Covid Shed?

[Kieran2020]

Hi all,

 

I’ve been losing my hair for about 5 years but have maintained well on 1mg finasteride daily for the majority of those years. However I had Covid around 4 months ago and have noticed my crown density has decreased quite a lot. I’m not entirely sure if it’s Covid or whether my body has adjusted to finasteride over the past years? 
 

I seem to have long Covid as I have a fast heart rate and my smell and taste is still pretty much not there. 
 

Is there anyone in a similar position/knowledgable about this that could shed some advice?

[Melvin- Admin]

1 hour ago, Kieran2020 said:

Hi all,

 

I’ve been losing my hair for about 5 years but have maintained well on 1mg finasteride daily for the majority of those years. However I had Covid around 4 months ago and have noticed my crown density has decreased quite a lot. I’m not entirely sure if it’s Covid or whether my body has adjusted to finasteride over the past years? 
 

I seem to have long Covid as I have a fast heart rate and my smell and taste is still pretty much not there. 
 

Is there anyone in a similar position/knowledgable about this that could shed some advice?

I had Covid around the same time (October), my sense of smell is probably at 75% still not fully recovered. But I didn't notice any hair shedding or hair loss. I don't think we can say for sure Covid affects hair in any meaningful way. You may have been stressed out, which is totally understandable after contracting Covid, that may have increased shedding. 

[ciaus]

Along with stress or some other undiagnosed medical issue, are you getting the finasteride from the same place you always have, and from a trusted source? And are they 1mg pills or are you cutting 5mg pills?

A 90 day bottle of 1mg pills or even less 5mg pills from a bad batch could have the same effect as you stopping the medication if it was damaged during manufacture or at some point in the supply chain before it got to you. Beyond that make sure if your bottle does have an expiration date its valid and you are storing it correctly (like not in a hot room, no direct exposure to moisture, cap securely fastened etc).

If none of the above is the issue, it could just be that the extra time the finasteride has been buying some of your vulnerable hairs is coming to pass. Unfortunately finasteride doesn't work perfectly, it lowers your DHT by up to about 70% so there's still some flowing around to do damage. Depending on how genetically sensitive different hairs on your head are, that can give them a few extra years or hopefully decades of extra time. If this is the case don't lose hope like some guys and stop taking it altogether, because it is still providing some protection for your other remaining hairs, preventing them from being bombarded with your full normal DHT levels. You never really 'maintain' in the perfect sense, its about putting brakes on hairloss as much as possible. 

[Shifty]

Plenty of news articles about this out there. I have spoken to a few people who have a myriad of post covid symptoms. 

 

https://www.fox43.com/article/news/health/coronavirus/covid19-causing-hair-loss-wigs-in-short-supply-tips-from-doctor/521-600db91c-280a-431d-b380-e91b8b602af9

[ciaus]

Interesting read, pasting the important parts here:

 

It's a condition called telogen effluvium where essentially what happens is a major illness stressor or event just shocks the body to the point where the hair follicles are off cycle, " she said.

Put simply, it's when more hairs than normal enter the shedding phase of the growth cycle at the same time.  Most people start to see their hair fall out in clumps 2 to 3 months after being very sick, especially if they had a fever.  "We are seeing a record number of cases than we usually see during this time," Dr. Oyetakin said.

However, COVID-19 isn't the only root of the problem, add stress to the list.  

"I think we can all agree that stress levels are a little bit elevated in this pandemic and stress leads to TF," she said.

 

...

In some cases, it can take up to 9 months before the hair shedding stops, but most people we talked to said theirs stopped after a few months.

[gillenator]

I concur that it is probably stress related from Covid and was just curious if you were also using minoxidil on your crown before contracting Covid?

[Melvin- Admin]

1 hour ago, ciaus said:

Interesting read, pasting the important parts here:

 

It's a condition called telogen effluvium where essentially what happens is a major illness stressor or event just shocks the body to the point where the hair follicles are off cycle, " she said.

Put simply, it's when more hairs than normal enter the shedding phase of the growth cycle at the same time.  Most people start to see their hair fall out in clumps 2 to 3 months after being very sick, especially if they had a fever.  "We are seeing a record number of cases than we usually see during this time," Dr. Oyetakin said.

However, COVID-19 isn't the only root of the problem, add stress to the list.  

"I think we can all agree that stress levels are a little bit elevated in this pandemic and stress leads to TF," she said.

 

...

In some cases, it can take up to 9 months before the hair shedding stops, but most people we talked to said theirs stopped after a few months.

I could see how Telogen Effluvium could happen, but its' not permanent. 

[Harry Bosch]

6 hours ago, ciaus said:

Along with stress or some other undiagnosed medical issue, are you getting the finasteride from the same place you always have, and from a trusted source? And are they 1mg pills or are you cutting 5mg pills?

A 90 day bottle of 1mg pills or even less 5mg pills from a bad batch could have the same effect as you stopping the medication if it was damaged during manufacture or at some point in the supply chain before it got to you. Beyond that make sure if your bottle does have an expiration date its valid and you are storing it correctly (like not in a hot room, no direct exposure to moisture, cap securely fastened etc).

If none of the above is the issue, it could just be that the extra time the finasteride has been buying some of your vulnerable hairs is coming to pass. Unfortunately finasteride doesn't work perfectly, it lowers your DHT by up to about 70% so there's still some flowing around to do damage. Depending on how genetically sensitive different hairs on your head are, that can give them a few extra years or hopefully decades of extra time. If this is the case don't lose hope like some guys and stop taking it altogether, because it is still providing some protection for your other remaining hairs, preventing them from being bombarded with your full normal DHT levels. You never really 'maintain' in the perfect sense, its about putting brakes on hairloss as much as possible. 

Interesting stuff.

I’ve found myself on both sides of this quandary as 10-year Fin success story suddenly going backwards.

my generic comes from India. I also moved to Florida and quarter 5mg pills.  Those factors open the possibilities you mentioned. i want to believe my batch of pills degraded in some way.

...or, like you explained, the unencumbered DHT could finally be inflicting long overdue damage.

adding dut 1xweek hasn’t seemed to help, so reconsidering my Fin source might be logical.  any suggested brand ?

 

 

[ciaus]

1 hour ago, Harry Bosch said:

reconsidering my Fin source might be logical.  any suggested brand ?

I cut generic 5mg finasteride that I get from my local pharmacy in the US, not sure who they source from and what substitute suppliers they may employ from time to time if necessary. That would definitely be something I would start doing homework on if I noticed a sudden dramatic shed though. Companies like Keeps.com, who have a business model that is basically just selling monthly home delivery subscriptions of generic finasteride and minoxidil would probably be a better place to purchase than the pharmacies, because they have more to lose in terms of complaints and profit loss, and so probably keep a closer eye on who they source from.

But for the highest manufacturing standards the gold standard is still Merck, but your going to pay for it if you go with their 1mg Propecia. The 5mg Proscar is actually a bit cheaper than the 1mg generic finasteride after you factor in cutting them into quarters. I priced it out one time and it came to about $20 a month, but you pay more up front to get that 90 day supply, think I remember it being about $220, maybe more or less now.

There's an interesting read in the first link that goes over alot of factors that go into making quality medications that alot of us don't think about. Below that are links to those online companies that specialize in dispensing the generics and will probably keep a better eye on their manufacturers because of their business model specialization. You won't get 5mg finasteride from them though, just the 1mg and the cheapest among them is about $20 for a month's supply.

https://www.wolfhair.com/wp-content/uploads/2016/02/Brand-Name-vs-Generic-Finasteride-Jan-Feb-2016.pdf

 

https://www.keeps.com/our-offering

https://www.forhims.com/hair-loss

https://www.getroman.com/hair-loss/

 

 

[champybaby]

I was dealing with a lot of stress/ emotional trauma — whatever you want to call it — and my sides started thinning. Hair in vertex and crown also went through an accelerated loss after being stable for 7 years on fin. The sides came back in full force; the top did not come back. The points ciaus makes here all resonate with me. fwiw.

edit: worth noting the negative changes began happening after about 3 months of what triggered the stress.

Edited February 17, 2021 by champybaby

[Harry Bosch]

20 hours ago, ciaus said:

I cut generic 5mg finasteride that I get from my local pharmacy in the US, not sure who they source from and what substitute suppliers they may employ from time to time if necessary. That would definitely be something I would start doing homework on if I noticed a sudden dramatic shed though. Companies like Keeps.com, who have a business model that is basically just selling monthly home delivery subscriptions of generic finasteride and minoxidil would probably be a better place to purchase than the pharmacies, because they have more to lose in terms of complaints and profit loss, and so probably keep a closer eye on who they source from.

But for the highest manufacturing standards the gold standard is still Merck, but your going to pay for it if you go with their 1mg Propecia. The 5mg Proscar is actually a bit cheaper than the 1mg generic finasteride after you factor in cutting them into quarters. I priced it out one time and it came to about $20 a month, but you pay more up front to get that 90 day supply, think I remember it being about $220, maybe more or less now.

There's an interesting read in the first link that goes over alot of factors that go into making quality medications that alot of us don't think about. Below that are links to those online companies that specialize in dispensing the generics and will probably keep a better eye on their manufacturers because of their business model specialization. You won't get 5mg finasteride from them though, just the 1mg and the cheapest among them is about $20 for a month's supply.

https://www.wolfhair.com/wp-content/uploads/2016/02/Brand-Name-vs-Generic-Finasteride-Jan-Feb-2016.pdf

 

https://www.keeps.com/our-offering

https://www.forhims.com/hair-loss

https://www.getroman.com/hair-loss/

 

 

Interesting info, thanks for compiling those resources.

Another advantage to brand Propecia: the pills are individually wrapped. Not only does this help with compliance, but it protects the pills from any possible adverse conditions, humidity, etc. This is pretty important if you’re storing upwards of 90 pills for 3 months.

Also, quartering any pill does expose the remaining three pieces to moisture and eventual degradation. This is something I overlooked in the past: if you quarter a pill, be sure to consume all four pieces in four consecutive days. 

I’ll look into sourcing brand-name Propecia. Most US insurances only cover generic, unfortunately. 

[ciaus]

16 hours ago, Harry Bosch said:

Another advantage to brand Propecia: the pills are individually wrapped. Not only does this help with compliance, but it protects the pills from any possible adverse conditions, humidity, etc. This is pretty important if you’re storing upwards of 90 pills for 3 months.

Also, quartering any pill does expose the remaining three pieces to moisture and eventual degradation. This is something I overlooked in the past: if you quarter a pill, be sure to consume all four pieces in four consecutive days. 

I’ll look into sourcing brand-name Propecia. Most US insurances only cover generic, unfortunately. 

 

This may seem to some like we've hijacked the thread a bit, but I believe making sure that the finasteride has been manufactured/transported/stored correctly is also crucial when unusual shedding like this occurs. After medical causes have been ruled out, or even while they are being ruled out, switching brands to another generic or even to the Propecia brand for 6-12 months can help to verify its not a finasteride sourcing issue too. 

Merck's patent on finasteride was still active back when I started, wasn't aware of pill cutting so I did use the Propecia brand for a few years. They were 90 pill bottles and while the bottle had a seal you needed to break, the pills weren't individually wrapped. The only individually wrapped Propecia pills I've seen are the sample packs my HT doctor would give out and that was back in the day. Each pill was in a little bubble mounted on a card and you pushed the bubble to pop the pill out. Have you seen 30/60/90 supplies that have individually wrapped pills?

On the degradation that the pill pieces can undergo, I always cut one pill at a time for that reason. And since each quarter is 1.25mg, that extra 25% of the recommended dose means even with a little degradation you are still getting a full dose. This is a pic of the pill cutter I use, it has a little cover so you can store the pieces until you finish them too. 

 

 

You should be fine quartering 5mg generic finasteride from US pharmacies, one pill at a time. I'm going to continue doing that unless I get a weird shed like the OP. While the pill is eliminated from your body within a day or so, its effect on your DHT is much longer, see the chart below, it takes your DHT levels over a week to fully recover. And again, with that quartering you have the extra .25mg padding to help offset any air exposure degradation, which is probably not that much if you are cutting one pill at a time.

 

 

Edited February 18, 2021 by ciaus
added description to the pic of the cutter

[Shifty]

Just curios, I have been taking 1mg Fin (ForHims). You are talking in 5gm and halves of. I have had good results with my complete regimen but is this something I should consider upping? 

[ciaus]

39 minutes ago, Shifty said:

Just curios, I have been taking 1mg Fin (ForHims). You are talking in 5gm and halves of. I have had good results with my complete regimen but is this something I should consider upping? 

 

No, that's just a stock picture of the cutter with some big generic pill. I just added an annotation to the picture to clarify that.

[Shifty]

8 minutes ago, ciaus said:

 

No, that's just a stock picture of the cutter with some big generic pill. I just added an annotation to the picture to clarify that.

I wasn't talking about the picture. I should have specified, I was talking  In general. I see users of Fin talk about 5mg and halves of. So I am curious if I should up at any point. Or don't bother right now because it holding. or, will more have a better result.

[ciaus]

17 minutes ago, Shifty said:

I wasn't talking about the picture. I should have specified, I was talking  In general. I see users of Fin talk about 5mg and halves of. So I am curious if I should up at any point. Or don't bother right now because it holding. or, will more have a better result.

Ok, so for the 5mg pills the standard practice is to cut them into quarters, so that you have four 1.25mg pieces, and then you take a piece a day. Thats what I do. I wouldn't go higher dosage than that to keep side effect chances low. So a 90 pill supply will last you about a year. I do that instead of the 1mg generics and it ends up saving alot of $$

Look at these price comparisons for the 90 5mg pills at pharmacies around me with goodrx, even the more expensive places are still alot cheaper. And you can print out as many of those free coupons as you want down the road, or get one of their free discount cards.

Edited February 18, 2021 by ciaus

[Harry Bosch]

Awesome stuff, thanks @ciaus

[Kieran2020]

Wow I got a lot more information on fin than I thought I would for this thread haha. Much appreciated everyone for your input. 
 

I’m using Dr Fox (an online pharmacy for the UK) for my Propecia 1mg. It is important to note that I had to switch to generic fin during the first lockdown as they ran out of stock however that was back in March/April last year so maybe it didn’t make too much of a difference. Unfortunately I don’t think UK pharmacies prescribe 5mg otherwise I would probably do the same thing you are doing @ciaus as you have clearly done your research. 
 

I’m hoping to look into oral minoxidil (2.5mg) in the near future however I will have to find a doctor familiar with this prescription who thinks it is safe to do so. 

[WhiteyUK]

Hi I also use Dr Fox for ordering finasteride 1mg tablets , I’ve been using for 3.5 months... what is the difference between generic fin (which I’ve got) and propecia ?

thanks in advance 

[Kieran2020]

18 minutes ago, Newyear newhair said:

Hi I also use Dr Fox for ordering finasteride 1mg tablets , I’ve been using for 3.5 months... what is the difference between generic fin (which I’ve got) and propecia ?

thanks in advance 

I did some research when I had to switch earlier this year for a couple of months, from what I found in people’s experiences was that there isn’t much of a difference at all (please correct me if I’m wrong someone who is more knowledgeable). 
 

The reason I use Propecia is because it’s a well known brand, and assuming it’s made in the correct way and conditions. Maybe I’m being too paranoid? Better to be safe than sorry anyhow.

[WhiteyUK]

Quite a difference in price tho

[ciaus]

5 minutes ago, Newyear newhair said:

Hi I also use Dr Fox for ordering finasteride 1mg tablets , I’ve been using for 3.5 months... what is the difference between generic fin (which I’ve got) and propecia ?

thanks in advance 

First and foremost, cost. Merck did lower the prices a bit after their patent expired, but Propecia is still alot more expensive than the equivelant 1mg generic brands. The other major factor is the quality and specialization of their manufacturing facilities, standards, etc. Merck is one of the largest pharmaceutical companies in the world so they can afford the best. A lot of the facilities that are used to make generic versions of medications operate on lower profit margins, so they are going to be cutting corners where they can, using the same equipment to make different kinds of medicines, operating in jurisdictions with less regulatory oversight that can lead to more quality issues. I posted this link a few posts up, putting it here again because it goes into alot of details about those kinds of factors alot of us don't think about.

https://www.wolfhair.com/wp-content/uploads/2016/02/Brand-Name-vs-Generic-Finasteride-Jan-Feb-2016.pdf

 

[WhiteyUK]

Thanks ciaus... understood 👍🏻

[Kieran2020]

These are my direct comparisons being on Propecia 1mg for 5 years. The first couple of photos are me at 18 years old (albeit not the greatest crown photo as a lot of the hair from the back of my head was covering) to me nearly at 25 years old. 
 

I was convinced I’d fully lose my hair by the time I was 21, although I feel comparing I have lost some still, I’ve definitely slowed the process - which is what my aim was in the first place. 

[ciaus]

 

20 minutes ago, Kieran2020 said:

These are my direct comparisons being on Propecia 1mg for 5 years. The first couple of photos are me at 18 years old (albeit not the greatest crown photo as a lot of the hair from the back of my head was covering) to me nearly at 25 years old. 

Those are some nice results, resizing and comparing side by side, especially for the front. Stick with it. There's a link below with a little more about telegon effluvium, like if this is just a shock from covid, and how it progresses and is usually temporary. Stay positive!

 

 

 

https://donovanmedical.com/hair-blog/te-resolution

 

Edited February 18, 2021 by ciaus