Increase Finasteride Dose or Switch to Dutasteride?

[jim1973]

I'm finding that 7-8 years of maintaining hair on oral Finasteride (1mg/day), its no longer working.  Is it more recommended to increase the dose of Finasteride or simply switch to Dutasteride?  I actually did add .5mg of oral Dutasteride once/week to my regimen with daily Fin 6 months ago but I'm still quickly losing ground. Seems my next option is to either increase my daily oral Finasteride dosage and eliminate Dutasteride or to eliminate Finasteride and start taking .5mg of oral Dutasteride every other day or even every day.  I'm also open to switching from oral meds to topical but most feedback states that oral meds always work better.  What is recommended for my situation?  

[RecycleBin]

If you can tolerate dutasteride which seems like the case then take the 0.5mg daily. Both drugs are 5-AR inhibitors finasteride targets type 2 only while dutasteride blocks both 1 and 2 so I don't see the point of taking fin a well. Dutasteride is known to block more than 90% of DHT so if you're still losing ground taking it I'd look into other causes and consult with a dermatologist. 

[duckling]

5 hours ago, jim1973 said:

I'm finding that 7-8 years of maintaining hair on oral Finasteride (1mg/day), its no longer working.  Is it more recommended to increase the dose of Finasteride or simply switch to Dutasteride?  I actually did add .5mg of oral Dutasteride once/week to my regimen with daily Fin 6 months ago but I'm still quickly losing ground. Seems my next option is to either increase my daily oral Finasteride dosage and eliminate Dutasteride or to eliminate Finasteride and start taking .5mg of oral Dutasteride every other day or even every day.  I'm also open to switching from oral meds to topical but most feedback states that oral meds always work better.  What is recommended for my situation?  

Even on finasteride + dutasteride if you are losing ground then its not your DHT causing it. You are already blocking so much. There has to be some other underlying cause. 

I am on fin + min + ketocanazole but still losing hair, so i did full body tests a little early this year and it showed vitamin d to be 8. ( so much deficiency!) and also obviously vitamin b12 came out to be 180. I am not sure this caused hair loss lately but atleast i will fix it and one more box i can tick and see what can be done next in 3-4 months.

[Mike10]

For  some, the genes  will over power the drugs especially those with aggressive hair loss

Edited April 9, 2023 by Mike10

[duckling]

1 hour ago, Mike10 said:

For  some, the genes  will over power the drugs especially those with aggressive hair loss

That is true because the meds for majority of people will slow down the hairloss but not completely stop it. And also the regrowth which some people get ( apart from the thickening effect for majority) slows down after 1-2 years. So they might expect more improvement which they had initially got and the same hair to be maintained for years.

With slow hairfall people don't realize that they are losing hair until 6-7 years when they eventually see one thin area appearing. Its not that meds didn't work as it was the reason the time of that loss was drastically increased. Also the seasonal shedding is something which adds to the worry.

[Melvin- Admin]

Switch to dutasteride.

[NikosHair]

22 hours ago, jim1973 said:

I'm finding that 7-8 years of maintaining hair on oral Finasteride (1mg/day), its no longer working.

You don't say how old you are, but a lot will change physiologically with age, especially into middle age and older.

There's a common misconception that the effect of DHT inhibitors stop working over time. The reality is hair follicles are organs and just like the rest of the organs in our body they deteriorate over time (I know ageing sucks!).

Rather than focus on trying to find a new cocktail of drugs (BTW, Topicals would be a waste of money), look at ways to improve your overall health & fitness. Lifestyle and stress levels are big contributors to the ageing process. As @Mike10 correctly identified, genes are a significant factor.

[jim1973]

@NikosHair I appreciate your feedback (along with others).  I recently turned 50 years old.  I've always been relatively healthy (daily exercise, zero sugar, never smoked or have done drugs, eat lean protein and vegetables mostly).  My only vice is alcohol, usually 2 drinks/night that can vary from beer, wine or vodka type.  I weigh 145lbs and have 11% body fat so overall healthy.  I agree with you that things can change with our bodies and hair but I was hoping that Fin and Min would keep the hairs strong for many more years to come.  I suppose I could cut out the alcohol but beyond that I don't think there is much more I can do related to lifestyle.  I am scheduled to get a hair transplant in September 2023 (I had maintained my hair for about 7 years without any noticiable loss until recently) but if I can't at least stop the shed and get back to maintaining what I have, I may need to cancel it due to the inevitable.  

[NikosHair]

22 hours ago, jim1973 said:

I've always been relatively healthy (daily exercise, zero sugar, never smoked or have done drugs, eat lean protein and vegetables mostly). 

Sounds like you are ahead of many 50+ guys. I'm a believer in focusing on the things you can control. Resistance/weight training is hugely beneficial for body image and overall health. Perhaps if you put up some photos pre and post-shed and others may offer advice if you should chase the hair aesthetics or just own it by accepting your fate.

Regarding the meds and your healthy lifestyle, I would consider adding Dutasteride twice a week to the finasteride. September is still a way off, so see if you can regain some ground before deciding.

[Melvin- Admin]

@jim1973

Watch my interview with Dr. Vaño, he suggested that those who lost efficacy with finasteride should switch completely to dutasteride, rather than adding it to their finasteride regimen.

 

[NikosHair]

22 hours ago, Melvin- Moderator said:

Watch my interview with Dr. Vaño, he suggested that those who lost efficacy with finasteride should switch completely to dutasteride, rather than adding it to their finasteride regimen.

Very good interview. Plenty of good questions and responses from the doctor. I'll give you a pass on the bit where you led the witness over the best delivery vehicle for topicals😉

The section (towards the end of the vid) where you mentioned the guy losing hair in the crown after 25 years on Fin. I think this does have some parallels to the OP. The doc referred to switching completely from fin to dut for non-responders. If there were a follow-up interview, I'd push him on what he defines as a non-responder. If someone has been responding for 8 or 25 years, what is the explanation they become a non-responder. Is this a clinical diagnosis? i.e. Fin no longer reduces DHT to the level it had done previously?

 @jim1973 keep us posted on what you decide and how it works out for you/

Until we have the data that people can become 'non-responders' having been responders, then I'm sticking to the ageing/lifestyle theory. Drawing a comparison with another organ, the skin. People slap on their favourite moisturizer and lather up on tretinoin in the hope of holding back the hands of time. Perhaps they look better for their age as a result. Ageing always wins. It's not that the beauty products have stopped working or they have become non-responders to tret.

 

Derek @ MPMD discusses the subject at 9:28 

 

 

[Mike10]

Dutasteride really leads more often to sides. that is why some Drs do not even wangt to prescribe it.

[FinallyHT]

When I went from 1mg to 2mg of fin, I saw gains.   Not sure why I stopped, but I no longer do 2mg a day. More fin does make a difference in my opinion.