generic math on finasteride, thoughts and a warning

[Spanker]

So, all of this is based on the five year study using a little guesstimation and math based on the bar grafts you will find by googling finasteride 5 years study and checking the images and reading the study which has been posted on many websites. The study says the average guy started with 876 hairs in a 1 inch circle. Keep in mind I didn't use any 10 year stats. I found that study a little more confusing and dependent on the age you started and how your initial response was. This is generic averages base on the mean of the subjects and their hair in a 1 inch circle and you may or may not fit into this average. Doing the math, it's also important to note that the mean subject would have had about 83 fu/cm2 (using 2.1 hairs per fu, please check my math) which really is fairly high, so these guys were not just super bald but could have been miniaturized.

 

In the first year you get an increase in hair but start to decline after that. It looks on the bar graft that they gained an average of about 90 hairs the first year before the decline putting you at 966 hairs at year one and at 914 by year five. That's a 1.35 percent per year reduction in hair on finasteride. If you only use year 3 to 5, where the hair loss begins a fairly linear reduction, it's at 1.8 percent of loss of hair count per year. If we do the same calculations starting after the first and going to the fifth on the placebo you get about 7 percent loss per year. Do a quick 10 year check by moving the decimal over one, assuming its fairly linear you'll see that on fin the average subject loses between 13 to 18 percent of his hair count while of fin he loses 70 percent of his hair count in the given area.

 

This is based on the five year study and assuming it's accurate and assuming that the loss rate remains fairly linear after 5 years. I've read about many guys that said they didn't notice further loss for 9 to 10 years and assuming the fell into the 1.8 percent category, this seems right, that you could lose 18 percent after you know your thinning and then it could start really looking rough.

 

I think this shows that it's important to start on fin as early as possible. Finasteride significantly slows loss and it's exponential with time.

 

This brings me to the warning. I see a lot of users, even doctors, and probably even me mention that fin could slow or stop your loss. This is a fairly loose use of the term stop. It could bring you above baseline, and stop for a year or two, but then you begin to lose ground and eventually you are likely to end of below baseline and continue further below with time. That's not to say that you shouldn't be on it. I think everyone that can tolerate it that wants a transplant should get on it and stay on it, but it doesn't truly stop hair loss in a long term sense when measuring in decades. Because of this you should only count on fin to slow your hair loss. Not stop it. I've seen no reason to think a man in his late twenties will not experience relatively significant loss by his late fifties just because of fin IF he was destined to be a high Norwood anyway. (Some if you are destined to be nw3s for most of your life and some low 4s. Not everyone is destined to be a nw6.) This is why it is important to get a through examination from your doctor to conclude what your final pattern may look like and plan your hairline height and density implanted accordingly on your first and subsequent sessions.

 

Finasteride is a great tool to combat hair loss and will likely provide you with many years of being fairly stable in terms of hair loss, but it is not a magic pill. Despite this, in a decade, would you rather have 30 percent of what you have it 82 percent if what you have? I did a fair amount if calculating so please feel free to check behind me.

 

Congratulations if you made it this far. You deserve a pat on the back. What are your thoughts?

[Uk86]

I just hope something better than finasteride comes out within the next 10 years!

[ontop]

Nice post spank but I thought I read different numbers from a Dr Bob bernstein paper that the average was 272 hairs gained per a year over a 5 yr period then drops down there after.

Maybe I'm wrong have to dig that back up.

 

Never the less, Fin can be good for guys who can use it but you must have it in the back of your mind that its just gives you some more time maybe 5 / 10 or even 15yrs to hold on what you have.

 

Fingers crossed that something better will come out in the next decade.

[Spanker]

Nice post spank but I thought I read different numbers from a Dr Bob bernstein paper that the average was 272 hairs gained per a year over a 5 yr period then drops down there after.

Maybe I'm wrong have to dig that back up.

 

Never the less, Fin can be good for guys who can use it but you must have it in the back of your mind that its just gives you some more time maybe 5 / 10 or even 15yrs to hold on what you have.

 

Fingers crossed that something better will come out in the next decade.

 

I have quite a but of hair and am very dependent of it. I started it around 31 years of age when I had a lot of hair and just receded temples with a diffusion of the first inch of hair. For guys like me fin is even more of a guessing game because I had yet to being a real pattern past a 2.5 so whose to say what my final pattern may be. 3, 4, 5, 6, diffuse? I have yet to lose noticeable ground. I do remember wrong my black hair and snapping a pic directly under a light and feeling like too much scalp was showing, then I shaved my head and it looked normal with no crown or horse shoe pattern. So, I caught it early and that's important for fin use. I have no idea what I'm destined to be which is a pretty good place to be at 36.

 

Yes, it's not going to hold you of forever, but I think you'll always be ahead of where you would be by staying on it. Even if it's just your lateral humps.

 

I would love for a typical dht blocker to come out on the us and would love to see a combined study of fin plus a topical blocker.

 

I doubt we'll ever see a total cure but we could come out with a treatment that it's so long term that it would be much less devastating. I.e., we basically have a 6 to 10 cure now. Maybe the next thing will take it to a 15 to 20 year cure, and so on, becoming so good that if you're willing to do medical maintenance for the duration and you start early, you'll never be bald.

 

 

I used to think duasteride would be that bridge by suppressing do much of your dht, but I've seen no evidence of that either.

[1978matt]

I know a guy who has been on fin since 1997 and it hasnt stopped him increasing two NWs from 2 to a full blown 4 at age 48. He would probably be an advanced NW6 based on strong family MPB history. No side effects either.

 

A lot just depends on genetic susceptibility. I'm of the school of thought that every follicle has a set number of growth phases before it dwindles down to nothing over time. DHT just acts as the trigger for each cycle.

 

Minoxidil I think just holds the growth phase longer which can cause a visible improvement in density however, I think the effect is only a slight slowing down of the balding process.

[Spanker]

I know a guy who has been on fin since 1997 and it hasnt stopped him increasing two NWs from 2 to a full blown 4 at age 48. He would probably be an advanced NW6 based on strong family MPB history. No side effects either.

 

A lot just depends on genetic susceptibility. I'm of the school of thought that every follicle has a set number of growth phases before it dwindles down to nothing over time. DHT just acts as the trigger for each cycle.

 

Minoxidil I think just holds the growth phase longer which can cause a visible improvement in density however, I think the effect is only a slight slowing down of the balding process.

 

Good point. The big question here is genetics. What are you supposed to be? My dad is a six, and was a patterned four or five by his late twenties. My mom's side has high temples. I don't think family history is a great indication of your ultimate pattern because there are so many variables (or can be). I also think many people, if not most are destined to thin with age, even without demonstrating an advanced pattern. Sure, there are old people with thick heads of hair, but it's fairly rare. A significant loss in density with age beginning in your 40s, 50s, and older is not uncommon. SMGs post from today is a nice example. The guy isnt bald, but had a pretty significant loss in density over his life time.

 

But, for someone that should be a nw6 and is a nw4, that's still a pretty good deal.

 

P.s. I am surprised the guy was a nw2 and 30, started fin and ended up a full nw4 by 48. He probably had additional or Ibsen thinning going on. (I think I do too). Most 30 year old nw2s arent full 4s by 48. But it's not uncommon. I guess what I'm saying is that The later you begin to bald the lower chance of being a high norwood level.

[Gram]

Good post spank. This is especially imp for young guys. Salesman present fin as the silver bullet to young guys pondering HTs (myself included who fell for it hook line and sinker) when in reality everyone responds differently. Some may halt altogether but it seems like the majority are just buying some time or decelerating loss. I also think the debate on receptor upregulation on fin/Dut has not been settled.

 

When I originally saw your title I actually thought this post was abou generic fin. Out of curiosity, does dr. K have a strong opinion about generic fin? I'm also curious as to what his thoughts are on topical fin as I've seen some or his local competitors begin to promote it. I wonder if oral in conjunction w topical is worth a damn, but if I know dr k he won't speculate and will instead defer to proven science to which there is little to none on the topic I believe.

[Swooping]

Finasteride just isn't strong enough for some phenotypes.

 

With 100% DHT inhibition AGA can't "exist". It's really that simple.

 

With no functional or full antagonism of AR AGA can't "exist" too.

 

Finasteride has like what a mean of 70% DHT inhibition.. This is a average number according to your response to the mediation this may be even lower for some phenotypes

 

If finasteride doesn't cut it for you then you have the option to go for dutasteride.

 

A recent study with dutasteride over a 5 year period as far as I recall of about 500+ japanese men showed that dutasteride maintained hair in 99.7% of subjects.

 

If dutasteride doesn't cut it for you then you may take it one step further and add a topical anti-androgen. You can't possibly suffer from androgenetic alopecia from such a combination unless you are some genetic rarity who doesn't respond well to medication.

 

We have preventative cures available this moment no doubt for everyone outside of some extremely rare examples.

 

The question is how far one wants to go.

Edited May 5, 2015 by Swooping

[Gram]

@swoop - my logical mind tells me youre probably correct, but do you know of any studies showing dht reduction when oral are taken in conjunction with topical? Even anything anecdotal would be interesting.

[Swooping]

@swoop - my logical mind tells me youre probably correct, but do you know of any studies showing dht reduction when oral are taken in conjunction with topical? Even anything anecdotal would be interesting.

 

Hey gram, unfortunately not. However I refer to "real" topical anti-androgens not 5ar inhibitors like dutasteride and finasteride. I mean more something like RU58841 which is a androgen receptor antagonist..

 

It isn't approved though, but many people use it nowadays, even in conjunction with finasteride/dutasteride. Such a combo is practically a preventative cure for everyone. CB-03-01 is also a topical anti-androgen that is running clinical trials currently as you may know. Let's hope it will be released asap!

 

A combination of a internal 5ar2 inhibitor and a topical anti-androgen is just so strong that it will act as a preventative cure for everybody, no doubt. Well outside the incredibly rare phenotypes that fail to respond to medication in some sort of way.

 

Anyway I even doubt that many phenotypes will continue to lose hair on solely dutasteride. It would be a very very small subset of people imo.

 

 

Finasteride just isn't strong enough for some though;

 

Edited May 5, 2015 by Swooping

[Gram]

Interesting swoop. Thanks for the reply. Do you believe that for those willing to experiment with the non fda approved/non big 3 that ru is the best place to start/most effective of the bunch?

[Swooping]

Interesting swoop. Thanks for the reply. Do you believe that for those willing to experiment with the non fda approved/non big 3 that ru is the best place to start/most effective of the bunch?

 

Yes Gram. RU is a very potent anti-androgen though, it is not be underestimated . The evidence that is out there points to it being more or just as effective than finasteride, but it isn't conclusive evidence.

 

Anecdotal experience does often show that it is very effective. Enough people who actually dropped finasteride and get on RU and get better results with less side effects for instance.

Kinda shame that RU never got through, let's hope that CB-03-01 will turn out to be very effective and will pull through.

[Uk86]

Kinda shame that RU never got through, let's hope that CB-03-01 will turn out to be

 

 

 

Why did RU not get through ? Does that mean it will never be FDA approved and available to buy legit?

[Spanker]

Kinda shame that RU never got through, let's hope that CB-03-01 will turn out to be

 

 

 

Why did RU not get through ? Does that mean it will never be FDA approved and available to buy legit?

I think the bottom line was the big pharm didnt see any money to be made with the current delivery method. Short half life and and I think you have to mix it every few weeks? Not sure. I am looking for the next cure too.