Need advice on Finasteride and next steps

[BlueSky99]

I’m 34yo male, middle eastern origin and have been suffering from hair loss since I hit puberty. It has become more noticeable since last year, specially my crown, which is what bothers me the most. Some of the specialists have quoted me for about 1500-2300 grafts to add some volume and apparently I’ve diffused thinning with no particular bad area. If I do it in US then I’ll go with Dr Nadimi or Dr Shapiro. Dr Konior is out of my budget. Another top choice is Dr Munib from Fuegenix but again, more expensive than Dr Konior and added travel expenses. Another choice right now is Dr Pekiner, I’ll save a lot and his work seems really good but again traveling to Turkey and specially traveling back with a bruised head is something to consider. Only looking at places that do not use technicians and do most of the work themselves. What I’d like is add some volume to the existing hairline and mid scalp and cover the crown  

I’ve seen people getting amazing results using finasteride. I’ve been using minoxidil 5% regularly for the last 2 years, once a day before bed. And I finally have prescription for fin but recently read about serious shedding with fin. I don’t want it to get bad, I feel like my hair right now with proper length is manageable. I was hoping I’d give fin a try for about 8-10 months and then decide if I need to get transplant. If I just recover some in my crown I’ll be happy. On the other hand if there’s no progress with fin and if it gets bad then I’ll be in a bad spot 1 year down the road with another year of wait for the procedure. 
 

Won’t be wasting money on PRP, just seems like a money grab to me. Better to use that money towards the transplant. 
 

Really hoping to get some advice on fin. And obviously I’ll keep using minoxidil and have also started using dermapen at 1.5mm. Will it be good to get started on fin 1mg a day right now? Also getting tested for low T and was hoping that might be an issue and exacerbate fin side effects. Right now I think I lose around 20-50 hair every day. I see only a few during shampooing and mostly when I rub in minoxidil at the end of the day. 
 

Attaching some pictures with a short haircut under direct harsh light, dried up, also after a session of dermapen, scalp is little bit red. Also attaching a couple with longer hair and completely wet. Any advice will be highly appreciated. 

[mr_peanutbutter]

you are on your road to norwood 5 without finasteride

[BlueSky99]

37 minutes ago, mr_peanutbutter said:

you are on your road to norwood 5 without finasteride

What’s the general consensus on use of topical finasteride vs taking in orally when it comes to efficacy and side effects? I was just reading about gynecomastia as a possible side effect. It all sounds scary, try to stop hair loss and end up with stuff like that. 

[Gatsby]

Male Pattern Baldness is progressive. It may plateau for a while but it is genetic and it continues. Surgery really is a last resort and medication is your front line of attack. I'm not a doctor but the incidence of side effects is very low but yes very real. But unless you take it you will not know if you can save your hair. So many people have said on this forum that they wish that they took finasteride at the beginning of their hair loss and not when it got to Norwood 3/4/5, etc. All the best.

[mr_peanutbutter]

3 hours ago, BlueSky99 said:

What’s the general consensus on use of topical finasteride vs taking in orally when it comes to efficacy and side effects? I was just reading about gynecomastia as a possible side effect. It all sounds scary, try to stop hair loss and end up with stuff like that. 

sideeffects definitely exist but they subside in 99% of cases after 2-6 weeks pf discontinuing the drug

 

gyno is indeed the only thing that will stay so in worst case you need surgery for that. so observr yoir nipples and stop taking it when you feel sth developing there

 

you could try 0.025.% topical finasteride solution, thats the lowest finasteride solution that works. it only lowers serum dht by 30%. this being said, i get the „same“ sideeffect with topical finasteride as with oral which is in my case really watery sperm

 

i wouldnt worry about the shed too much bc if you dont take fin i think you will lose your hair 100% (norwood 5). 

 

 

[Renegade]

Yes I wish I started sooner with finasteride as well. Start off with low dose of finasteride 0,25 mg and see how you feel. Go from there. 

If you feel bad or sides, try different brands of finasteride. 

For me personally, finasteride made from my local apothecary is not only much cheaper but works much better for me mentally and efficacy than the official propecia brand. 

With fin everybody gets a different response. General consensus is in the beginning it will raise your T levels because there's more leftover since the conversion to DHT is blocked. In longterm most say T levels drop again. 

For me atleast I feel like since using fin ironically my body looks more manly, I'm constantly shredded don't put on any fat.Also I'm much more emotionally stable. Maybe it is cause my hormonal profile actually got stabilized by fin, in a good way.

Therefore it would make sense to get a hormone level check before starting out with fin. Especially when you fear sides, otherwise you'll never know what you natural baseline was.

[Bucky O Hair]

10 hours ago, BlueSky99 said:

What’s the general consensus on use of topical finasteride vs taking in orally when it comes to efficacy and side effects? I was just reading about gynecomastia as a possible side effect. It all sounds scary, try to stop hair loss and end up with stuff like that. 

You are doing the right thing by getting tested for low Testosterone.

If I were you, I would ask your doctor to give you a full hormonal (endocrine) test to see what your levels are for all of your hormones (Testosterone, DHT, TSH, Estrogen, etc.) so you have a good understanding of what your baseline levels are currently at.

Most people just choose to take the drug, then gauge how they feel by using 'side effects' as their litmus test to see how they're doing.  To me, this is a little bit reckless as it is better to do a baseline test of your hormones, then do a future test to see how it has actually affected your hormone levels.  You may not experience side effects, but you may have thrown your levels off without even knowing it.  You may end up with elevated estrogen levels (resulting in gyno) that you may not notice until it's too late.  So I would do a before and after test to be certain.

Also, there are a lot of people on here who use finasteride topically (or do micro doses of fin instead of taking a full 1mg pill every day).  They could probably provide you with any insight as to whether or not it has been beneficial for them.

[BlueSky99]

10 hours ago, mr_peanutbutter said:

sideeffects definitely exist but they subside in 99% of cases after 2-6 weeks pf discontinuing the drug

 

gyno is indeed the only thing that will stay so in worst case you need surgery for that. so observr yoir nipples and stop taking it when you feel sth developing there

 

you could try 0.025.% topical finasteride solution, thats the lowest finasteride solution that works. it only lowers serum dht by 30%. this being said, i get the „same“ sideeffect with topical finasteride as with oral which is in my case really watery sperm

 

i wouldnt worry about the shed too much bc if you dont take fin i think you will lose your hair 100% (norwood 5). 

 

 

 

7 hours ago, Renegade said:

Yes I wish I started sooner with finasteride as well. Start off with low dose of finasteride 0,25 mg and see how you feel. Go from there. 

If you feel bad or sides, try different brands of finasteride. 

For me personally, finasteride made from my local apothecary is not only much cheaper but works much better for me mentally and efficacy than the official propecia brand. 

With fin everybody gets a different response. General consensus is in the beginning it will raise your T levels because there's more leftover since the conversion to DHT is blocked. In longterm most say T levels drop again. 

For me atleast I feel like since using fin ironically my body looks more manly, I'm constantly shredded don't put on any fat.Also I'm much more emotionally stable. Maybe it is cause my hormonal profile actually got stabilized by fin, in a good way.

Therefore it would make sense to get a hormone level check before starting out with fin. Especially when you fear sides, otherwise you'll never know what you natural baseline was.

Thank you! I totally forgot about Gyno. That is definitely the worst and most scary/costly side effect. 

Will I be able to catch it early? Does it start with sore nipples? As I hit puberty I could feel my nipples getting sore and something developing underneath, like a lump, tender to touch, thankfully it went away, lol. 

At the moment I’m strongly considering 0.025% fin topically. I see Bosley sells a 3% solution with minoxidil 6%, does that mean 0.3mg or 3mg per ml? 
 

Another thing is that my dad still has a full head of hair but with diffused thinning all over, does not look bad at all. I was hoping I’d end up like that. My mother’s side unfortunately suffers for hair loss, almost everybody. 
 

I already have a bottle of generic fin, might try to make 0.025% solution myself. 

[BlueSky99]

3 hours ago, Bucky O Hair said:

You are doing the right thing by getting tested for low Testosterone.

If I were you, I would ask your doctor to give you a full hormonal (endocrine) test to see what your levels are for all of your hormones (Testosterone, DHT, TSH, Estrogen, etc.) so you have a good understanding of what your baseline levels are currently at.

Most people just choose to take the drug, then gauge how they feel by using 'side effects' as their litmus test to see how they're doing.  To me, this is a little bit reckless as it is better to do a baseline test of your hormones, then do a future test to see how it has actually affected your hormone levels.  You may not experience side effects, but you may have thrown your levels off without even knowing it.  You may end up with elevated estrogen levels (resulting in gyno) that you may not notice until it's too late.  So I would do a before and after test to be certain.

Also, there are a lot of people on here who use finasteride topically (or do micro doses of fin instead of taking a full 1mg pill every day).  They could probably provide you with any insight as to whether or not it has been beneficial for them.

Thanks! Along with testosterone I’m also scheduling to get DHT and Estrogen tested before I start fin. Cost me about $150 for DHT + Estrogen and bought the Testosterone kit online for in-home testing. 
 

Reading about all these side effects, mostly gyno and infertility with risk of affecting the developing fetus is really scary. 
 

I used fin in the past intermittently but I can’t remember for how long, probably couple of months once or twice and I don’t recall any major side effects, probably decrease in libido. 

[Sunset Dune]

Gyno from puberty is natural and very common and it goes away 100% on its own. Gyno from Finasteride use is permanent you will need surgery which is very expensive. 
It’s a risk you will need to decide if it’s worth it Or go with topical which has far less sides. 

Edited May 2, 2023 by Sunset Dune

[mr_peanutbutter]

1 hour ago, Sunset Dune said:

Gyno from puberty is natural and very common and it goes away 100% on its own. Gyno from Finasteride use is permanent you will need surgery which is very expensive. 
It’s a risk you will need to decide if it’s worth it Or go with topical which has far less sides. 

gyno from puberty often doesnt go away by its own

majority of men who develop gyno and need surgery never touched finasteride

and the surgery is less expensive then a norwood 5 hairtransplant (not that i recommended to get gyno on purpose but if you argue with price then ht is really the last thing yoi should do when there ls medical prevention for hairloss)

[BlueSky99]

3 minutes ago, mr_peanutbutter said:

gyno from puberty often doesnt go away by its own

majority of men who develop gyno and need surgery never touched finasteride

and the surgery is less expensive then a norwood 5 hairtransplant (not that i recommended to get gyno on purpose but if you argue with price then ht is really the last thing yoi should do when there ls medical prevention for hairloss)

The lumps that I developed when I hit puberty went away on its own. Are you saying men are predisposed to developing gyno from finasteride if they developed it during puberty and should avoid it?

[mr_peanutbutter]

8 minutes ago, BlueSky99 said:

The lumps that I developed when I hit puberty went away on its own. Are you saying men are predisposed to developing gyno from finasteride if they developed it during puberty and should avoid it?

im just sayin that gyno doesnt always go  away like it was luckily the case for you

[BlueSky99]

6 minutes ago, mr_peanutbutter said:

im just sayin that gyno doesnt always go  away like it was luckily the case for you

I see different reports everywhere:

• Gynecomastia is common during adolescence due to the hormonal changes that come with puberty.
• About half of males between 12 and 16 experience gynecomastia in one or both breasts.
• For most people with pubertal gynecomastia, the breast mound will flatten within approximately two years of onset, and medical treatment or surgery is not needed.

[BlueSky99]

I am thinking of crushing 15 1mg generic fin tablets into fine powder and adding it to 60ml of 5% minoxidil (lot of stirring of course). Should give me .25mg (0.025%) fin per ml of application. Can someone check my maths on this? 🙂
 

I already have the fin prescription and it’s cheap and easy for me to get it from a local pharmacy so trying to make good use of it. 

Edited May 2, 2023 by BlueSky99

[BlueSky99]

Started with.025%(.25mg/ml) topical solution of finasteride, mixed with minoxidil 5% 🤞 Crushed and mixed 15x1mg finasteride tablets I got from local pharmacy with 60ml of 5% minoxidil. Will be applying 1-1.25ml once a day. The tablets didn't seem to have any coating and were plain white so hopefully less fillers. 

[Dillpickle123]

I can attest that gyno doesn’t go away I have it 10 years later and it’s 10k in Cali to get rid of it so probably will just live with it for awhile until I can afford to do it 

[BlueSky99]

16 hours ago, Dillpickle123 said:

I can attest that gyno doesn’t go away I have it 10 years later and it’s 10k in Cali to get rid of it so probably will just live with it for awhile until I can afford to do it 

Did you get if at the time of puberty or later as a side effect or using finasteride?

[BlueSky99]

So I got the test results, 

DHT: 42 ng/dl. Seems on the higher side but not too crazy?

Total testosterone: 562 ng/dl. This seems to be normal. 

Total estrogen: 96 pg/ml. Should have gotten tested for estradiol instead but this number doesn't seem too bad, ideally would've liked it to be lower. 

Not sure how I can monitor DHT levels as the topical finasteride seems to work mostly on scalp DHT levels. 

[Dillpickle123]

23 hours ago, BlueSky99 said:

Did you get if at the time of puberty or later as a side effect or using finasteride?

No as a teen and I haven’t seen it get worse on fin