Kevin does not like oral minoxidil

[Heisenberg]

"Nevertheless, the package inserts of commercial oral minoxidil (Loniten) for the treatment of arterial hypertension report pericardial effusion to be a common adverse effect with a frequency of 3% to 5%.":

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9678755/

[Melvin- Admin]

16 hours ago, Heisenberg said:

I consulted him myself recently, and he is arranging a prescription of oral minoxidil. He wouldn't have a clue if I take it or not.

The figures that I have mentioned relate to the information provided by the pharmaceutical company that manufactures the drug (it's put inside the box of pills), which was no doubt based on clinical trials etc. It is, for all intents and purposes, a warning. You can read the leaflet yourself here:

https://www.medicines.org.uk/emc/files/pil.4295.pdf

No one is saying that side effects don’t exist, of course they do, and anyone who says otherwise is lying. PFS is listed on finasteride as a warning. But that doesn’t mean that majority of people shouldn’t try it. Every medication has a risk. If you want zero risk, shave your head and forget about hair loss, that’s the only thing risk-free. Surgery is risky, medication is risky, shaving has no risk.

[Turkhair]

Heart is the number one killer

Damage to heart is cumulative, you won’t feel it in youth but as age advance, the things you did in youth, you will pay the price. So minoxidil is not for me, heart issues are terrible. You have to see a person with that to get an idea. All of us will get heart issues as we age unless very lucky. 

Heart is also a silent killer. You won’t get a warning. You won’t get pain. You feel fine but maybe you’re damaged.

Poor thing beats for life without getting rest. Not really a good idea to risk it. My clinic suggested me to use oral min too and I said no way. You’re crazy. 

[hairman22]

54 minutes ago, Turkhair said:

Heart is the number one killer

Damage to heart is cumulative, you won’t feel it in youth but as age advance, the things you did in youth, you will pay the price. So minoxidil is not for me, heart issues are terrible. You have to see a person with that to get an idea. All of us will get heart issues as we age unless very lucky. 

Heart is also a silent killer. You won’t get a warning. You won’t get pain. You feel fine but maybe you’re damaged.

Poor thing beats for life without getting rest. Not really a good idea to risk it. My clinic suggested me to use oral min too and I said no way. You’re crazy. 

It is very true you need to be cautious.

It is likely a terrible diet & will result in far bigger issues for your heart than taking low dose OM.

But it is important that OM can be dangerous & advise caution i agree

 

Your take on OM is quite the difference from laughing at people who suffer from PFS or who have had side affects.

Your not really very objective are you? No issue for Fin for you so its funny seeing people suffer from side affects

Edited July 5, 2023 by hairman22

[GoliGoliGoli]

1 hour ago, Turkhair said:

Heart is the number one killer

Damage to heart is cumulative, you won’t feel it in youth but as age advance, the things you did in youth, you will pay the price. So minoxidil is not for me, heart issues are terrible. You have to see a person with that to get an idea. All of us will get heart issues as we age unless very lucky. 

Heart is also a silent killer. You won’t get a warning. You won’t get pain. You feel fine but maybe you’re damaged.

Poor thing beats for life without getting rest. Not really a good idea to risk it. My clinic suggested me to use oral min too and I said no way. You’re crazy. 

Why not just use topical? The amount that goes systemic is far smaller than even a very low dose of oral min. 

[Heisenberg]

3 hours ago, Melvin- Moderator said:

No one is saying that side effects don’t exist, of course they do, and anyone who says otherwise is lying. PFS is listed on finasteride as a warning. But that doesn’t mean that majority of people shouldn’t try it. Every medication has a risk. If you want zero risk, shave your head and forget about hair loss, that’s the only thing risk-free. Surgery is risky, medication is risky, shaving has no risk.

Well, I've been accused of fearmongering for simply stating the risks, which are overtly declared by Pfizer themselves. Medicine is always about balancing risk versus reward. 

I agree, there is not much in life that doesn't carry a risk sadly. I assumed using Regaine was risk-free, and I was badly wrong. 

I have tried shaving my head very short, and it doesn't suit me at all. Losing one's hair really clubs a man like a bastard...

[Heisenberg]

24 minutes ago, GoliGoliGoli said:

Why not just use topical? The amount that goes systemic is far smaller than even a very low dose of oral min. 

That raises an interesting point. If topical minoxidil gets into the bloodstream, and, as Kevin Mann argues, the side effects are not dose-dependent (idiosyncratic), you could end up getting heart issues from topical minoxidil. I understand using topical is equivalent to using around 0.5mg of oral.

Edited July 5, 2023 by Heisenberg

[Heisenberg]

This woman was on 0.25 mg of oral minoxidil (OM) daily:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478873/

Edited July 5, 2023 by Heisenberg

[Heisenberg]

About 1h45m into this video, Dr Bhoyrul opines that topical is equivalent to using around 0.5mg of oral.

Edited July 5, 2023 by Heisenberg

[LeveledUp]

1 hour ago, Heisenberg said:

About 1h45m into this video, Dr Bhoyrul opines that topical is equivalent to using around 0.5mg of oral.

Hmm in that case, I should’ve been seeing amazing results on 2.5mg 🤪

[GoliGoliGoli]

49 minutes ago, LeveledUp said:

Hmm in that case, I should’ve been seeing amazing results on 2.5mg 🤪

Not if topical is more effective than oral due to saturating the hair follicle.... Who knows. 

Edited July 5, 2023 by GoliGoliGoli

[GoliGoliGoli]

3 hours ago, Heisenberg said:

That raises an interesting point. If topical minoxidil gets into the bloodstream, and, as Kevin Mann argues, the side effects are not dose-dependent (idiosyncratic), you could end up getting heart issues from topical minoxidil. I understand using topical is equivalent to using around 0.5mg of oral.

You're asking the right questions. People often get offended when you start asking questions like this (As you've seen in this thread already) because it calls into question their own personal decision to use these medications. But for people like us who are asking these questions, we are just genuinely curious and want to know whether the potential for saving your hair is worth the potential long term risks. 

The above question is particularly relevant to me because I use far more than the recommended dose of topical min. I think the instructions call for using 1 cap full, but typically I use more like 2.5-3 caps full in order to cover the entire area that I want to cover. Granted I only use once per day and not twice, and usually only use 5 or 6 days out of the week. But still it's very possible that there is a cardiac risk from using topical min. Sorry chumes (Goli included). 

[Heisenberg]

33 minutes ago, GoliGoliGoli said:

You're asking the right questions. People often get offended when you start asking questions like this (As you've seen in this thread already) because it calls into question their own personal decision to use these medications. But for people like us who are asking these questions, we are just genuinely curious and want to know whether the potential for saving your hair is worth the potential long term risks. 

The above question is particularly relevant to me because I use far more than the recommended dose of topical min. I think the instructions call for using 1 cap full, but typically I use more like 2.5-3 caps full in order to cover the entire area that I want to cover. Granted I only use once per day and not twice, and usually only use 5 or 6 days out of the week. But still it's very possible that there is a cardiac risk from using topical min. Sorry chumes (Goli included). 

Yes, I completely agree. To quote Dr Phil:

"Better to be awakened by a painful truth than lulled to sleep by a seductive lie."

I may have found a flaw, albeit a minor one, in Kev's argument when he argues that topical is better than oral.

I would be careful when using that much, as I didn't use nearly that much, and I seemed to have developed hyperkeratosis along the way, which is now preventing me from getting a HT, and may have resulted in the avoidable destruction of my hair follicles.

Contact dermatitis/eczema is also listed as a possible side effect, and we know that inflammation in the scalp can increase DHT. Failing obvious signs, I think the only way to truly know if your scalp is inflamed is to get a scalp biopsy, and even that is probably not completely conclusive, not least because it only examines a tiny area of the scalp.

Having used topical minoxidil for years, I may try oral every other day to start with (I read that is recommended in one study), as presumably if there were any heart issues, they would have showed up by now, though who knows. I'm still a bit on the fence though.

Edited July 5, 2023 by Heisenberg

[Heisenberg]

This is the advice that I read:

"We have since advised patients to start with alternate days of LDOM for 1 month and then increase it to daily dosages thereafter. "

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478873/

[ilag]

is oral or topical better?

[Heisenberg]

56 minutes ago, ilag said:

is oral or topical better?

That's a tricky one.

Personally speaking, and in my humble opinion, I think you are more likely going to have cardiac/heart symptoms or side effects with oral, but the potential adverse effects of topical on the scalp, and subsequently the follicles, means that oral is far safer for the health of your scalp and follicles. In hindsight, I wish I had never used topical.

Edited July 6, 2023 by Heisenberg

[GoliGoliGoli]

2 hours ago, Heisenberg said:

I would be careful when using that much, as I didn't use nearly that much, and I seemed to have developed hyperkeratosis along the way, which is now preventing me from getting a HT, and may have resulted in the avoidable destruction of my hair follicles.

I think if topical min had the potential to cause issues with getting HT's for anything more than a very small % of men, it would be pretty well known by now. But I could be wrong! I know Hasson and Wong resisted for a long time, but I heard recently they recommended it to a patient so maybe they've stopped being anti topical min. 

 

[GoliGoliGoli]

Just now, Heisenberg said:

That's a tricky one.

Personally speaking, and in my humble opinion, I think you are more likely going to have cardiac/heart symptoms or side effects with oral, but the potential adverse effects of topical on the scalp, and subsequently the follicles, means that oral is far safer for the health of your scalp and follicles. In hindsight, I wish I have never used topical.

How long did you use for btw? 

[Heisenberg]

1 minute ago, GoliGoliGoli said:

I think if topical min had the potential to cause issues with getting HT's for anything more than a very small % of men, it would be pretty well known by now. But I could be wrong! I know Hasson and Wong resisted for a long time, but I heard recently they recommended it to a patient so maybe they've stopped being anti topical min. 

 

Not sure. I wonder how many clinical studies have been done, and, if so, what the quality of those studies were. I suspect none have been done.

Also, just because a HT surgeon can't see obvious signs of inflammation etc. on a patient's scalp with a dermotoscope, it doesn't automatically follow that it's not there. In fact, I wonder how many HT surgeons even examine a patient with a dermotoscope prior to surgery.

[Heisenberg]

6 minutes ago, GoliGoliGoli said:

How long did you use for btw? 

Around 5 years or so I think.

[Heisenberg]

"In some cases, hair loss is gradual, without symptoms, and is unnoticed for long periods. In other cases, hair loss is associated with severe itching, burning and pain and is rapidly progressive. The inflammation that destroys the follicle is below the skin surface and there is usually no "scar" seen on the scalp. Affected areas of the scalp may show little signs of inflammation, or have redness, scaling, increased or decreased pigmentation, pustules, or draining sinuses.":

https://en.wikipedia.org/wiki/Scarring_hair_loss

[GoliGoliGoli]

9 minutes ago, Heisenberg said:

Not sure. I wonder how many clinical studies have been done, and, if so, what the quality of those studies were. I suspect none have been done.

Clinical studies would be useful, but I think it would have been observed fairly easily by HT surgeons if their patients who used topical min ended up with lackluster results. Often clinical studies on this type of thing come after an observed anecdotal pattern is noticed by medical professio

 

11 minutes ago, Heisenberg said:

Also, just because a HT surgeon can't see obvious signs of inflammation etc. on a patient's scalp with a dermotoscope, it doesn't automatically follow that it's not there. In fact, I wonder how many HT surgeons even examine a patient with a dermotoscope prior to surgery.

You may have said already, but what mechanism and ingredients do you think are causing hyperkeratosis or inflammation? 

[Heisenberg]

3 minutes ago, GoliGoliGoli said:

Clinical studies would be useful, but I think it would have been observed fairly easily by HT surgeons if their patients who used topical min ended up with lackluster results. Often clinical studies on this type of thing come after an observed anecdotal pattern is noticed by medical professio

Yeah, could well be some truth in that. I suspect the average person who has subjected themselves to a HT has attempted topical minoxidil at some point, but I may be wrong.

[Heisenberg]

5 minutes ago, GoliGoliGoli said:

You may have said already, but what mechanism and ingredients do you think are causing hyperkeratosis or inflammation? 

I think it was the alcohol, as that was the first thing that both Dr Bisanga and his clinical colleague suggested.

"Regaine for Men Extra Strength Scalp Foam 5% w/w Cutaneous Foam also contains butylated hydroxytoluene, which may cause local skin reactions (e.g. contact dermatitis), or irritation to the eyes or mucous membranes, and cetyl and stearyl alcohol, which may cause local skin reactions (e.g. contact dermatitis).":

https://www.medicines.org.uk/emc/product/5781/smpc

I've used the liquid version too, and I think there are some harsh chemicals in there too.

[Heisenberg]

Incidentally, in my honest opinion, products like L’Oréal Professionnel Serioxyl are just as bad, if not worse, as they throw in perfume too.

Edited July 6, 2023 by Heisenberg