alopie

I am looking for something similar to Hair Vitalic, or Complidermol 5a plus.

Essentially, a complex of leaf extracts (like saw palmetto) and vitamins (B6, D3, biotin, zinc) that have the potential to assist DHT inhibition.

Is there a good brand or any recommendations on what works best?

The general consensus is that oral finasteride peaks at 5mg/week, so anything more than 0.7mg daily would yield a minuscule benefit.

0.4mg is still not bad, and you would certainly protect your hair at this dosage, but if you could up it to 0.5mg or 0.6mg daily that would be great.

5mg oral minoxidil is a beast, I use 2mg oral and a bit of topical and I am happy with my results.

On 4/20/2024 at 2:04 AM, 4Godot said:

Do people generally feel oral minoxidil could halt or substantially slow hair loss by itself? Or only as an adjunct? I really dont do well with the hormonal/ finasteride meds

There are some studies that suggest minoxidil has the potential to alter dht pathways, and a dose of 5mg daily would significantly postpone and slow down your androgenic alopecia. My dermatologist advised me to use a lower dose (2mg oral daily) with a topical solution (5% once daily) for a better outcome. If you could add 0.25mg  oral finasteride every other day, that would be great too, for most people that combo might be enough to halt hair loss. Go to 0.75mg oral fin daily and 5mg oral min and you are likely entering the reversal phase 

I had a transplant 2 years ago, it went great, but I started having some side effects with my drugs and had to reduce my medication to:
- oral finasteride 0.6mg daily

- oral minoxidil 2mg daily

- topical minoxidil (a few drops on stubborn areas) daily

- Ketoconazole shampoo 3x/week + 1 session of dermarolling/week

I used a laser cap for 5 years, I am not sure how much it contributed as I was taking other medication, but I stopped as it takes time, it's probably not that effective and I don't want to be shooting lasers for that many months for unknown results.
I also used a complex of vitamins for hairloss (Complidermol 5a plus) that includes saw palmetto and biotin, but after 2 years I stopped as it was unclear how much of a benefit they provide, not to mention they are full of preservatives and additives that are under investigation, like most vitamin supplements.

Now, after reducing my medication (from 5mg to 2mg oral minoxidil and from 1mg to 0.6mg oral finasteride), I noticed that my hair is a bit thinner. This is expected, because the hair diameter is supposed to decrease on the newer dosage, even though my current regime should be sufficient for maintenance.

For my piece of mind, what else could I add to my current routine to better maintain my hair? (Should I go back to using the vitamin supplements or possibly increase dermarolling?)
 

No side effects on 0.5mg daily. Trying to do 5mg/week now to see how it goes.

On 2/4/2024 at 8:26 PM, DavidFrancis said:

Interesting discussion, 

Do you think there is a big difference between 2.5mg and 5mg oral minox ? 

The difference in shaft diameter is significant and noticeable, but not in hair count as much.
5mg is as good as it gets, you can't go higher than that.

I had to lower the dose on both fin and minoxidil due to side effects (testicular discomfort/pain, and a bit of dizziness). I took a 5 day break from minoxidil and finasteride that should not affect my overall progress. Now this is where I am:
 

- Oral finasteride 0.5mg daily
- Oral minoxidil 2mg daily
- Topical minoxidil 5% - only a few drops on some spots once daily

- Shampoo Ketoconazol 2% 2-3 times a week, occasional dermarolling

I had a transplant 2 years ago and everything is still looking good. I just want to maintain and not lose ground, hoping to thicken my existing hair if possible.
Is this regimen enough? Would vitamin supplements and LLLT provide any additional measurable benefit? Or should I try and increase minox to 2.5mg daily?
Please let me know your thoughts. 

Check @De Freitas Clinic in Valencia, Couto and Freitas are top surgeons in Spain
@De Freitas Clinic, can you help this guy by providing an estimated time for an in-person consultation? Couto's 2 years in Madrid is way too much 
 

3 minutes ago, jjalay said:

This is what i call a positive mind.

If you want to nuke your dht you could use oral dutasteride daily, dut mesotherapy and possibly add some oestrogen medication (used for gender transitioning) to grow some kind of gyno. This will resurrect hair follicles, but it comes with much bigger issues, so play safe and the time will come.

24 minutes ago, Calihome1 said:

I was offered Dec 2025 (in person only).

 Such a downer.  I would love to have him do the work with how well he does temples and points, but, waiting 2 years just for an in person is insane.

Good doctors take time, you won't regret it. In the meantime, try to stick to a good protocol, oral minox 2.5mg+, oral finasteride and possibly some topicals too. Quit smoking, and try to get a strong donor before the day comes. You will be surprised by how much you can gain before the HT in 2 years. There are people that used dermaroller and dutasteride mesotherapy and regrew hair from nowhere

On 1/22/2024 at 8:20 PM, Maorizio said:

I am not 100% sure but I think there was a study showed users return to baseline DHT levels almost half a year after discontinuation, so this stuff is really strong as it seems.

If 0.25mg EOD will work? I don’t know because all of us are built different, you can try build up the dosing, using something is still better than not using at all.

My plan was to use 0.5mg every other day and use topical in between, but I still have some minor testicular discomfort as a leftover, so I guess I can stop the topical and continue with 0.5mg eod. But since it accumulates, maybe I need a longer break from it (more than 3 weeks that I already did) and build up. In the first 3 years I was taking a solid 1mg daily and there was no side effects, not even loss of libido. The testicular discomfort must be either from accumulation or unrelated to finasteride.
I do not want to lose ground, that's why I don't want to take a longer break, pff this stuff is anyone, I thought I won the hair loss war for a long time  

1 hour ago, zach07 said:

Are you taking generic oral minoxidil? Any side effects? 

no side effects, my oral minoxidil is formulated at the farmacy. 

On 1/20/2024 at 4:10 PM, Maorizio said:

0.5mg eod and even 0.25mg eod will eventually build up in the tissue and lead to almost near results as 1mg daily, but sides will also might reappear.

That's exactly what I think is happening. My side effects started to appear after 4 years of use, but now it took me 3 weeks and side-effects are still here. I think that tissue binding might take more than a couple of months. Should I take it slow until I have no side effects and then start at 0.25mg eod? What do you think?

10 hours ago, hairman4321 said:

some people have found benefit using very very low dose topical dutasteride - it is supposed to be less absorbable systemically than topical finasteride.
urologists said everything is fine and its unrelated to finasteride - how did they explain the pain then? can you look into it further?

Hypermobile testicles and sensitivity in the area due to lifestyle choices (I seat many hours throughout the day for work).  I want to avoid topicals because they are difficult to apply and mess with the appearance of my hair. When I used topical finasteride, I felt like I could not control how much of it I am applying, and if I am applying it correctly, let alone the fact that it might be absorbed to a good extent.

I was told that the area there is so sensitive that there are many other reasons that could cause this. All the urologists I have seen so far are in unison that low dose finasteride is unlikely to cause testicular pain, or at least nothing irreversible. However, they are more concerned over the long-term use (beyond 10+ years) as there are not many studies regarding the safety profile for long term use. Hormonal imbalances, particular oestrogen abundance may be carcinogenic in men in the long run. They all seem to agree with this.

9 hours ago, gillenator said:

Do you have or do you feel any small or tiny lumps in your testicals at all?

No, nothing that I can feel. I also did 3 ultrasounds, both last year and this year. My ultrasounds included prostate, bladders and lower abdomen. Nothing, apart from a small abundance of bacteria in one of my urine tests, but both sperm and urine tests excluded STDs, and culture bacteria. Again, the urologists were not concerned at all, they prescribed some minor medication for inflammation as well as a kind of orthopedic boxers that can keep my testicles up in place.

I lowered the dose of finasteride and the discomfort has definitely decreased over the last month, I would say it's at a maximum 2-3/10, and it was 6/10. Sometimes, especially when I am standing, I do not feel any discomfort at all, so it looks like it happens when I am seated, that's why I am keeping my small dose finasteride for now (0.5mg every other day). I believe the topical solution was being absorbed and it was contributing to the side effects.

13 hours ago, DermMD said:

Correct. Board certified dermatologist here, agree. You need both. 

The question is if 5mg oral minoxidil + 0.25mg oral finasteride daily could be considered as potent as 1mg oral minoxidil + 1mg oral finasteride. This would be an interesting study. My experience is that, at least in the short term, 5mg minoxidil will increase the diameter of the hair, giving a fuller appearance. Long term, though, it is unclear if that 50-60% of androgens that are not blocked by 0.25mg finasteride can miniaturize hair.
If 5mg minox + 0.25mg oral fin is enough for maintenance, I would choose that over 1mg oral minoxidil + 1mg oral finasteride

I have been on finasteride for 5 years and I had my HT 3 years ago. After my HT, I was prescribed a combination of 5mg oral finasteride and 1mg oral dutasteride weekly, so I actually went from 7mg oral fin to this: 5mg oral fin + 1mg oral dut.

During the first year post-op, I did not have any side-effects. However, during the second year I started experiencing some testicular discomfort (pain at times) so I stopped dutasteride and I went back to my 7mg oral fin weekly, the pain went away after 3 weeks.

This year, after 12 months from my last testicular discomfort, I started feeling the same discomfort and pain while on oral finasteride 7mg weekly. I went to urologists, was told that everything is fine, and that it might be unrelated to finasteride, as it looked like it was position dependant. I stopped finasteride for 1 month and then I switched to topical 0.1% 1ml daily.

For a good 2 weeks, discomfort went away, but now I have also started feeling something really small again.

My assumption is that finasteride accumulated and there was in abundance on my tissues, but also topical is likely absorbed to a great extent.

Now I am slowly stopping topical and going back to a low dose oral finasteride at 0.5mg every other day or 0.25mg daily which I can better control. I am on 2mg oral minoxidil, ketoconazole 2% and dermaroller. I apply topical minoxidil 3x week on some weak spots, too. 
 

Is 0.25mg oral finasteride daily + 2mg oral minoxidil daily enough for maintenance for a month or two? I am planing on increasing to 0.5mg oral finasteride daily + 2.5mg oral minoxidil daily, which is viewed as an overall good protocol for maintenance.

9 hours ago, Eli_Avdikian said:

However, on a side note, I don't buy that someone can keep their hair on Oral Minox alone without some form of 5AR inhibition

5mg oral daily and twice dut weekly is a very potent combo, you will definitely get results.

5ar inhibition is important and it may increase hair diameter, that's why I am suggesting a 0.25mg oral daily. But your dut protocol is close to what I am suggesting. 

3 hours ago, 12345 said:

minoxidil inhibits dht? where did you read this?????

Here are two papers:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10461613/#:~:text=Multi-target mechanism of minoxidil,expression%2C thus reducing DHT production.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039155/

The general consensus is not that inhibits 5ar, but it can disrupt dht pathways which prevents tissue binding. Effectively, dht circulates in the blood stream but it get disrupted when it reaches the skin tissue. 

After getting my HT, I switched from topical to oral minox. I started at 5mg, but I grew a unibrow so I lowered that to 2.5mg, and some months even 2mg daily.

After reviewing the literature, it looks like 5mg oral minoxidil is so potent that it also disrupts dht pathways and it is such a beast that is nearly impossible for dht inhibition to miniaturize hairs that quickly. 
I am wondering if anyone here has tried 5mg oral minox alone, without finasteride? My suspicion is that the effect of 5mg oral minox might postpone hair miniaturization by 20 or more years, alone. If that's the case, it means we can use a super potent version of oral minox with a small oral dose of finasteride (0.25mg daily), and have less exposure to the androgenic side effects. 

9 hours ago, Sunset Dune said:

Even that is pretty useless 

According to the general consensus in literature, any DHT inhibition that is lower than 50% is unlikely to have an impact. However, combining treatments like finasteride with ketoconazole and caffeine, may take you from 60% to a 65% percent, depending on the type of DHT isotypes that each individual produces. If you want that 5%, then use ketoconazole and caffeine, but it won't change your overall condition. In that regard, I agree that it could be considered "pretty useless". 
Like making $50 per month from a side hustle is pretty useless compared to your salary. But compounding other side hustles on top of it could be less useless.
Top HT doctors incentivise the usage of ketoconazole and caffeine a couple of months post-op, 3x week. It's because they want to maximize their results, so they want that minor boost that comes with it, even if it's a 3% increase.

The big three should now be oral dutasteride, oral minoxidil and microneedling or some kind of mesotherapy. We found out that LLLT, biotin, caffeine, PRP, can be somewhat effective but the result is minor.

On 1/17/2024 at 10:01 PM, wembley said:

i think u should use it more often if you want ketoconazole 2% to work and leave it about 7 minutes in your scalp before wash.

3x week, leave it for at least 8 minutes, make sure it reaches the roots. Don't expect miracles, though

stopping finasteride temporarily for 1-3 months will not impact your results anyway. It takes time for dht levels to go back to normal and even more time to actually affect your hair. Just take oral minoxidil in the meantime to stay strong

Hair fibers, spray version. Toppik is a great one

The other day I saw a warning on the national healthcare system in the UK, that some cases of male breast cancer have been reported and may be linked to finasteride.

There are two studies that link male breast cancer and finasteride:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773955/ (significant increase in mbc cases)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956950/ (further investigation needed)

And there is also one other study performed by some Merck consultants that did not find any links (but those are consultants, so there is a conflict of interest).

My understanding is that the balance of oestrogen/testosterone may trigger malignancies, and this all makes sense from an endocrinological point of view. However, what is not clear is the amount of exposure needed (i.e. if it occurs at 5mg for 10 years, it is not fair to say that it will happen at 1mg for 10 years, but the risk might not be 1/5).

I know there are people here that take it for many years, and others that claim that male breast cancer can only coexist with gyno. So if you have gyno as a side effect, you stop and that's it.