being a very effective topical anti androgen and the most convincing speculative theory has to do with money. The makers of the drug described its effectiveness as a stand alone treatment to be comparable to, and perhaps a bit better then, finasteride. Given the cost, hundred of millions, to have a drug FDA approved it is easy to see why one would decide it wouldn't be worth it considering there is already a drug on the market which produces comparable results and is significantly more easy to use. People, myself included, would much rather swallow a pill every morning or night then cover the top of their scalp in a liquid. Also consider the fact that Merck was disappointed with the sales of Propecia, the numbers are underwhelming, and upjohn was equally disappointed with the sales of minoxidil, perhaps the market for hairloss is not as big as us, the online hair community, perceives it to be...I'm getting a bit speculative here.

It seems to depend on genes, but I would certainly say not a few months. A few months would be the case if one took minoxidil, saw great growth, then stopped cold turkey. I would venture to guess that if you stopped the hair loss would progress faster then it would have when you first noticed hair loss. Some of the case studies I have read regarding 5AR deficient men showed that upon administration of DHT they started thinning "in the horse shoe pattern" on the top of the scalp at a rate faster then the average rate of loss. This wasn't quantified or anything, just a remark made by the observers. For all we know it could have been the case that those few men had very strong balding genes. I'll see if I can dig up the reports. That being said, it is important to remember that by reducing the amount of 5AR type 2, lowering serum DHT by ~80-85% (It seems to be very difficult to measure levels in the DP), you will be significantly slowing, or possibly even halting, miniaturization of the hair follicles. So, its not a 'masking effect' since you are actually interfering with the balding process.

RU58841 is an experimental anti androgen developed by a a Dr. T Battmann over in Europe (France, Belgium, Germany, or Switzerland...I can't remember). It was shown to be a very powerful anti androgen, the handful of studies that were conducted showed few, if any, systemic side effects. A Scottish company (iirc) bought the right to it and made it too phase 2 clinical trials before dropping it for unknown reasons...so it goes. Links to outline of phase 1 & 2 trials. ISRCTN49873657 - A double blind, randomised, vehicle-controlled, safety and tolerance study of topical PSK 3841 solution at 5% administered twice daily over four weeks to healthy Caucasian males with androgenetic alopecia ISRCTN71083772 - A multi-centre, double-blind, randomised, vehicle-controlled study for a quantitative estimation of hair re-growth in male subjects with androgenetic alopecia treated over 6 month with two ethanolic PSK 3841 solutions (2.5% and 5%) Link to abstract of Battmann et al study RU 58841, a new specific topical antian - PubMed Mobile The effectiveness of RU58841 has been speculated, by it creators, to be >/ the effectiveness of finasteride. Note though, that RU58841 does not have the same method of action as its azasteroid cousins, fin and dut, in the sense that it does not inhibit the 5AR type 1 or 2. Instead, it has a high affinity for the androgen receptors and competes with DHT to bind with them. It is important to understand that this is an experimental compound and has not gone through the years of rigorous testing that the single AA treatment for androgenic alopacia has gone through. That, and the somewhat shady nature of procuring the compound, should make any prospective users think long and hard before considering it as a treatment. The bottom line, the stuff has not been approved for human use, although its effectiveness as an AGA treatment is undeniable. If anyone has any other question please feel free to post and I'll do the best to answer them.

Recently, one of the members in an online hairloss community I participate in reported that he had the RU58841, from 2 of the 3 big suppliers, 'tested'. He claims that both samples showed to be genuine RU58841 with little impurities. One companies RU was, reportedly, more pure then the other, but both had small traces of impurities. This caused a lot of discussion among many of the members, and led to concern over the precursors used in the synthesis of RU 58841 by the over seas labs. which produce the compound. Due to a number of inquiries from concerned users, regarding the purity of their RU58841, a North American supplier (who, as far as we can tell, buys RU from over seas and resells it) has stopped selling at this time until they do their own tests for purity. The poster did not actually post the results of the study and the members have been left to take him at his word. Granted, he is a RU58841 user so has little incentive to report anything other then what he feels to be the truth, but until he can provide what ever data he gathered to make his claim it is still up in the air. A number of users have discontinued RU58841 for the time being for fear that the impurities may be hazardous to their health. Personally, i have lowered my dose and applied every other day instead of 5 day/week. Not sure if any users on this board use RU58841, but if there are any I thought it may be of interest to them (if they don't already know).

I think you need to take a vitamin P supplement!