Dealing w/Finasteride Sides

[SLA]

Hi Everyone,

I will be 48 next month and am a NW5/6. I have been on finasteride for 17 months and am looking for some guidance and experience of those dealing with finasteride sides.

Currently on oral finasteride 1.25mg/daily, 2.5mg oral minoxidil/daily, laser helmet every other day- 20 min.

Over the past week, I noticed swelling and slight tenderness of the breast area which was more than normal. I have had a little of this prior, but nothing significant. I have been a little more active recently which has me concerned that elevated testosterone levels might be converting to estrogen. Don’t want it to develop into full gynecomastia.

I do not want to give up finasteride as I am pretty sure it is keeping my hair loss from progressing.

I have been reading and watching videos from various HT docs speaking about mitigating the side effects of finasteride and advice ranges. In one video, a HT doc (formerly recommended on this forum) advocated every 3 months stopping finasteride for 15 days to rid the excess from building up in the system. Dr. Vikram from Australia said on a video that even stopping finasteride for close to 1 month would likely have little to no impact. Then another well respected HT doctor said (read on reddit) that after 7 days of not using finasteride, someone would lose ground they would likely not be able to recover.

My current thinking is to stop for 7-15 days to flush possible excess from system and then returning to my current regimen. If that doesn’t work, I would then try to lower dose of maybe 1.25/mg 4 days per week which averages to .71mg/daily- literature shows the difference between .5mg and 1mg daily of finasteride not being too different in lowering scalp DHT.

If that doesn’t work well, perhaps trying topical finasteride, which although is not FDA approved for hair loss seems according to research and anecdotes (Dr. Wong included) to perform as well as oral with little going systemic. Any idea of best way to obtain in the US? I see HIMS.com offers a finasteride/minox spray? I have heard that Dr. Mwamba’s FUE clinic offers topical as well.

Thank you!

 

[Gatsby]

I am not a doctor. However my ‘opinion’ is to cease Finasteride until your side effects resolve. I would then commence on .5mg’s Monday, Wednesday and Friday. Overtime you could increase the dose on one day. In time you could increase the other day and again stay on this for some time. Then you could increase the dose on the third day and remain on this. But I would firstly get the advice from your doctor or dermatologist before thinking about attempting my suggestion. Wishing you all the best. 

[Melvin- Admin]

In my opinion, I would drop the oral finasteride entirely, and substitute it for the topical version. There's also topical dutasteride which you apply 1x per week.  Dr. Mwamba's clinic seems to have the most options. I believe they will be coming out with their version of Breezula. 

[SLA]

13 hours ago, Melvin- Moderator said:

In my opinion, I would drop the oral finasteride entirely, and substitute it for the topical version. There's also topical dutasteride which you apply 1x per week.  Dr. Mwamba's clinic seems to have the most options. I believe they will be coming out with their version of Breezula.

Thanks @Melvin- Moderator- Much appreciated and you are always helpful! I saved a post in my email which you wrote a while back about topical options including HappyHead, and Dr. Carlos Wesley as US options. I will explore Dr. Mwamba's options too.

 

[SLA]

Thanks again @Gatsbyand @Melvin- Moderator.

 

Would love to hear if anyone had actual experience or knows of anyone who made the successful transition from oral to topical finasteride.

[Raymond92]

15 hours ago, Melvin- Moderator said:

In my opinion, I would drop the oral finasteride entirely, and substitute it for the topical version. There's also topical dutasteride which you apply 1x per week.  Dr. Mwamba's clinic seems to have the most options. I believe they will be coming out with their version of Breezula. 

can you tell me a webshop where I can order topinal fin or dut? that you can trust 

[gillenator]

I agree with the great Gatsby…try cutting back every other day with .50mg and see if that resolves the sides with your breasts…however, if you eventually do decide to stop taking finasteride altogether, I suggest that you wean off the drug rather than stopping abruptly because stopping abruptly can potentially induce a significant shed cycle.

[SLA]

1 hour ago, gillenator said:

I agree with the great Gatsby…try cutting back every other day with .50mg and see if that resolves the sides with your breasts…however, if you eventually do decide to stop taking finasteride altogether, I suggest that you wean off the drug rather than stopping abruptly because stopping abruptly can potentially induce a significant shed cycle

Thank you @gillenator- The sides are very minor. I have been off for one day (after 17 months of use) and already I feel sides subsiding- maybe the placebo-who knows.

I have heard being off finasteride for a couple of weeks as a reset should likely not affect much. Might try that then going for a slightly lower does such as 1.25/mg 3-4 times per week.

Much appreciated

[gillenator]

I take approximately 1.25 every other day for years and still experience great efficiency, especially in my crown

[SLA]

Thanks @gillenator!

Here is a nice post I found with a graph that has research on finasteride's effect on serum and scalp DHT at different doses. Looks as if the .2mg daily dose is only a small percentage less effective than the 1mg daily dose. This was actually also shown in the Merck original study, but it is hypothesized that the 1mg was recommended in that it was already approved at 5mg for enlarged prostate.

 

 

[gillenator]

That’s awesome SLA, good clinical data…and yes 5mg Proscar was prescribed for treating the swelling of the prostrate, which was good for those who had prostrate cancer…it was subsequently discovered that the drug helped curb hair loss and even grew some new hair on some of those individuals.

[Al - Moderator]

When I was taking 1.25mg of finisteride, I would stop for about 3 days every few months. I just felt better doing that.

[SLA]

Thanks @BeHappy- I have seen in multiple places that sometimes too much finasteride can accumulate in the system resulting in sides. While finasteride has a short half life and leaves the bloodstream within a day or so, it remains in the tissue for a while. Also read the half life of the enzyme is 30 days, so it will still be suppressing DHT for up to 90 days (although less DHT).

That being said, I have heard doctors say that if you stop for a month, you should not lose any ground.

Much appreciated.